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  • 1. Breimer, Lars
    et al.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Longitudinal and cross-sectional study of registered nurses in Sweden who undertake a PhD showing that nurses continue to publish in English after their PhD but male nurses are more productive than female nurses2011In: Scientometrics, ISSN 0138-9130, E-ISSN 1588-2861, Vol. 87, no 2, p. 337-345Article in journal (Refereed)
    Abstract [en]

    A review of 649 PhDs undertaken by Swedish nurses and midwives found no evidence that they stop publishing in English after their PhD. The proportion of 70% for any publication in English was similar to that of MDs. A higher proportion of male than female nurses were high publishers of six or more (52% vs. 23%) and eight or more papers (44% vs. 14%) in a 5 year period. The standard of the PhDs of Swedish nurses was comparable to those of other biomedical PhDs and was consistent in pattern over the past two decades. The gender pattern of external examiners of female nurses evolved in that 1992–94, 75% were men, during 1996–97, 54% were men and from 2000 onwards 46% were men. Nurses were examined by foreign examiners in 20% of examinations. They came primarily from Norway and USA.

  • 2.
    Brorsson, Anna Lena
    et al.
    Department of Women's and Children's Health, Karolinska Institute and Hospital, Stockholm, Sweden.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Viklund, Gunnel
    Department of Women's and Children's Health, Karolinska Institute and Hospital, Stockholm, Sweden.
    Lindholm Olinder, Anna
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion: a study protocol2013In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 13, article id 212Article in journal (Refereed)
    Abstract [en]

    Background. Continuous subcutaneous insulin infusion (CSII) treatment among children with type 1 diabetes is increasing in Sweden. However, studies evaluating glycaemic control in children using CSII show inconsistent results. Omitting bolus insulin doses using CSII may cause reduced glycaemic control among adolescents. The distribution of responsibility for diabetes self-management between children and parents is often unclear and needs clarification. There is much published support for continued parental involvement and shared diabetes management during adolescence. Guided Self-Determination (GSD) is an empowerment-based, person-centred, reflection and problem solving method intended to guide the patient to become self-sufficient and develop life skills for managing difficulties in diabetes self-management. This method has been adapted for adolescents and parents as Guided Self-Determination-Young (GSD-Y). This study aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control. Here, we describe the protocol and plans for study enrolment.

    Methods. This study is designed as a randomized, controlled, prospective, multicentre study. Eighty patients between 12-18 years of age who are planning to start CSII will be included. All adolescents and their parents will receive standard insulin pump training. The education intervention will be conducted when CSII is to be started and at four appointments in the first 4 months after starting CSII. The primary outcome is haemoglobin A1c levels. Secondary outcomes are perceived health and QoL, frequency of blood glucose self-monitoring and bolus doses, and usage of carbohydrate counting. The following instruments will be used to evaluate perceived health and QoL: Disabkids, 'Check your health', the Diabetes Family Conflict Scale and the Swedish Diabetes Empowerment Scale. Outcomes will be evaluated within and between groups by comparing data at baseline, and at 6 and 12 months after starting treatment.

    Results and discussion. In this study, we will assess the effect of starting an insulin pump together with the model of Guided Self-Determination to determine whether this approach leads to retention of improved glycaemic control, QoL, responsibility distribution and reduced diabetes-related conflicts in the family.

    Trial registration: Current controlled trials: ISRCTN22444034

  • 3.
    Brorsson, Anna Lena
    et al.
    Karolinska institutet.
    Lindholm Olinder, Anna
    Viklund, Gunnel
    Granström, Therese
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Adolescents’ perceptions of participation in group education using the Guided Self-Determination-Young method: a qualitative study2017In: BMJ Open Diabetes Research & Care, ISSN 2052-4897, Vol. 5, no 1, article id e000432Article in journal (Refereed)
    Abstract [en]

    Objective Guided Self-Determination (GSD) is a person-centered communication and reflection method. Education in groups may have a greater impact than the content of the education, and constructive communication between parents and adolescents has been shown to be of importance. The purpose of this study was to describe adolescents’ perceptions of participation in group education with the Guided Self-Determination-Young (GSD-Y) method, together with parents, in connection with the introduction of continuous subcutaneous insulin infusion.

    Research design and methods In the present qualitative interview study, 13 adolescents with type 1 diabetes were included after completing a GSD-Y group education program in connection with the introduction of continuous subcutaneous insulin infusion at three hospitals located in central Sweden. The adolescents were interviewed individually, and qualitative content analysis was applied to the interview transcripts.

    Results Two categories that emerged from the analysis were the importance of context and growing in power through the group process. An overarching theme that emerged from the interviews was the importance of expert and referent power in growing awareness of the importance of self-management as well as mitigating the loneliness of diabetes.

    Conclusions GSD-Y has, in various ways, mitigated experiences of loneliness and contributed to conscious reflection about self-management in the group (referent power) together with the group leader (expert power). Overall, this highlights the benefits of group education, and the GSD method emphasizes the person-centered approach.

  • 4. Dahlberg, ER
    et al.
    Spets, E
    Svedbo Engström, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Sahlgrenska Academy, Institute of Medicine, University of Gothenburg.
    Larshans, M
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Medical Sciences, Uppsala University.
    Experiences of Hypoglycaemia in Adults with Diabetes Mellitus2017In: Journal of Diabetes and Treatment, article id J111Article in journal (Refereed)
    Abstract [en]

    Aims: To describe adults’ experiences of hypoglycaemia in diabetes mellitus, and the consequences of hypoglycaemia in daily life.

    Methods: This study was conducted using qualitative content analysis with an inductive approach. It was performed as a secondary analysis of semi-structured interviews. A total of 29 people participated in the study: 15 with type 1 diabetes and 14 with type 2 diabetes.

    Results: The theme that emerged was: Hypoglycaemia is an ever-present risk that manifests itself in different ways. The following categories were identified: Symptoms of hypoglycaemia can appear like a bolt from the blue. Knowledge comes from life experiences. Training and exercise today often have consequences tomorrow. Self-management may be perceived as a feeling of not being free. Family support can provide security in the illness.

    Conclusion: Hypoglycaemia is perceived as an ever-present risk that can come like a bolt from the blue, which in turn causes fear and problems in the daily life of people with diabetes. Better support, help and information from specialist nurses is needed. Family members should also be given more knowledge and information, in order to reduce the fear and discomfort of hypoglycaemia.

  • 5. Ewertzon, Mats
    et al.
    Alvariza, Anette
    Winnberg, Elisabeth
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Andershed, Birgitta
    Goliath, Ida
    Momeni, Pardis
    Kneck, Åsa
    Skott, Maria
    Årestedt, Kristofer
    Adaptation and evaluation of the Family Involvement and Alienation questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIM: To adapt the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability.

    BACKGROUND: Involvement in the professional care has proven to be important for family members. However, they have described feelings of alienation in relation to how they experienced the professionals' approach. To explore this issue, a broad instrument that can be used in different care contexts is needed.

    DESIGN: A psychometric evaluation study, with a cross-sectional design.

    METHOD: The content validity of the Family Involvement and Alienation Questionnaire was evaluated during 2014 by cognitive interviews with 15 family members to adults in different care contexts. Psychometric evaluation was then conducted (2015-2016). A sample of 325 family members participated, 103 of whom in a test-retest evaluation. Both parametric and non-parametric methods were used.

    RESULTS: The content validity revealed that the questionnaire was generally understood and considered to be relevant and retrievable by family members in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. Furthermore, the Family Involvement and Alienation Questionnaire (Revised), demonstrated satisfactory psychometric properties in terms of data quality, homogeneity, unidimensionality (factor structure), internal consistency and test-retest reliability.

    CONCLUSION: The study provides evidence that the Family Involvement and Alienation Questionnaire (Revised) is reliable and valid for use in further research and in quality assessment in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. 

  • 6.
    From, Ingrid
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Marusarz, Marika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Roeli, Kjell
    Sairanen, Raija
    Schröder, Margit
    Vabo, Grete
    Söderhamn, Olle
    Good nursing care for older nursing home clients in a Nordic context2009In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, no 4Article in journal (Refereed)
    Abstract [en]

    Introduction: In order to make nursing homes more attractive as work places in the Nordic countries, it should be important to identify possible issues that are central in good nursing care in this context. Aim: The aim of this study was to illuminate and interpret how good nursing care for older nursing home clients may be narrated by registered nurses in a Nordic context. Methods: Nine expert nurses from nursing homes in Denmark, Finland, Norway and Sweden narrated experiences of good nursing care for older people that were tape recorded, transcribed verbatim and analysed by means of qualitative content analysis. Results: Communication, creativity and community were the themes that constituted good nursing care for older people in the studied context. It was interpreted as a process of reciprocity between caregivers, clients and significant others, characterised by transcendence for the individuals that took part in the process. Discussion/Conclusion: Good nursing care in nursing homes demands mature individuals who are conscious and skilled professionals, able to create reciprocity in the care context. Such professional nurses could also serve as radiant role models to other registered nurses who are hesitant in entering nursing care of older people.

  • 7. Gardulf, Ann
    et al.
    Nilsson, Jan
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Lepp, Margret
    Lindholm, Christina
    Nordström, Gun
    Theander, Kersti
    Wilde-Larsson, Bodil
    Johansson, Eva
    The Nurse Professional Competence (NPC) scale: self-reported competence among nursing students on the point of graduation2016In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 36, p. 165-171Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients.

    OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors.

    METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated.

    RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs).

    SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

  • 8. Garmo, Anna
    et al.
    Garmo, Hans
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Long-term treatment effects of insulin pump therapy2011In: Practical Diabetes, ISSN 1528-252X, Vol. 28, no 7, p. 295-299Article in journal (Refereed)
    Abstract [en]

    Aims: The study was designed to examine potential long term effects on glycemic control and treatment satisfaction in people with diabetes type 1 who changed from multiple daily insulin injections (MDI) to insulin pump (CSII). Methods: Forty-six patients who changed from MDI to CSII were recruited at a Swedish medical clinic. They were followed one year prior to starting CSII and four years afterwards. Repeated measurements of HbA1c were performed during follow-up. Treatment satisfaction was assessed using Bradley’s Diabetes Treatment Satisfaction Questionnaire, status version. Results: After initiation of CSII, reductions of HbA1c were seen after the first year (0.66 units of percent [95% Cl, 0.46-0.91]) and after 2-4 years, (0.65 [95% Cl, 0.38-0.95]). Moreover, treatment satisfaction increased significantly after six months (10.0 score units [95%.CI, 8.0-12.0]) and remained at the same level after three years, (10.5 score units [95%.CI, 8.0-13.0]). Conclusions: Compared to MDI, insulin pump therapy improves glycemic control with sustained treatment satisfaction after up to 4 years. Our long term data provide further support for CSII as an effective and well tolerated treatment regimen for patients with type 1 diabetes.

  • 9.
    Garmo, Anna
    et al.
    Department of Internal Medicine, Falun Hospital, Health Care Dalarna, Falun, Sweden.
    Hörnsten, Åsa
    Department of Nursing, Umeå University, Umeå, Sweden.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    “The pump was a saviour for me”: Patients’ experiences of insulin pump therapy2013In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 30, no 6, p. 717-723Article in journal (Refereed)
    Abstract [en]

    The present study formed part of a larger study examining the potential long-term effects of glycaemic control and treatment satisfaction in people with type 1 diabetes mellitus who changed from multiple daily insulin injections to insulin pump therapy. Individuals (n=46) who made the transition between May 1999 and February 2004 participated.

    Aim: The aim of the study was to describe experiences of the impact of insulin pump therapy in adults with type 1 diabetes mellitus who were using an insulin pump for >5 years.  

    Method: During spring 2009, a subgroup of 16 individuals were interviewed through a narrative approach on the effects of insulin pump therapy on daily life. The interviews were analysed using content analysis.

    Results: The overarching theme revealed that insulin pump therapy was experienced as both a shackle and a lifeline. Six subthemes emerged: Being subjected to the therapy versus being empowered by it; Dependence versus autonomy; Feeling vulnerable versus feeling strengthened; Perceiving their care as routinized versus perceiving it as providing greater flexibility; Feeling burdened versus relieved; and Being stigmatized versus having a normalized life.

    Conclusions: Users of insulin pump therapy have different views about and experience of having used the technical equipment over years. Both positive and negative views emerged. However, it is difficult to identify any general trends that cover all views and can predict which individuals will be able to manage pump therapy in the best way. Even so, the subthemes and theme that emerged could be used by physicians and diabetes specialist nurses when counselling and planning educational programmes aimed at supporting self- management among people with insulin pump treatment. 

  • 10.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Brorsson, Anna Lena
    Uppsala University; Karolinska Institute and Hospital.
    Granstam, Elisabet
    Uppsala University/County Council of Västmanland; Västmanland County Hospital.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Patients’ experiences before starting anti-VEGF treatment for sight-threatening diabetic macular oedema: A qualitative interview study2017In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593Article in journal (Refereed)
    Abstract [en]

    The diabetic complication macular oedema (DME) is a growing problem worldwide because of the increasing number of patients suffering from diabetes mellitus (DM). DME is treated with injections of anti-vascular endothelial growth factor (anti-VEGF) in the eye. This real-world study aimed to describe patients’ experiences before they received their first injection in the eye. Twenty-one men and women aged 49 to 86 years were interviewed. The interviews were analysed using qualitative content analysis. Two categories and an overall theme ‘to be at a crossroads and a crucial phase in life with an uncertain outcome’ were found. The participants expressed thoughts and concerns at different levels, practical concerns about the treatment procedure, and other existential thoughts regarding hope for improved visual acuity or fear of deterioration. Cooperation between eye clinics and diabetes clinics should be strengthened to clarify who is responsible for providing the information and support required by patients.

  • 11.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patient reported outcomes and visual function among patients with diabetes related macular edema2016Conference paper (Refereed)
  • 12.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jani, Siba
    Modher Raghib, Aseel
    Granstam, Elisabet
    Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema2015In: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 29, no 8, p. 1183-1190Article in journal (Refereed)
    Abstract [en]

    Purpose

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients about to receive anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME).

    Material and methods

    In this cross-sectional study, 59 patients with diabetes mellitus, who regularly visited the outpatient eye-clinics, were included. Sociodemographic and clinical data were collected and the patients completed PRO measures before starting anti-VEGF treatment. PRO measures assessed eye-specific outcomes (NEI-VFQ-25) and generic health-related quality of life (SF-36).

    Results

    The participants consisted of 30 men and 29 women (mean age, 68.5 years); 54 (92 %) patients had type 2 diabetes; Five (9%) patients had moderate or severe visual impairment; 28 (47 %) were classified as having mild visual impairment. Some of the patients reported overall problems in their daily lives, such as with social relationships, as well as problems with impaired sight as a result of reduced distance vision.

    Conclusions

    Further studies are needed to investigate PRO factors related to low perceived general health in this patient population. It is important to increase our understanding of such underlying mechanisms to promote improvements in the quality of patient care.

  • 13.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting2016In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 121, p. 157-165Article in journal (Refereed)
    Abstract [en]

    Aims

    To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12 months in a real world setting.

    Methods

    In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68 years) with type 1 and type 2 diabetes diagnosed with DME were included. Medical data and two questionnaires were collected; an eye-specific (NEI VFQ-25) and a generic health-related quality of life questionnaire (SF-36) were used.

    Results

    The total patient group had significantly improved visual acuity and reduced retinal thickness at 4 months and remains at 12 months follow up. Thirty patients had significantly improved visual acuity, and 27 patients had no improved visual acuity at 12 months. The patients with improved visual acuity had significantly improved scores for NEI VFQ-25 subscales including general health, general vision, near activities, distance activities, and composite score, but no significant changes in scores were found in the group without improvements in visual acuity.

    Conclusions

    Our study revealed that anti-VEGF treatment improved visual acuity and central retinal thickness as well as patient-reported outcome in real world 12 months after treatment start.

  • 14.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patient-reported outcomes: in patients with diabetic macular oedema treated with anti-VEGF2016In: The 16th European Doctoral Conference in Nursing Science, 2016Conference paper (Refereed)
  • 15.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lundberg, Pranee
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientrelaterade utfallsmått vid införande av ny behandlingsform vid retinopati.2012In: SFSD (Svensk Förening för Sjuksköterskor i Diabetesvård) Symposium, Stockholm, 2012Conference paper (Refereed)
  • 16.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Quality of life among patients with diabetes macular edema2015Conference paper (Refereed)
    Abstract [en]

    Vision loss have a significant negative impact on quality of life. One of the most common causes of vision loss in patients with diabetes is diabetic macular edema - DME. Among DME patients, visual impairment is regarded as the most feared late diabetic complication. In January 2011 a new treatment for DME was approved, called anti-Vascular Endothelial Growth Factor, anti-VEGF- treatment. The treatment involves 3 injections every 4 weeks into the eye. The new treatment places increasing demands on the patient because of more visits and a stressful treatment. Beside that it is of great importance to learn more about the patient's experiences about the visual impairment and the new treatment.

    The aim of the study is to measure the effects of anti-VEGF treatment on vision related functioning, quality of life and sight-related variables.

    Fifty-nine patients are included in this longitudinal study at the eye clinics of two Swedish county hospitals. All patients who started anti-VEGF treatment were asked to participate.

    We have measured visual functioning with the eye-specific questionnaire - National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with the general questionnaire Short Form- 36 (SF-36). Medical variables were collected at baseline, after 4 months and one year respectively.

    A large number of patients are affected by diabetes each year and may suffer from visual impairment. These patients may be treated with this new form of treatment. Therefore it is of great importance to examine the patient's experiences of treatment and self-percieved quality of life to be able to provide the best possible information and procedures at the eye clinics.

  • 17.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Visual functioning and quality of life among patients with diabetic macular edema2015Conference paper (Refereed)
    Abstract [en]

    Background

    One of the most common causes of vision impairment in patients with diabetes is diabetic macular edema (DME) and is regarded as the most feared late diabetic complication. In January 2011 a treatment for DME was approved, called anti-Vascular Endothelial Growth Factor treatment. The treatment involves an injection into the vitreous of the eye and places increasing demands on the patient because of more visits and a stressful treatment. Therefore it is of most importance to capturing patients’ thoughts and feelings, so called Patient reported Outcome (PRO).

    Aim

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients with diabetes-related macula edema about to receive anti-vascular endothelial growth factor treatment for diabetic macular edema.

    Method

    Visual functioning was measured with National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with Short Form- 36 (SF-36). The initial eye examination included measurement of visual acuity with the ETDRS, and retinal thickness by OCT. In addition, medical variables were collected. The data collection was performed at baseline, after 4 months and one year. In this abstract we reported the result from the baseline.

    Result

    The participants were 30 men and 29 women (mean age, 68.5 years) and 92% of them had type 2 diabetes. With NEI VFQ-25, the participants showed the lowest score for the subscale of general health (mean 35.65 ± 22.04) and the highest for dependency (mean 93.48 ± 18.12). For SF-36, the participants gave the lowest score in the subscale of general health (mean 56.55 ± 22.14) and the highest for the subscale of role emotional (mean 88.73 ± 22.32). The mean ETDRS score in the eye planned for treatment was 63.9 (± 13.2) and the mean central retinal thickness was 396 (± 129).

    Conclusions: Patients diagnosed with diabetes macula edema about to receive anti-VEGF treatment reported low general health. Hence, it is of most importance to follow up patients’ thoughts and feelings (PRO) after the treatment is performed in order to promote improvements in the quality of patient care.

  • 18.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Public Health and Caring Sciences, Uppsala, Sweden.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Department of Ophthalmology, Västerås, Sweden.
    Anti-VEGF treatment for diabetic macular edema: a qualitative evaluation of patients experiences2013Conference paper (Refereed)
  • 19.
    Granström, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forsman, Henrietta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Granstam, Elisabet
    Uppsala universitet.
    Visual functioning and quality of life among patients with macular edema: a quantitative study2015Conference paper (Refereed)
  • 20.
    Graue, Marit
    et al.
    University college, Norway.
    Iversen, Marjolein
    University college, Norway.
    Sigurdadottir, Arun
    university of Akureyri.
    Zoffmann, Vibeke
    Diabetes Centre, Gentofte, Denmark.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Diabetes research reported by nurses in Nordic countries2013In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 10, no 2, p. 46-51Article in journal (Refereed)
    Abstract [en]

    Background: New knowledge from research studies is important as a foundation for high quality care in practice as well as crucial to further stimulate research in the future.

    Aim: To determine the total number of peer-reviewed articles on diabetes research reported by nurses in four Nordic countries (Denmark, Iceland, Norway and Sweden) from 1979 to 2009. Furthermore we wanted to identify the time periods in which they had been published, different study designs and number of publications related to nurse authors.

    Methods: We performed an electronic search for potentially relevant scientific articles between January 1, 1979 and December 31, 2009 using the MEDLINE, Medline in process, EMBASE, CINAHL, PsycINFO and Cochrane databases. The studies focused either on the diabetes population or diabetes health care professionals.

    Results: We included 164 scientific articles; 132 resulting from electronic search and 32 from manual search. They were published in 63 different scientific journals, with 52 (32%) published in nursing journals and typically by authors with university degrees. Only one of four authors had published five or more articles. The majority of the studies originated from a single country, with 23 (14%) including co-authors from another country.

    Conclusion: Research in diabetes reported by nurses has increased considerably after year 2000. Further action is needed to build stronger national network groups of researchers in diabetes nursing that would benefit from international collaborative research networks and facilitate funding opportunities.

  • 21.
    Husdal, Rebecka
    et al.
    Uppsala University, Medical sciences.
    Rosenblad, Andreas
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eliasson, Björn
    Gothenburg University .
    Jansson, Stefan
    Jerdén, Lars
    Stålhammar, Jan
    Steen, Lars
    Wallman, Thorne
    Thors Adolfsson, Eva
    Resource allocation and organisational features in Swedish primary diabetes care: changes from 2006 to 20132017In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 11, no 1, p. 20-28Article in journal (Refereed)
    Abstract [en]

    AIMS: To compare the resource allocation and organisational features in Swedish primary diabetes care for patients with type 2 diabetes mellitus (T2DM) between 2006 and 2013.

    METHODS: Using a repeated cross-sectional study design, questionnaires covering personnel resources and organisational features for patients with T2DM in 2006 and 2013 were sent to all Swedish primary health care centres (PHCCs) during the following year. In total, 684 (74.3%) PHCCs responded in 2006 and 880 (76.4%) in 2013.

    RESULTS: Compared with 2006, the median list size had decreased in 2013 (p<0.001), whereas the median number of listed patients with T2DM had increased (p<0.001). Time devoted to patients with T2DM and diabetes-specific education levels for registered nurses (RNs) had increased, and more PHCCs had in-house psychologists (all p<0.001). The use of follow-up systems and medical check-ups had increased (all p<0.05). Individual counselling was more often based on patients' needs, while arrangement of group-based education remained low. Patient participation in setting treatment targets mainly remained low.

    CONCLUSIONS: Even though the diabetes-specific educational level among RNs increased, the arrangement of group-based education and patient participation in setting treatment targets remained low. These results are of concern and should be prioritised as key features in the care of patients with T2DM.

  • 22. Husdal, Rebecka
    et al.
    Rosenblad, Andreas
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Eliasson, Björn
    Jansson, Stefan
    Jerdén, Lars
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Centre for Clinical Research Dalarna; Uppsala universitet.
    Stålhammar, Jan
    Steen, Lars
    Wallman, Thorne
    Thors Adolfsson, Eva
    Resources and organisation in primary health care are associated with HbA1c level: a nationwide study of 230958 people with Type 2 diabetes mellitus2017In: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210Article in journal (Refereed)
    Abstract [en]

    AIMS: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM).

    METHODS: People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.

    RESULTS: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01).

    CONCLUSIONS: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM.

  • 23.
    Iversen, Marjolein M.
    et al.
    Bergen Univ Coll, Fac Hlth & Social Sci, Ctr Evidence Based Practice, Bergen, Norway.;Stavanger Univ Hosp, Endocrinol Sect, Dept Med, Stavanger, Norway..
    Graue, Marit
    Bergen Univ Coll, Fac Hlth & Social Sci, Ctr Evidence Based Practice, Bergen, Norway.;Haukeland Hosp, Dept Pediat, Bergen, Norway..
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Smide, Bibbi
    Uppsala Univ, Dept Med Sci, Uppsala, Sweden..
    Zoffmann, Vibeke
    Rigshosp, Univ Copenhagen Hosp, Juliane Marie Ctr, Res Womens & Childrens Hlth, Copenhagen, Denmark..
    Sigurdardottir, Arun K.
    Univ Akureyri, Sch Hlth Sci, Akureyri, Iceland..
    Characteristics of nursing studies in diabetes research published over three decades in Sweden, Norway, Denmark and Iceland: a narrative review of the literature2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, no 2, p. 241-249Article in journal (Refereed)
    Abstract [en]

    Similarities and differences across borders of Nordic countries constitute a suitable context for investigating and discussing factors related to the development of diabetes nursing research over the last three decades. The present study reviewed the entire body of contemporary diabetes nursing research literature originating in four Nordic countries: Norway, Sweden, Denmark and Iceland. Our aims were (i) to catalogue and characterise trends in research designs and research areas of these studies published over time and (ii) to describe how research involving nurses in Nordic countries has contributed to diabetes research overall. The larger goal of our analyses was to produce a comprehensive picture of this research in order to guide future studies in the field. We conducted a narrative literature review by systematically searching Medline, Medline in process, EMBASE, CINAHL, PsycINFO and Cochrane databases. These searches were limited to studies published between 1979 and 2009 that had an abstract available in English or a Nordic language. Two researchers independently selected studies for analysis, leading to the inclusion of 164 relevant publications for analysis. In summary, Nordic nurse researchers have contributed to the development of new knowledge in self-management of diabetes in childhood, adolescence and adulthood, and to some extent also in the treatment and care of diabetes foot ulcers. Future research may benefit from (i) larger nurse-led research programmes organised in networks in order to share knowledge and expertise across national groups and borders, (ii) more multidisciplinary collaborations in order to promote patient-centred care and (iii) further research directed towards improving the dissemination and implementation of research findings. Using complex intervention designs and a mix of research methods will enrich the research.

  • 24.
    Johansson, Karin
    et al.
    Department of Health and Care Sciences. Linnaeus University, Växjö, Sweden.
    Almerud Österberg, Sofia
    Department of Health and Care Sciences. Linnaeus University, Växjö, Sweden.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Berglund, Mia
    School of Health and Education, University of Skövde, Sweden.
    Manoeuvring between anxiety and control: Patients experience of learning to live with diabetes: a lifeworld phenomenological study2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, article id 27147Article in journal (Refereed)
    Abstract [en]

    Research shows that people with diabetes want their lives to proceed as normally as possible, but some patients experience difficulty in reaching their desired goals with treatment. The learning process is a complex phenomenon interwoven into every facet of life. Patients and healthcare providers often have different perspectives in care which gives different expectations on what the patients need to learn and cope with. The aim of this study, therefore, is to describe the experience of learning to live with diabetes. Interviews were conducted with 12 patients afflicted with type 1 or type 2 diabetes. The interviews were then analysed with reference to the reflective lifeworld research approach. The analysis shows that when the afflicted realize that their bodies undergo changes and that blood sugar levels are not always balanced as earlier in life, they can adjust to their new conditions early. The afflicted must take responsibility for balancing their blood sugar levels and incorporating the illness into their lives. Achieving such goals necessitates knowledge. The search for knowledge and sensitivity to changes are constant requirements for people with diabetes. Learning is driven by the tension caused by the need for and dependence on safe blood sugar control, the fear of losing such control, and the fear of future complications. The most important responsibilities for these patients are aspiring to understand their bodies as lived bodies, ensuring safety and security, and acquiring the knowledge essential to making conscious choices.

  • 25. Johansson, Karin
    et al.
    Österberg, Sofia Almerud
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Berglund, Mia
    Patients' experiences of support for learning to live with diabetes to promote health and well-being: A lifeworld phenomenological study2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, article id 31330Article in journal (Refereed)
    Abstract [en]

    Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.

  • 26. Johansson, Unn-Britt
    et al.
    Kaila, Päivi
    Ahlner-Elmqvist, Marianne
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Isoaho, Hannu
    Saarikoski, Mikko
    Clinical learning environment, supervision and nurse teacher evaluation scale: psychometric evaluation of the Swedish version2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 66, no 9, p. 2085-2093Article in journal (Refereed)
    Abstract [en]

    Aim. This article is a report of the development and psychometric testing of the Swedish version of the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale. Background. To achieve quality assurance, collaboration between the healthcare and nursing systems is a pre-requisite. Therefore, it is important to develop a tool that can measure the quality of clinical education. The Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale is a previously validated instrument, currently used in several universities across Europe. The instrument has been suggested for use as part of quality assessment and evaluation of nursing education. Methods. The scale was translated into Swedish from the English version. Data were collected between March 2008 and May 2009 among nursing students from three university colleges, with 324 students completing the questionnaire. Exploratory factor analysis was performed on the 34-item scale to determine construct validity and Cronbach’s alpha was used to measure the internal consistency. Results. The five sub-dimensions identified in the original scale were replicated in the exploratory factor analysis. The five factors had explanation percentages of 60·2%, which is deemed sufficient. Cronbach’s alpha coefficient for the total scale was 0·95, and varied between 0·96 and 0·75 within the five sub-dimensions. Conclusion. The Swedish version of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale has satisfactory psychometric properties and could be a useful quality instrument in nursing education. However, further investigation is required to develop and evaluate the questionnaire.

  • 27. Johansson, Unn-Britt
    et al.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Werkö, Sophie
    Wikblad, Karin
    Patientutbildning vid diabetes: - en systematiskt litteraturöversikt2009Report (Other academic)
  • 28. Julin, Bettina
    et al.
    Willers, Carl
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Lindgren, Peter
    Muth, Karin Looström
    Svensson, Ann-Marie
    Lilja, Mikael
    Dahlström, Tobias
    Association between sociodemographic determinants and health outcomes in individuals with type 2 diabetes in Sweden2018In: Diabetes/Metabolism Research Reviews, ISSN 1520-7552, E-ISSN 1520-7560, Vol. 34, no 4, p. -9, article id e2984Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Concurrent multifactorial treatment is needed to reduce consequent risks of diabetes, yet most studies investigating the relationship between sociodemographic factors and health outcomes have focused on only one risk factor at a time. Swedish health care is mainly tax-funded, thus providing an environment that should facilitate equal health outcomes in patients, independent of background, socioeconomic status or health profile. This study aimed at investigating the association between several sociodemographic factors and diabetes-related health outcomes represented by HbA1c , systolic blood pressure, LDL cholesterol, predicted 5-year risk of cardiovascular disease as well as statin use.

    METHODS: This large retrospective registry-study was based on patient-level data from individuals diagnosed with type 2 diabetes mellitus during 2010-2011 (n = 416,228) in any of seven Swedish regions (~65% of the Swedish population). Health equity in diabetes care was analyzed through multivariate regression analyses on intermediary outcomes (HbA1c , systolic blood pressure, LDL), predicted 5-year risk of cardiovascular disease and process (i.e. statin use) after one-year follow-up, adjusting for several sociodemographic factors.

    RESULTS: We observed differences in intermediary risk measures, predicted 5-year risk of cardiovascular disease as well as process dependent on place of birth, sex, age, education and social setting, despite Sweden's articulated vision of equal health care.

    CONCLUSIONS: Diabetes patients' health was associated with sociodemographic prerequisites. In addition to demographics (age, sex) and disease history; educational level, marital status and region of birth are important factors to consider when benchmarking health outcomes, e.g. average HbA1c level, between organizational units or between different administrative regions.

  • 29. Kristoffersen Jahren, Nina
    et al.
    Nortvedt, Finn
    Skaug, Elin-Anne
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Källström Karlsson, Ingalill
    Praktiska grunder för omvårdnad2016 (ed. 1)Book (Refereed)
  • 30.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Blind diabetiker stärks i anpassad undervisning2003In: Vårdfacket, ISSN 0347-0911, no 3Article in journal (Other academic)
  • 31.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Blinda diabetiker glöms bort2006In: Omvårdnadsmagasinet, ISSN 1652-0858, no 3, p. 38-40Article in journal (Other academic)
  • 32.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Coping strategier hinder eller möjligheter2006In: Diabetes sjuksköterskornas konferens 2006, Stockholm, 2006Conference paper (Refereed)
  • 33.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Diabetes hela livet2003In: Regional konferens Västra Regionen, Vårdkedjan Diabetes, Pfizer, Skene, 2003Conference paper (Other academic)
  • 34.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Diabetes: Psykosociala aspekter vid diabetes2010 (ed. fjärde)Book (Other academic)
  • 35.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Diabetes-related blindness: studies of self-management, power, empowerment and health2005Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Individuals with diabetes and blindness meet problems in daily life that are related to both conditions. The aim was to study diabetes self-management, burden of diabetes, power, sense of coherence (SOC) and health among individuals with diabetes-related blindness. The aim was further to determine psychometric properties of a diabetes empowerment scale (DES) and to use it in the evaluation of an empowerment programme. The participants were 39 blind diabetic and non-diabetic individuals and 21 diabetic individuals with threat of blindness. A convenience sample of 195 diabetic patients completed DES and 9 blind diabetic individuals participated in the empowerment programme. Two reference groups from the SWED-QUAL population studies were also included. Data were collected by questionnaires, interviews and by scrutinizing medical records. Quantitative data were analyzed with parametric and non-parametric methods and qualitative data with content analysis. Blind diabetic individuals expressed more problems with self-management than did those with threat of blindness. In some health domains, blind diabetic individuals’ perceived significantly poorer health than did non-diabetic blind individuals. There were though individual differences in how blind individuals perceived their health as well as how burdensome they experienced their self-management. Individuals with power and strong SOC felt less burden and perceived better health when compared to those with weak SOC or non-power. The diabetes empowerment scale showed acceptable validity and reliability and was used, along with qualitative interviews, to evaluate the effect of the empowerment programme. Evaluation of the programme showed that the participants had improved knowledge and awareness of self-management. The programme seems suitable for blind individuals and creates an inspiring learning climate enhancing empowerment. It is concluded that blind individuals have problems in their diabetes self-management and perceive poor health but the experience of power is a factor of importance for health and an empowerment education programme may enhance power.

  • 36.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Diabetesrelaterad blindhet: egenvård, power och hälsa2006In: Visioner och verklighet, Uppsala, 2006Conference paper (Other academic)
  • 37.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    En personcentrerad kommunikations- och reflektionsmodell2012In: Omvårdnad vid diabetes / [ed] Karin Wigblad, Studentlitteratur AB, 2012, 2, p. 121-128Chapter in book (Other academic)
  • 38.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    FEND research network2007In: 12th FEND Annual Conference, Amsterdam, 2007Conference paper (Refereed)
  • 39.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Problembased learning for blind individuals2006In: Therapeutic patient education, Florence, 2006Conference paper (Refereed)
  • 40.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Retinopati och synnedsättning2012In: Omvårdnad vid diabetes / [ed] Karin Wikblad, Studentlitteratur AB, 2012, 2, p. 339-348Chapter in book (Other academic)
  • 41.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Retinopati och synnedsättning2006In: Omvårdnad vid Diabetes, Lund: Studentlitteratur , 2006Chapter in book (Other academic)
  • 42.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans kärnkompetenser: En kvalitativt god vård inom hälso- och sjukvård2015 (ed. 1)Book (Other academic)
  • 43.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Utbildning, lärande och stöd till anhöriga2015In: Reflektion i lärande och vård: en utmaning för sjuksköterskor / [ed] Mia Berglund och Margaretha Ekebergh, Lund: Studentlitteratur AB, 2015, 1, p. 215-223Chapter in book (Refereed)
  • 44.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Värdebaserad uppföljning av diabetesvård - analys från framtagande av nya uppföljningssystem: Presentation av historiska resultat för att tydliggöra möjligheter och utmaningar i framtida uppföljning2015Report (Other academic)
  • 45.
    Leksell, Janeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. The Swedish Association of Diabetes Specialist Nurses (SFSD); Uppsala University.
    Andersson, Mona
    Carlsson, BM
    Hypoglycemia - low blood glucose: underestimated and unexplored problems in people with type 2 diabetes2014In: Diabetes Research and Treatment, ISSN 2377-7206, Vol. 1, no 1, p. 103-107Article in journal (Refereed)
  • 46.
    Leksell, Janeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Andersson, Mona
    Carlsson, Britt-Marie
    A touch of diabetes: self-perceived knowledge among people with type 2 diabetes2009In: The 20th World Diabetes Congress, Montreal, Canada, 2009Conference paper (Other academic)
  • 47.
    Leksell, Janeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Berglund, Mia
    Schools of Health and Education, University of Skövde, Sweden.
    Koinberg, Ingalill
    Institute of Health and Care Sciences, University of Gothenburg, Sweden.
    Friberg, Febe
    Department of Health/Faculty of Social Sciences, University of Stavanger, Norway.
    The growing research field of patient education and learning: the significance of a Nordic network2015In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, no 2, p. 67-70Article in journal (Refereed)
    Abstract [en]

    The research field of patient learning and patient education is growing due to the high prevalence of people living with lifelong disease and illness. The aim of the present article is to argue for and describe the building of a Nordic Network for Patient Education and Learning. The article describes the Network and the activities, theoretical framework and ongoing research within the Network. If patients’ voices are to be heard within healthcare settings, patient learning and patient education are of the utmost importance. Furthermore, it is essential to share experiences from the research we have conducted and are currently carrying out with nurses in Nordic countries as well as around the world.

  • 48.
    Leksell, Janeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Medical Sciences Uppsala University.
    Billing, Ewa
    Medical Sciences Uppsala University.
    An evaluation of a cognitive educational program tailored for young women with mental illness: A qualitative interview study2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 3, p. 155-160Article in journal (Refereed)
    Abstract [en]

    Mental illness is a growing problem in numerous industrialized countries. Young women in particular report problems such as anxiety, worry and depression. The aim of this study was to evaluate a cognitive educational program offered to young women with mental illness by listening to how they discussed their own social skills and capability to obtain work or education. Five women in the age range of 18–26 years, who had been unemployed for at least four months, diagnosed as suffering from mental illness, and who also participated in a cognitive educational program were interviewed. The text from the interviews was analyzed using content analysis. The analysis resulted in the construction of the following theme: ‘Being together in an inspiring educational program supports the women’s own ability to devise a holistic life puzzle’. The participants’ answers were grouped into the following categories: ‘Perceptions of the educational program’ and ‘Social network’ with four subcategories. Being together with others in the same situation would appear to support the women’s own abilities, especially in an environment characterized by strict routines and nearness. These findings indicate the need to develop interventions for young women with mental illness which encourage spaces for collective support.

  • 49.
    Leksell, Janeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Funnell, Martha
    Sandberg, Gun
    Smide, Bibbi
    Viklund, Gunnel
    Wikblad, Karin
    Psychometric properties of the Swedish Diabetes Empowerment Scale2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 2, p. 247-52Article in journal (Refereed)
    Abstract [en]

    Objective: This study was conducted to determine the psychometric properties of the Swedish version of the Diabetes Empowerment Scale (Swe-DES-23). 

    Research design and methods: A convenience sample of 195 patients with type I and type 2 diabetes completed the Swe-DES-23 questionnaire. To establish discriminant validity, Swe-DES subscales were compared with the Semantic Differential in Diabetes scale (SDD) and a general health scale (EVGFP). Construct validity was tested using factor analyses. To determine unidimensionality of the subscales, interitem correlations were calculated. Internal consistency was tested by the use of the Crohnbach-alpha coefficient. 

    Results: The factor analysis resulted in four factors (empowerment subscales) with eigenvalues > 1.0, explaining 60% of the variance. The four empowerment subscales: goal achievement, self-awareness, stress management and readiness to change showed Crohnbach-alpha values ranging from 0.68 to 0.91. Patients with good self-reported health and low burden of diabetes scored significantly higher on almost all empowerment subscales. Only weak correlations were found between metabolic control and the empowerment subscales. 

    Conclusions: The SWE-DES-23 scale had acceptable validity and reliability and, thus, could be a suitable tool in evaluating empowerment-based education programmes. Further testing is needed to shorten the questionnaire.

  • 50.
    Leksell, Janeth
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gardulf, Ann
    Department of Labaratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Nilsson, Jan
    The Department of Health Science, Faculity of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Lepp, Margret
    The Institute of Health and Care Science, University of Gothenburg, Gothenburg, Sweden.
    Self-reported conflict management competence among nursing students on the point of graduating and registered nurses with professional experience2015In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 5, no 8, p. 82-89Article in journal (Refereed)
    Abstract [en]

    Objective: It has been shown that specific competence is necessary for preventing and managing conflicts in healthcare settings. The aim of this descriptive and correlation study was to investigate and compare the self-reported conflict management competence (CMC) of nursing students who were on the point of graduating (NSPGs), and the CMC of registered nurses (RNs) with professional experience.

    Methods: The data collection, which consisted of soliciting answers to items measuring CMC in the Nurse Professional Competence (NPC) Scale, was performed as a purposive selection of 11 higher education institutions (HEIs) in Sweden. Three CMC items from the NPC Scale were answered by a total of 569 nursing students who were on the point of graduating and 227 RN registered nurses with professional experience.

    Results: No significant differences between NSPGs and RNs were found, and both groups showed a similar score pattern, with the lowest score for the item: “How do you perceive your ability to develop the group and strengthen competence in conflict management and problem-solving, based on knowledge of group dynamics?”. RNs with long professional experience (>24 months) rated their overall CMC as significantly better than RNs with short (<24 months) professional experience did (p = .05). NSPGs who had experience of international studies during their nursing education reported higher CMC, compared with those who did not have this experience (p = .03). RNs who reported a high degree of utilisation of CMC during the previous month scored higher regarding self-reported overall CMC (p < .0001).

    Conclusions: Experience of international studies during nursing education, or long professional experience, resulted in higher self-reported CMC. Hence, the CMC items in the NPC Scale can be suitable for identifying self-reported conflict management competence among NSPGs and RNs

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