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  • 151. Basu, S
    et al.
    Zethelius, B
    Helmersson, J
    Berne, C
    Larsson, A
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Cytokine-mediated inflammation is independently associated with insulin sensitivity measured by the euglycemic insulin clamp in a community-based cohort of elderly men2011In: International Journal of Clinical and Experimental Medicine, ISSN 1940-5901, E-ISSN 1940-5901, Vol. 4, no 2, p. 164-168Article in journal (Refereed)
    Abstract [en]

    Both clinical and experimental studies suggest a close relation between an inflammatory state and insulin resistance. We investigated the association between cytokine-mediated inflammation (high sensitivity C reactive protein [hsCRP] and interleukin [IL] 6) and insulin sensitivity (insulin-mediated glucose disposal rate, assessed by the euglycemic insulin clamp) in a community-based cohort, with subgroup analyses of normal weight individuals without diabetes mellitus and metabolic syndrome (NCEP). hsCRP and IL- 6 were inversely associated with insulin sensitivity (multivariable-adjusted regression coefficient for 1-SD increase of hsCRP -0.12 (-0.21-(-0.03), p=0.01) and of IL-6 - 0.11 (-0.21-(-0.02), p=0.01) in models adjusting for age and components of the metabolic syndrome (systolic and diastolic blood pressure, antihypertensive drugs, HDL-cholesterol, triglycerides, fasting plasma glucose, waist circumference). The multivariable-adjusted association between hsCRP, IL-6 and insulin sensitivity were of a similar magnitude in normal weight individuals without diabetes and without the metabolic syndrome. Our data show that cytokine -mediated subclinical inflammation is independently associated with decreased insulin sensitivity also in apparently metabolically healthy normal weight individuals, indicating that the interplay between inflammatory processes and insulin resistance is present already in the early stages of the development of glucometabolic disease. (IJCEM1012002).

  • 152.
    Batz, Tommy
    Dalarna University, School of Education, Health and Social Studies.
    Sexual activity as a recovery method for optimizing skeletal muscle hypertrophy. A Review: "When I get that feeling, I want sexual healing"2014Student paper second term, 10 credits / 15 HE creditsStudent thesis
  • 153.
    Bayer, Johanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bohlin, Tore
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som kan påverka sjuksköterskestudentersupplevelse av stress samt förekommande copingstrategierbland sjuksköterskestudenter: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med litteraturöversikten var att belysa de faktorer som kan påverkasjuk-sköterskestudenters upplevelse av stress samt att undersöka vilkacopingstrategier som kan förekomma hos sjuksköterskestudenter vidstresshantering. Metod: Studien genomfördes som en litteraturöversikt.Litteratursökning utfördes i CINAHL with Full Text samt PubMed vilketresulterade i 16 artiklar som representerade sjuksköterskestudenter från 15 länder.Resultat: Utifrån de faktorer som orsakade stress hos sjuk-sköterskestudenteridentifierades tre huvudteman vilka var stressorer relaterade till teoretiskutbildning, stressorer under verksamhetsförlagd utbildning samt personligastressorer. Stressorer under verksamhetsförlagd utbildning var vanligastförekommande. Emotionsfokuserad coping var vanligast förekommande därcopingstrategier som att tala med vänner och familj, positivt tänkande och att ägnasig åt andra aktiviteter användes. Slutsats: Sjuksköterskestudenter upplever stressfrämst från teoretiska utbildningen i form av examinationer och denverksamhetsförlagda utbildningen där relationen till handledaren, vårda patienteroch dödsfall var de vanligast förekommande stressorerna. Sjusköterskestudenternaanvände sig av copingstrategier som kan ha positiv och negativ effektpå hälsan. Emotionsfokuserade och problemfokuserade copingstrategier användesmest frekvent. Undvikande copingstrategier var mer sällan förekommande.

  • 154.
    Begum, Mamotaz
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Khatum, Fazila
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Begum, Shamsunnaher
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Perceived beneficences of and compliance to the content in a mentorship program: A questionnaire baseline survey among nursing and midwifery educators in Bangladesh prior the development of a mentorship program2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Building midwifery educators’ capacity has been identified as an important component to ensure quality midwifery education and a midwifery workforce that can provide quality midwifery and newborn care. With the background of midwifery being recently introduced in colleges/institutions in Bangladesh, the midwifery educators would benefit from a mentorship program. In an attempt to provide recommendations for development of a mentorship program to midwifery faculty this study was conducted.

    Objective:

    To describe perceived beneficences of and compliance to the content in a mentorship program; pedagogic styles, students learning and nursing and midwifery educators’ opinions about their own working situation as midwifery educators in Bangladesh.

    Methods:

    The total number of participants were 59 (n= 59). Data were collected through a structured questionnaire with both open and closed response options, analyzed statistically and through content analysis.

    Result

    : The midwifery faculty finds it beneficial to participate in a mentorship programs because they perceive they can improve their own situation for the best of the country, moving midwifery forward. The most important skill/ability for faculty to teach the midwifery students was critical thinking and an ability to transfer theoretical knowledge into clinical practice, preferably by useing a variety of pedagogic styles. There is complicance among the midwifery faculty to use information technology to impact students’ learning experiences during clinical placement.

    Conclusion:

    Mentorship stands out to be a beneficial method of improving teaching and assessment of students’ performances particularly in clinical settings. Communication technology could be an option for providing support and mentorship to midwifery faculty. Information technology could be one important part of a mentorship program.

    Clinical applicability and suggestions for further research:

    The clinical applicability of this thesis is the provision of up-dated evidence-based information on complicance to modern technology to support the implementation of theoretical knowledge into clinical practice. Continuity of a mentorship program requires attention for sustainable outcome.

  • 155.
    Begum, Momtaj
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Sultana, Nazma
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Women’s and health care provider perceptions and experiences of bottlenecks in midwifery care: A qualitative meta-synthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Women die from preventable causes during pregnancy and childbirth and often in relation to delays in midwifery care. Professional hierarchies might hamper the rights and desires of midwives in provision of normal birth in terms of the provision of quality care to all women and newborns. In health systems where decision making in normal births are influence by doctors this is particularly relevant, with women themselves subordinate to all health care professionals. Aim: The aim of this meta-synthesis was to examine women’s and health care provider’s perceptions and experiences of bottlenecks in midwifery care related to availability, accessibility, acceptability and quality of midwifery care. Method: This study was a qualitative meta-synthesis with a deductive approach, 15 article were selected for this qualitative meta-synthesis. A framework for the evaluation of quality of care and coverage of health services was used for the deductive approach. Results: Four categories emerged based on availability, accessibility, acceptability and quality of care. The delays were due to less awareness of danger signs of severe complications in the community, and delays in decision making by male family members and less empowerment of women, and lack of collaboration between health care professionals. We also identified how to overcome this situation. Conclusion: Midwifes may provide quality maternal care to all women and children and earn trust from community people to promote normal pregnancy and birth and prevent delays when complications arise. Clinical implications: Midwives can provide continuity care and through collaboration with other health care professionals advocate for women empowerment.

  • 156.
    Begum, Mst. Marium
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Nahar., Most. Nargis
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parents’ and health care providers’ perceptions and experiences of supportive care in neonatal wards: A qualitative metasynthesis2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Four million infants die with in the first month of life and 27% of these deaths are directly related to low birth weight (LBW) or preterm birth. The main causes of infant death in premature and LBW infants is neonatal infections. It is thus crucial that the infant is taken care of in an appropriate way regarding caring and feeding and that care is provided to improve the child’s chances of survival and to lay the foundation for a healthy life. Aim: The aim of this meta-synthesiswas to examine parent`s and health care providers perceptions and experiences of supportive care in neonatal wards. Method: A qualitative meta-synthesis based on peer-reviewed scientific literature, and meta-ethnographic analysis method. In this meta-synthesis 16 articles were included. Result: The results comprised of two categories, Parents’ perspective of supportive strategies with eight corresponding preliminary patterns and Health care providers’ perspective of supportive strategies with six corresponding preliminary patterns. In the result section, each categories are presented with its corresponding preliminary patterns. The mothers experienced that the baby was unstable and therefore they wanted to be close to the baby at all times if something happened. Important was closeness to the infant is important, parental support according to needs, adequate communication and information with parents, genuine caring and continuous support to get close to the child. It also meant less light and less noise and privacy for the infant and the parent in the NICU ward.

    Conclusion

    Parents wanted to be able to be with his infant as rapidly after birth be reunited in case something happened. The importance of receiving information about their infant’s condition underpinned all communications that the parents undertook with NICU staff both in co-care when together with the child and part-care, when separated. Information for the parents was an important requirement of accepting their situation and immediately affected their anxiety. Clinical implications: The organizers of care must take in account that parents and infants will not be befitted by being cared for apart from each other. When planning for co-care enabling infants to be close to the parents, the mother-baby dyad should be prioritized. Context specific interview studies are suggested on co-care and part-care, parents and care providers perspectives.

  • 157.
    Begum, Mst. Marium
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Nahar, Most. Nargis
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Parents’ and health care providers’ perceptions and experiences of supportive care in neonatal wards: A qualitative metasynthesis2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Four million infants die with in the first month of life and 27% of these deaths are directly related to low birth weight (LBW) or preterm birth. The main causes of infant death in premature and LBW infants is neonatal infections. It is thus crucial that the infant is taken care of in an appropriate way regarding caring and feeding and that care is provided to improve the child’s chances of survival and to lay the foundation for a healthy life. Aim: The aim of this meta-synthesiswas to examine parent`s and health care providers perceptions and experiences of supportive care in neonatal wards. Method: A qualitative meta-synthesis based on peer-reviewed scientific literature, and meta-ethnographic analysis method. In this meta-synthesis 16 articles were included. Result: The results comprised of two categories, Parents’ perspective of supportive strategies with eight corresponding preliminary patterns and Health care providers’ perspective of supportive strategies with six corresponding preliminary patterns. In the result section, each categories are presented with its corresponding preliminary patterns. The mothers experienced that the baby was unstable and therefore they wanted to be close to the baby at all times if something happened. Important was closeness to the infant is important, parental support according to needs, adequate communication and information with parents, genuine caring and continuous support to get close to the child. It also meant less light and less noise and privacy for the infant and the parent in the NICU ward.Conclusion Parents wanted to be able to be with his infant as rapidly after birth be reunited in case something happened. The importance of receiving information about their infant’s condition underpinned all communications that the parents undertook with NICU staff both in co-care when together with the child and part-care, when separated. Information for the parents was an important requirement of accepting their situation and immediately affected their anxiety. Clinical implications: The organizers of care must take in account that parents and infants will not be befitted by being cared for apart from each other. When planning for co-care enabling infants to be close to the parents, the mother-baby dyad should be prioritized. Context specific interview studies are suggested on co-care and part-care, parents and care providers perspectives.

  • 158.
    Begum, Sufia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Akter, Rehena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mapping and Nursing Instructors Suggestions of Acceptable and Feasible Requirements for an accreditation Toolkit for Midwifery Educations in Bangladesh: A Questionnaire Study at Five Institutes/Colleges in Rangpur and Rajshahi Divisions2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    To build the midwifery workforce and maintain quality in midwifery educations, the development of an accreditation system has been initiated in Bangladesh.

    Objective:

    The objectives of this thesis are 1) to map five midwifery education sites in Rangpur and Rajshahi divisions, Bangladesh. The mapping describe the situation at the institutes/colleges and clinical sites in which the midwifery students and teachers are aimed to reach the learning outcomes of the courses in the 3 years diploma midwifery curricula, 2) to provide information to Bangladesh Nursing and Midwifery Council with acceptable and feasible requirements that could feed into an accreditation toolkit for nursing institutes with midwifery education from nursing instructors perspective.

    Methods:

    This questionnaire study includes a mapping of the situation at 5 institutes or colleges in the Rangpur and Rajshahi divisions, and 20 nursing instructors’ perceptions of acceptable and feasible requirements to be included in an accreditation tool for midwifery educations. Data were collected through a semi-structured questionnaire with closed and open response alternatives analyzed descriptive statistics and answers on open questions in text were categorized.

    Results

    : Eighty percent of the collages/institutions accepted the proportion theory 40% in relation to practice 60%. The need for adequately qualified midwifery teachers, clinical preceptors/mentors, skills lab facilities and simulation became obvious. Teacher’s and clinical supervisors’ continuous in-service training and available resources were crucial to deliver the midwifery curriculum. Continuous in-service training could cover skills in antenatal care, maintenance of pantographs, care of the newborn and brief knowledge about breast feeding was suggested. Conclusion: This study illuminates gaps in quality education in Rajshahi and Rangpur divisions that could be solved with continuous in-service trainings of the nursing instructors and midwives supervising midwifery students. The government initiated the initiative to support the development of an accreditation system and toolkit closing the gap between the participants outlined in the curricula and the implementation in clinical practice in Rajshahi and Rangpur division.

    The clinical applicability

    of this thesis is to inform Bangladesh Nursing and Midwifery Council with support from Directorate General of Nursing and Midwifery and supervision of Ministry of Health and Welfare on feasible and acceptable requirements that could be included in an accreditation toolkit for midwifery education in Bangladesh. The thesis findings could be used to inform NGOs and other donor organizations, national and international, on subjects and content when developing in-service trainings.

  • 159.
    Bel Mekki, Veronica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fernström, Pia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans uppfattning om omvårdnadsinsatser som främjar livskvalitet vid bipolär sjukdom: En kvalitativ intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Several studies have shown that persons with bipolar disorder have

    a poorer quality of life compared to the rest of the population. As a nurse in

    psychiatric care it is important to have knowledge about the disease in order to

    provide the best possible treatment with the goal to stabilize symptoms, prevent

    relapse and promote quality of life.

    Objective: Based on the nurse's perception, describe the nursing interventions

    promoting quality of life in bipolar disorder.

    Method: A qualitative content analysis based on eight semi-structured interviews.

    Results: The results showed three main themes: Knowledge about the disease: the

    importance of that both the patient and family members gain knowledge about the

    disease; Safety and continuity of care: knowing where and who to contact in care

    was of great importance and Person-centered care: be seen and treated as a unique

    person.

    Conclusion: Patient education which highlights the importance of regular habits,

    to avoid stress and to become aware of early signs can help stabilize symptoms

    and prevent relapse.

  • 160.
    Bellardini, Helena
    et al.
    Dalarna University, School of Health and Social Studies, Sport and Health Science.
    Henriksson, Anders
    Dalarna University, School of Health and Social Studies, Sport and Health Science.
    Tonkonogi, Michail
    Dalarna University, School of Health and Social Studies, Medical Science.
    Bra och enkla fystester2013Book (Other academic)
  • 161.
    Bellardini, Helena
    et al.
    Dalarna University, School of Health and Social Studies, Sport and Health Science.
    Tonkonogi, Michail
    Dalarna University, School of Health and Social Studies, Medical Science.
    Senior Power - Styrketräning för äldre2013 (ed. 1)Book (Other academic)
  • 162.
    Bellardini, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Tonkonogi, Michail
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Senior power: styrketrening for eldre2014 (ed. 1)Book (Other academic)
  • 163.
    Bellardini, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Tonkonogi, Michail
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Mckee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    The effect of gender on strength training in older people: a Swedish population study2012In: Psychology and Health, ISSN 0887-0446, E-ISSN 1476-8321, Vol. 27, no s1, p. 155-156Article in journal (Refereed)
    Abstract [en]

    Background: Physical exercise contributes to healthy ageing, and strength training has beenshown to improve independence in older people.

    Method: Six hundred older people wererandomly selected from the Swedish population, and sent a self-completion questionnaire(57% response rate, n¼343) examining exercise history, current strength training, andperceived benefits and barriers to strength training.

    Results: Gender was associated with aperceived positive effect of strength training on quality of life (Women 42% vs. Men 27%).The most commonly reported benefits of strength training were better mobility (71%), energy(70%), and muscle strength (69%), with most benefits endorsed more commonly by womenthan men. The most commonly reported barriers to strength training were believing otherforms of exercise more suitable (49%) and cost (20%; Women 31% vs. Men 13%).

    Discussion:To better promote healthy ageing, interventions should be embedded in an understanding ofthe effect of gender on exercise behaviour.

  • 164. Bentham, James
    et al.
    Ezzati, Majid
    A century of trends in adult human height2016In: eLIFE, E-ISSN 2050-084X, ISSN 2050-084X, Vol. 5, p. 1-29, article id e13410Article in journal (Refereed)
    Abstract [en]

    Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3– 19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8– 144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.

  • 165.
    Berg, Karolin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gunnarsdottir, Moeidur
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans copingstrategier vid stress: - En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Coping is the individual's ability to adapt to and handle different

    conditions. In order to handle stress in the nursing profession today, knowledge

    about different coping strategies may be needed. The nursing role and the

    responsibility of nurses has grown and more is required of the nurse. Unhealthy

    working environment can contribute to increased risk of stress at work. A part of

    SOC, a sense of coherence, is manageability, which can mean that a person has the

    resources to meet the demands and stress that she or he or she faces.

    Aim

    The aim of this review of literature was to compile the coping

    strategies nurses use to cope with stress

    Method

    The Literature review is based on 15 articles published between

    2008 and 2018. Databases used were Cinahl, PubMed and Psycinfo.

    Result

    The different coping strategies that were found showed that nurses

    could use

    Asking for help and social support, Positive thinking, Self-control,

    Problem solving, Acceptance, Escape and avoidance, Exercising religion

    and

    Recovery.

    Coping strategies were divided into two categories, Emotion-focused

    coping

    and Problem-focused coping.

    Conclusion

    The result in the literature review shows that nurses use several

    different coping strategies to handle stress. The most common coping strategy was

    to ask for help and social support.

  • 166.
    Berg, L
    et al.
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet; Department of Emergency Medicine, Falun Hospital.
    Göransson, K
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Östergren, J
    Department of Medicine Solna, Karolinska Institutet, Solna, Sweden ; Department of Emergency Medicine, Karolinska University Hospital, Solna, Sweden.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Interruptions in emergency department work: an observational and interview study2013In: BMJ Quality and Safety, ISSN 2044-5415, E-ISSN 2044-5423, Vol. 22, no 8, p. 656-663Article in journal (Refereed)
    Abstract [en]

    Objectiv.e Frequent interruptions are assumed to have a negative effect on healthcare clinicians’ working memory that could result in risk for errors and hence threatening patient safety. The aim of this study was to explore interruptions occurring during common activities of clinicians working in emergency departments.

    Method. Totally 18 clinicians, licensed practical nurses, registered nurses and medical doctors, at two Swedish emergency departments were observed during clinical work for 2 h each. A semistructured interview was conducted directly after the observation to explore their perceptions of interruptions. Data were analysed using non-parametric statistics, and by quantitative and qualitative content analysis.

    Results. The interruption rate was 5.1 interruptions per hour. Most often the clinicians were exposed to interruptions during activities involving information exchange. Calculated as percentages of categorised performed activities, preparation of medication was the most interrupted activity (28.6%). Face-to-face interaction with a colleague was the most common way to be interrupted (51%). Most common places for interruptions to occur were the nurses’ and doctors’ stations (68%). Medical doctors were the profession interrupted most often and were more often recipients of interruptions induced by others than causing self-interruptions. Most (87%) of the interrupted activities were resumed. Clinicians often did not regard interruptions negatively. Negative perceptions were more likely when the interruptions were considered unnecessary or when they disturbed the work processes.

    Conclusions. Clinicians were exposed to interruptions most often during information exchange. Relative to its occurrence, preparation of medication was the most common activity to be interrupted, which might increase risk for errors. Interruptions seemed to be perceived as something negative when related to disturbed work processes.

  • 167. Berg, Lena
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Göransson, Katarina
    An observational study of activities and multitasking performed by clinicians in two Swedish emergency departments2012In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 19, no 4, p. 246-251Article in journal (Refereed)
    Abstract [en]

    Objectives: To explore the type and frequency of activities and multitasking performed by emergency department clinicians.

    Methods: Eighteen clinicians (licensed practical nurses, registered nurses and medical doctors), six from each occupational group, at two Swedish emergency departments were followed in their clinical work for 2 h each to observe all their activities and multitasking practices. Data were analysed using qualitative and quantitative content analysis.

    Results: Fifteen categories of activities could be identified based on 1882 observed activities during the 36 h of observation. The most common activity was information exchange, which was most often performed face-to-face. This activity represented 42.1% of the total number of observed activities. Information exchange was also the most common activity to be multitasked. Registered nurses performed most activities and their activities were multitasked more than the other clinicians. The nurses’ and doctors’ offices were the most common locations for multitasking in the emergency department.

    Conclusion: This study provides new knowledge regarding the activities conducted by clinicians in the emergency department. The most frequent activity was information exchange, which was the activity most often performed by the clinicians when multitasking occurred. Differences between clinicians were found for activities performed and multitasked, with registered nurses showing the highest frequencies for both.

  • 168. Berg, Lena
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Göransson, Katarina
    The presence of emergency department crowding at a Swedish University hospital.: A longitudinal study using two crowding indicators as measures.2018Conference paper (Refereed)
  • 169.
    Berg, Lena
    et al.
    Akutkliniken Karolinska Universitetssjukhuset Solna ; Institutionen för Medicin Solna, Karolinska Institutet.
    Källberg, Ann-Sofie
    kutkliniken, Falu Lasarett ; Institutionen för Medicin Solna, Karolinska Institutet.
    Ehrenberg, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Karolinska institutet.
    Göransson, Katarina
    Karolinska institutet.
    Avbrott och störning i arbetet för akutmottagningspersonal - är det någon skillnad?2014Conference paper (Refereed)
  • 170.
    Berg, Lena
    et al.
    Karolinska institutet.
    Källberg, Ann-Sofie
    Karolinska institutet.
    Ehrenberg, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Karolinska institutet.
    Göransson, Katarina
    Karolinska institutet.
    Interruptions and disturbances in emergency department work assignments2014Conference paper (Refereed)
  • 171. Berg, Lena M
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Göransson, Katarina E
    Significant changes in emergency department length of stay and case mix over eight years at a large Swedish University Hospital2018In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013XArticle in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Describe the longitudinal development of crowding and patient/emergency department (ED) characteristics at a Swedish University Hospital.

    METHODS: A retrospective longitudinal registry study based on all ED visits with adult patients during 2009-2016 (N = 1,063,806). Patient characteristics and measures of ED crowding (ED occupancy ratio, length-of-stay [LOS], patients/clinician's ratios) were extracted from the hospital's electronic health record. Non-parametric analyses were conducted.

    RESULTS: The proportion of unstable patients (triage level 1-2) increased while the proportion of admitted patients decreased. All crowding variables were stable, except for LOS, which increased by 9 min/visit/year (95% CI: 8.8-9.1). LOS for visits by patients ≥ 80 years increased more compared to those 18-79 (248 min vs. 190 min, p < 0.001). Unstable patients increased their median LOS compared to stable patients (triage level 3-5). LOS for discharged patients increased with an average of 7.7 min/year (95% CI: 7.5-7.9) compared to 15.5 min/year (95% CI: 15.2-15.8) for those being admitted.

    CONCLUSION: Fewer admissions, despite an increase of unstable patients, is likely related to lack of in-hospital beds and contributes to ED crowding. The increase in median ED LOS, especially for patients in the subgroups unstable, ≥80 years and admitted to in-hospital care reflects this problem.

  • 172. Berg, Lena M
    et al.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Djärv, Therese
    Göransson, Katarina E
    Reasons for interrupting colleagues during emergency department work: a qualitative study2016In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 29, no SI, p. 21-26Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Emergency department team members frequently need to interact with each other, a circumstance causing multiple interruptions. However, information is lacking about the motives underlying these interruptions and this study aimed to explore clinicians' reasons to interrupt colleagues during emergency department work.

    METHOD: Semi-structured interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. The interviews were analyzed inductively using content analysis.

    RESULTS: The working conditions to some extent sustained the clinicians' need to interrupt, for example different routines. Another reason to interrupt was to improve the initiator's work process, such as when the initiators perceived that the interruption had high clinical relevance. The third reason concerns the desire to influence the work process of colleagues in order to prevent mistakes and provide information for the person being interrupted to improve patient care.

    CONCLUSION: The three identified categories for why emergency department clinicians interrupt their colleagues were related to working conditions and a wish to improve/influence the work processes for both initiators and recipients. Several of the reasons given for interrupting colleagues were done in order to improve patient care. Interruptions perceived as negative to the recipient were mostly related to the working conditions.

  • 173. Berg, Lena M
    et al.
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Medicine Solna, Karolinska Institutet; Department of Emergency Medicine, Falun Hospital.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östergren, Jan
    Djärv, Therese
    Brixey, Juliana J
    Göransson, Katarina E
    Factors influencing clinicians' perceptions of interruptions as disturbing or non-disturbing: a qualitative study2016In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 27, p. 11-16Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Emergency departments consist of multiple systems requiring interaction with one another while still being able to operate independently, creating frequent interruptions in the clinical workflow. Most research on interruptions in health care settings has focused on the relationship between interruptions and negative outcomes. However, there are indications that not all interruptions are negatively perceived by those being interrupted. Therefore, this study aimed to explore factors that influence when a clinician perceives interruptions as non-disturbing or disturbing in an emergency department context.

    METHOD: Explorative design based on interviews with 10 physicians and 10 registered nurses at two Swedish emergency departments. Data were analyzed using qualitative content analysis.

    RESULT: Factors influencing whether emergency department clinicians perceived interruptions as non-disturbing or disturbing were identified: clinician's constitution, external factors of influence and the nature of the interrupted task. The clinicians' perceptions were related to a complex of attributes inherent in these three factors at the time of the interruption. Thus, the same type of interruption could be perceived as either non-disturbing or disturbing contingent on the surrounding circumstances in which the event occurred.

    CONCLUSION: Emergency department clinicians' perceptions of interruptions as non-disturbing or disturbing were related to the character of identified influencing factors.

  • 174.
    Bergdahl, Sandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Löfgren, Josefin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Följsamhet till råd om egenvård hos patienter med diabetes typ 2: En litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes is an endocrine disorder and a global health problem, with the

    number falling ill persons greatly increases. Treatment of type 2 diabetes consists mainly of

    self-care, which places great demands on the patient and the healthcare system. A lack of

    compliance to advice on self-care can lead to poorer health for the patient and increased costs

    for society.

    Aim: The purpose of this literature review was to describe the factors that influence

    compliance to advice on self-care in patients with type 2 diabetes.

    Method: A literature review based on 15 scientific articles, both qualitative and quantitative

    articles were reviewed. The databases CINAHL and PubMed were used.

    Results: Factors affecting compliance to advice on self-care were identified and resulted in

    five broad categories: Information; Knowledge; Social support; technological support and

    Life situation revealed as important factors for low compliance to advice on self-care.

    Conclusion: It is very important to try to identify each individual's different conditions, in

    order to thus be able to cu

  • 175.
    Bergendahl, Sandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lövstrand, Madelene
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans preoperativa information för patientens postoperativa smärtupplevelse: - En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Hip surgery is a common operation, for both elective and acute approach. Nurses’ duties includes pain prevention and information to the patient. This with the patient always in focus. Studies have shown that it is most common to give the information verbally, and that patients want to know more preoperative about the postoperative phase to be more involved.

    Aim

    : The purpose of this literature review was to investigate the importance of nurses’ preoperative information for postoperative pain management.

    Methods

    : For the research the database CINAHL and PubMed was used. A review template was used, and only the articles with a medium high score has been used. This work is based on 17 articles which has been divided in main categories that was elective, acute, information and pain.

    Results

    : A relationship between preoperative information and postoperative pain was found in 13 of the articles. This connection indicate that the given information provided the patients to manage their postoperative pain. Patients undergoing elective surgery was better prepared and was given more patient activated education preoperative than acute surgery. Preoperative individual strategies was identified.

    Conclusion:

    Most of the studies showed that preoperative information is used to reduce postoperative pain by increasing patients’ participation and their ability to cope better. Since a connection was found between most of the articles in this work it increases the likelihood that there is a relationship between nurses’ preoperative information and patients’ postoperative pain experience.

  • 176.
    Bergens, Katarina
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Palmer, Ellinor
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Det goda bemötandet inom prehospital akutsjukvård: En litteraturöversikt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna litteraturöversikt var att beskriva vad som kännetecknar ett gott bemötande inom den prehospitala akutsjukvården och vilken betydelse bemötandet har för vården. Metod: Studien genomfördes som en litteraturöversikt och artiklar söktes via databaserna CINAHL och PubMed. De elva inkluderade artiklarna resulterade i kategorier och subkategorier som beskriver vad som är utmärkande för ett gott bemötande inom den prehospitala sjukvården och vilken betydelse det har för vården. Resultat: Resultatet visade att ambulanspersonalen ska anpassa kommunikationen efter patientens förutsättningar och de ska ha ett förhållningssätt som baseras på respekt, ödmjukhet och empati. En förutsättning för en god omvårdnad är att en omvårdnadsrelation, baserad på tillit och förtroende, upprättas. Omvårdnadsrelationen synliggör patientens sårbarhet, vilket ställer krav på ambulanspersonalen att visa respekt för patientens integritet. Slutsats: Patienten har inte bara fysiska utan även psykiska och sociala behov. Att ambulanspersonalen har en holistisk människosyn gör att patienten blir bemött som en unik individ och därmed får en bättre prognos medan brister i den prehospitala vårdkedjan kan äventyra patientsäkerheten.

  • 177.
    Bergens, Marika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johnson, Pernilla
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Arbetsrelaterade stressfaktorer ochsjuksköterskans möjlighet till en patientsäker vård2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this literature review was to describe the factors that influence work-related stress and how it affects the ability to provide a safe patient care.Methods: The study was conducted through a literature review and the articles were searched through databases CINAHL and PubMed. The 14 included articles resulted in two themes and five subthemes that describes factors for work-related stress and its effects.Results: The degree of workload, lack of communication and poor relationships at work was largely a contributing cause of work-related stress. Staff shortages did increase stress to the nurses who worked and came with additionally high risk of exhaustion and burnout. Time pressure meant that nurses did not manage important aspects of nursing care. The focus was on carrying out practical tasks while patient care did suffer. These factors contributed greatly to the compromise of patient safety, in terms of the nurses reduced concentration, which among other things led to missed or failed documentation and medication errors.Conclusion: Staff shortages and time pressure is greatly contributing factors in nurses become stressed and burned out. These factors make it difficult to maintain an evidence-based and patient-safe care.

  • 178.
    Berggren, Emma
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Graf, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar sjuksköterskors följsamhet till riktlinjer för handhygien utifrån en beteendeteori En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Healthcare-associated infections are a global problem and good handhygiene

    is the main tool in the fight against healthcare- associated infections.

    Adherence to hand hygiene is globally low. The nurse’s hands are the main source

    of spreading infection, and because of that the nurse’s behavior towards hand

    hygiene is important. The nurse’s intention to perform hand hygiene can be

    explained by the internal dimension, who are, according to the Theory of planned

    behaviour, attitudes, subjective norms and perceived behavioural control.

    Aim: The aim of this literature review was to describe the attitudes, subjective

    norms and perceived behavioural controls that affect nurses’ adherence to guidelines

    for hand hygiene.

    Method: This study was conducted as a literature review and based on fourteen

    articles of quantitative and qualitative method from the databases PubMed,

    CINAHL and Web of Science.

    Results: The results of the literature review demonstrate that, from the perspective

    of the Theory of planned behaviour, there were attitudes, subjective norms and

    perceived behavioural controls that affected nurses’ adherence to guidelines for

    hand hygiene. Nurses felt that personal protection was an important attitude that

    motivated to hand hygiene. In subjective norm the patient, colleagues and role

    models emerged as motivating factors to perform hand hygiene and the feeling that

    it is easy to perform hand hygiene was the most prominent factor under perceived

    behavioural control.

    Summary: Adherence to guidelines for hand hygiene is low in spite of national

    efforts and campaigns to increase adherence. The results showed that nurses’

    adherence to guidelines for hand hygiene was mainly influenced by personal

    protection, the patient, peers, role models and the feeling that it is easy to perform

    hand hygiene. The results of this literature review can be used to increase the

    knowledge in this area and develop new strategies to increase nurses’ adherence to

    guidelines for hand hygiene.

  • 179.
    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.

  • 180.
    Bergholm Andersson, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erfarenheter av att vårda personer med demenssjukdom: En kvalitativ intervjustudie med distriktssköterskor2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: District nurses come in contact with people who have dementia diagnosis to different extent.

    Aim: The aim of this study was to examine nurses' experiences in meeting people with dementia diagnosis and how they adapt giving care that are based on the patient's needs.

    Method: The study was qualitative and based on interviews with four district nurses. For processing the collected data content analysis was used.

    Results: The analysis revealed the three domains, the nurse's situation, the person with dementia diagnosis´ situation and adapting care measures. Further analysis led to four categories, facing a complex care situation, to be challenged, to take care of resources and to adapt their health care measures to the individual or to the dementia. The district nurses identified that people with dementia is a fragile and vulnerable group and to care for them was a challenge on many levels. It requires in-depth knowledge and an ability to see all the factors that surround this population, it´s challenging, complex and exciting. Working person-centered is something that both sought and done in practice, they also take good care of resources that will benefit the patients.

    Conclusion: The district nurses showed joy and commitment that were prominent and seemed to be linked to their education and knowledge. Research including people with dementia and others with limited decision-making capacaty are needed and desirable. Their participation would provide valuable knowledge that could lead to the development in the care concerning this vulnerable population.

  • 181.
    Bergholm, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bertilsson, Hans-Erik
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelser av att leva med bensår: Litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Leg ulcer is a symptom caused by different underlying illnesses of

    which poor venous circulation is the most common one. People over 65 years of

    age are at the highest risk. Leg ulcer is a burden both for the patient and the

    healthcare system.

    Aim:

    To describe patients experiences of life with leg ulcers.

    Method:

    This study was conducted as a literature review, in which 16 articles was

    included using the databases Cinahl, Pubmed and Psycinfo. The articles were of

    qualitative and quantitative design.

    Result:

    Patient experiences of living with leg ulcers resulted in three categories:

    To experience suffering, to feel restricted and to experience lack of knowledge.

    The patients experienced a lot of suffering regarding pain, sleep deprivation and

    negative emotions. The patients also experienced limitations caused by

    immobility, limitations in the choice of clothes and shoes and social restrictions.

    The patients lack of knowledge, information and the nurses lack of knowledge

    about leg ulcer treatment was obvious in this study.

    Conclusion:

    Patient perceived a lot of suffering and limitations caused by life with

    leg ulcers. Pain was the most dominant symptom and was rarely assessed or

    treated properly. Pain caused deterioration and enhancement of other symptoms

    with profound effect on patient's wellbeing. Added support, information and pain

    control could improve patient wellbeing.

  • 182.
    Berghov, Emmelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Danielsson, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att vårdas i ett isoleringsrum vid infektion eller risk för infektion – patientens upplevelse.: En litteraturöversikt.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim:

    To describe the experience of being cared for in an isolation room in patients with infection or at risk for infection.

    Background:

    Patients may need to be isolated for various reasons, either to prevent infection or to protect infection-sensitive patients. Multiresistant bacteria are an increasing problem around the world. In order to reduce antibiotic resistance and prevent infection of multiresistant bacteria, a measure is to isolate patients who are infected.

    Method:

    A literature review. The result is based on 14 articles, both qualitative and quantitative articles have been used.

    Result:

    There were both positive and negative experiences of being cared for in an isolation room. Among the positive experiences were feelings of security and the opportunity to privacy. The negative experiences were connected with the physical environment, ignorance and emotions like anxiety and loneliness. Also the healthcare professional´s attitudes, response and compliance with routines affected the patient´s experience of isolation care.

    Conclusion:

    The isolation experience is unique to each individual and factors that can affect the experience are the healthcare professional’s ability to provide adequate information, have a good behavior, and give the patient the opportunity to preserve social contacts.

  • 183.
    Bergkvist, Jonas
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    5-årig åldersklassindelning är inte optimal för triathlon: En deskriptiv tvärsnittsstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 184.
    Berglund, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pelleberg, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans bemötande av patienter med psykisk ohälsa inom somatisk vård: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: People with mental health problems often have a somatic comorbidity. Research shows that patients with mental health problems often experience that they are treated unfairly and being misunderstood when seeking somatic care. Good encountering is a prerequisite for the creation of a caring relationship which forms the foundation for good care. Encountering also affect the patient's health, compliance, and experience of care. Aim: The aim was to illuminate factors of significance for the encountering of patients with mental health problems in somatic care from nurse’s perspective. Method: A literature review based on 15 articles with both quantitative and qualitative design. Searches were made in the databases PubMed and Cinahl. Result: Factors of significance for encountering could be divided into three themes: attitudes, factors related to the patient meeting and factors related to organization. Both positive and negative attitudes to patients with mental health emerged. Factors related to the patient meeting were anxiety and fear, complex communication, and insufficient skills. Factors related to organization were environment, time and resources, support and prioritization of somatic care. Conclusion: Conclusions that may be drawn from this study are that several different factors may be relevant to encountering, and that there is room for improvement. Important areas of improvement that emerged are nurse´s attitudes and competence. The result also indicates that the organization within somatic care is not adapted to the care and encountering of patients with mental health problems.

  • 185. Berglund, Camilla
    et al.
    Voss Åhnebrink, Sofie
    Kvinnors beskrivning av fosterrörelser i fullgången graviditet: En studie med kvantitativ cross-over design och kvalitativ innehållsanalys2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are no general guidelines for the assessment of normal fetal movement

    but there are clear links between the woman attentions of lower or weaker fetal movements

    and the risk of the baby dying in late pregnancy. A self- estimation method under

    development for the description of fetal movements can be in a dialogue between the woman

    and the midwife lead to finding more children who are at risk.

    Objective: The purpose of this study is to describe and compare fetal movements intensity

    and type in the full-term pregnancy based on two self-assessment methods, and to investigate

    whether the women`s descriptions can be organized into a matrix under development.

    Design: A study with quantitative cross-over design and content analysis

    Findings: The women describe fetal movements equal based on the two self-rating methods

    except under the category of slow movements. It was almost twice as likely to feel a fetal

    movement that was under the domain of powerful moves. The expression that the women

    made use of to describe fetal movement went to sort into an already existing matrix.

    Conclusions: The matrix was useful, it was possible to sort the fetal movements regarding the

    intensity and type. The matrix can help the women to describe fetal movements for the timely

    detection of anomalies, this would reduce the risk of injury and death in utero.

  • 186.
    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

  • 187.
    Berglund, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Nicklas
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans omvårdnadsåtgärder för att förebygga vårdrelaterad urinvägsinfektion – en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of the literature review was to describe the nursing interventions the nurse can take to prevent health care related urinary tract infection.

    Background: According to Swedish national board of health and welfare (u.å.a) about 10 % of the hospitalized patients in 2008 was affected with a nosocomial infection. The most common nosocomial infection is urinary tract infection. This means more suffering for patients and costs society money. A nurse has a responsibility to promote health, prevent illness, restore health and prevent suffer for patients.

    Method: The study was conducted as a literature review. The articles were searched via the database PubMed and Cinahl. The result is based on 15 articles that met the inclusion criteria and quality control.

    Results: For the nurse to prevent health care -related urinary tract infection it requires nurse care measures like documentation, accurate indication, good hand hygiene , education and adherence to procedures at the insertion of the catheter.

    Conclusion: By following nursing interventions such as documentation, accurate indication, good hand hygiene, and adherence to routines, the essay writers claims that VRUI can be prevented and also prevent healthcare suffering of the patient. What the essay writers have taken up and discussed is something that the essay writers believe are included in the nurse's daily work. If the nurse takes responsible for their actions, update their knowledge, implement good hand hygiene, and follow the guidelines the essay writers claims that VRUI can be prevented.

  • 188.
    Bergman, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wanke, Julia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    HBTQ-personers erfarenheter av vårdpersonalens bemötande inom sjukvården – en litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund. Synen på HBTQ-personer i samhället är under förändring och i takt

    med att fler vågar vara öppna med sin sexuella läggning, konfronteras det

    heteronormativa synsättet. Historiskt sett är detta en grupp som mötts av

    diskriminering och stigmatisering ute i samhället och även i vårdsituationer och i

    mötet med vårdgivare. Lagändringar har framtagits för att stoppa

    marginaliseringen av denna grupp, vilket lett till attitydförändringar i samhället.

    Syftet med litteraturöversikten var att undersöka HBTQ-personers erfarenheter av

    vårdpersonalens bemötande inom sjukvården. Metod. Litteraturöversikt med 17

    kvalitativa och kvantitativa artiklar. Resultatet visade att denna grupp fortfarande

    erfar stigmatisering och diskriminering i mötet med vård och vårdgivare, samt att

    vårdpersonalen saknade betydande kunskap om denna grupp. Slutsats. Det finns

    fortsatta behov av forskning inom området, utbildning av vårdpersonal, samt

    införande av ämnet HBTQ i utbildningen för allmänsjuksköterskor.

  • 189.
    Bergman, Josefin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pettersson, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors, sjuksköterskestudenters och vårdpersonals kunskap och förhållningssätt till vårdhygien och meticillinresistenta Staphylococcus aureus (MRSA): En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Vårdrelaterade infektioner och MRSA är ett stort problem i vården. Bristande följsamhet till vårdhygien är en orsak till smittspridning. Den legitimerade sjuksköterskan har ett personligt och arbetsledande ansvar för arbetet med evidensbaserad vård och för att gällande riktlinjer efterföljs. Syfte: Att belysa vilka kunskaper och förhållningssätt sjuksköterskor, sjuksköterskestudenter och vårdpersonal har till vårdhygien och MRSA samt vilka faktorer som påverkar följsamhet till vårdhygien. Metod: Litteraturöversikt. Resultat: Bristande kunskap och förhållningssätt är faktorer som påverkar följsamhet till vårdhygien och MRSA. Aktivt ledarskap och samlade strategier mot smittspridning påverkar följsamhet till vårdhygien positivt. Hög arbetsbelastning kan vara en negativ påverkansfaktor. Kunskapsbrist inom hela vårdorganisationen om vårdhygien och MRSA har identifierats. Bristande kunskap kan leda till låg följsamhet och felaktigt förhållningssätt. Bristfälligt förhållningssätt till evidensbaserade riktlinjer leder till att sjuksköterskor skapar egna hygienrutiner. Åtgärder som förbättrar följsamhet innefattar; goda hygienförebilder, förbättrad kommunikation, arbete för en engagerad personalgrupp samt att vårdpersonal får utbildning i vårdhygien och MRSA. Slutsats: En bristande kunskap om vårdhygien och MRSA har påvisats. Sjuksköterskan har som arbetsledare en viktig roll i att påverka annan vårdpersonal positivt. Ökad kunskap om vårdhygien och MRSA, ett positivt förhållningssätt, ett aktivt ledarskap och samlade strategier förbättrar följsamheten.

  • 190.
    Bergman, Karolina
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Malin
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Äldres upplevelser av att flytta från det egna hemmet och att bo på ett särskilt boende.2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva upplevelsen av att flytta från det egna hemmet och att bo på ett särskilt boende utifrån den äldres perspektiv.

    Metod: Studien genomfördes som en litteraturöversikt. De vetenskapliga artiklarna söktes via databaserna PubMed, Academic Search Elite, Cinahl och Vård i Norden, vilket resulterade i 14 artiklar. De vetenskapliga artiklarnas kvalitet granskades utifrån granskningsmallar och endast artiklar med medelgod eller hög kvalitet har använts i resultatet.

    Resultat: Förändrad boendesituation medförde en stor omställning för den äldre. Betydelsefullt för anpassningsförmågan var den äldres delaktighet i beslutet att flytta och förberedelse inför flytten. Många äldre var nöjda med omvårdnaden. De fysiska behoven som exempelvis förflyttning prioriterades av personalen, medan de sociala och psykiska behoven inte uppmärksammades i lika stor utsträckning. Personalbrist och inarbetade rutiner innebar begränsningar och liten möjlighet för den äldre att påverka det dagliga livet. Att känna trygghet, värdighet och bli bemött på ett respektfullt sätt av personal var viktiga faktorer för upplevelsen.

    Slutsats: Delaktighet i flyttningsbeslutet och förberedelse inför flytten var viktiga faktorer för den äldres anpassning till det nya boendet. Genom att personalen lyssnade på den äldre ökade förutsättningarna för att bemöta den äldres behov och önskningar. Individuellt anpassad omvårdnad där hänsyn tas till hela människan och dennes livsvärld, bidrar till upplevelsen av värdighet, livskvalitet och välbefinnande hos den äldre som bor på ett särskilt boende.

  • 191.
    Bergman, Malin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärder som kan stödja nutritionsintaget för personer med demens – en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    In Sweden, around 160,000 people live with a dementia diagnosis, which is a neurological condition where brain tissue has faded. This will lead to a decrease in physiological and cognitive abilities. Nursing interventions related to a person with dementia focus on relieving symptoms and providing assistance towards the functional decrease. These interventions can be applied to nutritional intake since meal situations can be a complex task for people with dementia. To accommodate the individual, these actions can be performed from a person-centered spectra.

    Aim

    The aim of the literature review was to explore person-centered nursing measures that a nurse can apply for various factors to optimize nutrition intake in people with dementia.

    Method

    An overview compiled of 11 scientific articles.

    Findings

    Five interventions that benefited the nutritional intake for people with dementia were listen to music during the meal, receive personal assistance to aid food intake, verbal prompting as support, how the food was presented, training programs at mealtime.

    Conclusion

    From this overview, interventions have been identified that are beneficial to the person with dementia in connection with nutritional intake. When no interventions are applied to meals, the condition of the person with dementia could be worsened dramatically through, for example, disease and immobility, resulting in deterioration in quality of life.

    The interactions presented could be provided by caregivers and relatives through simple approaches.

  • 192. Bergman, Marita
    et al.
    Sabell, Linn
    Faktorer som påverkar följsamheten till hygienrutiner hos vårdpersonal respektive patienter och dess påverkan på vårdrelaterade infektioner: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva vilka faktorer som påverkar följsamheten till hygienrutiner hos vårdpersonal respektive patienter och dess påverkan på förekomst av vårdrelaterade infektioner. Metod: Examensarbetet utfördes som en systematisk litteraturöversikt med 24 vetenskapliga artiklar som grund till resultatet. Datainsamlingen gjordes i databaserna CINAHL with FULL TEXT och PubMed. Resultat: Huvudresultatet i litteraturöversikten har påvisat minskad frekvens av vårdrelaterade infektioner vid ökad följsamhet till hygienrutiner. Faktorer så som utbildning, påminnelser; visuella som hörbara, feedback; muntlig som skriftlig, motivation, olika typer av observationer och mätningar, ledarskap och ansvar, tillgänglighet av material samt implementering av förändringsstrategier, som implementerats enskilt eller i kombination, har sedan lett till ökad följsamhet till hygienrutiner hos vårdpersonal och patienter. Negativa faktorer för vårdpersonalens följsamhet rubriceras som hög arbetsbelastning, tidsbrist, personalbrist, okunskap, kontextuella normer samt glömska. Patientens empowerment, kunskap, samt följsamhet till handhygien visar att patienter kan stödja och stärka vårdpersonal i att utföra handhygien genom påminnelser. Slutsats: Faktorer som lett till ökad kunskap, ökad medvetenhet eller en kombination av dessa, har ökat följsamheten till hygienrutiner. Genom ökad följsamhet av hygienrutiner hos vårdpersonal och patienter har förekomsten av vårdrelaterade infektioner minskat.

  • 193.
    Bergman, Stefan
    et al.
    FoU Spenshult, Halmstad, Sweden. Primary Health Care Unit, Dep of Public Health and Community Medicine, The Sahlgrenska Academy, Universtiy of Gothenburg, Sweden. Dep of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund.
    Ann, Bremander
    FoU Spenshult, Halmstad, Sweden. Dep of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund. School of Busiess, Engineering and Science, Halmstad University, Halmstad, Sweden..
    Anna-Carin, Bergman
    Sannarpsgymnasiet, Halmstad, Sweden.
    Brorsson, Sofia
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Chronic widespread pain in adolescents is highly associated to stress and anxiety2015In: Meeting abstracts: 2015 ACR/ARHP Annual Meeting, 2015Conference paper (Refereed)
  • 194.
    Bergqvist, Yngve
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Bergquist, Jonas
    In memory of Niklas Lindegardh2012In: Bioanalysis, ISSN 1757-6180, E-ISSN 1757-6199, Vol. 4, no 6, p. 751-751Article in journal (Refereed)
  • 195.
    Bergstrand, Emelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Andersson, Mikaela
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelse av omhändertagande vid fysiskt trauma på en akutmottagning: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Trauma is the leading cause of death for people up to 40 years and

    causes great suffering for the affected person. When the person comes into the

    emergency department, it requires fast treatment and a structured approach from

    all of the trauma group. Every minute is important for the patient's prognosis. The

    encounter between the patient and the nurse is often short and intense.

    Aim: The purpose of this study is to describe patients' experience of care for

    physical trauma in an emergency department.

    Method: Articles have been applied for in the various relevant databases. Articles

    that answered the purpose was gathered and data were marked. This is to get an

    overview of the state of knowledge, which is compiled in the result.

    Results: The result shows that the communication and information were an

    important part of the care. Patients wanted the nurses to be honest and give clear

    information for patients, because it had impact on the experience of care. Feelings

    that arose in the connection with trauma was fear of the unknown, and not to hold

    control over their lives.

    Conclusion: Trauma care is a complex situation. The patient, purely somatic are

    in a life threatening situation but the mind is still present with many thoughts and

    questions. As the situation is life-threatening, the psychosocial needs will never be

    a priority of the traumacare. It will probably always remain, if no changes in the

    trauma team structure occurs.

  • 196. Bergstrom, Cecilia
    et al.
    Persson, Margareta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mogren, Ingrid
    Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy: pain status, self-rated health and family situation2014In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 14, article id 48Article in journal (Refereed)
    Abstract [en]

    Background: Pelvic girdle pain (PGP) in pregnancy is distinct from pregnancy-related low back pain (PLBP). However, women with combined PLBP and PGP report more serious consequences in terms of health and function. PGP has been estimated to affect about half of pregnant women, where 25% experience serious pain and 8% experience severe disability. To date there are relatively few studies regarding persistent PLBP/PGP postpartum of more than 3 months, thus the main objective was to identify the prevalence of persistent PLBP and PGP as well as the differences over time in regard to pain status, self-rated health (SRH) and family situation at 12 months postpartum. Methods: The study is a 12 month follow-up of a cohort of pregnant women developing PLBP and PGP during pregnancy, and who experienced persistent pain at 6 month follow-up after pregnancy. Women reporting PLBP/PGP (n = 639) during pregnancy were followed up with a second questionnaire at approximately six month after delivery. Women reporting recurrent or persistent LBP/PGP at the second questionnaire (n = 200) were sent a third questionnaire at 12 month postpartum. Results: A total of 176 women responded to the questionnaire. Thirty-four women (19.3%) reported remission of LBP/PGP, whereas 65.3% (n = 115) and 15.3% (n = 27), reported recurrent LBP/PGP or continuous LBP/PGP, respectively. The time between base line and the 12 months follow-up was in actuality 14 months. Women with previous LBP before pregnancy had an increased odds ratio (OR) of reporting 'recurrent pain' (OR = 2.47) or 'continuous pain' (OR = 3.35) postpartum compared to women who reported 'no pain' at the follow-up. Women with 'continuous pain' reported statistically significant higher level of pain at all measure points (0, 6 and 12 months postpartum). Non-responders were found to report a statistically significant less positive scoring regarding relationship satisfaction compared to responders. Conclusions: The results from this study demonstrate that persistent PLBP/PGP is a major individual and public health issue among women 14 months postpartum, negatively affecting their self-reported health. However, the perceived relationship satisfaction seems to be stable between the groups.

  • 197. Bergström, Aileen L
    et al.
    Guidetti, Susanne
    Tistad, Malin
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Tham, Kerstin
    von Koch, Lena
    Eriksson, Gunilla
    Perceived occupational gaps one year after stroke: An explorative study2011In: Journal of Rehabilitation Medicine, ISSN 1651-2081, Vol. 44, no 1, p. 36-42Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore and describe factors associated with occupational gaps and to identify factors at 3 months that predict occupational gaps one year post-stroke. A gap, a restriction in participation, is considered to be present when there is a discrepancy between what the individual wants to do and what they actually do in everyday life. DESIGN: Prospective longitudinal study. SUBJECTS: Two hundred persons with stroke. METHODS: Data from the Occupational Gaps Questionnaire, one year post-stroke, was used as the dependent variable in 3- and 12-month regression analyses. Domains of the Stroke Impact Scale, global life satisfaction, demographic and medical factors were used as independent variables. RESULTS: At 3 months, activities of daily living abilities, social participation and not being born in Sweden predicted occupational gaps at 12 months. Stroke severity and not being born in Sweden and 3 factors at 12 months: social participation, self-rated recovery, and global life satisfaction were associated with occupational gaps. CONCLUSION: Activities of daily living ability at 3 months predicted occupational gaps after stroke. Thus, it is possible to identify early on, and provide interventions for, those that risk participation restrictions. Not being born in the country might be an indicator of a risk for participation restrictions.

  • 198. Bergström, Anna
    et al.
    Peterson, Stefan
    Namusoko, Sarah
    Waiswa, Peter
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Knowledge translation in Uganda: a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework2012In: Implementation science, ISSN 1748-5908, Vol. 7, article id 117Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting.

    METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data.

    RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT.

    CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

  • 199. Bergström, Anna
    et al.
    Skeen, Sarah
    Duc, Duong M.
    Blandon, Elmer Zelaya
    Estabrooks, Carole
    Gustavsson, Petter
    Hoa, Dinh Thi Phuong
    Kallestål, Carina
    Malqvist, Mats
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings2015In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 10, article id 120Article in journal (Refereed)
    Abstract [en]

    Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose.

    Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries.

    Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge.

    Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

  • 200. Bergström, Eva-Britt
    et al.
    Wallin, Lars
    Karolinska Institutet.
    Thomson, Gill
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Postpartum depression in mothers of infants cared for in a Neonatal Intensive Care Unit: Incidence and associated factors2012In: Journal of Neonatal Nursing, ISSN 1355-1841, E-ISSN 1878-089X, Vol. 18, no 4, p. 143-51Article in journal (Refereed)
    Abstract [en]

    This longitudinal cohort study investigated the incidence of postpartum depression (PPD) among mothers of infants cared for in two Neonatal Intensive Care Units (NICU) and factors related to PPD onset. 123 mothers were posted the Edinburgh Post-Natal Depression Scale (EPDS) and a questionnaire to record infant and maternal data at 1 month, and a repeat EPDS scale at 4 months post-discharge. PPD incidence was 15% at 1 month, 14% at 4 months, and varied by NICU (23% vs. 8%). Pre-pregnancy and/or antenatal depression was significantly associated with the incidence of PPD. Mothers who experienced PPD at 1 month had an almost eight fold risk of experiencing PPD at 4 months. Women who were not offered counselling during their infant’s stay on the NICU had a 60% increased risk for PPD onset. The findings highlight the need for routine pre-natal screening and targeted support for mothers with infants admitted to NICU.

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