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  • 151.
    Busk, Ulrica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Edvall, Anne
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärder som kan lindra smärta i palliativ vård: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Pain was seen as only a physical problem but in the 1950’s pain began to be seen as a multidimensional problem. For patients in palliative care multidimensional pain is common. The key elements of palliative care should be a focus on: symptom relief, teamwork, continuity and communication as well as support for relatives.

    Aim:

    The aim is to compile research about which nursing measures can relieve pain in palliative care.

    Method:

    The study was conducted as a literature review and was based on 13 articles where quantitative and qualitative methods where reported.

    Result:

    The result is a number of complementary nursing measures that can alleviate pain in patients in palliative care. Knowledge of the pain's dimensions and pain assessment is a prerequisite for achieving optimal pain relief. Teamwork, psychosocial support and good communication between the patient and the careteam are important in palliative care.

    Conclusion:

    Patients should receive basic pharmacological pain relief together with complementary non-pharmacological pain management care measures.

    More research and knowledge about these nursing interventions and how these can be implemented in palliative care are needed. Greater knowledge about both the dimensions of pain and about pain scales is needed so that optimal pain assessment can be achieved.

  • 152.
    Busk, Victoria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sigfrids, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans erfarenheter av vård i livet slut på somatisk vårdavdelning – En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Palliative care and end-of-life care aims to prevent and relief suffering. Today people live longer which shows an increased care of dying patients. It can be expressed as challenging to care for a dying patient since this form of care still can be foreign to many nurses. Aim: The purpose of this literature review was to compile research-based knowledge of things that can affect the nurse's experiences of care in the end of life for the patient in a somatic hospital setting. Method: The study was conducted as a literature review which was based on twelve qualitative and three quantitative studies. The results were based on scientific articles that were found in databases such as PubMed and Cinahl.  Results: The main result that was identified in the study was competence, challenges and resources of care. Nurses had a lack of knowledge when caring for dying patients in a somatic hospital setting. The competence was inadequate and it appeared that there was a need of more education and the basic nursing education needs to be further developed in end of life care. Nurses who received education in end of life care were more safe caring for dying patients. Communication, for example building trust and the nurse’s ability to express themselves, were important factors. Nurses thought it was challenging to earn trust from the patient's relatives. Conclusion: The results have shown that the nurse's knowledge is important and the need for education and training has been clearly prominent. Today there is a lack of nurses and there is a need for more nurses with the right knowledge. Education and practical experience can help the nurses feeling safer in the role of caring for dying patients and communicating with them and their relatives.  

  • 153.
    Butkute Steponavicius, Lina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hur sjuksköterskan kan motivera vuxna patienter med Diabetes Mellitus typ II att ändra sin livsstil genom kost- och motionsvanor: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Typ II diabetes är en sjukdom som kan påverkas av vissa livsstilsfaktorer, till

    exempel rökning, fysisk inaktivitet, fel kost, övervikt, stort alkoholintag och högt blodtryck.

    Behandling för Diabetes Mellitus typ II börjar med förändring av sin livsstil, det vill säga

    icke-farmakologiskt behandling genom att framförallt förändra sina kost- och motionsvanor.

    Att motivera patienter med Diabetes Mellitus typ II till att förändra sin livsstil, är en viktig

    uppgift för sjuksköterskan.

    Syfte: Syftet med denna studie var att beskriva hur sjuksköterskan kan motivera vuxna

    patienter med Diabetes typ II att ändra sin livsstil genom kost- och motionsvanor.

    Metod: Studie genomfördes som litteraturöversikt med sexton vetenskapliga artiklar, där sju

    av artiklarna hade kvalitativ ansats och nio hade en kvantitativ ansats. Datainsamlingen

    skedde via databaserna CINAHL, PubMed och Science Direct med samma sökord.

    Huvudresultat: De olika studierna i resultatet visar att sjuksköterskan spelar en viktig roll

    vad gäller att motivera patienter med Diabetes Mellitus typ II att förändra sin livsstil genom

    kost- och motionsvanor. Avgörande faktorer för att motivera patienter att göra

    livsstilsförändringar var sjuksköterskans bemötande av patienter, att understödja patienter och under denna förändringsprocess skapa en god relation mellan patient och sjuksköterska. Ytterliggare viktiga faktorer var att sjuksköterska hade kunskap inom området och en förmåga att undervisa, ge råd individuellt och i grupp.

  • 154.
    Bygg, Erika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Morelius, Ellinor
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    KOL-patienters nutrition och sjuksköterskans omvårdnadsåtgärder: en litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Malnutrition is common in patients with chronic obstructive pulmonary disease (COPD). Malnutrition in patients with COPD can cause impaired immune system, increased dyspnoea, decreased quality of life, and the COPD risk being increased in severity as well as having a faster disease course. In 2030, COPD is estimated to be the third most common disease in the world. Therefore, it is important as a nurse to have knowledge of which nurse care can be used in malnutrition in COPD patients.

    Aim: The aim of this literature review was to compile COPD patients' perceived problems with nutrition and what nurse care the nurse can take in malnutrition.

    Method: A literature review based on 15 scientific articles.

    Results: There were problems that occur for COPD patients that were caused according to their nutrition. These conditions could be both physical and psychological. The nurse could seek advice from a dietician to be informed of the best solution regarding nutritional needs of the patient. As a nurse it was important to pass on knowledge and give support to the patient whilst also advising on selfcare according to the patient's current condition and preferences.

    Conclusion: The variety of nutritional problems COPD patients face were highly individual and are therefore a complex subject as the effects are both physical and psychological. In general, the nurse should work closely with the patient as there can be nutrition related problems and in doing so, ensures appropriate and safe care.

  • 155.
    Bylund, Frida
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fjällborg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters erfarenheter av att leva med långvarig ryggsmärta. En litteraturöversikt.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : Chronic back pain is one of the most common health problems and one of the most common causes of contact with primary care.

    Chronic back pain causes great socio-economic costs, but also costs in terms of

    human suffering. Chronic back pain cannot always be explained by pathophysiology and clinical findings, which often leads to missing diagnoses,

    impaired conditions for treatment and management strategies. The nurse in her

    health promotion has the task of relieving suffering, to enable this, suffering needs to be met, affirmed and understood as a whole. This literature review aimd to creating a deeper understanding of the whole by capturing individual experiences of living with chronic back pain.

    Aim:

    To compile knowledge about patient’s experiences of living with chronic back pain.

    Method:

    A literature review.

    Results:

    Five main categories emerged from the result; physical influence, psychological influence, social aspects, religious and cultural aspects, as well as experiences regarding the treatment of health care. Physical influences constituted barriers to everyday activities and life was forced to be shaped and adapted to the pain. The adaptation could lead to changed self-image and the opportunities for social interaction were limited. Mental illness was the experience that was found to the greatest extent in the result, and mainly in the form of depression and anxiety. Family, workplace and religious conviction turned out to have a great influence on how the chances of managing the pain were affected. The feeling of not being trusted strengthened the mental illness and contributed to worsening opportunities to deal with the pain.

    Conclusion:

    Suffering should be met, confirmed and understood on the basis of its entirety. The result of this study could contribute to an increased understanding and provide a deeper insight into how affected patients experience their pain, situation and environment. The knowledge could benefit the nurse in the health-promoting work.

  • 156. Byqvist Nilsson, Christina
    et al.
    Gammel, Camilla
    Specialistsjuksköterskors upplevelser av vårdandet av patienter med samsjuklighet2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: The purpose of this study is to describe how specialist nurses in psychiatric nursing experience caring for patients suffering from both mental illness and substance abuse problems.

    Method: Empirical qualitative study using semi-structured interviews were analyzed using qualitative content analysis. Five specialist nurses participated in the study.

    Results: From the analysis of the interviews revealed two categories wanting well and feel powerless. Moreover, it resulted in five categories follow the patient, the will to act, feel powerlessness, to feel resistance and fail in its competence.

    Conclusion: The current findings point at a connecting thought. This means that the specialist nurses express good intentions, want to do well and act for the best possible care for the patient. Also, there is a hope for the patients recovering. Due to insufficient skills, the nurses sometimes feel resistance to treat patients suffering from comorbidity. This creates a sense of powerlessness. The study has shown that supplementary training and further education will increase the

    possibilities for the specialist nurses to provide every patient with appropriate care. Also, it is important to note that the specialist nurses wish to give the patients this care.

  • 157.
    Byrskog, Ulrika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ahrne, Malin
    Small, Rhonda
    Andersson, Ewa
    Essen, Birgitta
    Adan, Aisha
    Ahmed, Fardosa Hassen
    Tesser, Karin
    Åhman-Berndtsson, Anna
    Schytt, Erica
    Rationale, development and feasibility of group antenatal care for immigrant women in Sweden: a study protocol for the Hooyo Project2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 7, article id e030314Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Somali-born women comprise a large group of immigrant women of childbearing age in Sweden, with increased risks for perinatal morbidity and mortality and poor experiences of care, despite the goal of providing equitable healthcare for the entire population. Rethinking how care is provided may help to improve outcomes.

    OVERALL AIM: To develop and test the acceptability, feasibility and immediate impacts of group antenatal care for Somali-born immigrant women, in an effort to improve experiences of antenatal care, knowledge about childbearing and the Swedish healthcare system, emotional well-being and ultimately, pregnancy outcomes. This protocol describes the rationale, planning and development of the study.

    METHODS AND ANALYSIS: An intervention development and feasibility study. Phase I includes needs assessment and development of contextual understanding using focus group discussions. In phase II, the intervention and evaluation tools, based on core values for quality care and person-centred care, are developed. Phase III includes the historically controlled evaluation in which relevant outcome measures are compared for women receiving individual care (2016-2018) and women receiving group antenatal care (2018-2019): care satisfaction (Migrant Friendly Maternity Care Questionnaire), emotional well-being (Edinburgh Postnatal Depression Scale), social support, childbirth fear, knowledge of Swedish maternity care, delivery outcomes. Phase IV includes the process evaluation, investigate process, feasibility and mechanisms of impact using field notes, observations, interviews and questionnaires. All phases are conducted in collaboration with a stakeholder reference group.

    ETHICS AND DISSEMINATION: The study is approved by the Regional Ethical Review Board, Stockholm, Sweden. Participants receive information about the study and their right to decline/withdraw without consequences. Consent is given prior to enrolment. Findings will be disseminated at antenatal care units, national/international conferences, through publications in peer-reviewed journals, seminars involving stakeholders, practitioners, community and via the project website. Participating women will receive a summary of results in their language.

  • 158.
    Bytyqi, Liridona
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Madeleine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Flickors berättelser om vaccination mot humantpapillomvirus under användning med och utan Guided Imagery: En kvalitativ studie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Vaccination is today the most common form of treatment that can be perceivedas painful in health care. Research has shown that a negative experience can occur in childrenif their pain, anxiety, and fear are not alleviated during vaccination.Objective: The aim of the study was to describe, based on stories, schoolgirls’ experiences ofthe vaccination against human papillomavirus (HPV) both with and without the distractionmethod Guided Imagery (GI).Method: This empirical study was conducted with a qualitative narrative design. The datawas collected through written stories. The data was taken from an intervention study andconsisted of 84 stories about HPV vaccination, written by 35 schoolgirls from grade 5 to 6.The data was analyzed based on a qualitative content analysis. The analysis resulted in 4domains and 14 categories.Results: Schoolgirls who received GI during HPV vaccination felt that pain and distractionfrom the injection varied in different degrees. The participants felt that the vaccination feltgood and that it was pleasant to daydream. While others thought the opposite and thatstandardcare was preferred instead.Conclusion: The study shows that pain during vaccination is central to many children. Thedistraction method GI could during vaccination be perceived as calming and it could relievethe pain-experience. However, also standard care could help children during vaccination.How children experienced vaccinations seemed to be very individual.

  • 159. Bäcklin, Jessica
    et al.
    Rapp, Ida
    Sjuksköterskans upplevelse av att vårda patienter med psykisk ohälsa: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Beskriva vad som påverkar sjuksköterskans upplevelse i omvårdnaden av vuxna patienter med psykisk ohälsa inom somatisk vård.

    Metod: En litteraturstudie. Resultat: Tillgängligheten av stöd och samarbete påverkar sjuksköterskans upplevelse av omvårdnad. När stöd erhölls upplevde sjuksköterskan ökad komfort samt en känsla av kompetens. Sjuksköterskan hade otillräckligt med kunskap för att kunna identifiera, bedöma, informera och behandla patienter med psykisk sjukdom. Grundutbildningen ansågs inte vara tillräcklig för att förbereda sjuksköterskan, och många uppgav att de hade fått lite eller ingen utbildning i vård, behandling och bedömning av patienter med psykisk sjukdom. Otillräcklig erfarenhet påverkade sjuksköterskans upplevelse vid vård av patienter med psykisk ohälsa.

    Slutsats: Litteraturstudien belyser vikten av kunskap, utbildning och färdighet för att ge en god vård till en utsatt patientgrupp. Mer utbildning krävs inom psykiatri, redan i grundutbildningen, så att sjuksköterskan känner sig tryggare i sin roll. Sjuksköterskan inom somatisk vård bör även regelbundet erbjudas utbildning inom ämnet. Något som efterfrågades var mer stöd från ledning och kompetent personal inom området psykiatri, och detta ansåg sjuksköterskorna skulle leda till en bättre och säkrare vård.

  • 160.
    Böhlmark, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Herde, Karolina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors erfarenheter av sjukvårdens bemötande vid endometrios: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Endometriosis is a common disease which affects every tenth woman in childbearing age. The disease has probably always existed, but is still unknown for people overall and the healthcare. Endometriosis gives symptoms of severe pain in the pelvic area, which occurs cyclically during menstruation or can also be constant.

    Aim

    To describe the experiences of health care encounter in women with endometriosis.

    Method

    A literature review based on eleven collected articles from the PubMed and Cinahl databases.

    Result

    The result was divided into five categories; to be mistaken, to be confirmed and seen, knowledge and information, delayed diagnosis and physical and mental exposure. The results showed that women's experiences of health care encounter were both positive and negative. Women's experiences were lashed by mistrust, neglect and not taken seriously. They experienced a vulnerable situation when they had to talk about private symptoms of menstruation and undergoing gynecological surveys. It was found that the women experienced a high level of knowledge from the healthcare sector and that it was a contributing factor to why they did not receive the help and support they needed. The women also felt that the lack of knowledge of the healthcare staff and the neglect of their symptoms contributed to delayed diagnosis. Positive response from healthcare professionals was characterized by being listened to, taken seriously and shown respect, these experiences of the encounter increased women's self-esteem.

    Conclusion

    A lack of knowledge from the healthcare sector is closely linked with experiences of poor encounter for women with endometriosis. It was also found that the causes of delayed diagnosis had different causes, such as ignorance and normalization of disease symptoms. The nurse has an important role in identifying women with endometriosis and giving them support so they feel seen and confirmed.

  • 161.
    Börjes-Andersson, Erica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fjärdsmans, Ida
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientens upplevelse av delaktighet i omvårdnad: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: According to Swedish law, patients have a legal right to be involved

    in their care. This also means that the nurse has a obligation towards the patient to

    make her/him involved. Despite this right, patients feels that they are not given the

    opportunity to be involved in their care.

    Aim: The aim of this study is to describe patient participation and nurses

    opportunity to promote and prevent the patient’s experience of participation.

    Method: The study is a literature review whose results are based on ten scientific

    articles published between the years 2005-2016.

    Results: The patient believes it is important that the nurse give the opportunity

    towards the patient to express themselves and be informed about the care situation.

    Through this the patient was given the opportunity to be involved. Patients want to

    be seen and heard, and seen as an equal partner in care. This requires an

    established relationship between nurse and patient.

    Conclusion: Studies show that patients find that there are obstacles to maintain

    patient participation and that the nurse’s approach is relevant to the patient’s

    experience of participation.

  • 162.
    C Brodén, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    L Sandgren, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientens upplevelse och värdering av vårdkvalitet - En jämförelse före och efter kommunalisering av hemsjukvården: En enkätstudie med kvantitativ ansats2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Undersöka hur hemsjukvårdspatienter och patienter med regelbundna hembesök

    upplever och värderar vårdkvalitet i kommunal hemsjukvård, identifiera förbättringsområden

    ur patientens perspektiv samt jämföra resultatet med motsvarande studie gällande

    landstingsansluten hemsjukvård från 2012.

    Metod: Studien var en deskriptiv och jämförande tvärsnittsstudie med kvantitativ ansats,

    datainsamling skedde i form av en enkät. Studien var en replikering av magisteruppsatsen

    ”Hemsjukvårdens kvalitet ur patientperspektiv”.

    Resultat: Patienternas upplevelse av kvalitet i hemsjukvården varierar, många delar upplevs

    ha mycket god kvalitet, andra delar upplevs som mindre bra. Resultatet stämde väl överens

    med resultatet från den replikerade studien.

    De påståenden som patienterna instämde med i hög grad gällde bemötande av patient och

    anhöriga, väntetid för hembesök, möjligheten att få telefonkontakt eller att få hembesök samt

    tillgång till hjälpmedel. De områden där patienterna upplevde brister handlade till stor del om

    patientinformation, symtomkontroll, patientens möjlighet till delaktighet och möjlighet att

    styra den egna vården snarare än att vården styrs av personalens rutiner.

    Slutsats: Förändringen av huvudmannaskapet hade inte förändrat patienternas värdering av

    kvalitet i hemsjukvården. Genom en tydligare personcentrering kan patientens upplevelse av

    vårdkvaliteten sannolikt öka för de områden där patienterna uppgav brister. Detta ställer krav

    på att alla inblandade: patient, vårdpersonal, chefer och politiker, arbetar för samma mål.

  • 163.
    Cahenzli, Jessica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hjort, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors upplevelser av och attityder till att vårda patienter med psykisk ohälsa inom somatisk vård- en litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Mental illness is increasing all over the world. Patients with mental illness also need treatment for physical affections. Because of this comorbidity and the increasing mental illnesses amongst the population, the number of patients with mental illness within somatic care increase. Previous research shows that patients with mental illness are avoided within somatic care and experience feelings of impotence. Patients with mental illness experience stigmatizing attitudes that had a negative impact on the important caregiving relation.

    Aim:

    The aim was to illustrate nurses’ experience of and attitudes caring for patients with mental illness within somatic care.

    Method:

    An outline containing fifteen scientific articles. The articles were searched for in the databases Cinahl, Pubmed and PsycInfo. The chosen articles for the literature review are ethically approved or that the authors of the studies made ethical consideration. The articles for this literature review achieve means with high standard after quality review. The result of the articles was analysed by the authors and sorted into categories based on similarities and differences.

    Results:

    Four main categories were found: emotions that nurses’ experience, nurses’ experiences of lack of knowledge that effects the care of patients with mental illness, nurses’ negative attitudes in care towards patients with mental illness, nurses’ and nurses’ experience of deficiency in the working environment.

    Conclusion:

    Nurses experienced different difficulties and negative attitudes caring for patients with mental illness within the somatic care and that might be a lack of knowledge. With more competence about patient with mental illness the nurses may experience more security and confidence in the care. Nurses’ emotions were insecurity, fear and frustration meeting with patients and that lead to negative attitudes. Expanded knowledge may give nurses confidence in care for this patients and that may lead to more positive attitudes to patients with mental illness.

  • 164.
    Camsund, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Corrigox, Sara
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelser av att leva med hjärtsvikt: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Heart failure can be a trying and distressing condition, common

    among the elderly population. Apart from the medical measures, treatment

    involves a lot of self-care. Healthcare professionals need to provide education and

    support, since this involves the patient taking a great deal of personal

    responsibility. With this in mind, healthcare needs to be person-centered.

    Aim: To describe, from a patients’ perspective, the experience of living with heart

    failure and how it affects quality of life.

    Method: A literary review, with studies collected from databases CINAHL,

    PubMed, PsycINFO and Web of Science.

    Results: The findings show that people with heart failure experienced many

    different issues, physical, social and mental, which had an impact on their daily

    life. Despite this, it was possible to come to terms with the situation and

    experience quality of life. The will to learn more about the condition was common

    although many were not aware of their diagnosis.

    Conclusion: Living with heart failure can be trying and mean forced alterations to

    physical, mental and social aspects of life. However, it is possible to live a

    satisfying life and experience good quality of life. Having access to healthcare is

    both an asset as well as a source of frustration. Nurses need to be aware of these

    experiences in order to be able to provide patient-centered care and support the

    patient’s resources and self-care abilities.

  • 165.
    Carlson, Åsa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Söderström, Monica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Vuxna personers upplevelser av att leva med diabetes typ 2: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Diabetes mellitus will be the seventh leading cause of death in 2030 and 422 million adults in the world are currently living with diabetes. Type 2 diabetes account for the vast majority of people affected with the disease. Diabetes can result in a variety of serious complications. Making lifestyle changes is a central part of the treatment and the patient’s ability to self-manage the disease is therefore emphasised. Nurses are responsible for providing high quality nursing care, and this includes collecting information about the patient and strengthening the patient’s ability for self-care.

    Aim:

    To describe adult persons’ experiences of living with diabetes type 2.

    Method:

    A literature review of 16 qualitative articles, which were critically reviewed, analyzed and compiled.

    Result:

    The persons’ experiences are presented in three main categories with associated subcategories. The emotional aspects of living with diabetes were prominent and many had difficulties adapting to a new lifestyle. Relationships were affected and social support was seen as important.

    Conclusion:

    Living with diabetes can cause emotional reactions and making lifestyle changes is a struggle for many. The social support from family and friends is important and receiving feedback, information and support from doctors and nurses regarding self-care is also of great importance.

  • 166.
    Carlsson, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Andersson, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som bidrar till ett stabilare mående hos patienter med emotionellt instabil personlighetsstörning i heldygnsvård: en kvalitativ intervjustudie ur ett patientperspektiv2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients with emotional unstable personality disorder is experienced as a

    difficult to treat patient population in inpatient care. Nursing staff knowledge surrounding the

    introduction and the treatment of this patient population is diverse, which means that the care

    is different. This can result in increased suffering of the patient and frustration in the staff

    group.

    Aim: The aim of the study was to describe factors that contribute to a more stable mood in

    patients with emotionally unstable personality disorder.

    Method: The method that has been used is a qualitative design with inductive approach. The

    study was based on six interviews with informants that who were patients diagnosed with

    emotionally unstable personality disorder. The interviews were analyzed using content

    analysis.

    Result: The results showed that the hospitality and commitment of the staff was of great

    importance. Structure and participation were other important factors for achieving a stable

    mood. It was revealed that inpatient care could contribute to an interruption of everyday life

    and meaningful activities were another important factor that emerged.

    Conclusion: Patients experienced to be treated as an individual by committed staff and to be

    involved in their care was part of the process towards a stable mood. Inpatient care structure

    and change of environment support for recovery and an opportunity to regain routines. There

    was a desire for more meaningful activities such as physical activity and psycho education to

    best take advantage of the period of care

  • 167. Carlsson, Eva
    et al.
    Ehnfors, Margareta
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet, Örebro university.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Accuracy and continuity in discharge information for patients wtih eating difficulties after stroke2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 2, p. 21-31Article in journal (Refereed)
    Abstract [en]

    Aims. To describe the accuracy and continuity of discharge information for patients with eating difficulties after stroke. Design. Prospective, descriptive. 

    Methods. The study investigated a sample of 15 triads, each including one patient with stroke along with his patient record and discharge summary and two nursing staff in the municipal care to whom the patient was discharged. Data were collected by observations of patients' eating, record audits and interviews with nurses. Data were analysed using content analysis and descriptive statistics. 

    Results. Accuracy of recorded information on patients' eating difficulties and informational continuity were poor, as was accuracy in the transferred information according to nursing staff's perceptions. All patients were at risk of undernutrition and in too poor a state to receive rehabilitation. Nevertheless, patients' eating difficulties were described in a vague and unspecific language in the patient records. Co-ordinated care planning and management continuity related to eating difficulties were largely lacking in the documentation. Despite their important role in caring for patients with eating difficulties, little information on eating difficulties seemed to reach licensed practical nurses in the municipalities. 

    Conclusions. Comprehensiveness in the documentation of eating difficulties and accuracy of transferred information were poor based on record audits and as perceived by the municipal nursing staff. Although all patients were at risk of undernutrition, had multiple eating difficulties and were in too poor a state for rehabilitation, explicit care plans for nutritional problems were lacking. Relevance to clinical practice. Lack of accuracy and continuity in discharge information on eating difficulties may increase risk of undernutrition and related complications for patients in continuous stroke care. Therefore, the discharge process must be based on comprehensive and accurate documentation.

  • 168.
    Carlsson, Ida
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Harnisch, Madelene
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fallförebyggande teamarbete för den äldre personen inom kommunal vård: En kvalitativ intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Older people over the age of 65 are over-represented in fall accidents in Sweden. As a nurse in municipal care, great demands are placed on a functioning fall prevention teamwork, in order to reduce suffering for the patient and for the costs of the health and medical care.  Aim: The aim of this study was to describe how nurses experiences the fall prevention teamwork for the older person in ordinary living in municipal care. Method: Empirical qualitative study with inductive approach. Focus group interviews with nine nurses who worked with the care of the elderly in municipal care in a municipality in central Sweden. Data was analyzed with qualitative content analysis.  Results: A fall prevention teamwork requires leadership with clear roles.  The organization and lack of clear leadership, communication and working under two different laws, SOL and HSL turned out to be an obstacle to fall prevention teamwork. Decisions on working methods, a project for this and someone who would lead this project were needed. Improvements in the structure experienced nurse were needed. Patient's self-determination and autonomy is an obstacle in case-prevention teamwork.  Conclusion: The organization needs to give the nurses the opportunity to develop teamwork with clear roles in fall prevention teamwork. Improved communication and information transfer is needed. Overview of how basic staff and nurses plan their working hours is needed.

  • 169.
    Carstensen, Gunilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sociology.
    Rosberg, Birgitta
    Uppsala University Hospital.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Åberg, Anna Cristina
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala University.
    Before evening falls: Perspectives of a good old age and healthy ageing among oldest-old Swedish men2019In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 82, p. 35-44Article in journal (Refereed)
    Abstract [en]

    The late life experiences of men in the oldest-old age group have been under-researched, and their perspectives on ageing successfully neglected. This study explored the perspectives of oldest-old Swedish men on what a ‘good old age’ and ageing successfully meant to them. A purposive sample of 17 men, aged 85-90 years, was drawn from the Uppsala Longitudinal Study of Adult Men. An interview guide explored participants’ perspectives on their ageing experiences and how they viewed ageing successfully. Participants were interviewed twice, with 1–2 weeks between interviews, and both interviews were recorded and transcribed. Content analysis identified four themes: i) Adaptation, concerning the ability to adapt to growing old with increasing limitations; ii) Sustaining Independence, related to financial resources and good health as the foundation for independence; iii) Belongingness, representing close relationships, established friendships, and the significance of the spouse; and iv) Perspectives of Time, also a common thread in all themes, in which past life experiences create an existential link between the past, the present and the future, establishing continuity of the self and enhancing life satisfaction. The participants presented themselves as active agents involved in maintaining meaning and achieving life satisfaction; a process related to the ability to manage changes in life. Our findings have resonance with models of healthy or successful ageing, but also diverge in important ways, since such models do not consider the significance of an individual’s life history for their present well-being, and primarily conceptualise health as an outcome, rather than as a resource.

  • 170.
    Cato, Cristin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ödman, Stefan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors erfarenhet av förebyggandeomvårdnadsåtgärder mot trycksår och undernäring: - En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    There is an established correlation between malnutrition and

    development of pressure ulcers. The incidence of malnutrition among patients has

    increased in recent years despite that risk assessment instruments exist in the

    organisations. Pressure ulcers remain one of the most common adverse event with a

    negative impact on the patients

    ’ quality of life and lack of patient-safety.

    Aim:

    The aim of this study was to describe nurses’ work on preventive measures

    against pressure ulcers and malnutrition.

    Method:

    The study was conducted as a literature review including 19 articles,

    published between 2008-2018, with quantitative, qualitative and mixed-methods

    approaches. Searches were made in the PubMed and CINAHL databases. The

    articles were quality-reviewed, analyzed and compiled into a result.

    Results:

    : Nurses appear to have positive attitudes to preventive measures towards

    pressure ulcers and malnutrition while the level of knowledge was generally low.

    Nurses valued their own clinical judgement high and felt that lack of time, high

    workload and severely ill patients constituted obstacles to adequate application of

    preventive measures. Organisational shortcomings emerged for the adequate use

    and implementation of risk assessment instruments. Lack of guidelines and work

    routines for preventive work could result in a deficient patient safety.

    Conclusion:

    The results show that the majority of nurses value nutrition in the

    preventive work but the level of knowledge and the application of measures were

    generally low. Introduction of guidelines could lead to increased knowledge and

    implementation of pressure ulcers and nutritional treatment in clinical work.

  • 171.
    Cerny, Jonna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Karlsson, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Personer med HIV och/eller AIDS upplevelser av hälso- och sjukvårdens bemötande: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    HIV is a retrovirus and, like many other retroviruses, HIV has its own enzyme. HIV develops to AIDS unless antiretroviral medicinal products are used. At present, it is estimated that 36.7 million of the population in the world is living with the disease and the predominant way to get infected is through unprotected sexual intercourse. Persons who are told they are HIV positive often react/experience a personal crisis. It is essential to meet the infected person with understanding and empathy, as well as receiving additional support from the healthcare professional. It is common that the care for HIV-infected people to suffer because of fear healthcare professionals have to get infected.

    Aim:

    Describe how people with HIV and AIDS experience the care from healthcare professionals.

    Method:

    The study has been carried out as a literature review and the result has been based on 15 scientific articles. The searches have been performed in Cinahl and PubMed. Two of the articles were found through secondary search.

    Result:

    This literature review describes how people with HIV and AIDS experience the care from healthcare professionals. The result is presented in six main categories: The need for support in connection with diagnosis, prejudice, discrimination and stigmatization, treatment, confidentiality, trust for caregiver and participation.

    Conclusion:

    The healthcare professionals' response to people living with HIV and / or AIDS is inadequate. They often suffer prejudice, stigmatization and discrimination, which contributes to unnecessary care for these people. More knowledge and education is necessary for healthcare professionals to improve their treatment and provide safe and equal care.

  • 172.
    Chakma, Krishna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Chakma, Sumana
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Social barriers for midwives to provide quality midwifery care in Bangladesh: A focus group discussion study with Midwifery Students2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Midwifery is central in addressing maternal and newborn health. Social barriers may prevent midwives from providing midwifery care with quality, which in the end can lead to, besides poor maternal and newborn health, burnout and midwives leaving the profession. Midwifery students are placed in the intersection between theory and practice, and their perspectives are vital when identifying these barriers in Bangladesh where the midwifery profession is newly established.

    Aim:

    To describe midwifery students’ perceptions on midwives realities in Bangladesh from social perspectives.

    Methods:

    A qualitative design in which deductive focus group discussions are held with 67 participants and analyzed with qualitative content analysis.

    Results:

    Several social factors that affected quality midwifery care were identified; gender inequality, physical and emotional violence, lack of safety and security, the role of tradition and the importance of education. Gender inequality was a major barrier that affected Bangladeshi midwives possibilities to provide quality midwifery care both directly and indirectly.

    Conclusion:

    In this male dominated society, women are disadvantaged in relation to men and feel insecure due to violence, particularly in rural areas, which affect the provision of quality midwifery care. To improve this, it is necessary to pay attention to all barriers, specially gender inequality and traditional and religious beliefs and practice.

    Clinical application:

    This result can be useful to design effective strategies to improve quality midwifery care which can reduce maternal mortality in the future. The study suggests that further studies should evaluate the effects of education of women to reduce barriers and improve quality midwifery care.

  • 173.
    Chiragli, Nigar
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Larsson, Lina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors rätt att bestämma över sin egen kropp: En intervjustudie om hur yrkesverksamma barnmorskor i Sverige främjar kvinnors rätt2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The Swedish midwife work with health promotion according to international standards. They promote the women’s right to decide about her own body. How midwives work to promote women’s right to decide about her own body in Sweden today is, to our knowledge, hardly described from midwives own perspective.

    The aim of this study was to describe how midwives in Sweden perceive that they in their profession promote women's right to decide about her own body.

    Method: Semi-structured interviews were conducted with eight midwives active in different areas of the midwife profession. The material was analyzed inspired by Martons phenomenographic approach where midwives' different perceptions of how they in their profession promote women's right to decide about her own body was the centre for the analysis.

    Result: The midwives' perceptions of how they in their profession promoted the right of women to decide about her own body were described in two categories with 4 collective conceptions. Midwives strengthen women in decisions and midwives support women in gaining access to their rights. Four collective perceptions are described: 1) individualizes care, 2) raise awareness among women of their rights, 3) empower women and 4) challenge heteronormativity.

    Conclusion: Swedish midwives perceived that they in their profession promoted the right of women to decide over her own body. This was the core value of the profession. Clinical applicability: The result may be used in the clinical practice to illuminate and highlight the Swedish midwife's role in the promotion of women's right to decide over her own body. The content of the Swedish Midwives’ profession can be given further attention nationally and globally, considering that the Swedish midwives have a unique competence area globally when it comes to promotion of women's right to decide over her own body.

  • 174.
    Christine Amoran, Folake
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mekonnen, Aklilu
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    God munhälsa och munvård hos äldre personer på särskilt boende; kunskap, attityd och utbildning bland vårdpersonal: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The normal aging process deteriorates the body`s function, which means that more elderly people need help and support with their daily care such as oral care. Studies have shown that oral care for elderly people in nursing homes is often inadequate, and always result to oral health problems. Because of this, knowledge and attitudes regarding oral health need to be compiled.

    Aim:

    The aim of this literature review is to compile nursing staffs` knowledge and attitude towards oral health in nursing homes and what measures have been taken regarding improvement of oral care.

    Materials and methods:

    This study was carried out as a literature review. The result is based on a total of 15 scientific articles, n=8 quantitative and n=7 qualitative. These articles were collected from databases CINAHL and PubMed.

    Results:

    The results in this study revealed lack of knowledge in oral care among nursing staff in nursing homes and factors affecting nursing staffs' attitudes towards performing good oral care. Educational programs and oral assessment showed significant improvements in the care residents oral status and increased nursing staff's knowledge in oral care.

    Conclusion:

    Nursing staffs’ knowledge and attitude to oral care were the main contributing factors to the fact that the oral care was not performed efficiently. On the other hand, oral care education has shown positive improvements in care residents.

  • 175.
    Craftman, Åsa
    et al.
    Sophiahemmet Högskola.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    von Strauss, Eva
    Hillerås, Pernilla
    Sophiahemmet Högskola.
    Westerbotn, Margareta
    Sophiahemmet Högskola.
    Unlicensed personnel administering medications to older persons living at home: a challenge for social and care services2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 201-210Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.

    AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.

    METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.

    RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.

    CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients.

    IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

  • 176.
    Craftman, Åsa
    et al.
    Sophiahemmet Högskola.
    Westerbotn, Margareta
    Sophiahemmet Högskola.
    von Strauss, Eva
    Hillerås, Pernilla
    Sophiahemmet Högskola.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    Older people's experience of utilisation and administration of medicines in a health- and social care context2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 760-768Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.

    AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.

    DESIGN: A qualitative descriptive study.

    METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.

    FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.

    CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.

    RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.

  • 177.
    Crona, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Bengtsson, Johanna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskor och undersköterskors behov av stöd vid möten med föräldrar som föder barn som inte lever: En kvalitativ intervjustudie med fokusgrupper2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    According to research health professionals are feeling grief, guilt and stress when they meet parents giving birth to stillborn babies. They are in need of support but research about what kind of support is limited.

    Aim:

    To identify midwives’ and assistant nurses’ need of support and what kind of support they need meeting parents giving birth to stillborn babies.

    Method:

    Eight midwives and five assistant nurses were interviewed and distributed in three focus groups. They were asked semi-structured questions based on a questionnaire. The analysis method was qualitative content analysis.

    Results:

    One theme and five categories were identified. The theme was: The will to do good. The categories were: Collegial support, Education, Support from the hospital management, Tutorial and Reflection and To be inexperienced.

    Conclusion:

    The need of support varied but all participants considered they were there for each other as a support and a need of continuity and education in their meetings with parents. They also wished for tutorials with regular occasions where they could meet with different professions in a group. Those participants with longer experience from childbirth care felt more secure in their meetings with parents giving birth to stillborn babies, compared with those with shorter experience.

    Clinical application:

    The study could lead to support being implemented in maternity units, which in the end could lead to better treatment for the affected parents.

  • 178. Cummings, Greta G
    et al.
    Estabrooks, Carole A
    Midodzi, William K
    Wallin, Lars
    Karolinska Institutet.
    Hayduk, Leslie
    Influence of organizational characteristics and context on research utilization2007In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 56, no 4 Suppl, p. 24-39Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite three decades of empirical investigation into research utilization and a renewed emphasis on evidence-based medicine and evidence-based practice in the past decade, understanding of factors influencing research uptake in nursing remains limited. There is, however, increased awareness that organizational influences are important.

    OBJECTIVES: To develop and test a theoretical model of organizational influences that predict research utilization by nurses and to assess the influence of varying degrees of context, based on the Promoting Action on Research Implementation in Health Services (PARIHS) framework, on research utilization and other variables.

    METHODS: The study sample was drawn from a census of registered nurses working in acute care hospitals in Alberta, Canada, accessed through their professional licensing body (n = 6,526 nurses; 52.8% response rate). Three variables that measured PARIHS dimensions of context (culture, leadership, and evaluation) were used to sort cases into one of four mutually exclusive data sets that reflected less positive to more positive context. Then, a theoretical model of hospital- and unit-level influences on research utilization was developed and tested, using structural equation modeling, and 300 cases were randomly selected from each of the four data sets.

    RESULTS: Model test results were as follows--low context: chi2= 124.5, df = 80, p <. 001; partially low: chi2= 144.2, p <. 001, df = 80; partially high: chi2= 157.3, df = 80, p <. 001; and partially low: chi2= 146.0, df = 80, p <. 001. Hospital characteristics that positively influenced research utilization by nurses were staff development, opportunity for nurse-to-nurse collaboration, and staffing and support services. Increased emotional exhaustion led to less reported research utilization and higher rates of patient and nurse adverse events. Nurses working in contexts with more positive culture, leadership, and evaluation also reported significantly more research utilization, staff development, and lower rates of patient and staff adverse events than did nurses working in less positive contexts (i.e., those that lacked positive culture, leadership, or evaluation).

    CONCLUSION: The findings highlight the combined importance of culture, leadership, and evaluation to increase research utilization and improve patient safety. The findings may serve to strengthen the PARIHS framework and to suggest that, although it is not fully developed, the framework is an appropriate guide to implement research into practice.

  • 179.
    Custerson, Ann-Louise
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jansson, Monika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Effekter av massage/beröring hos dementa respektive icke dementa äldre personer: Systematisk litteraturstudie med empiriskt tillägg2009Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Föreliggande systematiska litteraturstudie syftade till att kartlägga vad som fanns beskrivet i litteraturen om effekter av massage/beröring hos dementa respektive icke dementa äldre personer. Syftet var även att kartlägga personalens inställning till massage/beröring och denna omvårdnads- åtgärds effekter empiriskt. Artiklarna har sökts i Högskolan Dalarnas fulltextdatabas ELIN för vidare granskning. Artiklarna som valdes var från åren 1999-2009. Sökorden som användes var massage, older, elder, old*, geriatric, demen*, touch, effects, tactil. Av resultatet framkom att i större delen av studierna har massage/beröring en positiv effekt på välmående hos äldre dementa och icke dementa människor. Särskilt kunde noteras att massage kunde vara en metod att minska agiterat beteende och vandrande hos dementa personer. Personalens inställning till massage/beröring sågs som positiv i den bemärkelsen att massage/beröring gynnade patientens välmående och att personalen kunde interagera med patienten på ett mer positivt sätt. I det empiriska tillägget var huvudfyndet att massage/ beröring hade bättre effekt för sömnen för dementa än för icke dementa. Uttryckt i Martinsens omvårdnadsteoretiska termer måste omvårdnaden ha som utgångspunkt den andres bästa. För att komma fram till vad som är bäst för den andre måste man vara öppen och närvarande hos honom samt sträva efter att tolka hans situation och behov. Föreliggande studies resultat bidrar till kunskap om massage/beröring som metod för äldre med särskild betoning på demens.

  • 180. Dahl, Kari Elisabeth
    et al.
    Wang, Nina J.
    Skau, Irene
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life and associated factors in Norwegian adults2011In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, no 4, p. 208-214Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate associations between oral health-related quality of life assessed with the Oral Health Impact Profile (OHIP)-14 and demographic factors, number of teeth present, dental visits, dental health behaviour and self-rated oral health in a representative sample of 20-80-year-old Norwegians.

    Material and methods. The study was conducted in a stratified random sample of 3538 individuals. Questionnaires including questions on demographic factors, number of remaining teeth, dental visits, dental health behaviour, self-rated oral health and OHIP-14 were mailed to the sample. Bivariate and multivariate analyses were performed.

    Results. The response rate was 69%. The mean OHIP-14 score was 4.1 (standard deviation = 6.2). No problem was reported by 35% of the respondents. The most frequently reported problems were: physical pain (56%), psychological discomfort (39%) and psychological disability (30%). When the effect of all independent variables was analysed in multivariate analysis, self-rated oral health, frequency of dental visits, number of teeth, age and sex were significantly (P < 0.05) associated with the prevalence of having problems and frequent problems. Self-rated oral health had the strongest association with having problems [ odds ratio (OR) 4.5; 95% confidence interval (CI) 3.4-6.0] and with having frequent problems (OR 4.0; 95% CI 2.7-5.8). Dental health behaviour, use of floss and toothpicks and oral rinsing were not associated with having problems related to oral quality of life in multivariate analyses.

    Conclusion. In this Norwegian adult sample, self-rated oral health, frequency of dental visits, number of teeth, age and sex were associated with having problems as estimated using the OHIP-14.

  • 181. Dahl, KE
    et al.
    Wang, N
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Does oral health matter in people’s daily life?: Oral health-related quality of life in adults 35–47 years of age in Norway2012In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 10, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to assess the effect of oral health on aspects of daily life measured by the Dental Impact Profile (DIP) in 35- to 47-year-old individuals in Norway, and to study associations between reported effects and demographic variables, subjectively assessed oral health, general health, oral health behaviour and clinical oral health.

    Material and methods: A stratified randomized sample of 249 individuals received a questionnaire regarding demographic questions, dental visits, oral hygiene behaviour, self-rated oral health and general health and satisfaction with oral health. The DIP measured the effects of oral health on daily life. Teeth present and caries experience were registered by clinical examination. Bi- and multivariate analyses and factor analysis were used.

    Results: Items most frequently reported to be positively or negatively influenced by oral health were chewing and biting, eating, smiling and laughing, feeling comfortable and appearance. Only 1% reported no effects of oral health. Individuals with fewer than two decayed teeth, individuals who rated their oral health as good or practised good oral health habits reported more positive effects than others on oral quality of life (P = 0.05). When the variables were included in multivariate analysis, none was statistically significant. The subscales of the DIP were somewhat different from the originally suggested subscales.

    Conclusions: This study showed that most adults reported oral health to be important for masticatory functions and confirmed that oral health also had impacts on other aspects of life.

  • 182.
    Dahlberg, Råger
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Spets, Ewa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erfarenheter och upplevelser av hypoglykemi hos vuxna med diabetes mellitus: En kvalitativ intervjustudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Approximately one third of people with diabetes suffer episodes of hypoglycaemia with a loss of consciousness as a result. The incidence of hypoglycaemia is unpleasant and patients attempt to avoid this event, which often results in higher plasmaglucose values. Dedicated nursing care involves helping people to cope with unpleasant experiences of hypoglycaemia in daily life.

    Aim: To describe adults' experiences of hypoglycaemia in diabetes mellitus, and the consequences hypoglycaemia leads to daily life.

    Method: This study was conducted with a qualitative content analysis with an inductive approach. The study was conducted as a secondary analysis of semi-structured interwievs. The number of study participants were a total of 29 of which 15 with Type 1 diabetes and 14 with Type 2 diabetes.

    Results: The theme that emerged was: Hypoglycaemia is an ever present risk and is shaped differently with the following categories. Symptoms of hypoglycaemia could come as a bolt from the blue. Knowledge comes from life experiences. Training and exercise today - often have consequences tomorrow for patients. Self management could be perceived as a feeling of not being free. Family support – could mean security in illness.

    Conclusion: The incidence of hypoglycaemia is a common event and is perceived as unpleasant and unsafe event and causing fear in people suffering from diabetes. Undertreatment was seen as a consequence. Better support, help and information from the specialist nurses were needed. Knowledge and information, even to family members, was considered important to reduce the fear and discomfort of hypoglycaemia.

  • 183.
    Dahlqvist Jönsson, Patrik
    et al.
    Region Halland.
    Sandlund, Mikael
    Umeå Universitet.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svedberg, Petra
    Högskolan i Halmstad, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    The meaning of Shared decision making for persons with long-term mental illness2013Conference paper (Refereed)
  • 184. Dahlström, Ann-Charlotte
    et al.
    Mulder, Linn
    Sjuksköterskors erfarenheter av hot och våld på akutmottagningar: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva sjuksköterskor erfarenheter av hot och våld på akutmottagningar, sett ur ett internationellt perspektiv.

    Metod: Studien har genomförts som en litteraturstudie. Databassökningar har utförts på databaserna PubMed och CINAHL, originalpublicerade kvantitativa och kvalitativa forskningsstudier har kvalitetsgranskats och sammanställts.

    Resultat: Studien visade att sjuksköterskor hade erfarenhet av verbalt och fysiskt hot och våld i stor utsträckning. De verbala hoten och våldet bestod av svordomar och kränkningar. Det fysiska våldet visade sig genom att sjuksköterskorna blev spottade på, får knuffar, slag och sparkar. De som utövade hot och våld kunde vara patienten själv, närstående eller andra anhöriga.

    Slutsats: Sjuksköterskor på akutmottagningar världen över drabbas av olika typer av hot och våld. Detta påverkar både övriga patienter och övrig personal negativt. Ur arbetsmiljösynpunkt inkräktar hot och våld på patientsäkerheten. Bristande kommunikation som även kan feltolkas kan leda till hot och våld från patienter. Genom att genomföra förbättringsåtgärder och skapa strategier för bättre kommunikation kan hot och våld förebyggas.

  • 185.
    Dahné, Ylva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Thorin, Emma
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskan och patienter med strokeinduceradafasi – En litteraturöversikt om kommunikation ochpersoncentrering2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Stroke is a collective term for cerebral infarction and cerebral

    hemorrhage. Stroke often causes lifelong detrimental effects, such as aphasia.

    Aphasia means a reduced ability to understand spoken/written language and/or a

    reduced ability to express oneself adequately. To enable a good and person-centred

    care for the patients, an effective communication is a prerequisite.

    Aim: The aim of

    this study is to describe the factors that influence the person-centred care and

    communication between the nurse and patients affected by stroke induced aphasia.

    Method:

    The study is a literature review on bachelor level. The study is based on 15

    scientific articles that have been red and analyzed and where common themes have

    been identified.

    Result: The results revealed a number of strategies that promoted

    and hindered good communication between the nurse and people affected by stroke

    induced aphasia. These strategies concern seven areas:

    Verbal communication, Nonverbal

    communication, Seeing the patient as a competent and unique individual,

    Attention and involvement, The time aspect of communication with patients with

    aphasia, The importance of the surrounding environment for communication

    and The

    personnel's education and skills

    . Conclusion: There is no standard answer to how

    communication shall be achieved, each individual is unique and every situation

    requires a different solution. However, there are a number of aspects and methods

    that are important and useful when communicating with aphasic people. These are

    used to different degrees in health care.

  • 186.
    Dammgård, Emelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pernhall, Lina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskors erfarenheter av att främja hälsosamma levnadsvanor hos patienter med diabetes typ 2: En empirisk studie med kvalitativ ansats2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Diabetes is a people's disease that increases in society and in the world. Diabetes type 2 can be prevented, delayed or alleviated using healthy living habits, such as diet and exercise. Lifestyle treatment is therefore essential for achieving this.

    Purpose:

    To describe the district nurse's experience of promoting healthy living habits, diet and exercise, in type 2 diabetes patients.

    Method:

    An empirical study with qualitative interview method where seven district nurses participated in interviews.

    Results:

    The study highlighted the importance of district nurses' experiences and views on promoting healthy living habits, diet and exercise, to help and motivate patients with type 2 diabetes. To promote healthy living habits, in type 2 diabetes patients, are described as the basis of treatment. A very important task that is necessary to prevent as well as reduce the risk of complications to the disease. District nurses have experience and opportunities to promote healthy living habits in a variety of ways. Work on promoting healthy living habits is done individually, in groups and with the help of written information. District nurses also have experience and are aware of various obstacles to promote healthy living habits.

    Conclusion:

    District nurses should see each patient as a unique individual and then adjust the work to promote healthy living habits. Follow-up and continuity are needed to give the patient motivation for lifestyle changes and maintain them.

  • 187.
    Danielsson, Charlotta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustavsson, Malin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som kan försvåra möjligheten för sjuksköterskor att ge personcentrerad vård – en litteraturöversikt.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: According to the new patient law, patients' involvement in their own care will be expanded and strengthened further. As part of this work, personcentred care has been introduced in several Swedish regions and county councils. Positive effects of person-centred care have been proven to exist for both patients and healthcare providers. Aim: To describe factors that can complicate the ability for nurses to provide person-centred care. Methods: The thesis project was conducted as a literature review. Ten scientific articles published between 2010-2016 were included in the study. The articles were searched in the CINAHL and PubMed databases, as well as through Google Scholar free text search. Results: There were several themes with associated factors that could complicate the possibility for nurses to provide a person-centred care. Prominent factors include the attitude of the nurse and his or her view of the profession and the patient, lack of patient participation, lack of teamwork and communication, weak support from organization and management, poor environment and education, and high workload. Conclusion: Several factors that could make it difficult for the nurse to provide person-centred care were discovered, some of which were perceived to be more crucial than others. In order for nurses to be able to provide care based on patient participation, it is very important that awareness of these aggravating factors is increased. By working with a person-centred approach already during nursing education, the likelihood of successful implementation of person-centred care in Swedish healthcare increases

  • 188.
    Danielsson, Johan
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Nykvist, Karin
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Mäns upplevelser av miktionsproblem och erektil dysfunktion efter radikal prostatektomi: En litteraturöversikt2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet var att beskriva hur män upplever att de påverkats av miktionsproblem och erektil dysfunktion efter radikal prostatektomi. Metod: Examensarbetet utfördes som en litteraturöversikt med tio vetenskapliga studier. Resultat: Upplevelsen av förlorad kontroll vid miktionsproblem var det som främst påverkade männen samt medförde att det sociala livet blev lidande. Männen beskrev hur de var tvungna att planera inför olika sociala tillställningar, vilket upplevdes som stressande och ångestfyllt. Det framkom också att männen oroade sig för urinläckage, stark odör och upplevde möten med oförstående människor som frustrerande. Erektil dysfunktion var den vanligaste komplikationen efter behandling, men miktionsproblem var det som orsakade mest besvär. Det upplevdes som att männen förlorat sin självständighet. Det framkom även att erektil dysfunktion upplevdes av vissa män som den komplikation som gav störst besvär. Erektil dysfunktion påverkade männen och var mycket svårt att hantera. Det var svårt att finna en acceptans för att den erektila dysfunktion kunde vara bestående. Många av männen beskrev att en viktig del i deras liv förlorats, en del av deras maskulinitet. De kände sig ofullständiga och det fanns en rädsla för att förlora sin partner. Slutsats: Studier visar att erektil dysfunktion och miktionsproblem i samband med radikal prostatektomi ger upphov till stress, oro, ångest samt en känsla av ofullständighet.

  • 189.
    Danielsson, Madeleine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Lind, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskors strategier för att främja fysisk aktivitet under graviditeten: En Kvalitativ Intervjustudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

  • 190.
    Das, Lucky
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Chowdhury, Merry
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mapping of eight education sites and exploration of feasible requirements in an accreditation tool to ensure quality midwifery education in Bangladesh: A questionnaire study in Barisal, Chittagong and Sylhet divisions2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    An important component to ensure sustainable quality midwifery education is to have a country specific accreditation tool in place, based on evidence. In Bangladesh with a recently initiated new cadre of professional midwives, the accreditation system is in process of being developed. Objective: The objective of this thesis is twofold. First, to map eight midwifery education sites in Barisal, Chittagong and Sylhet divisions prior the development of an accreditation tool. Second, to explore requirements for the accreditation tool from the perspective of the midwifery faculty to ensure quality midwifery education in Bangladesh. Methods: This study is part of a national wide study. Thirty-six participants filled a semi-structured questionnaire with both open and closed response alternatives. Data were analyzed through essentially non-parametric statistics and qualitative descriptions. Results: The mapping showed that the proportion theory in relation to practice was 40% theory and 60% practice at the eight education sites. The content of a midwifery education that should be delivered in clinical placement by a midwifery clinical teacher or preceptor, mentoring the midwifery students, was identified as a main challenge. The possible solutions were having sufficient amount of well-trained midwifery teacher; negotiating with Gynecology and Obstetrics department and the policy makers on how mentoring of midwifery students could happen smoothly; and negotiating the need for training of trainers to head nurses of all labor wards. The relation between the education site and the clinical site was suggested to be included in an accreditation tool to improve the fulfillment of a midwifery education. Conclusion: The need of an accreditation tool was, perceived by midwifery faculty, as important in order to ensure sufficient standard in the midwifery education. Clinical implications: The clinical implication of this study lies in the development of strategies to increase the number of clinical mentors and trained midwifery teachers, and provision of training of trainers to the clinical nurse midwifes at all labor wards.

  • 191.
    Dellbrant, AnnaSofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Thunfors, Cristina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    BHV-sjuksköterskans upplevelse av att bemöta och vägleda föräldrar som är tveksamma till vaccination av sitt barn: En kvalitativ intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of the study was to highlight the child health care nurse’s experience of responding and guiding vaccine hesitant parents. Method: An empirical interview study with a qualitative approach was carried out. The study was based on semi-structured interviews with six child health care nurses. The analysis was formed as a manifest content analysis. Results: The analysis resulted in four main categories: Guiding by informing, Requirements to guide, Approaches to respond in a good way and The Child Health Care Nurse’s experiences of responding hesitant parents as well as thirteen subcategories. The main results showed that child health care nurse’s ways of guiding hesitant parents were quite similar to each other, but differences also occured. The key to guiding parents was to inform them about vaccination. It was important to individualize the information and guide after discussion about risks versus benefits and that parents were guided to take a considered decision. Conditions to guide parents in a good way was time, knowledge and support. The child health care nurse sought a good relationship with the parents through genuine consideration and respect for the decision that the parents made. The child health care nurse experienced emotions such as frustration, anxiety, nervousness, and that responding could feel awkward. It could even be difficult to responding hesitant parents, but that varied with the parent’s attitude. Conclusion: The child health care nurse can increase the possibility that parents may choose to vaccinate their child, through individualized guidance and responding hesitant parents in consideration and respect.

  • 192. Dindic, Azemina
    et al.
    Jonsson, Johanna
    Information och stöd anhöriga vill erhålla av sjuksköterskan vid den sena fasen av palliativ vård: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att ta reda på vad för information och vilket stöd anhöriga önskar erhålla av sjuksköterskan i den sena fasen av palliativ vård. Metod: Litteraturöversikt med urval av 13 artiklar av kvalitativ och kvantitativ ansats från databaserna Cinahl, PubMed och Medline. Resultat: Forskning visar att anhöriga önskar erhålla flera former av stöd och information i den sena fasen av palliativ vård. Den information som är mest önskvärd är information om sjukdomen, information om vårdandet samt att informationen ges både skriftligt och verbalt. Det stöd anhöriga anser som viktigast är familjecentrerad vård och stöd för delaktighet i vårdandet, gruppstöd och efterlevandestöd. Slutsats: Anhöriga med en närstående som vårdas i den sena fasen av palliativ vård önskar erhålla tydlig skriftlig och verbal information om sjukdomen och om vårdandet. De vill även erhålla stöd före, under och efter dödsfallet. Kunskap om anhörigas önskemål av stöd och information i den sena fasen av palliativ vård kan hjälpa sjuksköterskan att bättre bistå med hjälp i en tid som är svår för både patient och anhöriga. Detta ställer krav på sjuksköterskan att inkludera både patient, i denna studie benämnd som närstående, och dess anhöriga i vårdandet.

  • 193.
    Dittrich, Nick
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Akupressurens effekter och möjlig användninginom vård och omvårdnad: En litteraturöversikt2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The need for health care and nursing is increasing and new

    complementary approaches to address these are needed.

    Objective:

    To compile studies using acupressure and study the effects of

    acupressure on various symptoms, disorders and ill-health conditions.

    Method:

    The study was conducted as a literature review where 20 different

    articles were compiled.

    Result:

    Categorization was made in the three main headings: effects of

    acupressure

    , patient’s experience of acupressure and acupressure in health care

    and nursing

    . The application of acupressure was mainly threw fingers with a great

    variety of acupoints distributed over the entire body. Acupressure has a wide range

    of applications both in health care and nursing, and provides a non-invasive,

    uncomplicated, economical, simple and effective complementary intervention that

    nurses and patients can use. Identified areas where fatigue, sleep, depression,

    anxiety, stress, cognitive and functional recovery, agitated behavior,

    gastrointestinal function, hypertension, pain, thirst, incontinence, quality of life

    and health. Generally was acupressure an effective intervention that also patients

    experienced as positive.

    Conclusion:

    Acupressure proves to be a usable intervention in health care and

    nursing with different uses, although the effect is partly explained by placebo.

    Nevertheless acupressure offers a complementary intervention for patients, nurses

    and other health care professionals to relieve discomfort and to promote health and

    quality of life.

  • 194.
    Domeij, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Lennström, Charlotte
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskans erfarenhet av handläggning vid uppkommen grad II-bristning: Kvalitativ intervjustudie med barnmorskor verksamma vid förlossningsavdelning2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Many women sustain a second-degree tear when giving birth vaginally. The work field of a midwife includes managing these injuries. There is limited research regarding this field and the focus tend to be on third- and fourth-degree tears, even though second-degree tears may also result in long-term complications.

    Aim:

    The aim was to investigate the midwife’s experience of managing second-degree tears.

    Method:

    Eight semi-structured individual interviews were conducted with midwives working at a medium large maternity ward located in the middle of Sweden. Qualitative content analysis was used to analyze the material.

    Results:

    Four categories and two subcategories were identified. The categories were: Information, The support of colleagues, The need for follow-ups and Physical examination and the subcategories were: Feedback strategies and Documentation.

    Conclusion:

    The result show that midwives feel insecure when managing second-degree tears, especially the midwives with less experience. The midwives also requested more feedback from the women they sutured regarding their second-degree tears and the midwives also wished for a better follow-up for the women with second-degree tears. The result also showed that the midwives give different information to women regarding their tears. No pronounced routines were found regarding what information to give and in what way.

    Clinical application:

    The results of the study aim to increase the knowledge and to develop routines regarding second-degree tears. More knowledge is needed about information given about the tear and when it is the best time to give information.

  • 195.
    Drmac, Marijana
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jörgensen, Angelica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnad vid smärta: En litteraturöversikt om könsskillnader2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Pain is a common cause to seek healthcare. Pain is a subjective feeling; however, the interpretation of "male" and "female behavior" could interfere with the healthcare staff judgement and care – even though quality of care should be given person-centered and on equal terms.

    Aim:

    The aim of the study was to examine the differences in care, that may exist, between men and women with pain and highlight the gender´s meaning in quality of care.

    Method:

    This study was conducted as a literature review investigating the existing literature within this area. Seventeen scientific articles from the PubMed and Cinahl databases were analyzed and compiled into a result.

    Results:

    This review brings out the differences between the treatment and ease for men and women in pain with regards to their gender. Often women have a tendency to be undervalued when they are being cared for compared to men. Physical symptoms are often regarded as psychosomatic. Even the age of the patients was a contributing factor.

    Conclusion:

    This literature study reveals differences between genders pain care. Gender differences were identified in many sections of care. Men’s pain is treated better than women, and the women generally needs to wait longer in receiving treatment. Registered nurses should utilize person-centered treatment in order to decrease this gender gap. Increased equality in care can support a sustainable future.

  • 196. Duong, Duc M.
    et al.
    Bergström, Anna
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bui, Ha T. T.
    Eriksson, Leif
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Exploring the influence of context in a community-based facilitation intervention focusing on neonatal health and survival in Vietnam: a qualitative study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, no 15, article id 814Article in journal (Refereed)
    Abstract [en]

    Background

    In the Neonatal health – Knowledge into Practice (NeoKIP) trial in Vietnam, local stakeholder groups, supported by trained laywomen acting as facilitators, promoted knowledge translation (KT) resulting in decreased neonatal mortality. In general, as well as in the community-based NeoKIP trial, there is a need to further understand how context influences KT interventions in low- and middle-income countries (LMICs). Thus, the objective of this study was to explore the influence of context on the facilitation process in the NeoKIP intervention.

    Methods

    A secondary content analysis was performed on 16 Focus Group Discussions with facilitators and participants of the stakeholder groups, applying an inductive approach to the content on context through naïve understanding and structured analysis.

    Results

    The three main-categories of context found to influence the facilitation process in the NeoKIP intervention were: (1) Support and collaboration of local authorities and other communal stakeholders; (2) Incentives to, and motivation of, participants; and (3) Low health care coverage and utilization. In particular, the role of local authorities in a KT intervention was recognized as important. Also, while project participants expected financial incentives, non-financial benefits such as individual learning were considered to balance the lack of reimbursement in the NeoKIP intervention. Further, project participants recognized the need to acknowledge the needs of disadvantaged groups.

    Conclusions

    This study provides insight for further understanding of the influence of contextual aspects to improve effects of a KT intervention in Vietnam. We suggest that future KT interventions should apply strategies to improve local authorities’ engagement, to identify and communicate non-financial incentives, and to make disadvantaged groups a priority. Further studies to evaluate the contextual aspects in KT interventions in LMICs are also needed.

  • 197.
    Dusinkiewicz, Fenja
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Liss-Back, Amanda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Barnens upplevelser av att ha föräldrar som tidigt insjuknar i en demenssjukdom- en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: The purpose of this study was to describe research on children’s experiences of being a relative of a parent with early-onset dementia. Method: The study was conducted as a literature review where nine qualitative and two quantitative scientific articles were included in the analysis. Databases that were used to search for articles was Cinahl and Web of science. Results: The result was identified in four categories: Diagnosis, Role changes, Impact on daily life and Support. The result showed that the children felt that it was important to get information about the parent's diagnosis and that this information would be individualized. Furthermore, the children had negative experiences on the role changes within family. It was not unusual for the children to experience concern, grief and anxiety out of the role changes that occurred as a result of dementia. The children also expressed a need for time alone where they could do things such as spending time with friends, exercise or go on a vacation. The need to meet other children who were in similar situations was experienced by the children as an important part of being able to handle being a relative of a parent with early-onset dementia. Conclusion: The children experienced changes within the family. The nurse needs to pay attention to the childrens’ needs. However, this requires further research in the area to develop an adapted support for the children.

  • 198.
    Dykes, Fiona
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom; Chinese University of Hong Kong, Hong Kong; University of Western Sydney, Australia .
    Flacking, RenéeDalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chinese University of Hong Kong, Hong Kong; Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom.
    Ethnographic research in maternal and child health2015Collection (editor) (Other academic)
  • 199.
    Dykes, Fiona
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom; Chinese University of Hong Kong, Hong Kong; University of Western Sydney, Australia .
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chinese University of Hong Kong, Hong Kong; Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom.
    Introducing the theory and practice of ethnography2015In: Ethnographic Research in Maternal and Child Health / [ed] Fiona Dykes and Renée Flacking, Taylor & Francis, 2015, p. 1-14Chapter in book (Other academic)
  • 200.
    E. Adelved, Helen
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rönnholm, Anne Sinikka
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fysiska miljöns betydelse för välbefinnande för personer med demenssjukdom: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To describe different aspects of the physical environment which may affect

    the well-being for people with dementia. Method: The study was conducted as a

    literature review. Articles published between the years 2000-2016 was searched in

    the databases CINAHL, PubMed, PsycINFO and Web of Science. Results: Our

    results showed that physical factors such as sound, light, color, pattern, layout,

    furnishing and sensory stimuli as well as the possibility for activity had a positive

    impact on the behavioral and psychological symptoms for people with dementia,

    which led to well-being. Conclusion: Certain characteristics of the physical

    environment decreased behavioral and psychological symptoms of dementia,

    improved performance level, and reduced negative emotional symptoms.

    Observation of emotional symptoms for people with reduced communication skills

    is an important tool to identify the individual’s non-verbal expression.

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