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  • 201.
    Bergkvist, Jonas
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    5-årig åldersklassindelning är inte optimal för triathlon: En deskriptiv tvärsnittsstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 202.
    Berglund, Ann-Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pelleberg, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans bemötande av patienter med psykisk ohälsa inom somatisk vård: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • 204.
    Berglund, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Nilsson, Frida
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Parent’s experiences of feeding their preterm infant in Neonatal Units in Sweden.: Ethnographic design2016Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

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

    Design: The study was conducted using an ethnographic design.

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

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

  • 205.
    Berglund, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Nicklas
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans omvårdnadsåtgärder för att förebygga vårdrelaterad urinvägsinfektion – en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

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

  • 206.
    Bergman, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wanke, Julia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    HBTQ-personers erfarenheter av vårdpersonalens bemötande inom sjukvården – en litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

    mötet med vårdgivare. Lagändringar har framtagits för att stoppa

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

    Syftet med litteraturöversikten var att undersöka HBTQ-personers erfarenheter av

    vårdpersonalens bemötande inom sjukvården. Metod. Litteraturöversikt med 17

    kvalitativa och kvantitativa artiklar. Resultatet visade att denna grupp fortfarande

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

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

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

    införande av ämnet HBTQ i utbildningen för allmänsjuksköterskor.

  • 207.
    Bergman, Josefin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pettersson, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors, sjuksköterskestudenters och vårdpersonals kunskap och förhållningssätt till vårdhygien och meticillinresistenta Staphylococcus aureus (MRSA): En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

  • 208.
    Bergman, Karolina
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Malin
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Äldres upplevelser av att flytta från det egna hemmet och att bo på ett särskilt boende.2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

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

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

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

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

  • 209.
    Bergman, Malin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärder som kan stödja nutritionsintaget för personer med demens – en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

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

    Aim

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

    Method

    An overview compiled of 11 scientific articles.

    Findings

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

    Conclusion

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

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

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

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

  • 211.
    Bergman, Stefan
    et al.
    FoU Spenshult, Halmstad, Sweden. Primary Health Care Unit, Dep of Public Health and Community Medicine, The Sahlgrenska Academy, Universtiy of Gothenburg, Sweden. Dep of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund.
    Ann, Bremander
    FoU Spenshult, Halmstad, Sweden. Dep of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund. School of Busiess, Engineering and Science, Halmstad University, Halmstad, Sweden..
    Anna-Carin, Bergman
    Sannarpsgymnasiet, Halmstad, Sweden.
    Brorsson, Sofia
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Chronic widespread pain in adolescents is highly associated to stress and anxiety2015In: Meeting abstracts: 2015 ACR/ARHP Annual Meeting, 2015Conference paper (Refereed)
  • 212.
    Bergqvist, Yngve
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Bergquist, Jonas
    In memory of Niklas Lindegardh2012In: Bioanalysis, ISSN 1757-6180, E-ISSN 1757-6199, Vol. 4, no 6, p. 751-751Article in journal (Refereed)
  • 213.
    Bergstrand, Emelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Andersson, Mikaela
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelse av omhändertagande vid fysiskt trauma på en akutmottagning: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

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

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

    physical trauma in an emergency department.

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

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

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

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

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

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

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

    control over their lives.

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

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

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

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

    trauma team structure occurs.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • 219.
    Bergström, Julia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Särnö, Felicia
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Inkludering av nya motionärer på motionsanläggningar: Motionärers föreställningar om människor som inte motionerar2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose

    The main purpose of this study was to research the practitioners of physical exercise (PPE)

    opinions about non-practitioners of physical exercise (NPPE), regarding their health, lifestyle

    and characteristics.

    Method

    To enable inclusion of NPPE to training facilities where PPE attend, knowledge of the PPEs’

    opinions about NPPE are needed. NPPE often mention that the opinions of PPE discourage

    them from start to perform physical exercise at training facilities. Therefore, it was necessary

    to research if these opinions make an actual barrier for the start of exercise in NPPEs. To

    contribute this knowledge of opinions this study was a qualitative interview study with semi

    structured interviews.

    Result

    The respondents described health as a state of experienced balance between physical and

    physiological health. Unhealthiness was described by the opposite; imbalance. The

    consequences of this described imbalance are mentioned as fatigue, lack in concentration,

    overweight, high risk in diseases and decreased quality of life. What the respondents

    mentioned about a NPPE as an individual, were that they only did what's necessary, are

    unhealthy, lead an unbalanced lifestyle and suffer a higher risk of afflict the consequences

    mentioned above.

    Conclusion

    This study shows that the PPE do have opinions about NPPE. What is shown most clearly is

    that the respondents are more confident describing unhealthiness or the lifestyle choices

    associated with an unhealthy lifestyle, rather than describing the characteristics of unhealthy

    individuals. The study examines that the PPEs’ opinions about NPPE could be an actual

    barrier for NPPE to start performing physical exercise at training facilities where PPE

    perform their physical exercise. If these opinions are reflected in the environment of the

    training facilities, is not defined through this study and would require further research.

  • 220.
    Bergström, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sambandet mellan viktförlust och hälsorelaterad livskvalitet efter intensivvård - en retrospektiv tvärsnittsstudie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Patients who survived critical illness or injury often experience physical and mental health problems during the recovery period. Weight/muscle loss and pain are common problems. The purpose of this study was to describe how weight loss affects health-related quality of life and to investigate the diagnostic groups that had the greatest weight loss and experienced reduced mental health and pain at the time of the follow-up visit to intensive care clinic.

    Method: A retrospective cross-sectional study in which 185 patients undergoing critical illness were followed up after hospitalization. Weight before ICU and at the time of follow-up was recorded. Health-related quality of life was assessed by health-survey SF-36. Data were presented by descriptive- and analytical statistics.

    Results: Men estimated significantly improved physical function compared to women while women estimated significantly better mental health than men. Patients with gastrointestinal disorders and trauma had a significantly greater weight loss compared to patients with lung-related conditions. Only patients aged 73 years or older had a significantly impaired physical function. Factors that affect physical function was pain and mental well-being. Patients with aortic aneurysms had significantly poorer mental health and more pain compared with patients suffering from gastrointestinal problems. Patients with aortic aneurysm and intracerebral- and lung-related disorders had significantly more pain than gastrointestinal- and trauma patients.

    Conclusion: By identifying the diagnostic- and age groups suffering most from weight loss, physical and psychological problems after intensive care measures can be initiated early and possibly physical and mental suffering reduced.

  • 221.
    Bergström, Max
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Glader, David
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Betydelsefulla faktorer för framgångsrika idrottskarriärer inom längdskidåkning och skidskytte2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Cross country skiing is one of the most demanding endurance sports where the duration of physical effort during a competitive event usually lasts from three minutes up to four hours, or sometimes even longer. To reach national or international elite level, an athlete generally needs to invest 20 to 30 hours of training a week over many years. In biathlon, an athlete not only has to be a good skier, but also be able to carry a rifle and shoot on targets during high intense work load. The aim of this study was to identify athletes' own experiences of the crucial factors that allow for long and successful sport careers in cross country skiing. The study was qualitatively orientated, where semi-structured interviews were used to collect the athlete's perceptions. In total, nine individuals with at least 10 years of competitive cross country skiing or biathlon experience as adults at national or internationallevel participated. The interviews revealed several factors that athletes believe are crucial for achieving long and successful careers. These factors were: 1. Training and organization, 2. Socioeconomic factors, 3. Talent and genetic potential and 4. Recovery. To maintain long and successful careers in cross country skiing, athletes perceive that in addition to factors associated with the training process, support from family, their team and sponsors play important roles.

  • 222.
    Bergsvind, Ulrica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Söderqvist, Beatrice
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors upplevelse av att drabbas av hjärtinfarkt: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : When it comes to heart disease, women are degraded. Women get worse treatment, more often wrong or no diagnosis and research is less in women. As the man is the norm and reference the women also get treated after the same criteria. Women’s symptoms are different compered to men.

    Aim

    : The aim of this study was to explore women’s experiences of suffering from a myocardial infarction.

    Methods

    : The design is a literature review. Data collection occurred in the databases Cinahl and PubMed which resulted in eleven qualitative articles.

    Result

    s: Women experienced symptoms from different parts of the body, which may be from the gastrointestinal area, extremities and breast region. They deny the symptoms and try to find reasons why they occur. Care provides give lack of information and does not take them seriously, which causes women to feel insecure. Women still feel bad several months after the infarction and have difficulty coping with everyday life. They need support from the family that can give them support and help, although they do not always tell family how they feel.

    Conclusion

    : Women experience a variety of symptoms when they suffer from myocardial infarction, and symptoms may start from different parts of the body, not just in the breast region. They also experience that the caregiver provides inadequate information and do not take them seriously when they seek medical care. Many women have remaining symptoms several months after the infarction.

  • 223.
    Berneström, Anette
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Senior Alert och urininkontinens – en beskrivande registerstudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The

    purpose of the study is to identify urinary incontinence work with quality registry Senior Alerts urinary incontinence module in two municipalities over a fixed period January to June 2014 and from January to June 2015. The method was to use the registry data that is later held by the Depositary of the Senior Alert. The result showed that more than half of the individuals in risk assessments were conducted on municipal G had any form of urinary incontinence in both periods. The municipality M proportion was even higher, about 80%. Underlying causes of urinary incontinence was found to be the aspects mentioned in the Senior Alerts module except constipation problems and loss of sensation in the genital area that is not revealed as clearly as the other aspects. Using Senior Alert, a pattern emerged, and it is possible to provide individually tailored measures for people with incontinence problems. With simple measures, can patients with feces regime, toilet assistance, testing of incontinence aids can the scale of Senior Alert be helpful. The scale demonstrates what assistance may be needed for patients, health professionals then perform the action.

  • 224.
    Berntoft, Nina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johanna, Kallberg
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar informationsutbytet mellan sjuksköterskor hos olika vårdgivare vid in- och utskrivning av äldre patienter2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att belysa vilka faktorer som hindrade och möjliggjorde ett patientsäkert informationsutbyte mellan sjuksköterskor hos olika vårdgivare, vid in- eller utskrivning av äldre patienter.

    Metod: Uppsatsen utformades som en litteraturöversikt. Artiklar söktes i databaserna Cinahl, Pubmed och Web of science. Av de 14 artiklarna som användes var 8 kvalitativa, 3 kvantitativa och 3 artiklar hade en mixad kvalitativ/kvantitativ ansats.

    Resultat: Faktorer som hindrade ett patientsäkert informationsutbyte var: hög arbetsbelastning, bristfälliga rutiner, brist på kunskap, negativa attityder bland vårdpersonalen, brist på kontaktinformation samt information som var bristfälligt anpassad till mottagaren. Faktorer som möjliggjorde ett patientsäkert informationsutbyte identifierades som: Förbättrade rutiner, ökad samverkan mellan vårdgivare, att införa samordnare, bättre framförhållning, anpassad information till mottagaren samt att införa standardformulär.

    Slutsats: Ett patientsäkert informationsutbyte mellan hälso- och sjukvårdspersonal vid in- och utskrivning av äldre patienter, kräver ett omfattande samarbete mellan vårdgivare och ställer höga krav på sjuksköterskans kunskaper i kommunikation.

  • 225.
    Berterud Andersson, Catarina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Dennis, Katarina
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Lumbal spinal stenos och fotbäddar: Kan av formgjutna fotbäddar minska kvarstående ländrygg- och bensmärta hos patienter som opererats för lumbal spinal stenos? En kvasi-experimentell jämförande studie.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Lumbar spinal stenosis (LSS) is a common pathological condition in the lower back. The aim of most interventions when treating LSS is to reduce pain in the lower back and leg. The current knowledge regarding orthotics and low back pain is insufficient. Objectives: The aim with this study was to investigate weather custom-made orthotics would reduce self-reported pain in the lower back and leg, in patients who had had surgery for LSS. A second aim was to compare the self-reported pain in the lower back and leg, as well as low back function of the intervention group, with the one/year follow-up of a control group, who had undergone the same surgery two years earlier. Method: Eleven persons who had undergone surgery for LSS at the Spine surgery clinic of Strängnäs got to use custom-made orthotics for six weeks. Primary outcome measure was pain intensity in the lower back and leg, evaluated with the Numeric Rating Scale (NRS). To describe the baseline characteristics of the participants, low back function was measured with the Oswestry Low Back Pain Disability Index (ODI). To detect a change of the median value for pain intensity of the participants, before compared to after the intervention, Wilcoxon signed rank sum test was conducted (CI 95%). The post-intervention measurement was compared to a control condition; i.e. data was collected from the quality register from Swespine. Results: There was no difference in self-reported pain intensity in the lower back, compared to before the intervention (p=0,76). There was no difference in self-reported pain intensity in the leg, compared to before the intervention (p=0,40). There was no difference between the self-reported pain intensity for lower back (p=0,078) or leg (p=0,85) between the follow-up of the intervention group and the result from the one-year follow-up of the control group. Conclusion: This study could not detect any differences in pain in either the lower back or the leg after six weeks of using custom-made orthotics, compared with before the intervention. No difference could be found in self-reported pain intensity between the intervention group and the control for lower back or leg.

  • 226.
    Bihl, Sofi
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lausch Granlund, Elin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärder vid förstoppning hos vuxna: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva omvårdnadsåtgärder vid förstoppning hos vuxna.

    Design: En litteraturöversikt

    Metod: Artiklar till arbetet har sökts i databaserna PubMed och Cinahl. Resultatet

    har granskat, jämfört och sammanställt av författarna.

    Resultat: Författarna har funnit flera omvårdnadsåtgärder som visat signifikant

    förbättring av symtom vid förstoppning. De omvårdnadsåtgärder som undersökts i

    studierna är fibrer, rörelseträning vid toalettbesök, massage, probiotika, vätska och

    införande av protokoll där flera åtgärder visat signifikant förbättring vid

    förstoppning.

    Slutsats: Olika åtgärder har gjorts på flera olika patientkategorier där resultatet

    har varierat från objektiva fynd som exempelvis förbättrade tarmrörelser till

    subjektiva fynd så som ökad livskvalitet.

  • 227.
    Birath, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Edman, Sofia
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Förlossningsrädsla: En begreppsanalys ur barnmorskans perspektiv2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Fear of childbirth affects about one-fifth of all pregnant women and midwives face these in their work.

    Aim: The aim was to analys the concept fear of childbirth from a midwife perspective.

    Methods: A concept analysis with a hybrid model. First a theoretical phase with a search for literature, thereafter a fieldwork phase where five midwifes where interviewed followed by a final analytic phase.

    Results: Fear of childbirth is something that can affect women before, during or after pregnancy and childbirth. Fear of childbirth for primiparous women can be a lack of confidence in her ability to give birth, and for multiparous women have had a previous traumatic birth experience. The midwives described that fear of childbirth was a complex concept. Women did not usually use the word fear of childbirth, but the midwives interpreted what they noticed or saw in the woman as manifestations of fear of childbirth.

    Conclusion: Midwives use the concept in different ways and call for a clearer definition and way of working with fear of childbirth. The fear of childbirth is a great suffering for the pregnant woman and therefore the authors of this thesis consider that preventive work is important and that the midwife has a central and important role.

    Clinical Applicability: Midwives can use this study to develop their knowledge of fear of childbirth and see how other midwives view on the concept fear of childbirth.

  • 228. Bishop, David J.
    et al.
    Thomas, Claire
    Moore-Morris, Tom
    Tonkonogi, Michail
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Sahlin, Kent
    Mercier, Jacques
    Sodium bicarbonate ingestion prior to training improves mitochondrial adaptations in rats2010In: American Journal of Physiology. Endocrinology and Metabolism, ISSN 0193-1849, E-ISSN 1522-1555, Vol. 299, no 2, p. E225-E233Article in journal (Refereed)
    Abstract [en]

    We tested the hypothesis that reducing hydrogen ion accumulation during training would result in greater improvements in muscle oxidative capacity and time to exhaustion (TTE). Male Wistar rats were randomly assigned to one of three groups (CON, PLA, and BIC). CON served as a sedentary control, whereas PLA ingested water and BIC ingested sodium bicarbonate 30 min prior to every training session. Training consisted of seven to twelve 2-min intervals performed five times/wk for 5 wk. Following training, TTE was significantly greater in BIC (81.2 +/- 24.7 min) compared with PLA (53.5 +/- 30.4 min), and TTE for both groups was greater than CON (6.5 +/- 2.5 min). Fiber respiration was determined in the soleus (SOL) and extensor digitorum longus (EDL), with either pyruvate (Pyr) or palmitoyl carnitine (PC) as substrates. Compared with CON (14.3 +/- 2.6 nmol O(2).min(-1).mg dry wt(-1)), there was a significantly greater SOL-Pyr state 3 respiration in both PLA (19.6 +/- 3.0 nmol O(2).min(-1).mg dry wt(-1)) and BIC (24.4 +/- 2.8 nmol O(2).min(-1).mg dry wt(-1)), with a significantly greater value in BIC. However, state 3 respiration was significantly lower in the EDL from both trained groups compared with CON. These differences remained significant in the SOL, but not the EDL, when respiration was corrected for citrate synthase activity (an indicator of mitochondrial mass). These novel findings suggest that reducing muscle hydrogen ion accumulation during running training is associated with greater improvements in both mitochondrial mass and mitochondrial respiration in the soleus.

  • 229.
    Bivesjö, Jonna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strid, Emelie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelse av delaktighet i sin vård i livets slutskede: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    80% of the people that die every year in Sweden are believed to have benefited from palliative care. In order for patients to be involved in their care, they must be well informed about their condition. Reports show that not all palliative patients get a breakpoint conversation, which increases the risk that patients don’t feel involved in their care.

    Aim:

    To investigate patients’ experiences of participation in their end-of-life care

    Methods:

    The design is a literature review. Data collection has been done through searches in the databases PubMed and CINAHL.

    Results:

    The result was based on 15 scientific articles and were divided into four categories: patients’ need for information, shared decision-making, patients’ preferences, and experience of a good death. Most patients wanted information about their condition, but not everyone felt that they received it. It varied in how much patients wanted to be involved in the decision-making. Patients who wanted shared decision-making felt less that their wishes were met.

    Conclusions:

    To ensure that patients feel involved in their care, it is important to investigate the individual's needs and to adjust the care accordingly, as well as being aware that this may change over time.

  • 230.
    Bjerkefors, Anna
    et al.
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Tinmark, Fredrik
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för tillämpad idrottsvetenskap (LTIV).
    Arndt, Anton
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Seated Double-Poling Ergometer Performance of Individuals with Spinal Cord Injury - A New Ergometer Concept for Standardized Upper Body Exercise2013In: International Journal of Sports Medicine, ISSN 0172-4622, E-ISSN 1439-3964, Vol. 34, no 2, p. 176-182Article in journal (Refereed)
    Abstract [en]

    This study aimed to evaluate biomechanics during seated double-poling exercises in individuals with spinal cord injury (SCI) and to compare these with those of able-bodied persons (AB). 26 participants volunteered for the study; 13 with SCI (injury levels C7-T12), and 13 AB. A seated double-poling ergometer (SDPE) was developed. 3-dimensional kinematics was measured and piezoelectric force sensors were used to register force in both poles for calculation of power during incremental intensities. Significantly lower power outputs, (143.2 ± 51.1 vs. 198.3 ± 74.9 W) and pole forces (137.1 ± 43.1 vs. 238.2 ± 81.2 N) were observed during maximal effort in SCI compared to AB. Sagittal upper trunk range of motion increased with intensity and ranged from 6.1–34.8 ° for SCI, and 6.9–31.3 ° for AB, with larger peak amplitudes in flexion for AB (31.4 ± 12.9 °) compared to SCI (10.0 ± 8.0 °). All subjects with SCI were able to exercise on the SDPE. Upper body kinematics, power and force outputs increased with intensity in both groups, but were in general, lower in SCI. In conclusion, the SDPE could be successfully used at low to high work intensities enabling both endurance and strength training for individuals with SCI.

  • 231.
    Bjerre, Bo
    et al.
    Trafikverket.
    Kostela, Johan
    Dalarnas forskningsråd.
    Selén, Jan
    Statistiska Centralbyrån.
    Positive health-care effects of an alcohol ignition interlock programme among driving while impaired (DWI) offenders2007In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 102, no 11, p. 1771-1781Article in journal (Refereed)
    Abstract [en]

    Aims: To compare the costs of hospital care and sick leave/disability pensions between two groups of driving while impaired (DWI) offenders: participants in an alcohol ignition interlock programme (AIIP) and controls with revoked licences, but with no comparable opportunity to participate in an AIIP. Setting: As an alternative to licence revocation DWI offenders can participate in a voluntary 2-year AIIP permitting the offender to drive under strict regulations entailing regular medical check-ups. The participants are forced to alter their alcohol habits and those who cannot demonstrate sobriety are dismissed from the programme. Participants: are liable for all costs themselves. Design: Quasi-experimental, with a non-equivalent control group used for comparison; intent-to-treat design. Based on the number of occasions/days in hospital and on sick leave/disability pension, the health-care costs for public insurance have been calculated. Finding: Average total health-care costs were 25% lower among AIIP participants (1156 individuals) than among controls (815 individuals) during the 2-year treatment period. This corresponds to over €1000 (SEK9610) less annual costs per average participant. For those who complete the 2-year programme the cost reduction was more pronounced; 37% during the treatment and 20% during the post-treatment period. Conclusions: The positive health-care effects were due apparently to reduced alcohol consumption. The social benefit of being allowed to drive while in the AIIP may also have contributed. The reduction in health-care costs was significant only during the 2-year treatment period, but among those who completed the entire AIIP sustained effects were also observed in the post-treatment period. The effects were comparable to those of regular alcoholism treatment programmes. (PsycINFO Database Record (c) 2012 APA, all rights reserved)(journal abstract)

  • 232. Bjersing, Jan L
    et al.
    Larsson, Anette
    Palstam, Annie
    Sahlgrenska Academy, University of Gothenburg.
    Ernberg, Malin
    Bileviciute-Ljungar, Indre
    Löfgren, Monika
    Gerdle, Björn
    Kosek, Eva
    Mannerkorpi, Kaisa
    Benefits of resistance exercise in lean women with fibromyalgia: involvement of IGF-1 and leptin2017In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 18, no 1, article id 106Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chronic pain and fatigue improves by exercise in fibromyalgia (FM) but underlying mechanisms are not known. Obesity is increased among FM patients and associates with higher levels of pain. Symptom improvement after aerobic exercise is affected by body mass index (BMI) in FM. Metabolic factors such as insulin-like growth factor 1 (IGF-1) and leptin may be involved. In this study, the aim was to evaluate the role of metabolic factors in lean, overweight and obese women during resistance exercise, in relation to symptom severity and muscle strength in women with FM.

    METHODS: Forty-three women participated in supervised progressive resistance exercise, twice weekly for 15-weeks. Serum free and total IGF-1, IGF-binding protein 3 (IGFBP3), adiponectin, leptin and resistin were determined at baseline and after 15-weeks. Level of current pain was rated on a visual analogue scale (0-100 mm). Level of fatigue was rated by multidimensional fatigue inventory (MFI-20) subscale general fatigue (MFIGF). Knee extension force, elbow flexion force and handgrip force were assessed by dynamometers.

    RESULTS: Free IGF-1 (p = 0.047), IGFBP3 (p = 0.025) and leptin (p = 0.008) were significantly decreased in lean women (n = 18), but not in the overweight (n = 17) and the obese (n = 8). Lean women with FM benefited from resistance exercise with improvements in current pain (p= 0.039, n = 18), general fatigue (MFIGF, p = 0.022, n = 18) and improved elbow-flexion force (p = 0.017, n = 18). In overweight and obese women with FM there was no significant improvement in pain or fatigue but an improvement in elbow flexion (p = 0.049; p = 0.012) after 15 weeks of resistance exercise.

    CONCLUSION: The clearest clinical response to resistance exercise was found in lean patients with FM. In these individuals, individualized resistance exercise was followed by changes in IGF-1 and leptin, reduced pain, fatigue and improved muscular strength. In overweight and obese women FM markers of metabolic signaling and clinical symptoms were unchanged, but strength was improved in the upper limb. Resistance exercise combined with dietary interventions might benefit patients with FM and overweight.

    TRIAL REGISTRATION: The trial was registered 21 of October 2010 with ClinicalTrials.gov identification number: NCT01226784 .

  • 233.
    Bjuhr, Madelen
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordlander, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nyutexaminerade sjuksköterskors upplevelser under det första yrkesverksamma året - en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim was to explore the experiences of recently graduated nurses during their first year of practice.

    Method: A literature review based on fifteen scientific articles that were sought out in the databases PubMed and CINAHL.

    Results: Six categories were identified: not feeling prepared for the profession, lack of support, how relationships with colleagues and physicians were experienced, bullying from peers, the feeling of not being able to live up to the ideals and transition. Most participants felt that the demands put on them when they entered the work force were high and they felt ill-prepared to meet them, and also that they received little support and wanted more support than they were getting. Slightly more than half of the studies described predominantly positive relationships with colleagues. One or more study participants was exposed to bullying in almost half of the articles. Almost all newly qualified nurses felt that it was difficult, stressful and frustrating to start working, but after about six months, they felt competent to handle routine tasks, more comfortable in the professional role, more independent and confident.

    Conclusion: The first few months were perceived as difficult and overwhelming, but after six months, most began to feel comfortable in the professional role.

  • 234. Bjurbo, Camilla
    et al.
    Eriksson, Ulrika
    Källberg, Ann-Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Muntlin Athlin, Åsa
    Early identification of frail older patients by using the FRESH-instrument in the emergency department: a pilot study2018Conference paper (Refereed)
  • 235.
    Björ, Louise
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Svanberg, Sofia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Den äldre patientens upplevelse av vård utifrån ett personcentrerat perspektiv: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The elderly is a group that will be a major part of the population in the future. With increasing age, the risk of suffering from one or more diseases increases, which will place higher demands on healthcare. Swedish law states that healthcare has an obligation to promote patient integrity, participation and self-determination, but this is invalid in the care of the elderly. Many complex illnesses in an elderly person necessitate nursing based on the patient's individual needs. Person-centered nursing is about a partnership between the individual and healthcare staff, where the individual is at the center of care.

    Aim:

    To highlight the elderly patient's experience of care based on a person-centered perspective.

    Method:

    A literature review was conducted and the data was found in the databases CINAHL and PubMed, 13 articles with qualitative method were selected.

    Result:

    The results showed that there were similarities and differences in how the elderly patient experiences their care. These experiences can be divided into three main categories: self-determination, participation and integrity. The elderly patient had a longing for independence and self-determination, however, this was reversed due to a lack of time and competence shortage. The elderly had a desire to be involved in their care, where the relationship and communication were an important basis for creating participation. Many of the elderly did not feel confirmed as a unique individual of nursing staff.

    Conclusion:

    In order to promote the role of the elderly in their care, must a holistic perspective and a person-centered approach be applied, where the elderly is respected as a unique individual. With the older individual at the heart of his care, his right to self-determination, participation and integrity is strengthened, which in turn can lead to an increased quality of life.

  • 236.
    Björk, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelse och beskrivning av kommunikation med vuxna patienter med ADHD inom öppenvårdspsykiatrin: En kvalitativ intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Studies show patients' experience of communication with nurses, nurses need to have knowledge of communication and knowledge of disability patients with ADHD may have. Previous studies also illustrate various communication theories that are useful in healthcare relationships, but not so much regarding nurses’ experiences.

    Aim: To describe how nurses at outpatient psychiatric experience describe communication with adult patients with ADHD.

    Methods: The study had a qualitative design where data was collected through semi-structured interviews. Qualitative content analysis was used as analytical method.

    Results: The analyses resulted in one theme, four categories and eleven subcategories. Nurses at outpatient clinics experienced communication with patients with ADHD nourishing and debilitating at the same time. Various communication techniques were used in combination with the knowledge of disabilities to create the best conditions for communication with patients. Good attitude and a good approach were reported to be important.

    Conclusion: Nurses in outpatient psychiatry experienced communication with patients with ADHD as both nourishing and debilitating. The nurses adapt their communication to the patient’s needs and abilities, and they treat all needs of the patients' different with respect. Nurses felt that a good attitude and a good treatment was important for communication with patients with ADHD.

  • 237. Björk, Mathilda
    et al.
    Thyberg, Ingrid
    Nordenskiöld, Ulla
    Lindstrand, Jane
    Brodin, Nina
    Rosengren, Jenny
    Brorsson, Sofia
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Development of measuring devices for evaluating hand force in rheumatoid arthritis2015Conference paper (Refereed)
  • 238.
    Björk, Veronica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ingvarsson, Anngela
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors uppfattning om arbetet med den äldre personens resurser: En fenomenografisk studie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Hospitalization can bestow a feeling of autonomy deprivation and loss of abilities for the elderly persons. The elderly person expects to be seen by the nurse as an autonomous person and have their individual assets identified.

    Purpose: Purpose is to describe the nurses´ perceptions of the work with elderly persons´s assets during inpatient stay at a Geriatric ward.

    Method: Method is qualitative interview study with a phenomenographic methodology.

    Results: Nurses’ perceptions of the work with elderly person’s assets during inpatient stay at a Geriatric ward can be described in an overriding category and four categories. The overriding category was nurses have different understanding for the term assets. The four categories were; possibilities given to let de elderly person do what him/herself can do, the work with the elderly persons assets is sprung from a person-centered mindset, the elderly persons assets can be hidden and the elderly persons assets is not taken at use.

    Conclusion: Nurses’ percept an absence of work with the elderly persons assets despite theoretical awareness. Thru a person-centered way of working can the elderly persons assets be taken care of. As a nurse identify assets is a way of strengthen the elderly persons health and quality of life.

  • 239. Björkelund, Cecilia
    et al.
    Svenningsson, Irene
    Hange, Dominique
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Petersson, Eva-Lisa
    Ariai, Nashmil
    Nejati, Shabnam
    Wessman, Catrin
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Göteborgs universitet; Karolinska institutet.
    Westman, Jeanette
    Clinical effectiveness of care managers in collaborative care for patients with depression in Swedish primary health care: a pragmatic cluster randomized controlled trial.2018In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 19, no 1, article id 28Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Depression is one of the leading causes of disability and affects 10-15% of the population. The majority of people with depressive symptoms seek care and are treated in primary care. Evidence internationally for high quality care supports collaborative care with a care manager. Our aim was to study clinical effectiveness of a care manager intervention in management of primary care patients with depression in Sweden.

    METHODS: In a pragmatic cluster randomized controlled trial 23 primary care centers (PCCs), urban and rural, included patients aged ≥ 18 years with a new (< 1 month) depression diagnosis. Intervention consisted of Care management including continuous contact between care manager and patient, a structured management plan, and behavioral activation, altogether around 6-7 contacts over 12 weeks. Control condition was care as usual (CAU).

    OUTCOME MEASURES: Depression symptoms (measured by Mongomery-Asberg depression score-self (MADRS-S) and BDI-II), quality of life (QoL) (EQ-5D), return to work and sick leave, service satisfaction, and antidepressant medication. Data were analyzed with the intention-to-treat principle.

    RESULTS: One hundred ninety two patients with depression at PCCs with care managers were allocated to the intervention group, and 184 patients at control PCCs were allocated to the control group. Mean depression score measured by MADRS-S was 2.17 lower in the intervention vs. the control group (95% CI [0.56; 3.79], p = 0.009) at 3 months and 2.27 lower (95% CI [0.59; 3.95], p = 0.008) at 6 months; corresponding BDI-II scores were 1.96 lower (95% CI [- 0.19; 4.11], p = 0.07) in the intervention vs. control group at 6 months. Remission was significantly higher in the intervention group at 6 months (61% vs. 47%, p = 0.006). QoL showed a steeper increase in the intervention group at 3 months (p = 0.01). During the first 3 months, return to work was significantly higher in the intervention vs. the control group. Patients in the intervention group were more consistently on antidepressant medication than patients in the control group.

    CONCLUSIONS: Care managers for depression treatment have positive effects on depression course, return to work, remission frequency, antidepressant frequency, and quality of life compared to usual care and is valued by the patients.

    TRIAL REGISTRATION: Identifier: NCT02378272 . February 2, 2015. Retrospectively registered.

  • 240.
    Björkholm, Nicole
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Finn, Camilla
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Fem veckors träningsintervention utankostreglering påverkar intekroppssammansättningen hos överviktiga vuxna2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    PurposeThe purpose of the present study was to investigate whether relatively cheap and simpletraining intervention without food adjustments in a realistic environment can positively affectbody composition in only five weeks. The training methods the present study intended toexamine were high intensity interval exercise (HIIT) and low intensity walks.Methods14 adults with a body mass index between 25-35 kg/m2 completed a five-week trainingintervention without food adjustments. Relative and absolute fat mass and lean mass wasmeasured before and after the intervention with dual-energy X-ray absorbation (DXA). Thestudy subjects were divided into two groups where one group was instructed to complete HIITfor 30 minutes three times/week and the other group was instructed to complete three 60minutes low intensity walks three times/week at an intensity of 65% of their maximal heartrate.ResultsThe results did not show any significant differences in relative fat mass, absolute fat mass orlean mass in HIIT or low intensity walks after five weeks of training. p>0,05 for each value.ConclusionThe results of the present study show that a five week training intervention consisting of HIIT30 minutes three times/week or low intensity walks 60 minutes/week without foodadjustments does not affect the body composition in overweight adults.

  • 241. Björkman, Frida
    et al.
    Eggers, Andrea
    Stenman, Adam
    Bohman, Tony
    Karolinska institutet.
    Ekblom, Björn
    Ekblom, Örjan
    Sex and maturity status affected the validity of a submaximal cycle test in adolescents2018In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 107, no 1, p. 126-133Article in journal (Refereed)
    Abstract [en]

    AIM: This study assessed the validity and reliability of the Ekblom-Bak (EB) submaximal cycle test in adolescents and identified any sex- or maturity-related factors for prediction errors.

    METHODS: We recruited 50 healthy subjects through a public announcement in Stockholm, Sweden, in 2016. The 27 boys and 23 girls were aged 10-15 years and in Tanner stages I-IV. They performed an EB test and incremental treadmill running test for direct measurement of maximal oxygen uptake (VO2 max).

    RESULTS: The estimation error of VO2 max was 0.09 L/min. The correlation (r) was 0.86, and the standard error of the estimate (SEE) was 0.29 L/min. The largest overestimation was seen in prepubertal boys (0.49 L/min). The best precision of the EB test was achieved when boys in Tanner stages I and II were re-calculated using the prediction equation developed for adult women. This yielded a mean difference of -0.05 L/min, r = 0.92 and SEE 0.23 L/min, in the entire sample. The prediction error was lowered in boys, but not girls, with increasing pubertal maturity.

    CONCLUSION: The EB test was reasonably valid in adolescents, seemed to be related to sex and maturity status, and our findings support its use.

  • 242.
    Björlin, Hanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Anette
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnad av personer med missbruk och/eller beroende av alkohol eller droger i somatisk vård: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    People with abuse and/or addiction are present in society and are an increasing group. Diseases due to abuse and/or addiction to alcohol or drugs leads to the need for care in different care units. Aim: The aim is to put together knowledge about the nurse experience of patients with abuse and/or addiction to alcohol or drugs in somatic care. Method: This literature review summarizes results based on 11 academic articles. Canada, USA, Taiwan, England, Australia, Chile and Israel are the countries represented in the results. The articles are published between 2008-2018. Results: Based on the reviewed articles, 4 categories emerged. The categories are nurses experience of care, attitude, lack of knowledge and support at the workplace. The result shows that education and workplace support is lacking. Education and workplace support is required to achieve a better attitude from the nurse. Conclusion: The conclusion of this literature review is that the nurse needs support and education in order to work with a good attitude towards patients with addiction and/or addiction to alcohol or drugs.

  • 243.
    Björnberg Dillner, My
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Den nyutexaminerade sjuksköterskans största utmaningar: en litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There is a great shortage of nurses. Newly graduated nurses are a group at high risk of being burned out and up to every fifth nurse is considering leaving the profession within its first five years. Many of the newly graduated nurses feel unprepared for the nursing profession and several studies show the gap between theory and practice.

    Aim: Describing challenges the newly graduated nurse experiences during the first year of working.

    Method: The study has been conducted as a literature review. With the help of the search databases CINAHL and PubMed, a total of 20 articles form the base for the result.

    Result: Several factors are described by newly graduated nurses as challenges. This includes a theory-practice gap, the lack of support and mentoring, a lack of knowledge, poor work environment, staff shortages and an increasingly complex care with patients have multiple ilnesses who require an expertise that the newly graduated nurse cannot possibly possess.

    Conclusion: The challenges presented in the literature review's results are well-known and global problems, but also influential. The focus should be on both appointing new nurses but more importantly valuing the ones already employed/working. Newly graduated nurses need better support when they enter the workplace, much also indicates that the education should be looked over in order to match the reality and prepare the students for work life as well as possible.

  • 244.
    Björneke, Sara
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Etnell, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskors upplevelser av att arbeta med yoga för gravida - en kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Yoga during pregnancy has become increasingly popular in Sweden and the western world in recent years. Earlier studies suggest that yoga for pregnant women may increase well-being during pregnancy, reduce fear for giving birth and increase prenatal attachment. Today, yoga for pregnant women is available at private yoga and fitness centres and at certain maternity clinics. However, there seems to be a gap of knowledge about midwifes experiences of working with yoga for pregnant women. Aim: Describe midwives experiences of working with prenatal yoga. Method: Eight semistructured interviews were conducted with midwives who have experience instructing yoga classes during pregnancy. Qualitative content analysis was used for analysis of the material. Result: Four main categories were identified. The categories were Birth Preparation, Well-being during Pregnancy, Prenatal attachment, and Contraindication or Adjustment. Furthermore, there were 11 subcategories and an overall theme: Sense of security and Trust. Conclusion: The midwives experience that yoga during pregnancy can contribute to increased well-being, both mentally and physically, establish prenatal attachment and prepare the pregnant women for childbirth. The midwives emphasize that their professional experiences in midwifery contributes to a deeper dimension in the yoga classes, enabling a safe practise during pregnancy. Clinical application: The study can inspire midwives to work with, or recommend prenatal yoga and inspire to further studies.

  • 245.
    Björnemalm, Victoria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Grip, Elin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnor med bröstcancer och deras erfarenheter av omvårdnad efter genomförd mastektomi: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Breast cancer is the most common cause of death in middle-aged women in Sweden after lung cancer. Treatment of breast cancer usually consists of surgery, where the affected breast is removed, mastectomy. Diagnosis with breast cancer and walking through mastectomy can lead to complex changes in the woman's identity, as well as suffering, anxiety and altered self-esteem. The purpose of the nursing care must be that the woman being cared for should be independent, and experience health. The nurse must have communicative skills to maintain person-centered care.

    Purpose:

    To compile knowledge of what experiences women with breast cancer have of nursing after completed mastectomy.

    Method:

    A literature review. The result is based on 14 scientific articles.

    Results:

    In summary, healthcare staff had difficulty meeting the needs of women after completion of mastectomy. The results show that the women had experience of inadequate information from healthcare professionals about rehabilitation and complications after mastectomy. Nursing staff lacked knowledge of complications that may arise after mastectomy to meet the needs of women. The results of the studies indicated that women lacked follow-up after mastectomy. The women were pleased with the emotional support of healthcare professionals and that the healthcare staff were supportive, provided information and that they were available for questions. The women wished the care staff to provide a person-centered approach.

    Conclusion:

    Both positive and negative experiences were found in the results of the literature review regarding women's experiences of nursing after mastectomy. Most women in the chosen studies felt that healthcare staff could not meet their needs.

  • 246.
    Björner, Elin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Stjernqvist, Hanna
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Musik – en outnyttjad resurs inom hälsofrämjande arbete: Musikens potential att understödja arbetsmetoden FaR®2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The inactivity in society contributes to increased illness and so-called lifestyle- and welfare diseases which can lead to overweight, obesity and premature death. Objective: The aim of this study is to evaluate whether music can act as a motivator and work as an effective support to the physical activity referral (PaR®) Method: Literature study with systematic analysis. Results: PaR® is a work method within the health care system which aims to promote physical activity. The method has potential for development and there is adequate evidence that music can be an effective support to PaR®. We have identified limitations and therefore developed the method by adding music as a motivating component. Conclusion: Music has shown positive qualities in terms of increased motivation and adherence to physical activity. Music has therefore the potential to act as a motivating component in the working method PaR®. Increased adherence to the prescriptions is essential to improve the health for insufficiently active patients. In the long term benefit the public health.

  • 247.
    Björnhager, Erika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Heij Rose´n, Märet
    Närståendes upplevelser och behov av sjuksköterskans stöd och bemötande vid anhörigs psykossjukdom: En kvalitativ intervjustudie med närstående2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

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

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

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

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

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

  • 248. Blennborn, Maria
    et al.
    Nilsson, S.
    Hillervik, Charlotte
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hellberg, D.
    The couple's decision-making in IVF: one or two embryos at transfer?2005In: Human Reproduction, ISSN 0268-1161, E-ISSN 1460-2350, Vol. 20, no 5, p. 1292-1297Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate the decision-making process and factors that contribute to the decision of IVF participants to choose one or two embryos at transfer.

    Methods: Two hundred and seventy-four IVF patients equally distributed in males and females were personally interviewed using a semi-structured questionnaire which included 82 items.

    Results: In the whole study population, previous childbirth [odds ratio (OR) 2.1; 95% confidence interval (CI) 1.9–3.6], and spare embryos to freeze (OR 23.6; 95% CI 11.2–54.5) emerged as the most important variables in patients who had one embryo transferred, while previous IVF treatments (OR 0.3; 95% CI 0.1–0.6) and the assumed increased pregnancy chance (OR 0.1; 95% CI 0.05–0.3) were the most important decision-making factors among those who had two embryos. The women were more satisfied with the information (83 versus 71%; P=0.02), and more aware of the risks with twin pregnancies (77 versus 66%; P=0.03) than the males. The women were also more concerned about their age. Knowledge about risks of multiple pregnancies was higher in females (77%) than in males (66%, P=0.03).

    Conclusion: The results of this study indicate that despite good information about the risks for complications with multiple pregnancies, many patients wish to have two embryos transferred. Spare embryos to freeze, improvement of pregnancy rate in single embryo transfer and young age of the woman are predictive of choosing single embryo transfer. However, the final decision must always be made in agreement with the physician.

  • 249.
    Blessborn, Daniel
    et al.
    Dalarna University, School of Technology and Business Studies, Chemical Engineering.
    Römsing, Susanne
    Dalarna University, School of Education, Health and Social Studies, Chemistry.
    Bergqvist, Yngve
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Lindegardh, Niklas
    Assay for screening for six antimalarial drugs and one metabolite using dried blood spot sampling, sequential extraction and ion-trap detection2010In: Bioanalysis, ISSN 1757-6180, E-ISSN 1757-6199, Vol. 2, no 11, p. 1839-1847Article in journal (Refereed)
    Abstract [en]

    Background: More parasites are becoming resistant to antimalarial drugs, and in many areas a change in first-line drug treatment is necessary. The aim of the developed assay is to help determine drug use in these areas and also to be a complement to interviewing patients, which will increase reliability of surveys.

    Results: This assay detects quinine, mefloquine, sulfadoxine, pyrimethamine, lumefantrine, chloroquine and its metabolite desethylchloroquine in a 100-mu l dried blood spot. Most of the drugs also have long half-lives that make them detectable at least 7 days after administration. The drugs are extracted from the dried blood spot with sequential extraction (due to the big differences in physicochemical properties), solid-phase extraction is used as sample clean-up and separation is performed with gradient-LC with MS ion-trap detection.

    Conclusion: Detection limits (S/N > 5:1) at 50 ng/ml or better were achieved for all drugs except lumefantrine (200 ng/ml), and thus can be used to determine patient compliance. A major advantage of using the ion-trap MS it that it will be possible to go back into the data and look for other drugs as needed.

  • 250.
    Blixt, Annelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jansson, Sandra
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar livskvaliteten hos patienter med svårläkta bensår: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Chronic leg ulcers are defined as wounds below the knee joint that has not healed within six weeks. The nurse has an important role in the care of patients with chronic leg ulcers, although the characteristics of the chronic leg ulcers can complicate the nurse’s work.

    Aim:

    The aim of this literature review was to describe which factors affect the quality of life in patients with chronic leg ulcers.

    Method:

    To fulfill the aim, a literature review was conducted based on 16 articles of both qualitative and quantitative approach, as well as the approach "mixed-method".

    Results:

    Chronic leg ulcers affected the patients’ quality of life from the physical, social and emotional perspective. Odour, pain, social and physical limitations and lack of coping ability have a negative impact on the quality of life. The nurse’s technical skills and ability to satisfy the patient’s need for trust and support influenced the quality of life of this patient group.

    Conclusion:

    Chronic leg ulcers often mean a deteriorated quality of life. The characteristics of the chronic leg ulcers often include odour and pain, which limits the patients’ daily life both socially and physically. These patients often experience feelings of anxiety, fear and impaired self-esteem related to how they and their leg ulcer are perceived by others, which also adversely affects their quality of life. The quality of life in patients with chronic leg ulcers is also affected by the nurse’s technical skills and ability to satisfy the patients’ need for support and a trustworthy relationship.

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