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  • 201.
    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.

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  • 202.
    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.

  • 203.
    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.

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  • 204.
    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.

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  • 205.
    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.

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  • 206.
    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.

  • 207.
    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.

  • 208. 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.

  • 209.
    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.

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  • 210.
    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.

  • 211.
    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.

  • 212. 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)
  • 213.
    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.

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  • 214.
    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.

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  • 215. 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)
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  • 216.
    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.

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  • 217. 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.

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  • 218.
    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.

  • 219.
    Björklund, Glenn
    et al.
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Born, Dennis
    Würzburg University, Germany.
    Stöggl, Thomas
    Salzburg University, Austria.
    Swarén, Mikael
    Kungliga Tekniska Högskolan.
    Performance analysis of trail running in undulating terrain2017Conference paper (Refereed)
  • 220.
    Björklund, Glenn
    et al.
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Swarén, Mikael
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Låt underlaget bestämma löpsteget2014In: Svensk Idrottsforskning: Organ för Centrum för Idrottsforskning, ISSN 1103-4629, no 4, p. 8-11Article in journal (Other academic)
  • 221.
    Björklund, Glenn
    et al.
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Swarén, Mikael
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Required shooting efficiency to win World Cup and World Championship Biathlon races during the 2015-2016 season2016Conference paper (Refereed)
  • 222.
    Björklund, Glenn
    et al.
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Swarén, Mikael
    Kungliga Tekniska Högskolan.
    Born, Dennis-Peter
    Swiss Federal Institute of Sport, Magglingen, Switzerland.
    Stöggl, Thomas
    University of Salzburg, Salzburg, Austria.
    Biomechanical Adaptations and Performance Indicators in Short Trail Running2019In: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 10, article id 506Article in journal (Refereed)
    Abstract [en]

    Our aims were to measure anthropometric and oxygen uptake (V&#x2D9;" role="presentation" style="box-sizing: border-box; display: inline; line-height: normal; font-size: 20px; overflow-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; color: rgb(62, 61, 64); font-family: Georgia, "Times New Roman", Times, serif; position: relative; outline: 0px !important;">V˙V˙O2) variables in the laboratory, to measure kinetic and stride characteristics during a trail running time trial, and then analyse the data for correlations with trail running performance. Runners (13 men, 4 women: mean age: 29 ± 5 years; stature: 179.5 ± 0.8 cm; body mass: 69.1 ± 7.4 kg) performed laboratory tests to determine V&#x2D9;" role="presentation" style="box-sizing: border-box; display: inline; line-height: normal; font-size: 20px; overflow-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; color: rgb(62, 61, 64); font-family: Georgia, "Times New Roman", Times, serif; position: relative; outline: 0px !important;">V˙V˙O2 max, running economy (RE), and anthropometric characteristics. On a separate day they performed an outdoor trail running time trial (two 3.5 km laps, total climb: 486 m) while we collected kinetic and time data. Comparing lap 2 with lap 1 (19:40 ± 1:57 min vs. 21:08 ± 2:09 min, P < 0.001), runners lost most time on the uphill sections and least on technical downhills (-2.5 ± 9.1 s). Inter-individual performance varied most for the downhills (CV > 25%) and least on flat terrain (CV < 10%). Overall stride cycle and ground contact time (GCT) were shorter in downhill than uphill sections (0.64 ± 0.03 vs. 0.84 ± 0.09 s; 0.26 ± 0.03 vs. 0.46 ± 0.90 s, both P < 0.001). Force impulse was greatest on uphill (248 ± 46 vs. 175 ± 24 Ns, P < 0.001) and related to GCT (r = 0.904, P< 0.001). Peak force was greater during downhill than during uphill running (1106 ± 135 vs. 959 ± 104 N, P< 0.01). Performance was related to absolute and relative V&#x2D9;" role="presentation" style="box-sizing: border-box; display: inline; line-height: normal; font-size: 20px; overflow-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; color: rgb(62, 61, 64); font-family: Georgia, "Times New Roman", Times, serif; position: relative; outline: 0px !important;">V˙V˙O2 max (P < 0.01), vertical uphill treadmill speed (P < 0.001) and fat percent (P < 0.01). Running uphill involved the greatest impulse per step due to longer GCT while downhill running generated the highest peak forces. V&#x2D9;" role="presentation" style="box-sizing: border-box; display: inline; line-height: normal; font-size: 20px; overflow-wrap: normal; white-space: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; padding: 0px; margin: 0px; color: rgb(62, 61, 64); font-family: Georgia, "Times New Roman", Times, serif; position: relative; outline: 0px !important;">V˙V˙O2 max, vertical running speed and fat percent are important predictors for trail running performance. Performance between runners varied the most on downhills throughout the course, while pacing resembled a reversed J pattern. Future studies should focus on longer competition distances to verify these findings and with application of measures of 3D kinematics.

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  • 223.
    Björkman, Ylva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fagerström, Jessica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nyutexaminerade sjuksköterskors upplevelser från den första tiden i yrket: en litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The nursing situation worldwide is strained. There is a lack of both undergraduate and specialist trained nurses, and many nurses leave their first workplace early for another workplace or leave the profession altogether. The education for the profession differ between different universities, but in general, the nursing students feel prepared for their new professional role. How satisfied the nurse feels at work depends on several factors, including leadership, working hours and the opportunity offered for professional development.

    Purpose: The purpose was to describe the newly graduated nurses' early experiences within the profession in regards to inpatient care.

    Method: The research was conducted as a literature review based on 15 articles searched in the databases PubMed and CINAHL. The search-terms used were derived from the purpose. The included articles were quality appraises and then analyzed by identifying differences and similarities that were sorted into categories and subcategories.

    Result: The newly graduated nurses experienced stress and a high workload during the shift from student to nurse. Guidance and training were described as important factors to facilitate the transition. Teamwork was also an important factor and the team also affected the newly graduated nurse's self-confidence.

    Conclusion: Training and supervision are important for the newly graduated nurses to develop and obtain positive experiences early in the profession and thus want to stay in the workplace. It is therefore important to develop team collaboration as the team is of great importance for the early experiences in the profession.

  • 224.
    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.

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  • 225.
    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.

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  • 226.
    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.

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  • 227.
    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.

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  • 228.
    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.

  • 229.
    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.

  • 230.
    Björs, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Forslund, Ebba
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Föräldrars upplevelser vid beskedet att barnet dött före födelsen: En kvalitativ metasyntes2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year, about 2.6 million stillbirths occur globally. The majority occur in low- or middle-income countries. In 2018, 442 babies died before birth in Sweden. This means that Sweden have the highest proportion of stillbirths in the Nordic countries. It is a clear difference in proportion of stillbirths within Sweden´s regions and countries, which indicates opportunities to lower the number of stillborn babies nationally. Over the past 10 years, the number of stillborn in Sweden has been relatively constant.

    Aim: The aim for this study was to describe parent’s experience at the time of the diagnosis that the baby died before birth.

    Methods: Qualitative meta-synthesis. In total, 16 scientific studies were analyzed and qualified for this study. Data was analyzed by meta-ethnography.

    Results: Three main themes were identified. The Diagnosis, with subthemes; When every second is an eternity, Emotions that occur, Alone in silence and Not realizing the worst. The second main theme was The needs of parents with subtheme; Confirmation, The possibility to have impact on the care and The impact of the environment. The last main theme was Communication, with subthemes; Clear and empathetic and The unspoken.

    Conclusion: The parents experienced a waiting for the diagnosis, the next step and meeting their child. The diagnosis brought up a lot of emotions and reactions. The parents experienced loneliness in a situation that they could not control. The parents expressed a need for validation for themselves and their child. The environment influenced the way the parents handled the diagnosis. They needed to stay in a secluded part on the maternity ward. Parents expressed a need for open, clear and empathetic communication.

    Clinical applicability: The study can provide and increased knowledge to midwives and other caregivers who are encounters of the parents at the time of the diagnosis.

  • 231. 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.

  • 232.
    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.

  • 233.
    Blixt, Sonia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lilja Fryxell, Emma
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    ARBETSRELATERADE STRESSFAKTORER FÖR SJUKSKÖTERSKOR INOM AKUTSJUKVÅRDEN Litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT:

    Background: Work related stress among nurses contributes to a high percentage

    of sick leave. The work pace is often higher in the emergency care than in other

    work areas and the amount of people passing thru is high. Nurses working in

    emergency care are more exposed to stress. Coping strategies can be used to

    handle stress. Purpose: The purpose is to find out which stressors that has an

    impact on nurses health in the emergency care and which coping strategies that can

    be helpful to handle the stress. Method: Literature review of twelve qualitative

    and quantitative scientific articles regarding the nurse in emergency care, workrelated

    stressors and coping strategies. Results: Work-related stressors contributes

    to illness and suffering for the nurse in emergency care. Coping strategies like

    support from colleagues, debriefing, review of the workplace, and mindfulness

    contributes to that work-related stress is manageable and that health is achieved.

    Conclusion: Stressors such as lack of nurses, death or sexual abuse of children,

    violence and threats from patients and families, as well as deficiencies in the work

    environment contributes to work-related stress. Coping strategies may help to

    prevent work-related stress. But for coping strategies to work it is important to use

    the existing strategies and that time and opportunity are available at work to

    perform these.

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  • 234.
    Blom, Daniel
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Musikens inverkan på prestationen hos Trumslagare2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose:

    the purpose of this study was to see if the performance in the form of number of arrests of drummers were influenced with the help of music. Since the year 2000 so is it a sport that goes under the epithet" Extreme sport drumming" World’s Fastest Drummer (WFD) where it is at in 1 minute to make as many raids as possible on a snare drum. During these competitions used music as a tool without the participants perform the operation only to the sound that d that they do by the gambling. Method: The Method used in this study is of kvasiexperiment design in which the dependent /independent variable measured. In the study, eight adult professionals entered their experience ranges between 15 and more than 40 years’ total in the exercise of drumming. All participants used the same music where the song was" the Living dead" with Entombed and from the album Clandestine that gave out in 1991. Initially, participants were to perform step 1 without music to in subsections 2 to repeat the procedure again with the music. After completed the test answered the participants on how they experienced the music: Motivating, Annoying, or indifferent. Results: During this study was no significant difference detected between the conditions, some of the participants performed better without music than with. Conclusion: in Order to achieve an adequate effect of the music, so it seems that it has the best effect during the working hours where it then goes to draw the focus towards the music, and thus perform better.

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  • 235.
    Blom, Åsa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hertzberg, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Närståendes upplevelse av stöd, när anhörig drabbas av allvarlig sjukdom.: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Already in the 1970’s were significant others situation in the

    healthcare highlighted, and although there has been an increase on family-related

    research over the past 20 years, there are still gaps in family-related care.

    Aim: The aim was to describe significant others experience of needs from the

    nurse, when a patient suffer from a serious illness or injury.

    Method: The study was conducted as a literature review, which included 10

    articles of which 8 were qualitative and 2 were quantitative. Searches were made

    in Cinahl, PubMed and DiVA. The content was analyzed and themes were

    identified.

    Result: Two main themes and three subthemes were identified. The first main

    theme was the significant other’s needs, with the first subtheme being the meaning

    of communication in healthcare with the significant other and the second subtheme

    being recovery. The second main theme was available support, with the subtheme

    being significant others participation in care.

    Conclusion: The study implies that significant others felt a need to be involved in

    health care around the patient, especially by getting information. To involve the

    significant other can reduce the stress experience, which in turn can raise the trust

    in health care.

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  • 236.
    Blomberg, Alva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Back, Rickard
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som hindrar sjuksköterskan att arbeta trycksårsförebyggande: En litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pressure ulcer is a common healthcare injury despite the presence of risk assessment tools and guidelines. Pressure ulcer is an expensive injury that often causes extended hospital stay. Patients with pressure ulcers can experience malaise, pain, depression and loss of social life related to the wound. The nurse responsibility is to discover risk patients and give them proper preventive actions against pressure ulcers.

    Aim: The aim of the study is to describe factors that prevents the nurse from performing pressure ulcer preventions.

    Method: The study was conducted as a literature review. By comparing scientific articles results an overview of the current research situation took form. To find scientific articles the databases Cinahl, Pubmed and Web of science was used. 19 articles from year 2009 to 2019 was found and used in the result.

    Result: The result is divided in two categories; the nurses lack of pressure ulcer knowledge and organizational factors that prevents the nurse from performing pressure ulcer prevention. Factors that prevents the nurse from performing pressure ulcer prevention is lack of knowledge, negative attitudes towards the preventive work, lack of staff, lack of time, heavy workload, lack of pressure relief material and lack of training in school and at the workplace.

    Conclusion: The result shows that nurses had generally low knowledge regarding pressure ulcers and pressure ulcer prevention. The lack of knowledge was an obstacle for nurses in the providing of pressure ulcer prevention. Some nurses thought that risk assessment tools were no good, they rather use their clinical eye. The organizational obstacles meant that the nurses did not have time or possibility to provide pressure ulcer prevention. This means that the patients at risk does not always get the correct preventive care.

  • 237.
    Blomberg, Helena
    et al.
    Mälardalens högskola, Hälsa och välfärd.
    Stier, Jonas
    Mälardalens högskola, Hälsa och välfärd.
    Havererade vårdkontakter: De professionellas vittnesmål om vanskliga vårdrelationer; hur de kan förstås, hanteras och förebyggas2014Report (Other academic)
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  • 238.
    Blomgren, Johanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors upplevelser av kontinuerligbarnmorskeledd vård. Från tidig graviditet tillnybliven förälder - en Litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Continuous midwifery-led care is a concept based on the assumption that

    women who receive care the same midwife during pregnancy, childbirth and postpartum care

    will take an active part in their own care and feel a strong sense of satisfaction and personal

    control.

    Aim:

    To describe the knowledge of women's experiences of continuous midwifery-led care,

    from early pregnancy to being a new parent.

    Method:

    A literature review was conducted with 12 articles searched through Cinahl och

    Pubmed.

    Results:

    Continuous midwife-led care contributed to women taking active decisions

    regarding their care, feeling a greater sense of self-esteem and experiences an increased

    confidence before childbirth. The study highlighted the importance of a good relationship,

    clear information and that they had time to describe their wishes before delivery. The women

    felt that the continuous midwifery-led care was respectful and accessible and gave them

    emotional support and where conducted in a safe and competent way.

    Conclusion:

    Continuous midwifery-led care during maternity care, childbirth and postpartum

    periods can strengthen women's sense of participation in care, positively affect the

    relationship between the woman and midwife, and strengthen the woman's self-esteem before

    birth.

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  • 239.
    Blomkvist, Sven
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Grønning, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Musik som verktyg inom vården av personer med demenssjukdom – en litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Globally, dementia is considered one of the major diseases of the population. Symptoms of dementia are divided into cognitive, behavioral and physical. These cause severe suffering to the person with dementia and is a challenge for the relatives and healthcare professionals. Care and nursing for persons with dementia should, according to the National Board of Health and Welfare, be given from a person-centered approach. Previous research shows that person-centered care is recommended for providing high-quality care. The nurse's responsibility is nursing. The consensus concept of nursing is a human being, health, nursing and the environment. Previous research shows that music can be a useful in the care of people with dementia. Purpose: To present research describing how music is used in dementia care and demonstrate the possible effects on people with dementia.  Method: Literature review to compile the state of knowledge. Articles were searched in the databases PubMed, CINAHL and PsycINFO with the search words "dementia", "music", "care" and "nurs *". After the quality review, 16 articles were included. The articles were analyzed, interpreted and compiled in a result matrix. Result: The result of the literature review showed that music as part of the nursing and care had a positive effect on the symptoms associated with dementia. The most significant positive effects were found in the four areas of behavioral, psychological, cognitive symptoms and quality of life. Conclusion: Music is a good alternative and/or supplement in nursing and treatment of people with dementia.

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  • 240.
    Blomqvist, Julia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustafson, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors erfarenheter av och strategier vid svåra samtal med patienter i livets slut – en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this study was to describe nurses' experiences and strategies in situations of difficult conversations with patients at the end stage of life.

    Method: The study was conducted as a literature survey. The result is based on 14 articles of quantitative and qualitative approach, which were collected from CINAHL and PubMed.

    Results: Nurses experienced conversations with patients at the end stage of life as a difficult task to deal with. The lack of knowledge were the main factors that affected the implementation of difficult conversations. The nurses used different strategies in order to help the patient in the best way possible. The nurses had strategies that were about to try to build a relationship with the patient. They prepared themselves before they would meet with the patient to have such a great picture of the patient's situation as possible. The attitude towards the patient could adapt depending on the patient they met. Some nurses had as a strategy to avoid the difficult conversations with patients at end of life. It is because of a lack of knowledge about the management of difficult conversations.

    Conclusion: The lack of knowledge influenced the nurses handling of difficult conversations, thus it is highly relevant that the opportunity of additional theory is available. Practical knowledge can be obtained by colleagues and other workers within the profession, which can give nurses the opportunity to further develop strategies to improve the handling of difficult conversations.

  • 241.
    Boberg, Emma
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Grannas, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans omvårdnad av patienter med kognitiv svårighet som ADHD: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Attention Deficit/Hyperactivity Disorder (ADHD) is an increasingly common diagnosis among adults. Nurses need to have the ability to be able to meet this patient groups needs.

    Aim: The purpose is to describe nurses’ experience in care of patients with cognitive difficulties with focus on ADHD.

    Method: The design is a literature review of 9 qualitative and quantitative articles. The collection of data has been done via the databases Cinahl, Psycinfo and PubMed.

    Result: The review of the articles resulted in two main themes: Conditions and limitations in nursing care in patients with cognitive difficulties as ADHD with three subtopics Time, Treatment and Attitudes and Communication between nurse and patient and care units with two subtopics; Communication between nurse and patient and Communication between care units. The results show that conditions and limitations for example time, attitudes and relationships affected nursing in care of patients with cognitive difficulties as ADHD. There could be negative attitudes among healthcare professionals. However, a therapeutic relationship and communication between a nurse and a patient was found to benefit nursing patients with cognitive difficulties such as ADHD.

    Conclusion: Communication was an important factor in the care of patient with ADHD and the nurse had an important role in this. Time and the patient’s conditions could affect the nurses’ potential of communication.

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  • 242.
    Boberg, Kajsa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Ismail, Mahabat
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    En jämförelse mellan den självskattadeförlossningsupplevelsen hos kvinnor med normalgraviditet och kvinnor med graviditetsdiabetes: En retrospektiv tvärsnittsstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: How the midwife treats the women impacts her experience of childbirth. Women with GDM experience the diagnosis as stressful and worrisome, time-consuming and they wish for a pregnancy without GDM. The number of studies about their childbirth experience is low. Aim: A comparison of the self-assessed childbirth experience between women with a normal pregnancy and women with a GDM-diagnosis. To identify factors that can impact on the childbirth experience. Methods: A retrospective cross-sectional study. Data was collected thru a survey, using the VAS-scale, and registerdata from MFR. A total of 391 participated, 326 with a normal pregnancy and 65 with GDM. The material was analyzed using parametric and non-parametric statistics. Result: A total of 36,1% had a negative childbirth experience. It was more common within the GDM-group (55,4%) to have a negative experience than for women with a normal pregnancy (32,2%). Factors correlating with a negative experience was, a high BMI, born outside of Sweden, primiparous and if the women were unsatisfied with the provided pain-relief. Conclusion: Women with a GDM-diagnosis has a significantly more negative childbirth experience, factors related to pregnancy and childbirth showed a correlation with a negative childbirth experience. Clinical application: The results can be used to improve healthcare for women with GDM to contribute to a more positive childbirth experience.

  • 243.
    Bodin, Annelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ringlund, Sofie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors erfarenheter av att arbeta med personcentrerad vård inom vård- och omsorgsboende – En kvalitativ intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background In person-centered care the patient and his/her experience of illness, disease, social content and close relationships is central. Person-centered care emanates from three keywords developed at University of Gothenburg Centre for Person-Centered Care (GPCC): Partnership, the patient narrative and documentation. Purpose To describe the experiences nurses have from person-centered care and how they work with partnership, the patient narrative and documentation at general units in nursing homes. Method Descriptive study conducted with a qualitative deductive approach. The study was based upon eight semi-structured interviews and data was analyzed using qualitative content analysis. Results One theme was identified: The communicative conversation used as a tool in order to perform person-centered care. Three categories were predetermined and the analysis resulted in seven subcategories: Partnership; to utilize the patient´s knowledge, to utilize the knowledge held by relatives, caregivers and the nurse, The patient narrative and Documentation; documentation of the story of the patient´s life, documentation in individualized care-plans and documentation in the system of documentation from a personal- centered perspective. Conclusion The communicative conversation was essential in order to perform person-centered care. Within this conversation, the nurse will be able to develop a relationship with the patient and from that relationship a partnership will evolve. In addition, a communicative conversation is of crucial importance in order to evolve relationships with relatives and to maintain functional cooperation. However, it turned out that the nurses experienced that they worked too far from the older person and that they did not always have time for in-depth conversations.

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  • 244. Bogren Jungmarker, Emily
    et al.
    Lindgren, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hildingsson, Ingegerd
    Playing the second fiddle is okay: Swedish fathers' experiences of prenatal care2010In: Journal of midwifery & women's health, ISSN 1526-9523, E-ISSN 1542-2011, Vol. 55, no 5, p. 421-429Article in journal (Refereed)
    Abstract [en]

    In Sweden, prospective fathers are encouraged and welcome to attend prenatal visits, and pregnant women assess their partners’ involvement in prenatal care as very important. The aim of this study was to describe expectant fathers’ experiences of and involvement in prenatal care in Sweden. Data were drawn from a 1-year cohort study of 827 Swedish-speaking fathers recruited during their partners’ mid-pregnancy and followed up two months after childbirth. The participants reported that the most important issues in prenatal care were the woman’s physical and emotional wellbeing and the support she received from her midwife. However, care was identified as deficient in nearly all aspects of information, medical care, and fathers’ involvement. “Excessive” care was also reported and related to how the father was treated by the midwife, mainly in terms of attention to his emotional wellbeing. Although fathers prioritize the needs of their pregnant partners, it is important for caregivers to assess fathers’ needs and incorporate a family-oriented approach to prenatal care.

  • 245.
    Bogren, M.
    et al.
    PhD Student, University of Gothenburg, Gothenburg.
    Bajracharya, U.
    Maharajgunj Nursing Campus, Tribhuvan University, Nepa.
    Berg, M.
    Professor, Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Mälardalens högskola.
    Ireland, J.
    Midwife, RCM Union Learning Rep & Supervisor of Midwives, St Mary's Maternity Unit, Poole Hospital, United Kingdom.
    Simkhada, P.
    Senior Lecturer, School of Health and Related Research (ScHARR) University of Sheffield and MMIHS, United Kingdom.
    Van Teijlingen, Edwin
    Professor, Centre for Midwifery, Maternal & Perinatal Health, Bornemouth University & Visiting Professor, MMIHS, Tribhuvan University, United Kingdom.
    Nepal needs midwifery2013In: Journal of Manmohan Memorial Institute of Health Sciences, ISSN 2091-1041, Vol. 1, no 2, p. 41-44Article in journal (Refereed)
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  • 246. Bogren, M.
    et al.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, A.
    Kalid, M.
    Abdi Igal, A.
    Mohamed, J.
    Said, F.
    Pedersen, Christina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Byrskog, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Osman, Fatumo
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Health workforce perspectives of barriers inhibiting the provision of quality care in Nepal and Somalia: A qualitative study2020In: Sexual and Reproductive Healthcare, ISSN 1877-5756, Vol. 23, article id 100481Article in journal (Refereed)
    Abstract [en]

    Objective

    In this paper settings from Nepal and Somalia are used to focus on the perspectives of healthcare providers within two fragile health systems. The objective of this study was to describe barriers inhibiting quality healthcare in Nepal and Somalia from a health workforce perspective.

    Methods

    Data were collected through 19 semi-structured interviews with healthcare providers working in healthcare facilities. Ten interviews were conducted in Nepal and nine in Somalia.

    Results

    Various structural barriers inhibiting the availability, accessibility, and acceptability of the quality care were similar in both countries. Barriers inhibiting the availability of quality care were linked to healthcare providers being overburdened with multiple concurrent jobs. Barriers inhibiting the accessibility to quality healthcare included long distances and the uncertain availability of transportation, and barriers to acceptability of quality healthcare was inhibited by a lack of respect from healthcare providers, characterised by neglect, verbal abuse, and lack of competence.

    Conclusions

    Inequality, poverty, traditional and cultural practices plus the heavy burden placed on healthcare providers are described as the underlying causes of the poor provision of quality care and the consequential shortcomings that emerge from it. In order to improve this situation adequate planning and policies that support the deployment and retention of the healthcare providers and its equitable distribution is required. Another important aspect is provision of training to equip healthcare providers with the ability to provide respectful quality care in order for the population to enjoy good standard of healthcare services.

  • 247.
    Bogren, Malin
    et al.
    UNPF, Bangladesh.
    Begum, Farida
    UNPF, Bangladesh.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    The historical development of the midwifery profession in Bangladesh2017In: Journal of Asian Midwives (JAM), ISSN 2409-2290, Vol. 4, no 1, p. 65-74Article in journal (Refereed)
    Abstract [en]

    Sexual and reproductive health and rights have been identified as the core areas of practice, theory and research for the midwifery profession. The midwifery profession, as defined by the International Confederation of Midwives Global Standards, is new in Bangladesh. This paper aims to give an overview of the historical process that has taken place in the past decades to develop the midwifery profession in Bangladesh. The professional development of midwives is the result of many years of collaboration and relationship building among stakeholders such as the government, non-government organizations, academia, professional associations, United Nations agencies, and donors. All are working toward achieving the common goal of preventing/ reducing maternal and child mortality through education, the development of supportive laws, policies and guidelines, and the deployment of midwives. Lessons learnt from the Bangladesh experience can provide useful guidance for other countries in Asia that are currently establishing midwifery as a profession that aims to provide safe and high quality sexual, reproductive, maternal and newborn care.

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  • 248.
    Bogren, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Opportunities, challenges and strategies when building a midwifery profession. Findings from a qualitative study in Bangladesh and Nepal2018In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 16, p. 45-49Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of this paper was to identify opportunities and challenges when building a midwifery profession in Bangladesh and Nepal.

    Methods

    Data were collected through 33 semi-structured interviews with government officials, policy-makers, donors, and individuals from academia and non-government organizations with an influence in building a midwifery profession in their respective countries. Data were analyzed using content analysis.

    Findings

    The opportunities and challenges found in Bangladesh and Nepal when building a midwifery profession emerged the theme “A comprehensive collaborative approach, with a political desire, can build a midwifery profession while competing views, interest, priorities and unawareness hamper the process”. Several factors were found to facilitate the establishment of a midwifery profession in both countries. For example, global and national standards brought together midwifery professionals and stakeholders, and helped in the establishment of midwifery associations. The challenges for both countries were national commitments without a full set of supporting policy documents, lack of professional recognition, and competing views, interests and priorities.

    Conclusion and clinical application

    This study demonstrated that building a midwifery profession requires a political comprehensive collaborative approach supported by a political commitment. Through bringing professionals together in a professional association will bring a professional status. Global standards and guidelines need to be contextualized into national policies and plans where midwives are included as part of the national health workforce. This is a key for creating recognized midwives with a protected title to autonomously practice midwifery, to upholding the sexual and reproductive health and rights for women and girls.

  • 249.
    Bogren, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Byrskog, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    What prevents midwifery quality care in Bangladesh? A focus group enquiry with midwifery students2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 1, article id 639Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: With professional midwives being introduced in Bangladesh in 2013, the aim of this study was to describe midwifery students perceptions on midwives' realities in Bangladesh, based on their own experiences.

    METHOD: Data were collected through 14 focus group discussions that included a total of 67 third-year diploma midwifery students at public nursing institutes/colleges in different parts of Bangladesh. Data were analyzed deductively using an analytical framework identifying social, professional and economical barriers to the provision of quality care by midwifery personnel.

    RESULTS: The social barriers preventing midwifery quality care falls outside the parameters of Bangladeshi cultural norms that have been shaped by beliefs associated with religion, society, and gender norms. This puts midwives in a vulnerable position due to cultural prejudice. Professional barriers include heavy workloads with a shortage of staff who were not utilized to their full capacity within the health system. The reason for this was a lack of recognition in the medical hierarchy, leaving midwives with low levels of autonomy. Economical barriers were reflected by lack of supplies and hospital beds, midwives earning only low and/or irregular salaries, a lack of opportunities for recreation, and personal insecurity related to lack of housing and transportation.

    CONCLUSION: Without adequate support for midwives, to strengthen their self-confidence through education and through continuous professional and economic development, little can be achieved in terms of improving quality care of women during the period around early and late pregnancy including childbirth.The findings can be used for discussions aimed to mobilize a midwifery workforce across the continuum of care to deliver quality reproductive health care services. No matter how much adequate support is provided to midwives, to strengthen their self-confidence through education, continuous professional and economic development, addressing the social barriers is a prerequisite for provision of quality care.

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  • 250. Bogren, Malin
    et al.
    Rosengren, Josefin
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Berg, Marie
    Build professional competence and equip with strategies to empower midwifery students - An interview study evaluating a simulation-based learning course for midwifery educators in Bangladesh.2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 35, p. 27-31Article in journal (Refereed)
    Abstract [en]

    Use of simulation-based learning in midwifery education programmes is crucial. Due to midwifery educators in Bangladesh were lacking competence in using such pedagogical methods in their teaching, they were invited to participate in a simulation-based learning course. In this paper, we present a study on the perceived usefulness of this course. Semi-structured individual interviews were conducted with 17 of the 28 midwifery educators participating on the course and data were analysed using inductive content analysis. Findings showed that the simulation-based learning course for midwifery educators in Bangladesh was useful. It "builds the professional competence of midwifery educators" and "equips them with strategies to empower midwifery students". The findings show that a simulation-based learning course is of major importance in pre-service education in settings where the capacity of midwifery educators needs to be strengthened. However, without continuous in-service training, the midwives' competence will deteriorate and this in turn will threaten the quality of midwifery education and the midwifery profession. Thus, contextualized pre- and in-service simulation-based education to secure midwifery core competencies is necessary. Simultaneously implementing and evaluating pre- and in-service education programmes is the next step in the struggle to increase the quality of maternity care services.

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