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  • 2251. Äng, Björn
    et al.
    Monnier, A.
    Harms-Ringdahl, K.
    Neck/shoulder exercise for neck pain in air force helicopter pilots: a randomized controlled trial2009In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 34, no 16, p. E544-51Article in journal (Refereed)
  • 2252.
    Äretun Ulander, Amanda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Daniel
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientsäkerhet avseende läkemedelshantering i hemsjukvården: - En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The number of patients receiving medical care in their own home is increasing. Home health care is a trend that is expected to continue. Patient safety is a national and international priority, where medical management is a risk area both in home and institutional care. Previous research has focused more on patient safety in institutional care. Highlighting patient safety and what nurses can do to increase patient safety in home care is therefore important.

    Aim:

    The aim of this study was to explore patient safety risks regarding medical management in home health care and what nurses can do to increase patient safety in the area.

    Method:

    This study was conducted as a literature review and the result is based on 14 scientific articles. The searches were performed in the databases Cinahl and PubMed.

    Result:

    Nine patient safety risks were identified where lack of competence, shortcomings in communication, the delegation process, comorbidity and information transfer are some of them. The identified risks were further linked to three main areas depending on the underlying cause: Nurses and other health professionals; Patient and the home environment; Organisation and systems.

    Conclusion:

    Medical management is a significant risk area in home health care where many factors affect patient safety. That nurses and other home care professionals are well aware of these risks provide a good prerequisite for preventing and minimizing the incidence of medical related adverse events.

  • 2253.
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Cathepsin S as a biomarker: where are we now and what are the future challenges2012In: Biomarkers in Medicine, ISSN 1752-0363, Vol. 6, no 1, p. 9-11Article, review/survey (Refereed)
  • 2254.
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Diminished renal function and the incidence of heart failure2009In: Current Cardiology Reviews, ISSN 1573-403X, Vol. 5, no 3, p. 223-227Article in journal (Refereed)
    Abstract [en]

    Heart failure is one of the most common, costly, disabling and deadly diseases. During the last decade, several different indices reflecting renal function such as creatinine-based glomerular filtration rate, circulating levels of cystatin C and low-grade albuminuria have been demonstrated to be independent risk factors for heart failure. This review summarizes our current knowledge of the relationship between diminished renal function and the incidence of heart failure in the community, and also in individuals with increased risk of heart failure such as patients with overt cardiovascular disease, hypertension or diabetes. This review will also put forward important areas of future research in this field.

  • 2255.
    Ärnlöv, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Carlsson, Axel C
    Sundström, Johan
    Ingelsson, Erik
    Larsson, Anders
    Lind, Lars
    Larsson, Tobias E
    Higher fibroblast growth factor-23 increases the risk of all-cause and cardiovascular mortality in the community2013In: Kidney International, ISSN 0085-2538, E-ISSN 1523-1755, Vol. 83, p. 160-166Article in journal (Refereed)
    Abstract [en]

    Fibroblast growth factor-23 (FGF23), a regulator of mineral metabolism, has been linked to cardiovascular disease in chronic kidney disease. As community-based data of the longitudinal association between FGF23 and cardiovascular events are lacking, we investigated a possible relationship in 727 men of the Uppsala Longitudinal Study of Adult Men population-based cohort (mean age 77 years). During a median follow-up of 9.7 years, 110 participants died of cardiovascular causes. In Cox regression models adjusted for age and established cardiovascular risk factors, higher serum FGF23 was associated with a significantly increased risk for cardiovascular mortality (hazard ratio (HR) per increased s.d. of 1.36). This relationship remained significant, albeit attenuated, after adjustment for glomerular filtration rate (GFR) (HR 1.21). FGF23 was also associated with all-cause mortality, although the association was weaker than that with cardiovascular mortality, and it was nonsignificant in fully adjusted multivariate models. Spline analysis suggested a log-linear relationship between FGF23 and outcome. Participants with a combination of high FGF23 (>60 pg/ml), low GFR (<60 ml/min), and micro-/macro-albuminuria (albumin/creatinine ratio above 3 mg/ml) had an almost eightfold increased risk compared with participants without these abnormalities. Thus, a higher FGF23 level is associated with an increased cardiovascular mortality risk in the community. Clinical trials are needed to determine whether FGF23 is a modifiable risk factor.Kidney International advance online publication, 5 September 2012; doi:10.1038/ki.2012.327.

  • 2256.
    Ärnlöv, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala Univ, Dept Publ Hlth & Caring Sci, Sect Geriatr, Uppsala, Sweden.
    Carlsson, Axel C.
    Sundström, Johan
    Ingelsson, Erik
    Larsson, Anders
    Lind, Lars
    Larsson, Tobias E.
    Serum FGF23 and risk of cardiovascular events in relation to mineral metabolism and cardiovascular pathology2013In: American Society of Nephrology. Clinical Journal, ISSN 1555-9041, E-ISSN 1555-905X, Vol. 8, no 5, p. 781-786Article in journal (Refereed)
    Abstract [en]

    Background and objectives Circulating fibroblast growth factor-23 is associated with adverse cardiovascular outcomes in CKD and non-CKD individuals, but the underlying mechanism remains unclear. This study tested whether this association is independent of mineral metabolism and indices of subclinical cardiovascular pathology. Design, setting, participants, & measurements The prospective association between fibroblast growth factor-23 and major cardiovascular events (a composite of hospital-treated myocardial infarction, hospital-treated stroke, or all-cause mortality) was investigated in the community-based Prospective Investigation of the Vasculature in Uppsala Seniors (n=973; mean age=70 years, 50% women) using multivariate logistic regression. Subjects were recruited between January of 2001 and June of 2004. Results During follow-up (median=5.1 years), 112 participants suffered a major cardiovascular event. In logistic regression models adjusted for age, sex, and estimated GFR, higher fibroblast growth factor-23 was associated with increased risk for major cardiovascular events (odds ratio for tertiles 2 and 3 versus tertile 1=1.92, 95% confidence interval=1.19-3.09, P<0.01). After additional adjustments in the model, adding established cardiovascular risk factors, confounders of mineral metabolism (calcium, phosphate, parathyroid hormone, and 25 (OH)-vitamin D), and indices of subclinical pathology (flow-mediated vasodilation, endothelial-dependent and -independent vasodilation, arterial stiffness, and atherosclerosis and left ventricular mass) attenuated this relationship, but it remained significant (odds ratio for tertiles 2 and 3 versus tertile 1=1.69, 95% confidence interval=1.01-2.82, P<0.05). Conclusions Fibroblast growth factor-23 is an independent predictor of cardiovascular events in the community, even after accounting for mineral metabolism abnormalities and subclinical cardiovascular damage. Circulating fibroblast growth factor-23 may reflect novel and important aspects of cardiovascular risk yet to be unraveled. Clin J Am Soc Nephrol 8: 781-786, 2013. doi: 10.2215/CJN.09570912

  • 2257.
    Ärnlöv, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Ingelsson, E
    Sundström, J
    Lind, L
    The impact of body mass index and the metabolic syndrome on the risk of cardiovascular disease and mortality in middle-aged men2010In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 121, no 2, p. 230-236Article in journal (Refereed)
    Abstract [en]

    Background— The purpose of this study was to investigate associations between combinations of body mass index (BMI) categories and metabolic syndrome (MetS) and the risk of cardiovascular disease and death in middle-aged men. Methods and Results— At age 50 years, cardiovascular risk factors were assessed in 1758 participants without diabetes in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM). According to BMI-MetS status, they were categorized as normal weight (BMI <25 kg/m2) without MetS (National Cholesterol Education Program criteria; n=891), normal weight with MetS (n=64), overweight (BMI 25 to 30 kg/m2) without MetS (n=582), overweight with MetS (n=125), obese (BMI >30 kg/m2) without MetS (n=30), or obese with MetS (n=66). During follow-up (median 30 years), 788 participants died, and 681 developed cardiovascular disease (composite of cardiovascular death or hospitalization for myocardial infarction, stroke, or heart failure). In Cox proportional-hazards models that adjusted for age, smoking, and low-density lipoprotein cholesterol, an increased risk for cardiovascular disease was observed in normal-weight participants with MetS (hazard ratio 1.63, 95% confidence interval 1.11 to 2.37), overweight participants without MetS (hazard ratio 1.52, 95% confidence interval 1.28 to 1.80), overweight participants with MetS (hazard ratio 1.74, 95% confidence interval 1.32 to 2.30), obese participants without MetS (hazard ratio 1.95, 95% confidence interval 1.14 to 3.34), and obese participants with MetS (hazard ratio 2.55, 95% confidence interval 1.81 to 3.58) compared with normal-weight individuals without MetS. These BMI-MetS categories significantly predicted total mortality rate in a similar pattern. Conclusions— Middle-aged men with MetS had increased risk for cardiovascular events and total death regardless of BMI status during more than 30 years of follow-up. In contrast to previous reports, overweight and obese individuals without MetS also had an increased risk. The present data refute the notion that overweight and obesity without MetS are benign conditions.

  • 2258.
    Ärnlöv, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Larsson, Tobias E
    The authors reply2013In: Kidney International, ISSN 0085-2538, E-ISSN 1523-1755, Vol. 84, no 3, p. 621-Article in journal (Refereed)
  • 2259.
    Ärnlöv, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Ruge, Toralph
    Ingelsson, Erik
    Larsson, Anders
    Sundström, Johan
    Lind, Lars
    Serum endostatin and risk of mortality in the elderly: findings from 2 community-based cohorts2013In: Arteriosclerosis, Thrombosis and Vascular Biology, ISSN 1079-5642, E-ISSN 1524-4636, Vol. 33, no 11, p. 2689-2695Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Experimental data imply that endostatin, a proteolytically cleaved fragment of collagen XVIII, could be involved in the development of cardiovascular disease and cancer. Prospective data concerning the relation between circulating endostatin and mortality are lacking. Accordingly, we aimed to study associations between circulating endostatin and mortality risk.

    APPROACH AND RESULTS: Serum endostatin was analyzed in 2 community-based cohorts: the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS; women 50%, n=931; mean age, 70 years; median follow-up, 7.9 years) and the Uppsala Longitudinal Study of Adult Men (ULSAM; n=748; mean age, 77 years; median follow-up, 9.7 years). During follow-up, 90 participants died in PIVUS (1.28/100 person-years at risk), and 417 participants died in ULSAM (6.7/100 person-years at risk). In multivariable Cox regression models adjusted for age and established cardiovascular risk factors, 1 SD higher ln(serum endostatin level) was associated with a hazard ratio of mortality of 1.39 and 95% confidence interval, 1.26 to 1.53, on average in both cohorts. In the ULSAM cohort, serum endostatin was also associated with cardiovascular mortality (177 deaths; hazard ratio per SD of ln[endostatin] 1.45, 95% confidence interval [1.25-1.71]) and cancer mortality (115 deaths; hazard ratio per SD of ln[endostatin] 1.35, 95% confidence interval [1.10-1.66]).

    CONCLUSIONS: High serum endostatin was associated with increased mortality risk in 2 independent community-based cohorts of the elderly. Our observational data support the importance of extracellular matrix remodeling in the underlying pathophysiology of cardiovascular disease and cancer.

  • 2260.
    Ärnlöv, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Sundström, J
    Ingelsson, E
    Lind, L
    The impact of body mass index and the metabolic syndrome on the risk of diabetes in middle-aged men2011In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 34, no 1, p. 61-65Article in journal (Refereed)
    Abstract [en]

    Objective: The existence of an obese subgroup with a healthy metabolic profile and low diabetes risk has been proposed; yet long-term data are lacking. We aimed to investigate associations between combinations of BMI categories and metabolic syndrome and risk of type 2 diabetes in middle-aged men.

    Research design and methods: At age 50, cardiovascular risk factors were assessed in 1,675 participants without diabetes in the community-based Uppsala Longitudinal Study of Adult Men (ULSAM) study. According to BMI/metabolic syndrome status, they were categorized as normal weight (BMI <25 kg/m2) without metabolic syndrome (National Cholesterol Education Program criteria, n = 853), normal weight with metabolic syndrome (n = 60), overweight (BMI 25–30 kg/m2) without metabolic syndrome (n = 557), overweight with metabolic syndrome (n = 117), obese (BMI >30 kg/m2) without metabolic syndrome (n = 28), and obese with metabolic syndrome (n = 60). We investigated the associations between BMI/metabolic syndrome categories at baseline and diabetes incidence.

    Results: After 20 years, 160 participants had developed diabetes. In logistic regression models adjusting for age, smoking, and physical activity, increased risks for diabetes were observed in the normal weight with metabolic syndrome (odds ratio 3.28 [95% CI] 1.38–7.81; P = 0.007), overweight without metabolic syndrome (3.49 [2.26–5.42]; P < 0.001), overweight with metabolic syndrome (7.77 [4.44–13.62]; P < 0.001), obese without metabolic syndrome (11.72 [4.88–28.16]; P < 0.001), and obese with metabolic syndrome (10.06 [5.19–19.51]; P < 0.001) categories compared with the normal weight without metabolic syndrome category.

    Conclusions: Overweight or obese men without metabolic syndrome were at increased risk for diabetes. Our data provide further evidence that overweight and obesity in the absence of the metabolic syndrome should not be considered a harmless condition.

  • 2261.
    Ärnlöv, Johan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Zethelius, B
    Risérus, U
    Basu, S
    Berne, C
    Vessby, B
    Alfthan, G
    Helmersson, J
    Serum and dietary beta-carotene and alpha-tocopherol and incidence of diabetes in a community based study of Swedish men2009In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 52, no 1, p. 97-105Article in journal (Refereed)
  • 2262.
    Åberg, Anna Cristina
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Aktuell geriatrisk forskning i Uppsala2018In: Svensk geriatrik, ISSN 2001-2047, no 2, p. 9-12Article, review/survey (Other academic)
  • 2263.
    Åberg, Anna Cristina
    Uppsala universitet, Geriatrik.
    Bedömning, test och instrument2012In: Äldres hälsa: ett sjukgymnastiskt perspektiv / [ed] Rydwik, Elisabeth, Lund: Studentlitteratur , 2012, 1. uppl.Chapter in book (Other academic)
  • 2264.
    Åberg, Anna Cristina
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Generell Motorisk Funktionsbedömning: GMF Manual2011Book (Other academic)
  • 2265.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Cedervall, Y
    Giedraitis, V
    Berglund, L
    Lennhed, B
    Rosendahl, E
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kilander, L
    Can Timed Up-and-GO (TUG) Dual Task Performance Aid Diagnosis of Dementia?2017Conference paper (Refereed)
  • 2266.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Cedervall, Y
    Lundberg, C
    Giedraitis, V
    Berglund, L
    Kilander, L
    Ingelsson, M
    Rosendahl, E
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Timed Up-and-Go dual-task performance in people with cognitive impairment2018Conference paper (Refereed)
  • 2267.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Örebro universitet.
    Inpatient geriatric care in Sweden: Important factors from an inter-disciplinary team perspective2017In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 172, p. 113-120Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to describe factors of importance for the quality of inpatient geriatric care from an inter-disciplinary team perspective, an area that has not been previously studied to our knowledge. The study design was qualitative descriptive with data being collected from focus-group interviews with members of geriatric care teams. The data collection was conducted at a Swedish university hospital with 69 beds for geriatric care. It comprised five group interviews with a total of 32 staff members, including representatives of all the seven professions working with geriatric care. Data was analysed using qualitative content analysis and a thematic framework approach. Three main themes were identified as being perceived as characterising important factors essential for quality geriatric care:

    • Interactive assessment processes,
    • A holistic care approach, and
    • Proactive non-hierarchical interaction

    Aspects of time and goal-orientation were additionally running like common threads through these themes and informed them. Accessibility, open communication, and staff continuity were experienced as prerequisites for well-functioning teamwork. Including patients and relatives in care planning and implementation was seen as essential for good care, but was at risk due to budget cuts that imposed shortened hospital stays. To meet the care demands of the growing population of older frail people, more specialised team-based care according to the concept of Comprehensive Geriatric Assessment – which is possibly best provided by older-friendly hospitals – appears as a constructive solution for reaching high degrees of both staff and patient satisfaction in geriatric care. More research is needed in this area.

  • 2268.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordmark, S
    Lyhagen, J
    Lindberg, I
    Finch, T
    The Swedish version of the normalisation process theory measurement s-nomad: Translation, adaptation and pilot testing2018In: BMJ Evidence-Based Medicine, ISSN 2515-446X, Vol. 23, no Suppl 1, p. A33-A33Article in journal (Refereed)
  • 2269.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordmark, S
    Lyhagen, J
    Lindberg, I
    Finch, T
    The Swedish version of the Normalization Process Theory Measure S-NoMAD: Translation, adaptation and pilot testing2018Conference paper (Refereed)
  • 2270.
    Åberg, Anna Cristina
    et al.
    The Swedish School of Sport and Health Sciences, Box 5626, SE-114 86 Stockholm, Sweden ; Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala Science Park, SE-751 85 Uppsala, Sweden.
    Elmgren Frykberg, Gunilla
    Uppsala universitet, Rehabiliteringsmedicin.
    Halvorsen, Kjartan
    Uppsala universitet, Reglerteknik; Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Medio-lateral stability of sit-to-walk performance in older individuals with and without fear of falling2010In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 31, no 4, p. 438-443Article in journal (Refereed)
  • 2271.
    Åberg, Anna Cristina
    et al.
    Uppsala universitet, Geriatrik.
    Frykberg, G.
    Mellberg, Y.
    Halvorsen, Kjertan
    Medio-lateral stability of sit-to-walk performance in older individuals with and without fear of falling2009In: Proceedings of the XIX Conference of the International Society for Posture & Gait Research Bologna, Italy—June 21-25, 2009, 2009Conference paper (Refereed)
  • 2272.
    Åberg, Anna Cristina
    et al.
    Uppsala universitet, Geriatrik.
    Frykberg, GE
    Uppsala universitet.
    Tarassova, Olga
    Uppsala universitet.
    Halvorsen, Kjartan
    Uppsala universitet.
    Momentum-development and stability in sit-to-walk compared to sit-to-stand among older individuals with and without fear of falling2010In: 20th Nordic Congress of Gerontology 30 May – 2 June 2010 -  Reykjavík, Iceland: Program / Abstract Overview, 2010Conference paper (Refereed)
  • 2273.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Grundström, A
    Cedervall, Y
    Dual-task timed up and go test as part of memory assessment: a pilot study2015Conference paper (Refereed)
  • 2274.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala University.
    Halvorsen, Kjartan
    Uppsala University.
    From, Ingrid
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bruhn Bergman, Åsa
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Oestreicher, Lars
    Uppsala University.
    Melander-Wikman, Anita
    Luleå University of Technology.
    A study protocol for applying user participation and co-learning: lessons learned from the eBalance project2017In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 14, no 5, article id 512Article in journal (Refereed)
    Abstract [en]

    The eBalance project is based on the idea that serious exergames—i.e., computer gaming systems with an interface that requires physical exertion to play—that are well adapted to users, can become a substantial part of a solution to recognized problems of insufficient engagement in fall-prevention exercise and the high levels of fall-related injuries among older people. This project is carried out as a collaboration between eight older people who have an interest in balance training and met the inclusion criteria of independence in personal activities of daily living, access to and basic knowledge of a computer, four staff working with the rehabilitation of older adults, and an interdisciplinary group of six research coordinators covering the areas of geriatric care and rehabilitation, as well as information technology and computer science. This paper describes the study protocol of the project’s initial phase which aims to develop a working partnership with potential users of fall-prevention exergames, including its conceptual underpinnings. The qualitative methodology was inspired by an ethnographical approach implying combining methods that allowed the design to evolve through the study based on the participants’ reflections. A participatory and appreciative action and reflection (PAAR) approach, accompanied by inquiries inspired by the Normalization Process Theory (NPT) was used in interactive workshops, including exergame testing, and between workshop activities. Data were collected through audio recordings, photos, and different types of written documentation. The findings provide a description of the methodology thus developed and applied. They display a methodology that can be useful for the design and development of care service and innovations for older persons where user participation is in focus.

  • 2275.
    Åberg, Anna Cristina
    et al.
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    Lindmark, Birgitta
    Department of Neurosciences, Uppsala University, University Hospital, Uppsala, Sweden Read More: http://informahealthcare.com/doi/abs/10.3109/02699052.2014.919534.
    Lithell, Hans
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    Development and reliability of the General Motor Function Assessment Scale (GMF)--a performance-based measure of function-related dependence, pain and insecurity.2003In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 25, no 9, p. 462-72Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To develop a scale for assessment of three components-dependence, pain and insecurity - related to motor functions of importance for activities of daily living among older rehabilitation patients and to establish its clinical practicality and reliability.

    METHOD: A General Motor Function Assessment Scale (GMF) with the above aims was constructed. Clinical practicality was explored by questionnaires to 14 physiotherapists. Inter-rater and test-retest reliability was tested on patients in three different forms of geriatric rehabilitation (n=20-25) and analysed by percentage agreement (PA) and a non-parametric statistical method, which provide measures of the random disagreement separately from the systematic part of the disagreement.

    RESULTS: In the clinical test the GMF was found to be time efficient and clinically adequate. Analysis of reliability showed overall high values of PA (PA> or =70) and of the rank-order agreement coefficient (r(a)>0.82), and low degrees of systematic disagreement.

    CONCLUSIONS: GMF was found to be a clinically useful assessment scale in geriatric rehabilitation. The statistical analyses indicted a high degree of reliability. Comparison of these results with reliability of comparable rating scales is difficult on account of the statistical methods used in other studies, which commonly do not take into account the non-metric properties of the data.

  • 2276.
    Åberg, Anna Cristina
    et al.
    Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Geriatrik.
    Lindmark, Birgitta
    Lithell, Hans
    Evaluation and application of the General Motor Function assessment scale in geriatric rehabilitation2003In: Disability and Rehabilitation, Vol. 25, no 7, p. 360-8Article in journal (Refereed)
  • 2277.
    Åberg, Anna Cristina
    et al.
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala ; The Swedish School of Sport and Health Sciences, Stockholm.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation/Physiotherapy, Umeå University, Umeå.
    Rosendahl, Erik
    Department of Health Science/Health and Rehabilitation, Luleå University of Technology, Luleå, Sweden.
    Implementation of evidence-based prevention of falls in rehabilitation units: a staff's interactive approach2009In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, no 13, p. 1034-1040Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To provide strategies to assist healthcare professionals in the area of rehabilitation to improve prevention of falls. DESIGN: A conceptual framework is described as a foundation for the proposal of 2 intertwined strategies, of intervention and implementation, which target the questions: Which strategies for intervention represent the current best evidence? and: How can these strategies be implemented and continuously developed? RESULTS: Strategies for multifactorial and multiprofessional fall preventive interventions are presented in terms of a "fall prevention pyramid model", including general, individualized, and acute interventions. A systematic global fall risk rating by the staff is recommended as an initial procedure. Fall event recording and follow-up are stressed as important components of local learning and safety improvement. Development of implementation strategies in 3 phases, focusing on interaction, facilitation and organizational culture, is described. CONCLUSION: A well-developed patient safety culture focusing on prevention of falls will, when successfully achieved, be seen by staff, patients and their significant others as being characteristic of the organization, and will be evident in attitudes, routines and actions. Moreover, it provides potential for positive side-effects concerning organizational and clinical improvements in additional areas.

  • 2278.
    Åberg, Anna Cristina
    et al.
    Uppsala universitet, Geriatrik ; Akademiska sjukhuset.
    Lundin-Olsson, Lillemor
    Umeå Universitet.
    Rosendahl, Erik
    Umeå Universitet.
    Nationell satsning för ökad patientsäkerhet: Fall och fallskador: åtgärder för att förebygga2011Other (Other academic)
  • 2279.
    Åberg, Anna Cristina
    et al.
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Sweden.
    Sidenvall, Birgitta
    Department of Public Health and Caring Sciences, Uppsala University, Sweden.
    Hepworth, Mike
    University of Aberdeen, Scotland, United Kingdom.
    O´Reilly, Karen
    University of Aberdeen, Scotland, United Kingdom.
    Lithell, Hans
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    Continuity of the self in later life: perceptions of informal caregivers2004In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 14, no 6, p. 792-815Article in journal (Refereed)
  • 2280.
    Åberg, Anna Cristina
    et al.
    Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, PO Box 609, S-751 25, Uppsala, Sweden.
    Sidenvall, Birgitta
    Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Sweden.
    Hepworth, Mike
    Department of Sociology and Anthropology, University of Aberdeen, Scotland, UK.
    O´Reilly, Karen
    Department of Sociology and Anthropology, University of Aberdeen, Scotland, UK.
    Lithell, Hans
    Department of Public Health and Caring Sciences, Section of Geriatrics, Uppsala University, PO Box 609, S-751 25, Uppsala, Sweden.
    On Loss of activity and independence, adaptation improves life satisfaction in old age2005In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 14, no 4, p. 1111-1125Article in journal (Refereed)
  • 2281.
    Åberg, Anna Cristina
    et al.
    The Swedish School of Sport and Health Sciences, Stockholm, Sweden ; Department of Public Health and Caring Sciences/Geriatrics, Uppsala, Sweden.
    Thorstensson, Alf
    The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Tarassova, Olga
    The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Halvorsen, Kjartan
    Uppsala universitet, Avdelningen för systemteknik ; School of Technology and Health, KTH-Royal Institute of Technology, Stockholm, Sweden.
    Calculations of mechanisms for balance control during narrow and single-leg standing in fit older adults: a reliability study2011In: Gait & Posture, ISSN 0966-6362, E-ISSN 1879-2219, Vol. 34, no 3, p. 352-357Article in journal (Refereed)
  • 2282.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Att mäta oral hälsorelaterad munhälsa2005In: 43:e Odontologiska riksstämman, Göteborg, 2005Conference paper (Other academic)
  • 2283.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Tandhygienist idag och i framtiden2012Conference paper (Other (popular science, discussion, etc.))
  • 2284.
    Öhrn, Kerstin
    Dalarna University, School of Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Using an Extended Theoryof Reasoned Action to Change Oral Hygiene Behavior and Gingival Outcomes2012Conference paper (Refereed)
  • 2285.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Edman, Kristina
    Uppsala universitet.
    Oral Impact on Daily Performance: association with clinical variables.2014Conference paper (Refereed)
  • 2286.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    A comparison of two questionnaires measuring oral health-related quality of life before and after dental hygiene treatment in patients with periodontal disease2012In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 10, no 1, p. 9-14Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to compare the usefulness of two different questionnaires assessing oral health-related quality of life (OHRQoL) at the basic examination and after initial dental hygiene treatment (DHtx).

    Methods: A total of 42 patients referred for periodontal treatment completed the Oral Health Impact Profile (OHIP-14) and the General Oral Health Assessment Index (GOHAI) at the basic periodontal examination. They underwent DHtx and completed the questionnaires once again after the treatment.

    Results: No statistically significant differences could be found between the two assessments, neither for the total scores nor for any of the separate items of the OHIP-14 or the GOHAI. However, the GOHAI questionnaire seems to result in a greater variety in the responses indicating that the floor effect is not as pronounced as for the OHIP-14. Those who had rated their oral health as good reported significantly better OHRQoL on both questionnaires. The same pattern was found for patients who reported that they were satisfied with their teeth. After DHtx and necessary extractions, there was a statistically significant correlation between the number of teeth and the total scores on both questionnaires. No other statistically significant correlations with periodontal variables could be found.

    Conclusion: No statistically significant difference could be found after DHtx compared to before in regard to OHRQoL assessed with OHIP-14 and GOHAI. However, there was a greater variety in the responses with the GOHAI questionnaire; it may hereby be more useful for patients with periodontal disease.

  • 2287.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Sanz, Mariano
    Prevention and therapeutic approaches to gingival inflammation2009In: Journal of Clinical Periodontology, ISSN 0303-6979, E-ISSN 1600-051X, Vol. 36, p. 20-26Article in journal (Refereed)
    Abstract [en]

    The most important preventive and therapeutic effort to reduce inflammation is to remove the dental plaque thoroughly. Oral self-care is thus of crucial importance to achieve and maintain oral health. There is a scarcity of scientific evidence on the most effective models for behavioural change aimed to improve oral hygiene. There is a need for randomized-controlled trials, based on behavioural sciences and performed with great methodological rigour, to investigate the usefulness of these proposed behavioural changes. Oral hygiene regimens for patients with natural teeth as well as dental implants should include brushing twice daily, inter-dental cleaning once daily and rinsing with efficient rinses as an adjunct to mechanical infection control. Power toothbrushes are preferable as they are more effective than manual toothbrushes. Inter-dental brushes seem to be most effective and useful for inter-dental cleaning. Scaling and root planing is effective in reducing inflammation and probing depths in patients with periodontitis.

  • 2288.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Svanberg, A
    Mucositis - cryotherapy as pain prevention2005In: 10th Nordic Forum for BMT Nurses, Uppsala, 2005Conference paper (Other academic)
  • 2289.
    Öijer, Ronya
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Tjäder, Evelina
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Hälso- och sjukvårdpersonals följsamhet till hygienföreskrifter avseende handhygien och faktorer som påverkar detta: En litteraturstudie2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med föreliggande studie var att redogöra för hälso- och sjukvårdspersonalens följsamhet till hygienföreskrifter avseende handhygien och de faktorer som påverkar detta. Metod: Artiklar söktes via CINAHL, Pubmed och Scopus. Sökord som användes i olika kombinationer var: hand hygiene, adherence, hygiene guidelines, health care workers, compliance, hand disinfection, infection control, nursing, nurse och hand cleansing. Tretton vetenskapliga artiklar erhölls. Vidare gjordes en manuell sökning ifrån inkluderade artiklars referenslistor och genererade två artiklar som ingick i resultatet. Resultat: Resultatet visade att hälso- och sjukvårdspersonalens följsamhet till hygienföreskrifter avseende handhygien var låg. Vidare framkom av resultatet att det fanns sju kategorier av faktorer som påverkade följsamheten till hygienföreskrifterna. Dessa var: utbildning och kunskap, arbetsbelastning och tidsbrist, tillgänglighet, hudproblem och handskar. Slutsats: Följsamheten till hygienföreskrifter avseende handhygien är låg. Kontinuerlig utbildning i kombination med ökad tillgänglighet och minskad arbetsbelastning är de viktigaste förutsättningarna för att öka följsamheten till hygienföreskrifter gällande handhygien.

  • 2290. Öresland, Stina
    et al.
    Määttä, Syliva
    Norberg, Astrid
    Jörgensen, MW
    Lützen, Kim
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nurses as guests or professionals in home health care2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 3, p. 371-83Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: ;guest' and ;professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm.

  • 2291.
    Östberg, Karin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ståhle, Hanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärder vid sarkopeni: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva omvårdnadsåtgärder som kan användas för äldre personer som har eller riskerar att utveckla sarkopeni. Metod: Studien genomfördes som en litteraturöversikt där artiklarna söktes i databaserna PubMed och Cinahl. Resultat: Åtgärderna som framgick av resultatet var att främja: fysisk aktivitet, kost och näringstillförsel och kombinationen fysisk aktivitet och näringstillförsel. Genom fysisk aktivitet och en god näringstillförsel kunde äldre med sarkopeni eller risk för sarkopeni förbättra fysiska funktioner och muskelstyrka. Slutsats: . En god nutrition med tillräckligt innehåll av protein är nödvändiga åtgärder vid sarkopeni. Äldre personer med sarkopeni fick god effekt av att börja träna trots att de redan vara nedsatta funktionsmässigt. Därför kan sjuksköterskan i mötet med patienten uppmuntra och informera om viktiga livsstilsförändringar som kan förebygga och förbättra de funktionsnedsättningar som sarkopeni innebär.

  • 2292.
    Österlund Efraimsson, Eva
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Motiverande samtal2013In: Patientundervisning / [ed] Birgitta Klang Söderkvist, Stockholm: Studentlitteratur, 2013, 3, p. 209-228Chapter in book (Other academic)
  • 2293.
    Österlund Efraimsson, Eva
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Bettembourg Grundström, Aina
    Andersson, Katrin
    Göthman, Birgitta
    Experiences of lung-cancer care : Perspectives of patients and significant others: An empirical, qualitative study2012Conference paper (Refereed)
  • 2294.
    Österlund Efraimsson, Eva
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Drevenhorn, Eva
    Göteborgs universitet, Institutionen för vårdvetenskap och hälsa, University of Gothenburg, Institute of Health and Care Sciences.
    Primärvårdens mottagningar2013In: Omvårdnad i primärvården / [ed] Christina Bökberg, Stockholm: Studentlitteratur, 2013, p. 126-144Chapter in book (Other academic)
  • 2295.
    Österlund Efraimsson, Eva
    et al.
    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.
    Fossum, Björn
    Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm; Sophiahemmet University, Stockholm, Sweden.
    Larsson, Kjell
    National Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .
    Klang, Birgitta
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Red Cross University College of Nursing, Stockholm, Sweden .
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care2015In: European Clinical Respiratory Journal, ISSN 1399-3003, Vol. 2, article id 27915Article in journal (Refereed)
    Abstract [en]

    Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes.

    Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care.

    Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations.

    Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communicationwasmainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation.

    Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking.

    Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.

  • 2296.
    Österlund Efraimsson, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fossum, Bjöörn
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Larsson, Kjell
    Klang, Birgitta
    Use of motivational interviewing in smoking cessation at nurse-led chronic obstructive pulmonary disease clinics2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 4, p. 767-782Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study to describe to what extent Registered Nurses, with a few days of education in motivational interviewing based communication, used motivational interviewing in smoking cessation communication at nurse-led chronic obstructive pulmonary disease clinics in primary health care.

    Background. For smokers with chronic obstructive pulmonary disease the most crucial and evidence-based intervention is smoking cessation. Motivational interviewing is often used in healthcare to support patients to quit smoking.

    Method. The study included two videotaped consultations, the first and third of three at the clinic, with each of 13 smokers. Data were collected from March 2006 to April 2007. The nurses’ smoking cessation communication was analysed using the Motivational Interviewing Treatment Integrity scale. To get an impression of the consultation, five parameters were judged on a five-point Likert-scale, with five indicating best adherence to Motivational Interviewing.

    Results. Evocation’, ‘collaboration’, ‘autonomy-support’ and ‘empathy’ averaged between 1·31 and 2·23 whereas ‘direction’ scored five in all consultations. Of communication behaviours, giving information was the most frequently used, followed by ‘closed questions’, ‘motivational interviewing non–adherent’ and ‘simple reflections’. ‘Motivational interviewing adherent’, ‘open questions’ and ‘complex reflections’ occurred rarely. There were no important individual or group-level differences in any of the ratings between the first and the third consultations.

    Conclusion. In smoking cessation communication the nurses did not employ behaviours that are important in motivational interviewing.

  • 2297.
    Österlund Efraimsson, Eva
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Fossum, Bjöörn
    Ehrenberg, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Larsson, Kjell
    Klang Söderkvist, Birgitta
    Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics inprimary health care2012Conference paper (Refereed)
  • 2298.
    Österlund Efraimsson, Eva
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Fossum, Bjöörn
    Ehrenberg, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Larsson, Kjell
    Klang Söderkvist, Birgitta
    Use of Motivational Interviewing in smoking cessation at nurse-led Chronic Obstructive Pulmonary Disease clinics2012Conference paper (Refereed)
  • 2299.
    Österlund Efraimsson, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Klang, Birgitta
    Larsson, Kjell
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fossum, Bjöörn
    Communication and self-management education at nurse-led COPD clinics in primary health care2009In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 77, no 2, p. 209-217Article in journal (Refereed)
    Abstract [en]

    Objective. The aim of the study was to explore the structure, content in communication and self-management education in patients’ first consultations at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary healthcare.

    Method. Thirty consultations performed by seven registered nurses were videotaped; structure and content in the consultation was analyzed using Pendleton's Consultation Map. Nurses’ self-management education was assessed from the content of the conversation: whether important and relevant information and self-management education was given, and how investigations were performed.

    Results. Each consultation lasted for a mean time of 37.53 min. Communication about reasons for consultations concerned mainly medical and physical problems and to a certain extent patients’ perceptions. Teaching about self-management and smoking cessation was of an informative nature. Two consultations ended with shared understanding, and none of the patients received an individual treatment-plan.

  • 2300.
    Österlund Efraimsson, Eva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Olai, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Zakrisson, Ann-Britt
    Larsson, Kjell
    Inhalation treatment among persons with dementia, asthma and/or COPD: a research idea for further discussion and planning2012In: International Primary Care Respiratory Group, Edinburgh, 2012Conference paper (Other academic)
    Abstract [en]

    Background: There has been insufficient study of the care of persons with diagnosed dementia and the contemporary presence of asthma and/or Chronic Obstructive Pulmonary Disease (COPD). Inhalation treatment requires active patient participation, which is more difficult for a person who has dementia. A consequence of incorrect inhalation technique will be a lack of benefit of medicine affecting dyspnea, fatigue, sleeping problems, cognitive capability and respiratory infections such as pneumonia. Pneumonia is the most common symptom affecting health and well-being among elderly. Improved care and treatment for asthma and COPD may be of importance to these people’s health, quality of life and to community medical costs. The aim is to describe inhalation treatment among persons with dementia who also have asthma and/or COPD. The aim is also to examine the effects of training in inhalation technique and inhalation aids for nursing staff working in dementia care.

    Research questions: 

    • How is the presence of asthma and/or COPD among persons with dementia related to expected incidence? 
    • What inhalation techniques and levels of inhalation strength occur among patients with asthma, COPD and dementia? 
    • How is the quality of life for persons with dementia and asthma and/or COPD influenced by whether the nursing staff is given training in inhalation technique, inhalation aids and devices?

    Method: The project will be planned in two parts: firstly, a descriptive epidemiological mapping, scrutinizing register and journal data of the diagnoses asthma and COPD among persons with dementia: secondly, an observation of inhalation techniques and a control of inhalation strength among patients in dementia care with asthma and/or COPD. This will be carried out before and after a randomized controlled training intervention in inhalation technique and inhalation aids given to nursing staff in dementia care.

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