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  • 251.
    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.

  • 252.
    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.

  • 253. Blom, Elin S
    et al.
    Wang, Yijing
    Skoglund, Lena
    Uppsala universitet.
    Hansson, Anita C
    Ubaldi, Massimo
    Lourdusamy, Anbarasu
    Sommer, Wolfgang H
    Mielke, Matthew
    Hyman, Bradley T
    Heilig, Markus
    Lannfelt, Lars
    Nilsson, Lars N G
    Ingelsson, Martin
    Increased mRNA Levels of TCF7L2 and MYC of the Wnt Pathway in Tg-ArcSwe Mice and Alzheimer's Disease Brain.2010In: International Journal of Alzheimer's Disease, ISSN 2090-8024, E-ISSN 2090-0252, Vol. 2011Article in journal (Refereed)
    Abstract [en]

    Several components in the Wnt pathway, including β-catenin and glycogen synthase kinase 3 beta, have been implied in AD pathogenesis. Here, mRNA brain levels from five-month-old tg-ArcSwe and nontransgenic mice were compared using Affymetrix microarray analysis. With surprisingly small overall changes, Wnt signaling was the most affected pathway with altered expression of nine genes in tg-ArcSwe mice. When analyzing mRNA levels of these genes in human brain, transcription factor 7-like 2 (TCF7L2) and v-myc myelocytomatosis viral oncogene homolog (MYC), were increased in Alzheimer's disease (AD) (P < .05). Furthermore, no clear differences in TCF7L2 and MYC mRNA were found in brains with frontotemporal lobar degeneration, suggesting that altered regulation of these Wnt-related genes could be specific to AD. Finally, mRNA levels of three neurogenesis markers were analyzed. Increased mRNA levels of dihydropyrimidinase-like 3 were observed in AD brain, suggesting that altered Wnt pathway regulation may signify synaptic rearrangement or neurogenesis.

  • 254.
    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.

  • 255.
    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)
  • 256. Blomberg, Jonas
    et al.
    Blomberg, Fredrik
    Sjösten, Anna
    Sheikholvaezin, Ali
    Bolin-Wiener, Agnes
    Elfaitouri, Amal
    Hessel, Sanna
    Gottfries, Carl-Gerhard
    Zachrisson, Olof
    Ohrmalm, Christina
    Jobs, Magnus
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Pipkorn, Ruediger
    No evidence for xenotropic murine leukemia-related virus infection in Sweden using internally controlled multiepitope suspension array serology2012In: Clinical and Vaccine Immunology, ISSN 1556-6811, E-ISSN 1556-679X, Vol. 19, no 9, p. 1399-1410Article in journal (Refereed)
    Abstract [en]

    Many syndromes have a large number of differential diagnoses, a situation which calls for multiplex diagnostic systems. Myalgic encephalomyelitis (ME), also named chronic fatigue syndrome (CFS), is a common disease of unknown etiology. A mouse retrovirus, xenotropic murine leukemia-related virus (XMRV), was found in ME/CFS patients and blood donors, but this was not corroborated. However, the paucity of serological investigations on XMRV in humans prompted us to develop a serological assay which cover many aspects of XMRV antigenicity. It is a novel suspension array method, using a multiplex IgG assay with nine recombinant proteins from the env and gag genes of XMRV and 38 peptides based on known epitopes of vertebrate gamma-retroviruses. IgG antibodies were sought in 520 blood donors and 85 ME/CFS patients and in positive-and negative-control sera from animals. We found no differences in seroreactivity between blood donors and ME/CFS patients for any of the antigens. This did not support an association between ME/CFS and XMRV infection. The multiplex serological system had several advantages: (i) biotinylated protein G allowed us to run both human and animal sera, which is essential because of a lack of XMRV-positive humans; (ii) a novel quality control was a pan-peptide positive-control rabbit serum; and (iii) synthetic XMRV Gag peptides with degenerate positions covering most of the variation of murine leukemia-like viruses did not give higher background than nondegenerate analogs. The principle may be used for creation of variant tolerant peptide serologies. Thus, our system allows rational large-scale serological assays with built-in quality control.

  • 257.
    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.

  • 258.
    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.

  • 259.
    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.

  • 260.
    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.

  • 261.
    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.

  • 262.
    Boccaccio, Jamila
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Schytz Lindqvist, Jeanette
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    En meningsfull tillvaro för den äldre människan: En litteraturöversikt2013Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte; Syftet med denna litteraturöversikt var att beskriva upplevelsen av vad som skapar en meningsfull tillvaro samt hur sjuksköterskan kan stödja och främja en meningsfull tillvaro för de äldre vid särskilda boenden. Metod; Studien genomfördes som en litteraturöversikt. Artiklar publicerade mellan åren 2000-2012 söktes i databaserna CHINAL, ELITE, PubMed, SweMed samt i tidskriften Vård i Norden. Resultat; Resultatet visade på att upprätthållandet av kroppens fysiska och mentala förmågor hade stor inverkan för den upplevda hälsan. Social gemenskap, goda vårdrelationer och ett aktivt delagande i den egna vardagen ansågs även placera den äldre i ett sammanhang, vilket också grundade för meningsfullhet och välbefinnande. Konklusion; För att uppnå en god omvårdnad av de äldre krävdes sjuksköterskor med ett stort kunnande och engagemang där goda omvårdnadsrelationer skapades utifrån den enskildes livsberättelse, behov och önskningar.

  • 263.
    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.

  • 264. 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.

  • 265.
    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)
  • 266.
    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.

  • 267.
    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.

  • 268.
    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.

  • 269. 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.

  • 270. Bogren, Malin
    et al.
    Sathyanarayanan, Doraiswamy
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Akhter, Halima
    Akter, Dalia
    Begum, Momtaz
    Chowdhury, Merry
    Das, Lucky
    Akter, Rehana
    Khatun, Yamin Ara
    Development of a context specific accreditation assessment tool for affirming quality midwifery education in Bangladesh2018In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 61, p. 74-80Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: using the International Confederation of Midwives (ICM) Global Standards for Midwifery Education as a conceptual framework, the aim of this study was to explore and describe important 'must haves' for inclusion in a context-specific accreditation assessment tool in Bangladesh.

    DESIGN: A questionnaire study was conducted using a Likert rating scale and 111 closed-response single items on adherence to accreditation-related statements, ending with an open-ended question. The ICM Global Standards guided data collection, deductive content analysis and description of the quantitative results.

    SETTING: twenty-five public institutes/colleges (out of 38 in Bangladesh), covering seven out of eight geographical divisions in the country.

    PARTICIPANTS: one hundred and twenty-three nursing educators teaching the 3-year diploma midwifery education programme.

    FINDINGS: this study provides insight into the development of a context-specific accreditation assessment tool for Bangladesh. Important components to be included in this accreditation tool are presented under the following categories and domains: 'organization and administration', 'midwifery faculty', 'student body', 'curriculum content', 'resources, facilities and services' and 'assessment strategies'. The identified components were a prerequisite to ensure that midwifery students achieve the intended learning outcomes of the midwifery curriculum, and hence contribute to a strong midwifery workforce. The components further ensure well-prepared teachers and a standardized curriculum supported at policy level to enable effective deployment of professional midwives in the existing health system.

    KEY CONCLUSIONS: as part of developing an accreditation assessment tool, it is imperative to build ownership and capacity when translating the ICM Global Standards for Midwifery Education into the national context.

    IMPLICATIONS FOR PRACTICE: this initiative can be used as lessons learned from Bangladesh to develop a context-specific accreditation assessment tool in line with national priorities, supporting the development of national policies.

  • 271.
    Bohlin, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Eleonore
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Personcentrerad vård i praktiken: Identifiering avbarriärer ur ett sjuksköterskeperspektiv2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Research suggests that care based on a person-centered basis

    contributes to a higher quality of care, and has a positive impact on the patients and

    the healthcare profession. At the same time, studies point out that health care is facing

    a variety of challenges in order to introduce a person-centered approach into daily

    care.

    Aim:

    To describe which barriers prevent the nurse to work person-centered in the

    healthcare meeting with the patient.

    Methods:

    The study was conducted as a literature review, the result is based on 16

    scientific articles.

    Results:

    Several factors that may constitute difficulties for the nurse to work personcentered

    in the healthcare meeting with the patient were identified and generated four

    categories:

    Collaboration and Teamwork, Attitude and Culture, Time and Resources,

    and

    Communication and The patient Narrative. The result indicates cooperation

    difficulties between different health care professions, contradictory attitudes and

    routines that not lie on a scientific basis. Lack of educational opportunities and

    knowledge about what person centered care means and how a person-centered

    approach should be applied in clinical practice. High workload and lack of time

    affected the nurse's ability to establish a relationship with the patient, and contributed

    to stress and feelings of inadequacy.

    Conclusion:

    Summary the literature study indicates that there are several barriers that

    make it difficult for the nurse to work person-centered in the meeting with the patient.

    In order for a person-centered approach to be practiced, active work is required

    individually and collectively at different levels within an organization to become part

    of the daily practice.

  • 272. Bohm, Cornelia
    et al.
    Sundberg, Jenny
    Föräldrars upplevelse av stöd från hälso- och sjukvårdspersonalen, när deras barn diagnosticerats med cancer: En litteraturstudie2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet: Syftet med denna litteraturöversikt var att beskriva föräldrars upplevelse av stöd från hälso- och sjukvårdspersonalen då deras barn diagnosticerats med cancer. Metod: Examensarbetet genomfördes som en litteraturöversikt. Vetenskapliga artiklar söktes i Högskolan Dalarnas biblioteks prenumererade databaser CINAHL och SAGE Journal Online. Av de 12 vetenskapliga artiklarna som användes var fem av kvalitativ ansats, tre var av kvantitativ ansats och fyra var av mixad metod. Resultat: Resultatet visade att föräldrar till cancerdiagnosticerade barn behövde olika typer av stöd, så som känslomässigt, psykologiskt, socialt samt avlastning. Samtalsgrupper behövdes för att föräldrarna skulle få träffa andra i liknande situationer och utbyta erfarenheter. Slutsats: Hälso- och sjukvårdspersonalen bör tänka på hur kommunikation används och information ges. Varje förälder ses som unik och bör därför bemötas individuellt. Föräldrarna behövde stöd i olika former för att kunna bearbeta sitt barns cancerdiagnos. Hälso- och sjukvårdspersonalen bör sträva efter en fungerande relation till barnet och föräldrarna för att skapa förtroende och en förutsättning för bästa möjliga vård.

  • 273.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Alfredsson, Lars
    Hallqvist, Johan
    Vingård, Eva
    Skillgate, Eva
    The influence of self-reported leisure time physical activity and the body mass index on recovery from persistent back pain among men and women: a population-based cohort study.2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, article id 385Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: There is limited knowledge about leisure time physical activity and the body mass index (BMI) as prognostic factors for recovery from persistent back pain. The aim of this study was to assess the influence of leisure time physical activity and BMI on recovery from persistent back pain among men and women in a general population.

    METHODS: The study population (n=1836) in this longitudinal cohort study consisted of participants reporting persistent back pain in the baseline questionnaire in 2002-2003. Data on leisure time physical activity, BMI and potential confounders were also collected at baseline. Information on recovery from persistent back pain (no back pain periods ≥ 7 days during the last 5 years) was obtained from the follow-up questionnaire in 2007. Log-binomial models were applied to calculate Risk Ratios with 95 percent Confidence Intervals (CI) comparing physically active and normal weight groups versus sedentary and overweight groups.

    RESULTS: Compared to a sedentary leisure time, all measured levels of leisure time physical activity were associated with a greater chance of recovery from persistent back pain among women. The adjusted Risk Ratios was 1.46 (95% CI: 1.06, 2.01) for low leisure time physical activity, 1.51 (95% CI: 1.02, 2.23) for moderate leisure time physical activity, and 1.67 (95% CI: 1.08, 2.58) for high leisure time physical activity. There were no indications that leisure time physical activity influenced recovery among men, or that BMI was associated with recovery from persistent back pain either among men or among women.

    CONCLUSIONS: Regular leisure time physical activity seems to improve recovery from persistent back pain among women.

  • 274.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Alfredsson, Lars
    Jensen, Irene
    Hallqvist, Johan
    Vingård, Eva
    Skillgate, Eva
    Does a healthy lifestyle behaviour influence the prognosis of low back pain among men and women in a general population? A population-based cohort study2014In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 4, no 12, article id e005713Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To study the influence of healthy lifestyle behaviour on the prognosis of occasional low back pain among men and women in a general population.

    DESIGN: Cohort study with a 4-year follow-up.

    SETTINGS: General population in Stockholm County, Sweden.

    PARTICIPANTS: The study sample comprised 3938 men and 5056 women aged 18-84 from the Stockholm Public Health Cohort reporting occasional low back pain in the baseline questionnaire 2006.

    MEASURES: Lifestyle factors and potential confounders were assessed at baseline. The lifestyle factors smoking habits, alcohol consumption, leisure physical activity and consumption of fruit and vegetables were dichotomised using recommendations for a health-enhancing lifestyle and combined to form the exposure variable 'healthy lifestyle behaviour'. The exposure was categorised into five levels according to the number of healthy lifestyle factors met. The follow-up questionnaire in 2010 gave information about the outcome, long duration troublesome low back pain. Crude and adjusted binomial regression models were applied to estimate the association between the exposure and the outcome analysing men and women separately.

    RESULTS: The risk of developing long duration troublesome low back pain among women with occasional low back pain decreased with increasing healthy lifestyle behaviour (trend test: p=0.006). 21% (28/131) among women with no healthy lifestyle factor (reference) experienced the outcome compared to 9% (36/420) among women with all four factors. Compared to the reference group, the risk was reduced by 35% (RR 0.65, 95% CI 0.44 to 0.96) for women with one healthy lifestyle factor and 52% (RR 0.48, 95% CI 0.31 to 0.77) for women with all four healthy lifestyle factors. There were no clear associations found among men.

    CONCLUSIONS: Healthy lifestyle behaviour seems to decrease the risk of developing long duration troublesome low back pain among women with occasional low back pain and may be recommended to improve the prognosis.

  • 275.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Bottai, Matteo
    Björklund, Martin
    Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study.2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To develop predictive models for short-term and long-term clinically important improvement in women with non-specific chronic disabling neck pain during the clinical course of physiotherapy.

    DESIGN: Longitudinal cohort study based on data from a randomised controlled trial evaluating short-term and long-term effects on sensorimotor function over 11 weeks of physiotherapy.

    PARTICIPANTS AND SETTINGS: Eighty-nine women aged 31-65 years with non-specific chronic disabling neck pain from Gävle, Sweden.

    MEASURES: The outcome, clinically important improvement, was measured with the Patient Global Impression of Change Scale (PGICS) and the Neck Disability Index (NDI), assessed by self-administered questionnaires at 3, 9 and 15 months from the start of the interventions (baseline). Twelve baseline prognostic factors were considered in the analyses. The predictive models were built using random-effects logistic regression. The predictive ability of the models was measured by the area under the receiver operating characteristic curve (AUC). Internal validity was assessed with cross-validation using the bootstrap resampling technique.

    RESULTS: Factors included in the final PGICS model were neck disability and age, and in the NDI model, neck disability, depression and catastrophising. In both models, the odds for short-term and long-term improvement increased with higher baseline neck disability, while the odds decreased with increasing age (PGICS model), and with increasing level of depression (NDI model). In the NDI model, higher baseline levels of catastrophising indicated increased odds for short-term improvement and decreased odds for long-term improvement. Both models showed acceptable predictive validity with an AUC of 0.64 (95% CI 0.55 to 0.73) and 0.67 (95% CI 0.59 to 0.75), respectively.

    CONCLUSION: Age, neck disability and psychological factors seem to be important predictors of improvement, and may inform clinical decisions about physiotherapy in women with chronic neck pain. Before using the developed predictive models in clinical practice, however, they should be validated in other populations and tested in clinical settings.

  • 276.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Côté, Pierre
    Boyle, Eleanor
    Cassidy, J David
    Carroll, Linda J
    Skillgate, Eva
    Prognosis of patients with whiplash-associated disorders consulting physiotherapy: development of a predictive model for recovery2012In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, article id 264Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients with whiplash-associated disorders (WAD) have a generally favourable prognosis, yet some develop longstanding pain and disability. Predicting who will recover from WAD shortly after a traffic collision is very challenging for health care providers such as physical therapists. Therefore, we aimed to develop a prediction model for the recovery of WAD in a cohort of patients who consulted physical therapists within six weeks after the injury.

    METHODS: Our cohort included 680 adult patients with WAD who were injured in Saskatchewan, Canada, between 1997 and 1999. All patients had consulted a physical therapist as a result of the injury. Baseline prognostic factors were collected from an injury questionnaire administered by Saskatchewan Government Insurance. The outcome, global self-perceived recovery, was assessed by telephone interviews six weeks, three and six months later. Twenty-five possible baseline prognostic factors were considered in the analyses. A prediction model was built using Cox regression. The predictive ability of the model was estimated with concordance statistics (c-index). Internal validity was checked using bootstrapping.

    RESULTS: Our final prediction model included: age, number of days to reporting the collision, neck pain intensity, low back pain intensity, pain other than neck and back pain, headache before collision and recovery expectations. The model had an acceptable level of predictive ability with a c-index of 0.68 (95% CI: 0.65, 0.71). Internal validation showed that our model was robust and had a good fit.

    CONCLUSIONS: We developed a model predicting recovery from WAD, in a cohort of patients who consulted physical therapists. Our model has adequate predictive ability. However, to be fully incorporated in clinical practice the model needs to be validated in other populations and tested in clinical settings.

  • 277.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Tegern, Matthias
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Concurrent validity of an isokinetic lift test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207054Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to assess the concurrent validity of the IsoKai isokinetic lift test peak force (IsoKaiPeak) in comparison to a submaximal 5-10RM deadlift test (5-10RMDL), and to develop an equation for converting the IsoKaiPeak in Newton (N) to an estimated 1RM (1RMest) deadlift load in kilograms (kg). The participants included 28 males and 16 female employees in the Swedish Armed Forces (20-59 years). Each participant conducted the IsoKai lift test, followed by the 5-10RMDL test at one occasion. The Pearson's correlation coefficient, with a 95% confidence interval was calculated to evaluate the validity between the IsoKaiPeak and the 1RMest deadlift load derived from the 5-10RMDL test. Univariate and multivariable linear regressions were used to derive the equation for calculating the 1RMest deadlift load based on the IsoKaiPeak. The IsoKaiPeak showed good- to-excellent correlation with the 1RMest deadlift weight with a correlation coefficient of 0.84 (0.72-0.91) for the total sample, and 0.65 (0.37-0.83) and 0.81 (0.53-0.93) in males and females, respectively. The final equation, 1RMest deadlift weight (kg) = -51.63 + (0.08 x IsoKaiPeak) + (2.28 x BMI), explained 72% (adjusted R2 = 0.72) of the total variance in the 1RMest, and had a standard error of the estimate (SEE) of 16.57 kg. In conclusion, the IsoKai isokinetic lift test could be considered a highly valid measure of maximal dynamic muscular strength in comparison to the 5-10RMDL. The equation can be used to convert the IsoKai lift test (N) results to an 1RMest deadlift load (kg), but with consideration of the relative large SEE.

  • 278.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Tegern, Matthias
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Reliability and agreement of the IsoKai isokinetic lift test - a test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 12, article id e0209419Article in journal (Refereed)
    Abstract [en]

    This study was performed to evaluate the reliability and agreement of the IsoKai isokinetic lift test as it is currently administered in admission to the Swedish Armed Forces. The study included an intrarater (n = 534) and interrater reliability sample (n = 137), of Swedish male conscripts who performed the test on two test occasions about two hours apart. Two-to-four lifts were performed at each occasion, and the highest mean (IsoKaiMF) and peak force (IsoKaiPF) produced (N) were used for evaluation. All intraclass coefficients showed excellent reliability. The interrater analyses resulted in intraclass coefficients of 0.942 (95% CI; 0.920-0.959) and 0.858 (95% CI; 0.806-0.896) for the IsoKaiMF and IsoKaiPF, respectively, while the corresponding coefficients for the intrarater analyses were 0.935 (95% CI; 0.923-0.946) and 0.865 (95% CI; 0.842-0.886). Agreement, the capability of a test to detect changes, was assessed by the standard error of measurement (SEM/SEM%) and the smallest real difference (SRD/SRD%). These estimate indicated that it is possible to achieve measurements relevant to use in real practice with the IsoKai isokinetic lift test. Bland and Altman analyses revealed no systematic errors in either sample. Based on these findings, the IsoKai isokinetic lift test is suggested to be a highly reliable test for maximal dynamic muscular strength. The test could be of use in selection procedures in order to accurately evaluate maximal dynamic muscular strength, and for evaluating longitudinal changes in strength.

  • 279.
    Boland, Sofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bång, Christina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    När barn misstänks fara illabarnhälsovårdssjuksköterskorserfarenheter avanmälningsplikten: En kvalitativ intervjustudie2017Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The child health nurse has an important role to act early when suspecting child maltreatment. They also have a legal obligation to report such case to the social services. This is similar to other professionals who meet children in their duties. Nevertheless, previous research shows a varying compliance to this obligation.Aim: The aim of this study was to describe child health nurses’ experiences to identify signs and report to child health services when suspecting child maltreatment.Method: Qualitative content analysis based on five semi structured interviews with nurses working with child health.Results: To identify and report when suspecting child maltreatment where found to involve worrying about a child, working together whit colleagues and other professions and to have a good relationship with the family. It also involved focusing on the children’s best interests, to be affected on a personal level and having to alert the social services and cooperating with them. Cooperating with colleagues within the child health care was highlighted as very important. The most prominent in the contact with social services was difficulties and frustration over the lack of feedback and the desideratum of an improved cooperation.Conclusion: Previous research shows a varying compliance to the legal obligation to report when child maltreatment is suspected. It has been found that there are barriers that complicates the child health nurses’ work. This study found that a deficient cooperation between the social services and the child health nurses could form such barrier. It was also found that support from colleagues and a close collaboration with other professions within child health services was of great importance in efforts to identify and report when suspecting child maltreatment.

  • 280.
    Boltenstern, Rebecca
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Granath, Ingrid
    Dalarna University, School of Health and Social Studies, Caring Science.
    Mammors upplevelser i samband med beskedet att det väntade barnet dött i livmodern2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 281.
    Boman, Alexandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nykvist, Elisabeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Möjliga faktorer som kan påverka hälso- och sjukvårdspersonalens följsamhet till de basala hygienrutinerna med fokus på handhygien: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Healthcare-related infections are the most common healthcare injuries and lead to increased patient suffering, prolonged hospital stays and higher costs. Healthcare-associated infections can be prevented by healthcare personnel through compliance with basic hygiene routines. Although there are current regulations regarding this, the compliance of healthcare personnel is low. It is therefore important to find out what factors can give the staff an increased compliance to basic hygiene routines.

    Aim:

    The purpose of the literature review was to describe possible factors that may affect the compliance of healthcare personnel with basic hygiene routines focusing on hand hygiene. Method: The method of this study has been formed as a literature review and it is based on 13 scientific articles of both qualitative and quantitative methods, which were aquiered by search from the databases Cinahl, PubMed and PsycInfo.

    Findings:

    The results showed that there are several factors that affect the healthcare personnel’s compliance with basic hygiene routines. Particularly prominent factors that provide increased compliance were knowledge, training and placement of hygiene materials and sinks. Time, stressful and acute situations also affected compliance. Conclusion: Compliance to hand hygiene is low, despite current regulations and national efforts. There are several factors to consider in order to increase the compliance of healthcare personnel with basic hygiene routines, and this literature review can contribute to increased knowledge of these factors.

  • 282.
    Boquist, Linnéa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Larsson, Marit
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Beröringsbehandling hos patienter med cancer: En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Each year around 64 000 people are diagnosed with cancer and tumor

    diseases are the second common cause of death in Sweden. Getting the diagnosis of cancer

    means a stressful time both physically and mentally. Nurse’s role is to alleviate suffering and

    promote god health. Touch is a universal human need and becomes particularly clear when a

    deadly disease affects a person.

    Aim: The aim is to illustrate the experiences of touch treatment of nurses and patients with

    cancer.

    Method: A literature review, fourteen research papers. Five qualitative and nine quantitative.

    Results: The result was divided in two areas: patient’s experiences of touch treatment and nurse’s experiences of touch treatment. In the area of patients experiences two categories

    showed: Soothing effect and supportive effect as well as subcategories: physical discomfort,

    physiological discomfort, well-being and closeness. In the area of nurse’s experiences

    emerged one category: Education in touch therapy as well as the subcategory experiences of

    touch therapy.

    Conclusion: Touch has a short-term symptom relief effect of pain, anxiety, nausea and

    provides increased well-being. Therewith the physical contact between nurse and patient

    improved and led to that the existential loneliness was reduced. The nurses saw the patient as a person instead for a patient with a disease.

  • 283.
    Boqvist, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Varkki, Sofia
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Mitt barns fysiska aktivitet: En enkätundersökning om föräldrars inställningar och attityder till sitt barns fysiska aktivitet2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The aim of this survey was to examine parents approach and attitude against their children’s physical activity.

    Method

    The survey has been chosen as the method in the study and has been distributed online. The survey has been developed by validated questionnaires and via a newsletter from a school sent to parents whose children are in grade eight. A municipality in central Sweden has been contacted by a convenience sample and then recommended the chosen school. Qualitative data were analyzed using content analysis and in quantitative data the numbers of participants were compiled.

    Result

    Parents mostly believed that their children should be physically active and readily outside organized sports. The results have also shown that parents believe that the school is important in the promotion of varied physical activity.

    Conclusion

    Nine out of ten parents felt that their children should be physically active. The parents felt that children mainly should be active outside of organized sports and made it clear that they are the mainstay when children are active. The parents felt that their children should be introduced to physical activity through the school or by the child’s own interest. Further research should aim to examine what the obstacles and opportunities are in the parents' preferences and attitudes to a child to be physical active. Because of the low number of participants the validity were considered inadequate and the result is only representative of the group that participated.

  • 284.
    Borch, Ellen
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Sörensen Duppils, Gill
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Hov, Reidun
    Athlin, Elsy
    Group supervision to strengthen nurses in their preceptor role in the bachelor nursing education: Perceptions before and after participation2013In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 13, no 2, p. 101-105Article in journal (Refereed)
    Abstract [en]

    Background: A collaborative project was carried out at four bachelor nursing colleges in Sweden and Norway, to support preceptors in the clinical fields by means of group supervision.

    The aim of this study was to investigate the preceptors’ views on their own ability and satisfaction in the role before and after taking part in group supervision during one year and to describe their perception of the supervision model used.

    Method: Forty-five preceptors participated in the study. Baseline and endpoint questionnaires were used for data collection. 

    Results: Before taking part in group supervision most preceptors expressed that they were content with their ability and knowledge with regards to the preceptor role.  Despite this most of them considered that the participation had increased their ability to supervise students, and more than half of them considered that it also had promoted to their personal development. At the end of the project a majority of them had positive experiences of group supervision. Most of the structure and climate factors in the supervision model were considered important and almost all were highly realised. Conclusion: The study showed that group supervision could be a valuable tool to provide support to preceptors in bachelor nursing education.

  • 285.
    Borg, Johan
    Lund universitet.
    The Participation Pyramid: a response to "Reconsideration ICF scheme" by Heerkens et al. 20172018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 1, p. 123-124Article in journal (Other academic)
  • 286.
    Borg, Johan
    et al.
    Lunds universitet.
    Ekman, Björn Olof
    Östergren, Per-Olof
    Is centre-based provision of hearing aids better than community-based provision?: A cluster-randomized trial among adolescents in Bangladesh2018In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 13, no 6, p. 497-503Article in journal (Refereed)
    Abstract [en]

    Purpose: In response to the need for hearing aids in low-income countries, an approach to provide hearing aids through trained community workers was developed. This study compares the effectiveness of the community-based approach with that of a centre-based approach. Methods: One hundred and forty adolescents (56% girls; 12-18 years; mean: 15 years) from eleven sub-districts participated in a cluster-randomized trial comparing a community-based service (n = 75) with a centre-based service (n = 65) in Bangladesh. The International Outcome Inventory for Hearing Aids (IOI-HA) was administered to the participants six weeks after fitting of a hearing aid, and its scores were analyzed by Mann-Whitney U-tests and an ordinal regression model. Results: The community-based approach performed as well as the centre-based approach on five out of seven outcome measures. The latter approach performed statistically significantly better on Residual participation restrictions (p = .007) and Impact on others (p = .012), but the effect sizes were small. Controlling for sex, age, hearing loss, place of living and proxy responses did not change the results. Conclusions: The community-based approach is a viable and effective option for hearing aid delivery in low-resourced settings. The approach needs to be adapted to particular contexts, and possible down-sides may need to be counteracted by special interventions.

  • 287.
    Borg, Johan
    et al.
    Lunds universitet.
    Larsson, Stig
    Assistive devices for people affected by leprosy: Underutilised facilitators of functioning?2009In: Leprosy Review, ISSN 0305-7518, E-ISSN 2162-8807, Vol. 80, no 1, p. 13-21Article in journal (Refereed)
    Abstract [en]

    Objectives People affected by leprosy and their families face social and economic problems. The focus of interventions is often on prevention of disabilities and socioeconomic rehabilitation. The objective of this study was to explore to what extent the potential of assistive devices to facilitate activities and participation of people affected by leprosy has been utilised. Design Published literature was reviewed and the findings analysed. Results Considerable attention has been given to the protecting role of assistive devices. The focus of assistive devices facilitating functioning has been on mobility aspects of self-care and domestic life. Conclusions The findings indicate that the potential of assistive devices to facilitate activities and participation in life areas such as work and employment is still waiting to be utilised on a broad scale.

  • 288.
    Borg, Johan
    et al.
    Lunds universitet.
    Larsson, Stig
    Ostergren, Per-Olof
    The right to assistive technology: for whom, for what, and by whom?2011In: Disability & Society, ISSN 0968-7599, E-ISSN 1360-0508, Vol. 26, no 2, p. 151-167Article in journal (Refereed)
    Abstract [en]

    Despite its facilitating role in creating opportunities for people with disabilities to exercise human rights, access to assistive technology is limited in many countries. It is therefore promising that the Convention on Rights of Persons with Disabilities (CRPD) addresses this area. The purpose of this study was to analyse the assistive technology content of the CRPD from a basic human rights perspective in order to clarify its limitations and opportunities for formulation of policies and implementation strategies. Data were collected through a content analysis of the CRPD. It is concluded that a non-discriminatory interpretation of the provisions entitles all people with disabilities to a right to demand available and affordable assistive technology. Ensuring this right is a national as well as an international responsibility.

  • 289.
    Borg, Johan
    et al.
    Lunds universitet.
    Larsson, Stig
    Ostergren, Per-Olof
    Eide, Arne H.
    The Friction Model - a dynamic model of functioning, disability and contextual factors and its conceptual and practical applicability2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 21, p. 1790-1797Article in journal (Refereed)
    Abstract [en]

    Purpose. To develop a model of the dynamics of functioning, disability and contextual factors which harmonises with the International Classification of Functioning, Disability and Health (ICF). Method. Model parts based on ICF were identified and a model drawing from engineering concepts was developed. The conceptual and practical applicability of the model was discussed. Results. The so called Friction Model was created, which incorporates the ICF entities capacity, performance, environmental factors, health condition, body functions and structures, and personal factors. Friction describes the interaction between a person and his or her environment. The coefficient of friction is defined as the ratio between capacity and performance. Conclusion. Carrying conceptual strengths and limitations, the Friction Model appears to offer opportunities for practical applications, including ICF-based alternatives to health-economic analyses. Harmonising with the ICF model and terminology, the model uses friction to describe the interaction between a person and the environment. The coefficient of friction can be used as a simple measure of how facilitating an environment is. The applicability is not limited to functioning of people with impairments.

  • 290.
    Borg, Johan
    et al.
    Lunds universitet.
    Larsson, Stig
    Ostergren, Per-Olof
    Rahman, A. S. M. Atiqur
    Bari, Nazmul
    Khan, A. H. M. Noman
    Assistive technology use and human rights enjoyment: a cross-sectional study in Bangladesh2012In: BMC International Health and Human Rights, ISSN 1472-698X, E-ISSN 1472-698X, Vol. 12, article id 18Article in journal (Refereed)
    Abstract [en]

    Background: About half a billion people with disabilities in developing countries have limited access to assistive technology. The Convention on the Rights of persons with Disabilities requires governments to take measures to ensure provision of such technologies. To guide implementation of these measures there is a need for understanding health outcomes from a human rights perspective. The objective of this study was therefore to explore the relation between assistive technology use and enjoyment of human rights in a low-income country. Methods: Data was collected in eight districts of Bangladesh through interviews of people with hearing impairments using and not using hearings aids, and people with ambulatory impairments using and not using manual wheelchairs (N = 583). Using logistic regression, self-reported outcomes on standard of living, health, education, work, receiving information and movement were analyzed. Results: The adjusted likelihood of reporting greater enjoyment of human rights was significantly higher among people using hearing aids compared to non-users for all outcomes except working status. Compared to non-users, users of wheelchairs reported a significantly higher adjusted likelihood of good ambulatory performance and a significantly lower adjusted likelihood of reporting a positive working status. Further analyses indicated that physical accessibility to working places and duration of wheelchair use had a statistically significant impact on the likelihood of reporting positive work outcomes. Conclusions: The findings support the notion that assistive technology use increases the likelihood of human rights enjoyment, particularly hearing aid use. Physical accessibility should always be addressed in wheelchair provision.

  • 291.
    Borg, Johan
    et al.
    Lunds universitet.
    Larsson, Stig
    Östergren, Per-Olof
    Rahman, A. S. M. Atiqur
    Bari, Nazmul
    Khan, A. H. M. Noman
    User involvement in service delivery predicts outcomes of assistive technology use: A cross-sectional study in Bangladesh2012In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 12, article id 330Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge about the relation between user involvement in the provision of assistive technology and outcomes of assistive technology use is a prerequisite for the development of efficient service delivery strategies. However, current knowledge is limited, particularly from low-income countries where affordability is an issue. The objective was therefore to explore the relation between outcomes of assistive technology use and user involvement in the service delivery process in Bangladesh. Methods: Using structured interviews, data from 136 users of hearing aids and 149 users of manual wheelchairs were collected. Outcomes were measured using the International Outcome Inventory for Hearing Aids (IOI-HA), which was adapted for wheelchair users. Predictors of user involvement included preference, measurement and training. Results: Users reported outcomes comparable to those found in other high- and low-income countries. User involvement increased the likelihood for reporting better outcomes except for measurement among hearing aid users. Conclusions: The findings support the provision of assistive technology as a strategy to improve the participation of people with disabilities in society. They also support current policies and guidelines for user-involvement in the service delivery process. Simplified strategies for provision of hearing aids may be explored.

  • 292.
    Borg, Johan
    et al.
    Lunds universitet.
    Lindstroem, Anna
    Larsson, Stig
    Assistive technology in developing countries: national and international responsibilities to implement the Convention on the Rights of Persons with Disabilities2009In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 374, no 9704, p. 1863-1865Article in journal (Refereed)
  • 293.
    Borg, Johan
    et al.
    Lunds universitet.
    Lindstrom, Anna
    Larsson, Stig
    Assistive technology in developing countries: a review from the perspective of the Convention on the Rights of Persons with Disabilities2011In: Prosthetics and orthotics international, ISSN 0309-3646, E-ISSN 1746-1553, Vol. 35, no 1, p. 20-29Article in journal (Refereed)
    Abstract [en]

    Background: The ‘Convention on the Rights of Persons with Disabilities’ (CRPD) requires governments to meet the assistive technology needs of citizens. However, the access to assistive technology in developing countries is severely limited, which is aggravated by a lack of related services. Objectives: To summarize current knowledge on assistive technology for low- and lower-middle-income countries published in 1995 or later, and to provide recommendations that facilitate implementation of the CRPD. Study design: Literature review. Methods: Literature was searched in web-based databases and reference lists. Studies carried out in low- and lower-middle-income countries, or addressing assistive technology for such countries, were included. Results: The 52 included articles are dominated by product oriented research on leg prostheses and manual wheelchairs. Less has been published on hearing aids and virtually nothing on the broad range of other types of assistive technology. Conclusions: To support effective implementation of the CRPD in these countries, there is a need for actions and research related particularly to policies, service delivery, outcomes and international cooperation, but also to product development and production.

  • 294.
    Borg, Johan
    et al.
    Lunds universitet.
    Ostergren, Per-Olof
    Users’ perspectives on the provision of assistive technologies in Bangladesh: awareness, providers, costs and barriers2015In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 10, no 4, p. 301-308Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this work was to contribute to a better understanding of challenges and solutions to equitable provision of assistive technologies in resource limited environments by (i) describing sources of awareness, types of providers and costs of assistive technologies; (ii) describing common reasons for not possessing assistive technologies; and (iii) comparing these sources, providers, costs and reasons among younger and older men and women living in urban and rural settings. Methods: Descriptive and analytic statistics were used to analyze crosssectional data from a total sample of 581 hearing aid users, wheelchair users, individuals with hearing impairments not using hearing aids and individuals with ambulatory impairments not using wheelchairs living in eight districts of Bangladesh. Results: Major sources of awareness, types of providers and costs paid varied between users of different types of assistive technology. Lack of affordability was the main reason for not possessing assistive technology. Outcome differences were found between younger and older groups, men and women, and literate and illiterate respondents, while no differences related to place of living were identified. Conclusions: Age, gender, type of impairment and socioeconomic status need to be considered when planning and implementing equitable provision of assistive technologies.

  • 295.
    Borg, Richard
    Dalarna University, Not School affiliated.
    Digerdöden i Skeby socken [Biblioteket testar avhandlingsfunktioner]: Vittnesmål från överlevande2025Doctoral thesis, monograph (Other academic)
    Abstract [en]

    There were different forms of the Black Death, and they were spread in different ways, though they were caused by the same organism. The Bubonic Plague was a form carried by such animals as rats and the fleas that lived on them, both of which exhibited symptoms of the disease. When a flea bit an infected rat, it would get sick; subsequently, if it bit another rat or a human being, it would vomit as it bit, infecting that animal or person. 

  • 296.
    Borg, Sixten
    et al.
    Lund University, Department of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, SE-223 81 Lund, Sweden.
    Eeg-Olofsson, Katarina
    University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, SE-413 46 Gothenburg, Sweden and Sahlgrenska University Hospital, Gothenburg, Sweden.
    Palaszewski, Bo
    Region Västra Götaland, Department of Data Management and Analysis, SE-405 44 Gothenburg, Sweden.
    Svedbo Engström, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, SE-413 46 Gothenburg, Sweden.
    Gerdtham, Ulf-G
    Lund University, Department of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, SE-223 81 Lund, Sweden; The Swedish Institute for Health Economics (IHE), Box 2127, SE-220 02 Lund, Sweden; Department of Economics, School of Economics and Management, Box 7082, SE-220 07 Lund, Sweden.
    Gudbjörnsdottir, Soffia
    University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, SE-413 46 Gothenburg, Sweden and Centre of Registers Västra Götaland, SE-413 45 Gothenburg, Sweden.
    Patient-reported outcome and experience measures for diabetes: development of scale models, differences between patient groups and relationships with cardiovascular and diabetes complication risk factors, in a combined registry and survey study in Sweden2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 1, article id e025033Article in journal (Refereed)
    Abstract [en]

    Purpose The Swedish National Diabetes Register (NDR) has developed a diabetes-specific questionnaire to collect information on individuals' management of their diabetes, collaboration with healthcare providers and the disease’s impact on daily life. Our main objective was to develop measures of well-being, abilities to manage diabetes and judgements of diabetes care, and to detect and quantify differences using the NDR questionnaire.

    Design, setting and participants The questionnaire was analysed with using responses from 3689 participants with type 1 and 2 diabetes, randomly sampled from the NDR population, combined with register data on patient characteristics and cardiovascular and diabetes complication risk factors.

    Methods We used item response theory to develop scales for measuring well-being, abilities to manage diabetes and judgements of diabetes care (scores). Test–retest reliability on the scale level was analysed with intraclass correlation. Associations between scores and risk factor levels were investigated with subgroup analyses and correlations.

    Results We obtained scales with satisfactory measurement properties, covering patient reported outcome measures such as general well-being and being free of worries, and patient reported experience measure, for example, access and continuity in diabetes care. All scales had acceptable test–retest reliability and could detect differences between diabetes types, age, gender and treatment subgroups. In several aspects, for example, freedom of worries, type 1 patients report lower than type 2, and younger patients lower than older. Associations were found between some scores and glycated haemoglobin, but none with systolic blood pressure or low-density lipoprotein cholesterol. Clinicians report positive experience of using scores, visually presented, in the patient dialogue.

    Conclusions The questionnaire measures and detects differences in patient well-being, abilities and judgements of diabetes care, and identifies areas for improvement. To further improve diabetes care, we conclude that patient-reported measures are important supplements to cardiovascular and diabetes complication risk factors, reflecting patient experiences of living with diabetes and diabetes care.

  • 297.
    Borgström, Maritza
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Föräldrars erfarenhet av behandling med Minifom och Semper magdroppar vid kolik: en kvantitativ, deskriptiv studie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Colic affects at least 10% of newborns and parents seek help. The aim was to present why infants whose parents sought help for colic, where not included in two trials studying the effect of acupuncture in infantile colic and to describe the use of simethicone and probiotics amongst those infants that according to a diary still fulfilled the criteria for infantile colic after a baseline week with cows milk free diet.

    Method: A quantitative, descriptive sub-study based on unpublished data, collected in two RCTs, examining the effect of acupuncture in 228 infants with colic. Screening lists and background data from a questionnaire answered by the infant’s parents was analyzed.

    Results: 636 infants were screened for participation in the two trials. Of these, 389 were not included as they according to the diary cried < 3 hours per day and thereby did not fulfill the criteria for colic. Either parents had overestimated the crying or infants reduced symptoms of colic when introducing a cow’s milk free diet. Almost every included infant in the first trial (2010) and 76% in the second (2015) had been treated with simethicone but only 2,7 % and 5,4% of the parents reported effect. The use of probiotics increased from 14,8% to 86,3% in the second trial. Zero and 3,2% respectively reported effect. There was a significant association between treatment with simethicone and having more than one child, having earlier experience from colic in the family and having a normal delivery. Treatment with probiotics was associated with higher frequency of complications during pregnancy, exclusive breastfeeding, food allergies and/or intolerances in the infant’s family and having less problems with eczema and skin rashes.

    Conclusion: The use of a diary is valuable to assess the infants crying and can help nurses to adapt their advice and support to these families. Excluding cows milk protein helped many infants with excessive crying. Most parents had tried simethicone and probiotics without experiencing effect.

  • 298.
    Bornehag, Hanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Victoria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Upplevelser hos personer med typ 2 diabetes avseendehälsofrämjande åtgärder: En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Type 2 diabetes increases globally, mainly due to an unhealthy lifestyle. Through health promotion interventions type 2 diabetes can be prevented and avoided.Aim: The aim of this study was to describe the experiences of persons with type 2 diabetes with respect to health promotion.Method: This study was a literature review based on 15 scientific articles within current subjects. Selected articles were reviewed and summarized in the categories Experiences about health promotion and Experiences regarding advice about health promotion.Result: Persons with type 2 diabetes experienced difficulties in changing their dietary habits and phyiscal activity habits. Knowledge of health promotion measures existed, however, they lacked the motivation and knowledge about how to achieve them. Advice and support from healthcare professionals, related parties and group education was an important factor in the implementation of health promotion measures.Conclusion: Persons with type 2 diabetes need support from different parties in order to implement health promotion measures. Changing their dietary and physical activity habits has sometimes been perceived as difficult. With support from health care, close relatives and group training, strategies for health-enhancing changes can be created. By meeting people in the same situation, people with type 2 diabetes can get a positive exchange of knowledge.

  • 299. Bostrom, Anne-Marie
    et al.
    Rudman, Ann
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustavsson, Jens Petter
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Nursing, Huddinge, Sweden.
    Factors associated with evidence-based practice among registered nurses in Sweden: a national cross-sectional study2013In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 13, article id 165Article in journal (Refereed)
    Abstract [en]

    Background: Evidence-based practice (EBP) is emphasized to increase the quality of care and patient safety. EBP is often described as a process consisting of distinct activities including, formulating questions, searching for information, compiling the appraised information, implementing evidence, and evaluating the resulting practice. To increase registered nurses' (RNs') practice of EBP, variables associated with such activities need to be explored. The aim of the study was to examine individual and organizational factors associated with EBP activities among RNs 2 years post graduation.

    Methods: A cross-sectional design based on a national sample of RNs was used. Data were collected in 2007 from a cohort of RNs, included in the Swedish Longitudinal Analyses of Nursing Education/Employment study. The sample consisted of 1256 RNs (response rate 76%). Of these 987 RNs worked in healthcare at the time of the data collection. Data was self-reported and collected through annual postal surveys. EBP activities were measured using six single items along with instruments measuring individual and work-related variables. Data were analyzed using logistic regression models.

    Results: Associated factors were identified for all six EBP activities. Capability beliefs regarding EBP was a significant factor for all six activities (OR = 2.6 - 7.3). Working in the care of older people was associated with a high extent of practicing four activities (OR = 1.7 - 2.2). Supportive leadership and high collective efficacy were associated with practicing three activities (OR = 1.4 - 2.0).

    Conclusions: To be successful in enhancing EBP among newly graduated RNs, strategies need to incorporate both individually and organizationally directed factors.

  • 300. Boström, Anne-Marie
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustavsson, Petter
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Registered nurses' application of evidence based practice: a national survey2009In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 15, no 6, p. 1159-1163Article in journal (Refereed)
    Abstract [en]

    Background. Evidence-based practice (EBP) is a worldwide approach to improving health care. There is, however, a shortage of studies examining whether or not newly graduated health care professionals are actually applying EBP in their daily work.

    Objectives. To examine the application of EBP in clinical practice by registered nurses (RNs) 2 years post graduation and to explore whether the application of EBP differed with regard to the clinical settings where RNs were working.

    Method. A cross-sectional design using a national sample. Data were collected in 2007 from 987 RNs (response rate 76%). Six items measuring respondents' self-reported extent of applying EBP were used.

    Results. Of the 987 RNs, 19% formulated questions and performed searches in data bases, 56% used other information sources, 31% appraised the literature, 30% participated in practice development and 34% participated in evaluating clinical practice. A greater proportion of the RNs working in elder care applied EBP compared with the RNs working in hospitals, psychiatric care and primary care.

    Conclusions. The RNs applied the components of EBP to a rather low extent 2 years post graduation despite EBP being an important objective in Swedish health care and educational programmes since the 1990s. These findings support other studies reporting the implementation of EBP in organizations as a complex and often slow process. The differences in the RNs extent of applying EBP in relation to their workplace indicate that contextual factors and the role of the RN in the organization are of importance for getting EBP into practice.

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