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  • 251.
    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.

  • 252. 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.

  • 253.
    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.

  • 254.
    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.

  • 255.
    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.

  • 256.
    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.

  • 257. Borg, Johan
    Assistive technology - A facilitator of human freedoms for people with disabilities?2011Conference paper (Other academic)
  • 258.
    Borg, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Commentary on selection of assistive technology in a context with limited resources2019In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 14, no 8, p. 753-754Article in journal (Refereed)
  • 259.
    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)
  • 260.
    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.

  • 261.
    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.

  • 262.
    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.

  • 263.
    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.

  • 264.
    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.

  • 265.
    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.

  • 266.
    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)
  • 267.
    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.

  • 268.
    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.

  • 269.
    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.

  • 270.
    Born, Dennis
    et al.
    University of Würzburg.
    Stöggl, Thomas
    University of Salzburg, Salzburg, Austria.
    Swarén, Mikael
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Björklund, Glenn
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Near-Infrared Spectroscopy: More Accurate Than Heart Rate for Monitoring Intensity in Running in Hilly Terrain2017In: International Journal of Sports Physiology and Performance, ISSN 1555-0265, E-ISSN 1555-0273, Vol. 12, no 4, p. 440-447Article in journal (Refereed)
    Abstract [en]

    Purpose:

    To 1) investigate the cardiorespiratory and metabolic response of trail running and 2) evaluate whether heart rate (HR) adequately reflects the exercise intensity or whether the tissue saturation index (TSI) could provide a more accurate measure when running in hilly terrain.

    Methods:

    Seventeen competitive runners (female: n=4, V’O2max: 55±6 mL·kg−1·min−1; male: n=13, V’O2max: 68±6 mL·kg−1·min−1) performed a time trial on an off-road trail course. The course was made up of two laps covering a total distance of 7 km and included six steep up- and downhill sections with an elevation gain of 486 m. All runners were equipped with a portable breath-by-breath gas analyzer, HR belt, global positioning system receiver and near-infrared spectroscopy (NIRS) device to measure the TSI.

    Results:

    During the trail run, the exercise intensity within the uphill and downhill sections was 94±2% and 91±3% of HRmax, 84±8% and 68±7% of V’O2max, respectively. The oxygen uptake (V’O2) increased within the uphill and decreased within the downhill sections (P< .01). While HR was unaffected by the altering slope conditions, the TSI was inversely correlated to the changes in V’O2 (r = - .70, P< .05).

    Conclusions:

    The HR was unaffected by the continuously changing exercise intensity, however, the TSI reflected the alternations in V’O2. Recently used exclusively for scientific purpose, this NIRS based variable may offer a more accurate alternative to HR to monitor running intensity in the future, especially for training and competition in hilly terrain.

  • 271.
    Born, Dennis
    et al.
    Nationellt Vintersportcentrum.
    Stöggl, Thomas
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Swarén, Mikael
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Sperlich, Billy
    Björklund, Glenn
    Mittuniversitetet, Avdelningen för hälsovetenskap.
    Is heart rate a valid measure to monitor exercise intensity during trail running in undulating terrain?2015Conference paper (Refereed)
  • 272.
    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.

  • 273. 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.

  • 274. 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.

  • 275. Boström, Anne-Marie
    et al.
    Kajermo, Kerstin Nilsson
    Nordström, Gun
    Wallin, Lars
    Karolinska Institutet.
    Barriers to research utilization and research use among registered nurses working in the care of older people: does the BARRIERS scale discriminate between research users and non-research users on perceptions of barriers?2008In: Implementation science : IS, ISSN 1748-5908, Vol. 3, p. 24-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: One strategy to enhance research use and change current practice is to identify barriers and then implement tailored interventions to reduce these barriers. In nursing, the BARRIERS scale has been frequently used to identify nurses' perceptions of barriers to research utilization. However, this scale has not been applied to care of older people, and only one study has investigated how identified barriers link to research utilization. Therefore, the purpose of this study was twofold: to describe RNs' perceptions of barriers to and facilitators of research utilization and to examine the validity of the BARRIERS scale in relation to research use.

    METHODS: A cross-sectional survey design was used and registered nurses (RNs) working in the care of older people participated (response rate 67%, n = 140/210). Two questionnaires, the BARRIERS scale and the Research Utilization Questionnaire (RUQ), were used. Data were analyzed using descriptive and bivariate inferential statistics.

    RESULTS: Characteristics of the organization and the presentation of research findings were rated as the most prominent barriers. The three items most frequently reported as barriers were: the nurse is isolated from knowledgeable colleagues with whom to discuss the research (89%); the facilities are inadequate for implementation (88%); and, the relevant literature is not compiled in one place (81%). Surveyed RNs suggested more support from unit managers and better availability of user-friendly reports in Swedish to enhance research use.The RNs reported a modest use of research. A weak but significant correlation was found between the Research Use index in RUQ and the Presentation subscale in the BARRIERS scale (r = -0.289, p < 0.01), suggesting that the RNs reporting more research use were less likely to perceive presentation of research as a barrier. Dividing the sample into research users (n = 29) and non-research users (n = 105), the research users rated significantly lower on the subscales Presentation, Nurse and Research in the BARRIERS scale.

    CONCLUSION: The BARRIERS scale revealed differences in the perception of barriers between research users and non-research users. Thus, methodologically the scale appears useful in identifying some types of barriers to research utilization but not organizational barriers. The identified barriers, however, are general and wide-ranging, making it difficult to design useful specific interventions.

  • 276. Boström, Anne-Marie
    et al.
    Kajermo, Kerstin Nilsson
    Nordström, Gun
    Wallin, Lars
    Karolinska Institutet.
    Registered nurses' use of research findings in the care of older people2009In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 18, no 10, p. 1430-41Article in journal (Refereed)
    Abstract [en]

    AIMS: To describe registered nurses' reported use of research in the care of older people and to examine associations between research use and factors related to the elements: the communication channels, the adopter and the social system.

    BACKGROUND: Research use among registered nurses working in hospital settings has been reported in many studies. Few studies, however, have explored the use of research among registered nurses working in the care of older people.

    DESIGN: A cross-sectional survey.

    METHODS: In eight municipalities, all registered nurses (n = 210) working in older people care were invited to participate (response rate 67%). The Research Utilisation Questionnaire was adopted. Questions concerning the work organisation and research-related resources were sent to the Community Chief Nurse at each municipality. Descriptive statistics and logistic regression were applied.

    RESULTS: The registered nurses reported a relatively low use of research findings in daily practice, despite reporting a positive attitude to research. The registered nurses reported lack of access to research reports at the work place and that they had little support from unit managers and colleagues. Registered nurses working in municipalities with access to research-related resources reported more use of research than registered nurses without resources. The factors 'Access to research findings at work place', 'Positive attitudes to research' and 'Nursing programme at university level' were significantly associated with research use.

    CONCLUSIONS: There is a great potential to increase registered nurses' use of research findings in the care of older people. Factors which were linked to the communication channels and the adopter were associated with research use.

    RELEVANCE TO CLINICAL PRACTICE: Strategies to enhance research use should focus on access to and adequate training in using information sources, increased knowledge on research methodology and nursing science and a supportive organisation.

  • 277. Boström, Anne-Marie
    et al.
    Wallin, Lars
    Karolinska Institutet.
    Nordström, Gun
    Evidence-based practice and determinants of research use in elderly care in Sweden2007In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 13, no 4, p. 665-73Article in journal (Refereed)
    Abstract [en]

    RATIONALE AND OBJECTIVE: Evidence-based practice is a strategic ingredient in today's health care. Despite extensive efforts to produce and disseminate clinical guidelines, research uptake is still a difficult task. In Sweden, elderly care (EC) has shifted from hospital care to community-based care, and the major nursing-staff group in EC has no university education. These and other factors make implementation of evidence-based care particularly challenging in EC settings. The purpose of this study was to identify determinants of research utilization in EC.

    METHOD: Two questionnaires that cover research utilization and organizational climate were mailed to all staff (n = 132) working in seven EC units. The response rate was 67%.

    RESULTS: Of all respondents, 28% reported that they used research findings in daily practice (the RU group). Remaining respondents constituted the non-RU group. Significant differences existed between the RU group and the non-RU group as per six individual and six organizational factors. Using logistic regression models, four factors were significantly related to research utilization, namely: attitudes toward research (OR = 5.52, P = 0.004); seeking research that is related to clinical practice (OR = 5.56, P = 0.019); support from unit manager (OR = 4.03, P = 0.044) and access to research findings at work place (OR = 6.65, P = 0.005).

    CONCLUSIONS: Individual and organizational factors were associated with the use of research in EC. Despite distinguishing conditions in EC settings, identified factors reflect well-known determinants of research use that, as in many other health care contexts, should be considered in the endeavours of evidence-based practice.

  • 278. Boström, Anne-Marie
    et al.
    Wallin, Lars
    Karolinska Institutet.
    Nordström, Gun
    Research use in the care of older people: a survey among healthcare staff2006In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 1, no 3, p. 131-40Article in journal (Refereed)
    Abstract [en]

    Background.  Sweden has one of the largest proportions of older people in the world. To manage the healthcare needs of an aging population, there has been an alteration from hospital care to community-based care. In these settings, the majority of staff is enrolled nurses (EN) and nurse aides (NA) without university education. Aim and design.  The overall aim of this cross-sectional survey was to explore staff perceptions of factors related to research utilization in the care of older people. Method.  Questionnaires covering research utilization and demographics were sent to all staff (n = 132) working in seven units in older people care. The response rate was 67% (n = 89). The respondents consisted of ENs/NAs (n = 63), Registered Nurses (RN) and rehabilitation professionals (RP) as physiotherapists and occupational therapists (RN/RP n = 26). Results.  Most of staff reported positive attitudes towards research. The RNs/RPs stated more often than the ENs/NAs that they wanted to base their practice on research (81% vs. 25%; P = 0.001). The RNs/RPs also reported a greater extent of research use in daily practice (54% vs. 17%; P = 0.001). Support from colleagues (77% vs. 22%; P < 0.001) and unit managers (73% vs. 10%; P < 0.001) for implementing research findings was also more frequently reported by the RNs/RPs compared with the ENs/NAs. The majority of the ENs/NAs stated Do not know on many items concerning attitudes towards research, support for research utilization and actual use of research. Conclusions.  Despite overall positive attitudes towards research, the majority of staff did not use research findings in daily practice. This was particularly valid for the EN/NA group. Relevance to clinical practice.  There is an urgent need for managers and others in the care of older people to develop strategies for implementing evidence-based practice that involves the EN/NA group.

  • 279.
    Boström, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Persson, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Web-baserat stöd i astmavården – en randomiserad kontrollerad studie2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective

    The aim of this study was to examine the impact on asthma control and lung function of a web-based support program for asthma patients in primary care.

    Method

    The study was a quantitative, parallel, 2-arm, randomized controlled trial over a 6-month period.

    Both groups received asthma care based on how it was conducted at the health centers and the intervention group also gained access to a newly created web-based support program (Astmakollen) for asthma patients. In total, 83 participants completed the study, of whom 39 were in the intervention group and 44 in the control group.

    Results

    This study has showed significant improvement in asthma management in the sample group who had access to the web-based support program for 6 months. The mean score for asthma control test in the intervention group increased by 2,23 points while the score in the control group remained almost the same. The effect size for this change measured in Cohens

    d was 0,57. The mean score of lungfunction in the intervention group increased by 0,3% during the study period, while it deteriorated in the control group and the effect size amounted to 0,45. The difference between the groups were significant.

    Conclusions

    In this study, it appears that eHealth can provide improved asthma control and maintained lung function and be a complement in today's asthma care by increasing accessibility of personalized and evidence-based care.

  • 280. Bozkurt Ahman, H
    et al.
    Giedraitis, V
    Cedervall, Y
    Berglund, L
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Correlations Between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers2018Conference paper (Refereed)
  • 281. Bozkurt Åhman, H
    et al.
    Cedervall, Y
    Giedraitis, V
    Berglund, L
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Combining Two Dual-Task Tests to Discriminate Between People with Dementia Disorder, Mild Cognitive Impairment, Subjective Cognitive Impairment, and Healthy Controls2019Conference paper (Refereed)
  • 282. Bozkurt Åhman, H
    et al.
    Giedraitis, V
    Cedervall, Y
    Berglund, L
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Rosendahl, E
    Ingelsson, M
    Åberg, Anna Cristina
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Correlations Between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers2019Conference paper (Refereed)
  • 283. Brehmer, Lovisa
    et al.
    Alexanderson, Kristina
    Schytt, Erica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Days of sick leave and inpatient care at the time of pregnancy and childbirth in relation to maternal age2017In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 45, no 3, p. 222-229Article in journal (Refereed)
    Abstract [en]

    AIMS: To explore whether older women differ from younger women with respect to sick leave and inpatient care at the time around their first pregnancy and delivery.

    METHODS: This was a descriptive population-based cohort study. The study population included all 236,176 nulliparous women registered as living in Sweden who gave birth to their first singleton infant in 2006-2010. Data from nationwide Swedish registers were used. Maternal age was categorized in five-year intervals. Time was calculated in years with the delivery date as the starting point, from two years before and up to three years after delivery. Descriptive statistics were used to calculate mean values and ANOVA tables were used to obtain the 95% confidence intervals of the means. Restriction was used to reduce potential confounding.

    RESULTS: Women aged ⩾35 years had a higher annual mean number of sick leave days from two years before to one year after their delivery date compared with younger women. The range for all age categories in the year before the delivery date, including pregnancy, was 15.3-37.4 mean sick leave days. The mean number of inpatient days increased with each age category during the year after the date of delivery in the range 1.4-4.3 days.

    CONCLUSIONS: This first explorative study indicates the need for more knowledge on morbidity among older primiparous women. They had a higher number of days with sick leave and hospitalization in the year before and after their delivery date. This might reflect higher health risks during pregnancy and childbirth among older women; however, social factors and reverse causation might also be influential.

  • 284. Breimer, Lars
    et al.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Longitudinal and cross-sectional study of registered nurses in Sweden who undertake a PhD showing that nurses continue to publish in English after their PhD but male nurses are more productive than female nurses2011In: Scientometrics, ISSN 0138-9130, E-ISSN 1588-2861, Vol. 87, no 2, p. 337-345Article in journal (Refereed)
    Abstract [en]

    A review of 649 PhDs undertaken by Swedish nurses and midwives found no evidence that they stop publishing in English after their PhD. The proportion of 70% for any publication in English was similar to that of MDs. A higher proportion of male than female nurses were high publishers of six or more (52% vs. 23%) and eight or more papers (44% vs. 14%) in a 5 year period. The standard of the PhDs of Swedish nurses was comparable to those of other biomedical PhDs and was consistent in pattern over the past two decades. The gender pattern of external examiners of female nurses evolved in that 1992–94, 75% were men, during 1996–97, 54% were men and from 2000 onwards 46% were men. Nurses were examined by foreign examiners in 20% of examinations. They came primarily from Norway and USA.

  • 285.
    Breivik, Mia
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Midwives’ perceptions of HIV-positive women’s sexual and reproductive health and rights in urban Namibia: An interview study with ten midwives2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Namibia has challenges in the area of sexual and reproductive health and rights. Working with sexual and reproductive health care, midwives are an important facilitating factor for a better sexual and reproductive health in Namibia.

    Aim:

    To explore midwives’ perceptions of HIV-positive women's sexual and reproductive health and rights in urban Namibia.

    Method:

    A qualitative study with ten midwives at a hospital in Windhoek. Individual interviews were done using an interview guide. The method used for analysis was phenomenography. The phenomenon being studied was the sexual and reproductive health and rights of HIV-positive women and the phenomenon was studied through the perceptions of midwives.

    Findings:

    The midwives perceived that improvements of HIV-positive women’s reproductive health were obstructed. The midwives perceived that the HIV-positive women’s reproductive possibilities and decisions were related to HIV. According to the midwives’ perceptions, sexual relations could be complicated by HIV and it was difficult for HIV-positive women to use condoms.

    Conclusion:

    The findings of this study can be used to reflect on the current situation for HIV-positive women in Namibia. The midwives' perceptions highlight the need to reduce the remaining stigma related to HIV and to work towards the empowerment of HIV-positive women.

  • 286.
    Brelin, Rickard
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Färnström, Joel
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Fenomenet Timeouter inom Idrotten Ishockey: Sammanställning av matchstatistik från SHL säsongen 2017/18 & spelare, samt tränares och spelares erfarenheter på fenomenet timeouter inom ishockey.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose

    The purpose of the study is to analyze match statistics of timeouts from the 2017/18 season of the Swedish Hockey League (SHL) and based on the analysis obtain coaches and players approach experiences off timeouts.

    Method

    Method during the study was a mixed method, whit both a qualitative and a quantitative research through interviews and statistical compilation of statistics from SHL seson 2017/18. The study's selection to the interviews was coaches and players at the elite level in the sports ice hockey and match statistics was taken and compiled from the Swedish Ice Hockey Association's database from the 2017/18 season in SHL.

    Results

    The result of the study shows that during the SHL season 2017/18 less than half of possible timeouts were taken and most of the timeouts were taken in the third period of teams in lower positions in games. During the timeouts, the trainers are most active and the interviewees' overall experience is that the powerbreak has a major impact on numbers of timeouts and that coaches are waiting to take their timeouts to the end of the matches.

    Conclusion

    The conclusions of this study are that the powerbreak has a major impact on that less than half of the timeouts being use. Powerbreaks has become an extra timeout when teams gets a longer break one time per period during the matches. This means that teams save their timeout to the end of the matches. Most timeouts are taken by teams in lower positions and by teams at the bottom of the table. Which is logical since teams at the bottom of the table are more often in lower position at the end of matches when most timeouts are used.

  • 287.
    Brisenheim, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hagsköld, Ylva
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelser av att vårdas på en akutmottagning: -en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The demands and expectations on a nurse in the emergency room

    are high. They are responsible for many patients and have to make many decisions

    on their own, sometimes with very short reflection time. They face a wide variety

    of patients with different problems and personalities, each requiring their own

    method of approach and interaction in order for him or her to feel acknowledged.

    Aim: The aim of the literature review is to examine patient's experiences of being

    cared for in an emergency room.

    Method: Articles for the work has been searched in different databases. Articles

    in-question has been read and the relevant finding has been highlighted, to analyze

    and compile the results.

    Results: The analysis resulted in three subheadings: Information, Treatment and

    Care environment, with sectioning of positive and negative experiences. Many

    patients were satisfied with the care, but had low expectations from the start.

    Conclusion: There is much that needs to be changed to allow patients to have a

    more positive experience of the emergency room. Care units must work harder

    with to ensure that patients will feel secure and safe, for example, better

    information on waiting times and a treatment where the nurse sees the whole

    patient.

  • 288.
    Brorson, Marie
    Dalarna University, School of Health and Social Studies.
    Doulors erfarenheter av sitt arbete med somaliska invandrarkvinnor En intervjustudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 289.
    Brorson, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Doulors erfarenheter av sitt arbete med somaliska invandrarkvinnor: En intervjustudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Doulor/kulturtolkar är kvinnor som ska ge sina kvinnliga landsmän stöd och hjälp i

    kontakten med den svenska hälso- och sjukvården. I Örebro läns landsting

    startades ett projekt med doulor/kulturtolkar under 2013. Syftet med denna studie

    är att utforska dessa doulors erfarenheter av sitt arbete och vilken information de

    anser är relevant för invandrarkvinnor som ska besöka en barnmorska i

    primärvården. Metoden har varit kvalitativ med individuella intervjuer med fem

    doulor i Örebro. Resultatet visade att invandrarkvinnor önskar stöd och

    information dels i form av hjälp att förstå språket och information i samband med

    besök i vården t.ex. på vårdcentral, dels i form av en djupare förklaring av

    innebörden i informationen. Doulornas uppgift har varit att förklara på ett sätt så

    att invandrakvinnorna förstår. Invandrarkvinnorna har också sökt stöd hos

    doulorna när de har haft oro angående kvinnlig könsstympning, och för att få veta

    vad cellprovtagning är. Slutsatsen är att denna studie visar överensstämmelse i

    hög grad med tidigare forskning inom området.

  • 290.
    Brorsson, Anna Lena
    Karolinska institutet.
    Diabetes during childhood and adolescence: studies of insulin treatment, patient-reported outcomes, and evaluation of an empowerment-based education2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    There is a lack of studies demonstrating positive effects on glycaemic control and HRQoL in children and adolescents starting CSII treatment. Guidelines recommend measuring perceived HRQoL routinely. It is important to have questionnaires, not overly comprehensive or timeconsuming, to measure HRQoL in children and adolescents as well as their parents. Structured and person-centred education has been emphasized as a key to successful selfmanagement. Guided Self-Determination-Young (GSD-Y) is a person-centred communication and reflection method. The overall aim of this thesis was to increase the knowledge regarding glycaemic control, type of treatment, HRQoL, and a theory-based education among youth with type 1 diabetes.

    Study I was a retrospective case-control study comparing children and adolescents starting CSII (n=216), with a control group treated with MDI (n=215). Children and adolescents who had started CSII showed improvement in glycaemic control, measured as HbA1c, during the first six months. For boys, this improvement could be identified throughout the first year.

    In Study II, 197 parents and their children with type 1 diabetes completed the proxy and child versions of the questionnaires Check your Health and DISABKIDS to test the psychometric properties of Check your Health by proxy. The test of the reliability and validity of this questionnaire showed acceptable psychometric properties.

    Study III, an RCT evaluating a GSD-Y education, included 71 adolescents starting CSII and their parents. The intervention group (n=37) attended seven group education sessions, lasting for about two hours each, using the GSD-Y method. The participants were followed for six months. The GSD-Y method showed a positive effect on glycaemic control, especially for participants with an HbA1c above 63 mmol/mol (n=48) at inclusion (p= 0.037); furthermore, readiness to change increased (p=0.037). A correlation was identified between HbA1c and goal achievement (rs=-0.475, p=0.001), and readiness to change (rs=-0.487, p=0.001).

    In Study IV, 13 adolescents were interviewed after the intervention with GSD-Y. From the qualitative analysis, two categories emerged: the importance of context, and growing in power through the group process. An overarching theme that emerged from the interviews was the importance of expert and referent power in growing awareness of the importance of self-management, as well as mitigating the loneliness of diabetes. Further, the findings showed that it is valuable for adolescents to meet other young people in the same situation, and to share their experiences from living with diabetes.

    In conclusion the four studies showed, treatment with CSII may initially result in improved HbA1c. Group education with the GSD-Y method, for adolescents and their parents, has the potential to further improve HbA1c, mitigate the loneliness of diabetes, and contribute to conscious reflection about self-management. The Check your Health questionnaire by proxy has shown acceptable psychometric characteristics, and may be useful in both studies and clinical settings.

  • 291.
    Brorsson, Anna Lena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala universitet.
    Franko, Mikael Andersson
    Lindholm Olinder, Anna
    A person-centered education for adolescents with type 1 diabetes - a randomized controlled trial2019In: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 20, no 7, p. 986-996Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Young people with type 1 diabetes and their parents need to receive person-centred education to be able to manage their diabetes. Guided Self-Determination-Young (GSD-Y) is a person-centred communication and reflection education model that can be used in educational programmes for young people with type 1 diabetes.

    OBJECTIVE: To evaluate whether GSD-Y leads to improved glycaemic control, increased self-perceived health and health-related quality of life, fewer diabetes-related family conflicts, and improved self-efficacy in a group-based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents.

    METHODS: This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for twelve months. The intervention group (n=37) attended seven group training sessions over a period of five months, using the GSD-Y model, the control group received standard care. Variables evaluated were HbA1c, self-perceived health, health-related quality of life, family conflicts, self-efficacy, and usage of continuous glucose monitoring.

    RESULTS: When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at twelve months, favouring the intervention group (62 vs. 70 mmol/mol, p=0.009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after twelve months (p=0.019). The intervention showed no effect on self-perceived health, health-related related quality of life, family conflicts, or self-efficacy.

    CONCLUSIONS: An intervention with GSD-Y may have an effect on glycaemic control. The content of the GSD-Y groups may serve as a model for person-centred care in adolescents with type 1 diabetes. This article is protected by copyright. All rights reserved.

  • 292.
    Brorsson, Anna Lena
    et al.
    Department of Women's and Children's Health, Karolinska Institute and Hospital, Stockholm, Sweden.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Viklund, Gunnel
    Department of Women's and Children's Health, Karolinska Institute and Hospital, Stockholm, Sweden.
    Lindholm Olinder, Anna
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    A multicentre randomized controlled trial of an empowerment-inspired intervention for adolescents starting continuous subcutaneous insulin infusion: a study protocol2013In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 13, article id 212Article in journal (Refereed)
    Abstract [en]

    Background. Continuous subcutaneous insulin infusion (CSII) treatment among children with type 1 diabetes is increasing in Sweden. However, studies evaluating glycaemic control in children using CSII show inconsistent results. Omitting bolus insulin doses using CSII may cause reduced glycaemic control among adolescents. The distribution of responsibility for diabetes self-management between children and parents is often unclear and needs clarification. There is much published support for continued parental involvement and shared diabetes management during adolescence. Guided Self-Determination (GSD) is an empowerment-based, person-centred, reflection and problem solving method intended to guide the patient to become self-sufficient and develop life skills for managing difficulties in diabetes self-management. This method has been adapted for adolescents and parents as Guided Self-Determination-Young (GSD-Y). This study aims to evaluate the effect of an intervention with GSD-Y in groups of adolescents starting on insulin pumps and their parents on diabetes-related family conflicts, perceived health and quality of life (QoL), and metabolic control. Here, we describe the protocol and plans for study enrolment.

    Methods. This study is designed as a randomized, controlled, prospective, multicentre study. Eighty patients between 12-18 years of age who are planning to start CSII will be included. All adolescents and their parents will receive standard insulin pump training. The education intervention will be conducted when CSII is to be started and at four appointments in the first 4 months after starting CSII. The primary outcome is haemoglobin A1c levels. Secondary outcomes are perceived health and QoL, frequency of blood glucose self-monitoring and bolus doses, and usage of carbohydrate counting. The following instruments will be used to evaluate perceived health and QoL: Disabkids, 'Check your health', the Diabetes Family Conflict Scale and the Swedish Diabetes Empowerment Scale. Outcomes will be evaluated within and between groups by comparing data at baseline, and at 6 and 12 months after starting treatment.

    Results and discussion. In this study, we will assess the effect of starting an insulin pump together with the model of Guided Self-Determination to determine whether this approach leads to retention of improved glycaemic control, QoL, responsibility distribution and reduced diabetes-related conflicts in the family.

    Trial registration: Current controlled trials: ISRCTN22444034

  • 293.
    Brorsson, Anna Lena
    et al.
    Karolinska institutet.
    Lindholm Olinder, Anna
    Viklund, Gunnel
    Granström, Therese
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University.
    Adolescents’ perceptions of participation in group education using the Guided Self-Determination-Young method: a qualitative study2017In: BMJ Open Diabetes Research & Care, ISSN 2052-4897, Vol. 5, no 1, article id e000432Article in journal (Refereed)
    Abstract [en]

    Objective Guided Self-Determination (GSD) is a person-centered communication and reflection method. Education in groups may have a greater impact than the content of the education, and constructive communication between parents and adolescents has been shown to be of importance. The purpose of this study was to describe adolescents’ perceptions of participation in group education with the Guided Self-Determination-Young (GSD-Y) method, together with parents, in connection with the introduction of continuous subcutaneous insulin infusion.

    Research design and methods In the present qualitative interview study, 13 adolescents with type 1 diabetes were included after completing a GSD-Y group education program in connection with the introduction of continuous subcutaneous insulin infusion at three hospitals located in central Sweden. The adolescents were interviewed individually, and qualitative content analysis was applied to the interview transcripts.

    Results Two categories that emerged from the analysis were the importance of context and growing in power through the group process. An overarching theme that emerged from the interviews was the importance of expert and referent power in growing awareness of the importance of self-management as well as mitigating the loneliness of diabetes.

    Conclusions GSD-Y has, in various ways, mitigated experiences of loneliness and contributed to conscious reflection about self-management in the group (referent power) together with the group leader (expert power). Overall, this highlights the benefits of group education, and the GSD method emphasizes the person-centered approach.

  • 294.
    Brorsson, Sofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Bremander, Ann
    Lunds universitet.
    Qualitative differences in the muscle activity in the forearm flexor and extensor muscles in healthy men and women in different ages2012In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 71, no s3, p. 755-755Article in journal (Refereed)
  • 295.
    Brorsson, Sofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science. School of Business and Engineering, Department of Exercise Physiology, Biomechanics and Health, Halmstad University, Halmstad, Sweden.
    Nilsdotter, Anna
    Department of Research and Education, Halmstad County Hospital, Halmstad, Sweden.
    Thorstensson, Carina
    Department of Clinical Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden ; Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
    Bremander, Ann
    Department of Clinical Sciences, Lund, Section of Rheumatology, Lund University, Lund, Sweden 7 Research and Development Center, Spenshult, Oskarstrom, Sweden.
    Differences in muscle activity during hand dexterity tasks between women with arthritis and a healthy reference group2014In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 15, article id 154Article in journal (Refereed)
    Abstract [en]

    Background. Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group.

    Methods. Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC.

    Results. The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and—for the EDC—also when writing with a pen and using a key (p < 0.02). The exercise “rolling dough with flat hands” required the lowest %MVIC and may be less effective in improving muscle strength.

    Conclusions. Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.

  • 296.
    Brorsson, Sofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Nilsdotter, Anna
    Department of Research and Education, Halmstad Central Hospital.
    Thorstensson, Carina
    Lunds universitet.
    Bremander, Ann
    Lunds universitet.
    Hand flexor and extensor muscle activity in daily activities and hand exercises in women with rheumatoid arthritis or hand osteoarthritis2012In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 71, no s3, p. 754-754Article in journal (Refereed)
  • 297.
    Brorsson, Sofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Thorstensson, C.
    Nilsdotter, A.
    Bremander, A.
    Two different sets of hand exercises: improved grip strength after eight weeks in patients with arthritis2014Conference paper (Other academic)
  • 298.
    Brosius, Anders
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Markus, Sara
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelse av bedsiderapportering: En litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose: To compile the current studies on patients' experience and perception of bedside report in hospital care.

    Methods: The literature review was based on 16 scientific articles, eight qualitative, seven quantitative and one mixed methods. The articles were searched through databases Cinahl and PubMed and analyzed using content analysis, five themes were created based on the analysis.

    Results: Five themes were created based on the result: treatment and communication, expenditure of time, participation, safe and secure care and confidential information.

    Patients were generally positive to the method and felt that they were involved in their care. They stated that the transfer of information between nurse and patient was an important aspect that contributed to a sense of participation and safe care. Lack of time during the bedside reporting and that the nurses used an incomprehensible language were deficiencies raised by the patients related to the method.

    Conclusion: It is important that the nurses strive to create a balance of power in the relationship with the patient. This can be achieved by giving time and to adapt the language to the unique patient. This literature review can provide an understanding of how patients can experience bedside report and the factors that promote and inhibit participation. The result can be used as a guide in the introduction of the method in clinical practice.

  • 299.
    Broström, Britt
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ernstsson, Marianne
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Postoperativ smärta: Metoder för bedömning och omvårdnadsåtgärder: En litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Postoperative pain is often undertreated. There are several

    reasons why it is important with good pain relief after surgery. Ease of the

    acute pain but also to prevent complications and long lasting pain.

    Aim: To describe the nurse´s assessment and nursing care of postoperative

    pain in adults.

    Methods: Literature review based on 16 articles, published between 2010-

    2016. The articles were found in the databases PubMed, CINAHL and Web

    of Science.

    Results: The nurse´s attitude and time for creating a relationship with the

    patient, is a prerequisite for correct pain assessment. Apart from

    administration of analgesics, there is nursing care that can relieve pain,

    which the nurse can use, for example change position or give information.

    Conclusion: There are many factors that influence the nurse´s pain

    assessment, where the patient´s participation and the nurse´s attitude are

    important components. Also nursing care can ease pain.

  • 300.
    Brottare, Emelie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Närståendes och vårdpersonals erfarenheter av kommunikation i den palliativa vården – En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract:

    It often means a grievous grief for relatives when a beloved person's life is coming to an end, which also means that the life you have collectively shared is coming to an end. In accordance with person-centered care, health care professionals should work for a partnership between relatives, the patient and the healthcare professional. In palliative care, relatives often take a major responsibility for the patient's care, while at the same time they are in crisis and they also have a need for support and information. Care interventions to the patient are often based on the needs that the relative´s communicated. In order to carry out a person-centered care, it is therefore important to make clear what experiences the relatives and the health professionals have of communication in palliative care.

    Aim:

    The aim was to compile studies describing how communication is experienced by relatives and healthcare professionals in palliative care.

    Methods:

    A literature review based on 15 scientific articles, all of which were collected in the CINAHL database. The articles were of qualitative and quantitative design.

    Results:

    It has positive significance for the patient and the relative´s that initially already at a breakpoint communication include relative´s. Structured communication models between related and health professionals favored the dialog between them. It was considered difficult to structure how communication shall be performed, when communication takes place at an individual level.

    Conclusions:

    There were differences of the quality of communication depending on whether the healthcare professional worked in specialized palliative care. When relative´s felt insecure and anxious, it affected the patients. Health professionals experienced differences in what the patient wanted for arrangements and what the relative´s mediated that the patient needed.

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