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  • 251.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Malmqvist, Inga
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    von Koch, Lena
    Designing sustainable healthcare environments2011In: 19th International Conference on Health Promoting Hospitals and Health Services, Turku, Finland, 2011Conference paper (Refereed)
  • 252.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet; Chalmers University of Technology.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Wijk, Helle
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2796-2816Article in journal (Refereed)
    Abstract [en]

    AIM: To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties.

    BACKGROUND: The physical healthcare environment is regarded as a quality factor for healthcare. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment.

    DESIGN: Systematic psychometric review.

    DATA SOURCES: A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016).

    REVIEW METHOD: COSMIN guidelines were used to evaluate psychometric data reported.

    RESULTS: Twenty-three instruments were included. Most of the instruments are intended for for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated.

    CONCLUSIONS: Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators is user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required. 

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  • 253.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Svedbo Engström, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Sahlgrenska akademin.
    Wijk, Helle
    Development of the Content and Quality in Briefs Instrument (CQB-I)2012In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 5, no 3, p. 74-88Article in journal (Refereed)
    Abstract [en]

    Objective: The Content and quality of Briefs Instrument (CQB-I) was designed to develop a valid and reliable audit instrument to examine the content and quality of information in documents (briefs) created in the early stages of designing healthcare environments.

    Background: The importance of effective briefing has been emphasised in many research studies during the past two decades. However, there is no developed instrument for auditing the content and quality of the documents, which makes this paper interesting.

    Methods: The study had a methodological and developmental design based on an established methodology for instrument development and validation. The development process consisted of three main phases: item generation and scale construction, assessment of face and content validity, and finally, testing of the reliability. To obtain face and content validity, expert panels reviewed the CQB-I. Content validity was assessed by using the Content Validity Index (I-CVI=item level, S-CVI=scale level). The reliability was tested by test-retest and inter-rater reliability. Results: CQB-I was found to have good content validity (I-CVI =0.78 – 1.0 and S-CVI=0.98). Inter-rater reliability was acceptable (Spearman’s correlation = 0.62) and the stability was considered high for both raters (83% respectively 88%).

    Conclusions: The instrument can be used as a guide for the work process in the design team and contribute to the ongoing development of making the design process more user-oriented with the ultimate goal of healthcare environments designed for a patient-centered care.

  • 254.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chalmers tekniska högskola, KI.
    Wijk, Helle
    Sahlgrenska Akademin, Göteborgs Universitet .
    Space planners' perception of an assessment instrument for briefs in the pre-design phase of new healthcare environments2014In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 8, no 1, p. 67-80Article in journal (Refereed)
    Abstract [en]

    Objectives: The main purpose of the study was to investigate the usability of a new developed instrument designed to assess the content and quality in programs for new healthcare environments (CQB-I). We studied the perception of using the instrument on a group of space-planners. The study is part of a larger project designed to assure the quality of early and main stages of the planning of new care environments with a focus on policy documents (programs or briefs), created in the early phases of the planning process. The instrument measures whether there is a clear mission statement for the project based on user needs and care activities that will take place in the new healthcare environment. Furthermore, the instrument measures if there are clear patient-related outcome measures specified and if the information in the documents is person-oriented and knowledge-based.

    Method: The study used a mixed method where the relevance and usability of the instrument was estimated and a focus group interview was conducted.

    Findings: The study showed that CQB-I perceived to be a relevant instrument primarily as a guide for programming, but also for monitoring the produced programs.  Instruments can help to bring research results into planning and contribute to dialogue and collaboration in the early stages by orienting process of user needs, discuss and write down clear performance indicators and related quality assurance process.

     

  • 255.
    Eliasson, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Englund, Louise
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans arbete med att underlätta faktorer som påverkar följsamhet till hygienrutiner: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Health care-related infections are a worldwide problem and generate suffering and socioeconomic losses. The extent of the problem can be decreased through proper hygiene, which in itself requires that healthcare professionals comply with current guidelines and procedures.

    Purpose:

    The purpose of the literature review was to highlight the nurse's facilitation of factors that affect the compliance with hygiene routines to promote patient safety.

    Method:

    A literature review based on 15 scientific articles of qualitative, quantitative and mixed method.

    Results:

    Identified factors that affect compliance with hygiene routines are divided into the following main categories: Attitudes, skills development, work organization and leadership. The nurse can facilitate compliance by being a role model, by working with continuing training and by encouraging reflection. Teamwork can be promoted by working with straightforward communication, common goals, and feedback on performance and results.

    Conclusion:

    To reduce health care-related infections and promote patient safety, the nurse need to understand that the factors that affect compliance with hygiene routines are dependent on each other in a complex interaction. The behavior of compliance can be facilitated by the nurse striving to improve the employees' attitude towards hygiene prevention.

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  • 256.
    Elmgren, Annie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordegren, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Anhörigas upplevelse av palliativ vård – Enlitteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    palliative care takes place in the final stages of life. When it is no

    longer possible to cure the patient, the palliative care will alleviate different types

    of suffering. It should also be a support for the relatives and that means the

    palliative care also has an impact on the lives of the relatives, before and after the

    death.

    Aim:

    to describe the family's experience of the palliative care.

    Design:

    a literature review where previously published research on the subject was

    compiled.

    Results:

    communication and personal treatment could have both a positive and

    negative impact on the family's well-being. Family caregiver´s had a big

    responsibility and difficult tasks but also positive experiences. The palliative care

    team was an important part of the family's well-being, but there were also

    shortcomings that implied a burden on the relatives. Preparing for the palliative

    phase was a difficult task and the care team was an important supportive function.

    Conclusion:

    the results show that there is much in the palliative care that relatives

    appreciate and increase their well-being. There are also things that can be changed

    and improved from their point of view. Communication between relatives and

    healthcare is a key part of improving palliative care.

  • 257.
    Emanuelsson, Susanne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Helgesson, Sara
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskans och sjuksköterskans erfarenheterav att arbeta med FaR®, FYSS och rådgivande samtalinom primärvården: En enkätstudie2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To describe the district nurses´ and nurses´ experiences of working with physical activity referrals, physical activity in health promotion and treatment [FYSS] and counseling in primary care.Method: The study was based on a questionnaire with closed-and open-ended questions about PAR, FYSS and counseling in the primary care among 34 district nurses and 12 nurses who were working in the primary care in Dalarna (response rate 25%). Quantitative data was analyzed with descriptive statistics and qualitative data with qualitative content analysis.Results: The results showed that a majority of district nurses and nurses discussed physical activity in health conversations. A majority of the participants considered themselves to have sufficient knowledge to prescribe PAR and counseling in combination with prescription of PAR and felt that they had sufficient knowledge of the counseling. The participants who did not have sufficient knowledge of the counseling and physical activity had a need for more knowledge about motivational interviewing as well as method PAR and FYSS. Half of the participants indicated that they did not prescribe PAR and a slightly majority did not use FYSS. Reasons for this were lack of knowledge and practices both within the organization and for the individual district nurse/nurse. The most common barrier was lack of time.Conclusion: The results show tendencies to a need for clear routines that reach the individual district nurse/nurse in primary care where he/she is given the opportunity to have sufficient training in the method PAR, FYSS and counseling. The routines should provide the opportunity to organize work so that the time is available for working with PAR and counseling. The work could then be in accordance with national guidelines and therefore well placed to increase physical activity and provide better conditions for the health of the population. This study results should, however, be considered in relation to the low response-rate.

  • 258.
    Emelie, Jonsson
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Luise, Opitz
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans oberoende omvårdnadsåtgärder för att förebygga smärta hos barn vid venpunktion – en litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Många barn genomgår venprovtagningar och PVK-inläggningar utan någon smärtlindring på akutmottagningar. Detta kan leda till mycket obehag och smärta. Det kan även skapa rädsla för medicinska procedurer i framtiden och leda till att barnen inte söker vård när de blir sjuka som vuxna. Syfte: Syftet var att hitta och sammanställa oberoende omvårdnadsåtgärder som sjuksköterskan kan använda före eller under venpunktioner hos barn på akutmot-tagningen för att lindra smärta. Metod: Kunskapsläget sammanställdes i en litteraturöversikt. Resultat: De flesta aktiva och passiva distraktionsmetoderna och lokala smärtlind-ringsmetoder var effektiva för att lindra smärtan vid venpunktioner hos barn. Slutsats: Det behövs mer forskning om effekterna av oberoende omvårdnadsåtgär-der för att lindra procedursmärta hos barn för att kunna bli en rutinmässig del inom vården.

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  • 259.
    Emtfors Kyrk, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kolm, Åsa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskors erfarenhet av delaktighet gällande patienter med diabetes typ 2 efter rådgivning.2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes typ 2 är en folksjukdom som ökar både i Sverige och globalt sett. För att hjälpa patienten med diabetes typ 2 gäller det för distriktssköterskan att få patienten delaktig i sin egenvård. Empowerment är ett begrepp som används för att stärka individen till att bli självständig och att sätta sina egna mål. Enligt socialstyrelsen är det en rekommendation att använda sig av grupprådgivning vid diabetes typ 2, men det har visat sig att det inte används i så hög grad som är önskvärt.

    Syfte: Syftet var att belysa distriktssköterskors erfarenheter av delaktighet efter rådgivning av patienter med diabetes typ 2.

    Metod: En kvalitativ intervjustudie med semistrukturerade intervjuer. Åtta distriktssköterskor med erfarenhet av diabetesrådgivning intervjuades.

    Huvudresultat: En analys av intervjuerna resulterade i fem kategorier

    Erfarenhet av delaktighet

    Hinder för delaktighet

    Underlättande faktorer till delaktighet

    Typ av patientutbildning/rådgivning

    Distriktssköterskans ansvar

    Slutsats

    För att förhindra senkomplikationer hos diabetespatienter så krävs det att distriktssköterskan kan få patienten så delaktig som möjligt. Hinder samt underlättande faktorer till delaktighet ses. Riktlinjer rekommenderar grupprådgivning inom diabetesvården, så en utökad satsning på detta kan leda till att delaktigheten ökar och senkomplikationer minskar. Distriktssköterskorna bör bli mera medvetna om vilken betydelse patienternas delaktighet har.

  • 260.
    Enehage, Ann-Charlotte
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pousette, Sofia
    Omvårdnadspersonals erfarenheter av personcentrerat förhållningssätt i vården av personer med demenssjukdom - En kvalitativ intervjustudie2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : The National Guidelines for Care show that people with dementia should be cared for by dealing with a person-centred approach. Nevertheless, studies show that person-centered approach in nursing work with patients with dementia living in nursing homes is insufficient. Purpose: To investigate nursing staff experiences of person-centered approach in dementia-related persons in dementia homes. Methodology: A qualitative interview study with qualitative content analysis. Result: Working with people with dementia is challenging for nursing staff and places great demands on the ability to adapt both the environment and the treatment based on the needs and desires of the persons with dementia. In many situations, nursing staff are faced with dilemmas that can be difficult to solve. The person-centered approach places demands on the staff but also on the design of the operation. Conclusion: Time, knowledge and genuine interest are considered to be important factors in the work of people with dementia. Time shortages and organizational factors often create obstacles to nursing staff's ability to work with a person-centered approach.

  • 261.
    Engdahl, Alexandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Lisa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans identifiering av smärta hos personer med demenssjukdom – en litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Within the next few years and in many countries, dementia will double, which means that the nurse's competence in assessing pain on people with dementia will increase. Therefore, it is of great importance that the nurse knows which assessment tools are useful for people with dementia and what expressions are important to pay attention to in order to reduce suffering and increase the quality of life for the patient.

    Aim:

    The aim of this study was to compile research-based knowledge about how the nurse can identify pain in individuals with dementia.

    Method:

    The study is a literature review of which 15 scientific articles were included. The study included qualitative, quantitative and mixed articles. The articles were searched in the PubMed, Web of Science and CINAHL databases.

    Results:

    The results show that there are many different pain assessment tools and pain expressions that the nurse can use and observe to identify pain in people with dementia. Some measuring instruments that proved useful for people with dementia were Doloplus-2, ePAT, PAINAD, PACSLAC and MOBID-2. The most painful expressions were facial expressions, body language and behavioral changes.

    Conclusion:

    It is easier to see behavioral changes on the patient if the nurse is aware of the patient earlier. It is important that the nurse has a good knowledge of what dementia is and means to more easily identify pain in people with dementia.

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  • 262.
    Engström, Gabriella
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    Humming as a potential tool for facilitating feeding situations between persons with dementia, and their caregiver. A single case study2012In: Music and Medicine, ISSN 1943-8621, Vol. 4, no 4, p. 231-236Article in journal (Refereed)
    Abstract [en]

    Persons with dementia (PWDs) have a major cognitive decline in the ability to meet universal self-care needs, including self-feeding and maintaining a sufficient intake of fluids and food. The aim was to describe whether caregivers’ humming during lunch situations affected eating and feeding problems in PWDs. An experimental single-case design was used, involving video observation. At baseline, PWDs were fed by their caregivers in the usual way and at intervention the PWDs were fed while a caregiver hummed. Analysis using the Edinburgh Feeding Evaluation (EdFED) showed that for Mrs Smith, the EdFED score decreased from a mean score of 14 at baseline to a mean score of 8.5 during the intervention. Mrs Green experienced a decrease in mean score from 12 at baseline to 8.5 during the intervention. This pilot study suggests that humming during lunch situations might enhance eating and feeding abilities for PWD and should be further studied

  • 263.
    Engström, Gabriella
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    Williams, Christine
    Florida Atlantic University.
    Götell, Eva
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Evaluation of communication behavior in persons with dementia during caregivers’ singing2011In: Nursing Reports, ISSN 2039-439X, E-ISSN 2039-4403, Vol. 1, no 4, p. 15-20Article in journal (Refereed)
    Abstract [en]

    The number of persons with dementia (PWD) is increasing rapidly worldwide. Cognitive impairments and communication difficulties are common among PWD. Therefore, gaining mutual togetherness in caring relation between PWD and their caregivers is important. This study was to investigate the effects of music therapeutic care (MTC) during morning care situations on improving verbal and nonverbal communication behaviors in people with dementia. An observation study with 10 PWD participating. Videotaped interactions (VIO) between PWD and their caregivers were conducted during eight weekly sessions, four recordings consisted of usual morning care and four recordings were of morning care with MTC intervention. The Verbal and Nonverbal Interaction Scale was used to analyze the recorded interactions at a later time. The unsociable verbal variable Cursing decreased significantly (P=.037) during MTC when compared with the baseline measurement. A significant (P=.000) reduction was observed for the unsociable nonverbal variable Does not respond to question. MTC significantly (P=.01) increased the mean score for the sociable nonverbal variable – Calm – relaxed. For sociable verbal communication, significant differences were observed for the variables Use coherent communication (P=.012), Use relevant communication (P=.009), Responds to questions (P=.000), Humming (P=.004), Singing (P=.000). MTC during morning care situations can be an effective non-pharmacological treatment, as well as nursing intervention in order to improve sociable communication behaviors, as well as reduce unsociable communication behaviors of PWDs

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  • 264.
    Engström, Gabriella
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    Williams, Christine
    , Florida Atlantic University.
    Götell, Eva
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    The Impact of Singing in Caring for a Person With Dementia: Single Case Analysis of Video Recorded Sessions2011In: Music and Medicine, ISSN 1943-863X, Vol. 3, no 2, p. 95-101Article in journal (Refereed)
  • 265.
    Engvall, Oksana
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mossberg, Natalja
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Riskfaktorer och förebyggande omvårdnadsåtgärder för trycksårsutveckling vid intra – och postoperativ vård.2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet var att beskriva vilka riskfaktorer som kan föreligga avseende utveckling av trycksår i samband med operation samt vilka förebyggande omvårdnadsåtgärder sjuksköterskan bör utföra för att reducera risken att patienten utvecklar trycksår intra- och postoperativt. Metod: En litteraturstudie som inkluderade 15 vetenskapliga artiklar. Artikelsökning gjordes i databaser som Cinahl, PubMed. Alla 15 artiklar var av kvantitativ ansats med hög eller medelhög kvalitet. Resultat: I resultatet presenterades att riskfaktorer som hög ålder, nedsatt nutritionsstatus, diabetes, hjärt-kärlsjukdomer, lungsjukdomar, operationstiden och väntan på operation var relevanta för trycksårsutvecklingen i samband med operation. Signifikanta omvårdnadsåtgärder påvisades vara att hålla patienten varm under operation och rätt användning av tryckavlastande hjälpmedel. I det postoperativa skedet var det viktigt med förbättring av nutritionsstatus samt klinisk observation av huden och tillämpning av riskbedömningsinstrument. Slutsats: Det krävdes mer kunskap och medvetenhet om riskfaktorer för utveckling av trycksår samt insats, hos både allmänsjuksköterskor och specialistsjuksköterskor för att förebygga trycksår i samband med operation. Att formulera och tillämpa en individuell omvårdnadsplan ansågs vara betydelsefull i det förebyggande arbetet mot trycksår.

  • 266.
    Ericson, Jenny
    et al.
    Department of Paediatrics, Falu Hospital.
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Estimated breastfeeding to support breastfeeding in the neonatal intensive care unit2013In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 42, no 1, p. 29-37Article in journal (Refereed)
    Abstract [en]

    Objective. To evaluate the effects of estimated breastfeeding on infant outcomes in comparison to test weighing and to describe staff members experiences of estimated breastfeeding as a method for supporting the transition from tube feeding to breastfeeding.

    Design. A mixed method evaluation. Setting Neonatal Intensive Care Unit (NICU) in Sweden. Participants The study included 365 preterm (25th36th gestational weeks) infants and 45 nurses or nurse assistants. Methods A retrospective comparative medical record study was used to assess infant outcomes during a period of test weighing (196 infants) and again after the implementation of estimated breastfeeding (169 infants). A qualitative survey was conducted to explore the staff experiences of estimated breastfeeding.

    Results. No differences were found between groups regarding duration of tube feeding, length of hospital stay, gestational age, weight at discharge, and rate of any breastfeeding. Infants in the estimated breastfeeding group had a higher risk of not being exclusively breast milk fed than infants in the test-weighing group (OR = 2.76, CI [1.5, 5.1]). Staff perceived estimated breastfeeding as a more facilitative and less stressful method for mothers than test weighing. Some staff had difficulty following guidelines while simultaneously providing person-centered care.

    Conclusions. Estimated breastfeeding is a nonintrusive and feasible method for assessing and supporting the transition from tube feeding to breastfeeding among preterm infants in a NICU. However, the increased risk for not being exclusively breastfed is of concern. Additional research is needed to assess whether this method is appropriate and feasible in varying contexts and cultures. JOGNN, 42, 29-37; 2013. DOI: 10.1111/j.1552-6909.2012.01423.x

  • 267.
    Ericson, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Uppsala University; Falu Hospital.
    Palmér, Lina
    University of Borås.
    Cessation of breastfeeding in mothers of preterm infants: A mixed method study2020In: PLoS ONE, E-ISSN 1932-6203, Vol. 15, no 5, article id e0233181Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Many women cease breastfeeding earlier than desired. This study examined the cessation of breastfeeding among mothers of preterm infants. Thus, the aim was to describe the cessation of breastfeeding in mothers of preterm infants up to 12 months after birth.

    METHOD: This mixed methods study used a convergent design with both qualitative data, consisting of written comments, and quantitative data, on breastfeeding status and breastfeeding satisfaction. The data were collected from questionnaires sent to the mothers at three points during the first year after birth. In total, 270 mothers of preterm infants who breastfed at the time of discharge from the neonatal unit provided data for the study. The quantitative and qualitative data were analysed separately with statistical tests and hermeneutical analysis, respectively and then together according to the convergent mixed methods design.

    RESULTS: Four themes of the meanings of the cessation of breastfeeding were identified in the qualitative analysis: "Desire to regain the mother's and the infant's well-being", "The mothers interpretation that the infants actively ceased breastfeeding", "The mother's body and/or the infants' signals showing the way" and "The mother's own will and perceived external obstacles". Mothers who did not breastfeed as long as they wanted were more likely to report less satisfaction with breastfeeding, a shorter breastfeeding period, and less activity when ceasing breastfeeding. In comparison, mothers who breastfed as long as they wanted were more satisfied with breastfeeding, breastfed for a longer period of time and were more active in decision making in breastfeeding cessation.

    CONCLUSION: Maternal passivity or activity influenced the cessation of breastfeeding in mothers of preterm infants who breastfed at the time of discharge from the neonatal unit. Passive behaviour related to breastfeeding may result in early cessation of breastfeeding, and low breastfeeding satisfaction while active behaviour may increase breastfeeding length and satisfaction.

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  • 268.
    Ericson, Jenny
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Palmér, Lina
    Experiences of breastfeeding support in mothers of preterm infants2018Conference paper (Refereed)
  • 269.
    Erika, Jäderström
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nygren, Michael
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsinsatser av sjuksköterskan med betydelse för följsamhet till rekommenderade livsstilsförändringar vid behandling av hypertoni.: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hypertoni är ett hälsoproblem världen över och även en av de främsta riskerna för kardiovaskulära sjukdomar som är en stor orsak för dödsfall i världen. En orsak till hypertoni är livsstilen. Faktorer som kost, rökning, alkohol, fysisk aktivitet och stress spelar in. Det är också livsstilen som kan behöva förändras när en person har hypertoni. En av sjuksköterskans arbetsuppgifter är att upptäcka det förhöjda blodtrycket och identifiera de hälsorisker som finns. Syfte: Att undersöka vilka omvårdnadsinsatser som påverkar följsamheten till livsstilsförändringar vid hypertoni. Design: Litteraturöversikt Metod: Författarna har sökt artiklar i databaserna PubMed och Cinahl. Tillsammans har de granskat artiklarna i granskningsmallar och sammanställt ett resultat. Resultatet har sedan kategoriserats för att identifiera vilka insatser som påverkar följsamheten hos patienten. Resultat: Sjuksköterskan behöver utbildning för att ge en god vård och kunna motivera patienten. Olika samtalstekniker kan effektivt användas av sjuksköterskan för att få patienten motiverad och följsam till behandlingen. Vården behöver också patientcentraras och individualiseras. Slutsats: För att få en god följsamhet behöver vården anpassas efter patienten. För att kunna göra detta måste både sjuksköterskan och patienten utbildas i hypertonivård och sjuksköterskan även i samtalstekniker, för att på ett bra sätt kunna stödja patienten.

  • 270.
    Eriksson, Ann
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindström, Ewa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors upplevelser av att vårda patienter med smärta En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Pain is an individual experience and pain is a major cause of people

    seeking care. To provide safe and good care requires the nurse´s to assess and

    evaluate patients' pain. The nurse's experiences can cause a number of obstacles

    that can make a good and safe care can´t be achieved. Objective: To describe

    nurses ' experiences of caring for patients with pain. Method: Literature review

    based on 15 scientific articles both kvalitativ- and quantitative batch.

    Results: This literature study's results showed that nurses are experiencing a lack

    of knowledge when it comes to caring for patients with pain. The nurse´s is

    experiencing inadequate and frustrated not to be able to provide optimal pain relief

    and a great fear to start an abuse of patients. Conclusion: It is important to

    continue research on nurses' experiences in order to clarify any obstacles that

    hinder efforts to provide good, safe care to patients with pain.

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  • 271.
    Eriksson, Caroline
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hillrings, Patricia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors behov av stöd och information i samband med livmoderhalscancer: En litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every year 55,000 people receive a cancer diagnosis in Sweden, which in most cases resulted in feelings of anxiety and anguish. A cervical cancer diagnosis subjects women to suffering. Alongside the diagnosis women often felt vulnerable, exposed and incomplete. The diagnosis also affected the feeling of femininity and contributed to feeling less sexually active due to physical chances to the body.

    Aim: The aim of the study was to describe women's experience of the needs in terms of support and information from diagnosis to end of treatment in cervical cancer in the scientific literature.

    Methods: The study was conducted as a literature review that included 17 scientific articles, of which were 13 qualitative, three quantitative and one covering both approaches. Search Articles made in PubMed, Cinahl and Web of Science. A manual search was also conducted.

    Results: The result showed that women affected by cervical cancer were in great need of emotional and sexual aid. Persons who gave the chiefly support according to the women were family, friends, cancer patients and nurses. The women had the need to obtain information about their sexuality affected by cervical cancer and for disease complications and side effects.

    Conclusion: The nurse will work in a holistic, which involves the whole person. Since cervical cancer can affect a woman physically, psychologically, socially, sexuality and existentially, support and information important components in the disease process. The nurse must assess women's individual needs and dare to talk about them.

  • 272.
    Eriksson, Christine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lindholm, Annica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att undersöka sjuksköterskans roll i teamet till patienter med både intellektuell funktionsnedsättning och alkoholmissbruk2015Independent thesis Basic level (degree of Bachelor), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att stärka sjuksköterskans kompetens i den psykiatriska omvårdnaden som

    en del i teamet, för patienter med både intellektuell funktionsnedsättning och ett

    alkoholmissbruk. Metod: Examensarbete utfördes som en litteraturstudie med tio

    artiklar av kvalitativ ansats. Datainsamling har gjorts i databaserna CINAHL och

    PsycInfo. Resultat: Resultatet beskrivs med utgångspunkt i tre teman

    sjuksköterskans roll, sjuksköterskans organisatoriska förutsättningar och

    utbildning och utvecklingsbehov. Flera av artiklarna påvisade att man behöver

    stärka sjuksköterskans roll och profession, och att det behövs mer utbildning om

    patienter med en intellektuell funktionsnedsättning och missbruk. Slutsats:

    Resultatet påvisar att det finns ett litet underlag av vetenskapliga studier gällande

    den aktuella gruppen, men att det finns flera studier om psykisk sjukdom och

    missbruk. Det framkom brister och svårigheter för sjuksköterskan att vårda

    patienter med intellektuell funktionsnedsättning, psykisk sjukdom och/eller

    missbruk samt att sjuksköterskans roll behöver tydliggöras utifrån en mängd

    aspekter.

  • 273.
    Eriksson, Elina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Kristina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Situationen för anhöriga och sjuksköterskan vid plötsligt dödsfall – en litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Losing a loved one is something that is very traumatic and bewildering. Reactions to the crisis usually appear under different phases, these are the shock phase, reaction phase, processing- and repair phase and reorientation phase. It is important that communication is honest and that it always will be helping for the patient or the relatives. Purpose: The purpose of this study is to compile existing research articles to highlight the situation of family members and staff of sudden death. Method: A literature review conceders on 13 scientific articles. The literature search conceders the databases CINAHL and PubMed. Results: The results of the study showed that relatives needed different support at different stages and that the information is given in such a straight and honest way as possible. Staff felt that education was important for the management of care and that they sought the support and expertise of more experienced colleagues. Conclusion: The information about the cause of death to the families was very important and that the staff were open and honest. Relatives appreciated that the staff were available. Nurses that have sufficient training increases self-confidence enables the handling of difficult situations and knowledge will help to support families better.

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  • 274.
    Eriksson, Frida
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Köpmans, Emma
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskans upplevelser av att motivera patienter med diabetes typ 2 till hälsosammare levnadsvanor genom evidensbaserad vård: Kvalitativ intervjustudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes is a common disease and can be prevented by a healthy lifestyle. It is the district nurse's responsibility to inform and motivate patients in a health promotion and preventive manner. The district Nurse's role is to critically review evidence-based research to achieve a safe quality care. Purpose: The district Nurse's experiences of motivating patients with diabetes type 2 to healthier lifestyles by evidence-based care. Method: A qualitative approach was used. Interviews were conducted with seven district Nurses. The material was analyzed according to Graneheim and Lundmans content analysis. Results: The approach of the district nurses must be based on the patient's situation and personalize information. Support from the district nurse shall the patient be able to dedicate time and effort to implement these changes. The informants in this study illustrate the importance of informing the patient of diabetes and which complications that may arise. To achieve a patient safe care of high quality the district nurses deemed that an evidence-based knowledge was a prerequisite. Conclusion: To motivate patients to change their lifestyle, the district nurse must pass diabetes information and teach the patient how these lifestyle changes affect the health. The information must be based on evidence-based knowledge.

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  • 275.
    Eriksson, Henrik
    et al.
    Röda Korset Högskola.
    Salzmann-Erikson, Martin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pringle, Keith
    Uppsala Universitet.
    Virtual Invisible Men: Shared experiences of early parenthood in an Internet forum for fathers2014In: Culture, Society and Masculinities, ISSN 1941-5583, E-ISSN 1941-5591, Vol. 6, no 1Article in journal (Refereed)
  • 276.
    Eriksson, Karoline
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kuhlman, Patrice
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelser av språkbarriärer i hälso- och sjukvården: - En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: People have immigrated to Sweden for over a century and in recent years there immigrations has increased. Language barriers affect patients' confidence in health care, which in turn can aggravate an already exposed situation for the patient. In order to avoid language barriers, interpreters are used in some cases, but since these are not always available, patient safety is threatened in several areas. Important information can be lost, which might lead to the patient being misdiagnosed and therefore having to wait for continued care longer than necessary.

    Aim: The aim of this study was to describe nurses' experiences of language barriers in health care.

    Method: A literature review containing fifteen scientific articles. Articles were searched in the databases CINAHL and PubMed. Articles that were included were ethically approved and received medium to high quality in quality auditing.

    Result: Three main categories were identified: (1) feeling of inadequacy not being able to provide good care (2) experiences of stress and (3) experiences of using communication aids to overcome language barriers, that have subcategories: experiences of communication via interpreters and experiences of using communication tools.

    Conclusion: The results of the literature review showed that the occurrence of language barriers meant that the nurse felt an insufficiency to provide good care and that it created a sense of stress and insufficiency in the professional role. Different communication aids were used and these were experienced both positively and negatively by nurses. Language barriers entail difficulties in working person-centered, and also constitute a threat to patient safety, since important information can be absent.

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  • 277. Eriksson, Leif
    et al.
    Nga, Nguyen Thu
    Målqvist, Mats
    Persson, Lars-Ake
    Ewald, Uwe
    Wallin, Lars
    Uppsala universitet, Karolinska Institutet.
    Evidence-based practice in neonatal health: knowledge among primary health care staff in northern Viet Nam2009In: Human Resources for Health, ISSN 1478-4491, Vol. 7, p. 36-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: An estimated four million deaths occur each year among children in the neonatal period. Current evidence-based interventions could prevent a large proportion of these deaths. However, health care workers involved in neonatal care need to have knowledge regarding such practices before being able to put them into action.The aim of this survey was to assess the knowledge of primary health care practitioners regarding basic, evidence-based procedures in neonatal care in a Vietnamese province. A further aim was to investigate whether differences in level of knowledge were linked to certain characteristics of community health centres, such as access to national guidelines in reproductive health care, number of assisted deliveries and geographical location.

    METHODS: This cross-sectional survey was completed within a baseline study preparing for an intervention study on knowledge translation (Implementing knowledge into practice for improved neonatal survival: a community-based trial in Quang Ninh province, Viet Nam, the NeoKIP project, ISRCTN44599712). Sixteen multiple-choice questions from five basic areas of evidence-based practice in neonatal care were distributed to 155 community health centres in 12 districts in a Vietnamese province, reaching 412 primary health care workers.

    RESULTS: All health care workers approached for the survey responded. Overall, they achieved 60% of the maximum score of the questionnaire. Staff level of knowledge on evidence-based practice was linked to the geographical location of the CHC, but not to access to the national guidelines or the number of deliveries at the community level. Two separated geographical areas were identified with differences in staff level of knowledge and concurrent differences in neonatal survival, antenatal care and postnatal home visits.

    CONCLUSION: We have identified a complex pattern of associations between knowledge, geography, demographic factors and neonatal outcomes. Primary health care staff knowledge regarding neonatal health is scarce. This is a factor that is possible to influence and should be considered in future efforts for improving the neonatal health situation in Viet Nam.

  • 278.
    Eriksson, Linda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hammar, Lina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Upptäcka depression hos äldre med hjälp av olika metoder: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att beskriva hur sjuksköterskan kan identifieratecken på depression hos patientgruppen äldre. Metod: Arbetet har gjorts som enlitteraturöversikt. Resultat: Det finns ett antal beprövade mätinstrument somsjuksköterskan kan använda för att upptäcka tecken på depression hos den äldrebefolkningen. Geriatric Depression Scale (GDS) finns i flera versioner med olikaomfattning och används i huvudsak på äldre patienter i långtidsboende. PatientHealth Questionnaire (PHQ) används främst i primärvården på patienter utankognitiv funktionsnedsättning, finns även den i varianter med varierandeomfattning. Cornell Scale of Depression in Dementia (CSDD) är ett mätinstrumentsom passar bra då patienterna har demens eller annan kognitivfunktionsnedsättning. Det finns även försök med att utveckla nya mätinstrument.Slutsats: Den mest tillämpade metoden för att upptäcka tecken på depression hos äldre är att använda sig av något av de mätinstrument som finns. De mätinstrumentsom finns är till viss del anpassade efter olika patienter och verksamheter. Rätttröskelvärde för valt instrument är viktigt.

  • 279.
    Eriksson, Lovisa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Persson, Johanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar sjuksköterskansattityd till patienter med blodsmitta2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Today bloodborne infection is a big healtproblem around the world and over 35milion people live with HIV. Every year 780 000 die from hepatit B-virus and 350-500 milionfrom hepatit C-virus. In Sweden a large amount of nurses would choose to not treat a patientwith bloodborne infection. Care workers around the world are exposed to the risk of gettinginfected because of insufficient hygiene routines.Aim: To elucidate the factors that influence nurses' attitudes to patients with contaminatedblood.Method: Literature reviewResults: Factors influencing nurses' attitudes to patient with contaminated blood wereidentified. High level of knowledge, length of education, the desire to care, high empathylevel and experience of caring for patients with a blood infection are factors that affect nurses'attitudes positively. Low level of knowledge and fear of becoming infected influence nursesattitude negatively. Two factors were identified that can both affect the nurse's attitudepositively and negatively: cause of infection and gender/age.Conclusion: In the health sector globally, it is important to have knowledge about bloodtransmission method and the hygiene practices that protect healthcare workers from becominginfected. Knowledge and further research on the factors influencing nurses' attitudes topatients with blood contamination can lead to better relationship between the nurse and thepatient. In order to provide good care to patients with a blood infection further research thathighlights factors is needed.

  • 280.
    Eriksson, Margita
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Öhrn, Sandra
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Behandlingspersonals attityder till arbete med suicidnära patienter: En deskriptiv och komparativ totalundersökning med kvantitativ ansats2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The aim of the study was to examine the attitudes to work with inpatients with suicidal behavior among all health care personnel in psychiatric care and addiction care. Subsidiary aim was to in-vestigate whether there were any differences between psychiatric care and addiction care based on background variables used in the study.

    The method used for the study was a descriptive and comparative census survey with quantitative approach.

    The results showed that there are significant differences when comparing the independent variables with the seven attitude questions which were used. Workplace showed significant difference in five attitude questions, working time showed significant difference in four attitude questions. Gender and if you have experienced any patient committed suicide showed significant differences in three attitude questions, experience of sufficient training showed significant difference in two attitude questions. How often staff worked with suicidal inpatients closely and age group showed significant difference on one attitude question. The survey also showed significant differences between psychi-atric care and addiction care based on how long you been employed, experience of adequate train-ing, if any inpatient the health care personnel had worked with has committed suicide, gender and age group.

  • 281.
    Eriksson, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Westblad, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Utevistelsens betydelse för personer med demenssjukdom boende på vårdhem – En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : The number of people with dementia is increasing in Sweden and the rest of the world. The disease has major impact on life itself, quality of life and autonomy for the affected person. There is still no treatment that cures the disease, but much can be done to increase the quality of life and support for people with dementia. In general, outdoor stay has proven to be of great importance to well-being. However, due to the often restricted outdoor environment's availability and lack of time from the healthcare professionals, many people with dementia rarely outweigh those who can independently provide for their own ability for outdoor stay. Therefore, it is important to describe the knowledge of outdoor stay for people with dementia living at nursing homes. Aim: The purpose is to put together knowledge about the meaning of outdoor stay for people with dementia living at nursing homes. Method: A literature review based on 13 scientific articles, quantitative and qualitative. Result: Outdoor stay in the form of different types of gardens, outdoor activities and exposure of daylight have positive effects on persons with dementia disease, as increased well-being and physical and cognitive function, and need of medication. Health care professionals and family members have knowledge about positive effects of outdoor stay for people with dementia disease, and it is important to make outdoor stay possible and offer activities outdoors that are individually adapted by need and ability. Conclusions: For people with dementia outdoor stay had positive results and as a contributing factor to people with dementia disease feeling increased quality of life. The outdoor activities should be individually adapted to the greatest effect on their well-being.

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  • 282.
    Eriksson, Martina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sundgren, Frida
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors upplevelser och behov av stöd vid akuthjärtinfarkt- En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Heart disease is common in the population and myocardial infarction is the most common cause of death for women. Research on myocardial infarction in women has improved but needs to be more known. There are differences in men and women during a myocardial infarction who, together with other factors, make their opportunities for medical care worse.Aim: To describe women´s experiences and needs during a myocardial infarction, from onset to discharge from hospital.Method/Design: Literature review consisting of critical review of 13 nursing studies.Result: Women with myocardial infarction experience pain, anxiety, fear, stress and a changed self-image. A nurse needs to be aware of this to be able to give person-centered care and the support that they need. Women often feel they are not taken seriously because of atypical symptoms. This together with lack of knowledge, results in a delay of treatment.Conclusion: Person-centered care needs to be used to be able to respond to their experiences and needs of support. The nurse can understand the woman and disseminate knowledge to improve the possibilities for adequate nursing and survival.

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  • 283.
    Eriksson, Sofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Metcalfe, Michael
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Följsamhet till Early Warning Scores samt faktorer som påverkar följsamheten – en litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Early recognition of serious clinical deterioration is of great importance for

    minimizing suffering and serious adverse events. For early recognition, several physiological

    track and trigger systems have been developed, among them the early warning scores. These

    have been implemented in many places across the world but there is uncertainty about

    adherence to these systems.

    Aim: The aim of this study was to investigate adherence to Early warning score-systems and

    to evaluate what factors affect this adherence.

    Method: The study was conducted as a literature review including 14 articles with

    quantitative, qualitative and mixed-methods approaches. Searches were made in the PubMed,

    CINAHL and Web of Science databases. Content-analysis was used to identify themes.

    Results: Adherence seems higher to observations than to clinical responses. The main

    factors affecting adherence are the clinical experience of nurses, collaboration between

    professions, staffing, miscalculation, documentation and reporting.

    Conclusion: Adherence to EWS is lacking in many ways and several causes for this have

    been accounted for. Factors affecting adherence was the clinical experience of nurses,

    cooperation between professions, staffing, miscalculation, documentation and reporting.

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  • 284.
    Eriksson, Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Laitinen, Veronica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bemötande i vården vid övervikts- och fetmaproblematik En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Overweight and obesity cause today more deaths than underweight.

    There is a public health disorder that is increasing worldwide . Overweight and

    obesity leads to both physical and mental problems and inconvenience for the

    patient.

    Aim: The purpose of this study is to highlight the treatment of obese and

    overweight patients from the patient and the health-care personnel’s’ perspective.

    Methods: A literature review.

    Findings: It emerged that patients with a higher BMI experienced negative

    attitude from medical professionals , that they felt not being listened to and

    excluded. Patients dreaded to seek care. It appears that healthcare staff had a

    negative attitude and are not willing to care for overweight or obese patients.

    Conclusions: Overweight and obese patients are a vulnerable group of patients in

    both society and in healthcare. Patients feel they are not heard, they will be

    excluded and not taken seriously. Caregivers agrees that they must help these

    patients, despite the state a large part of health care workers that they would rather

    not care for obese patients.

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  • 285.
    Eriksson, Tim
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Brobäck, Alexander
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Livskvalitet hos barn med akut lymfatisk leukemi: Litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Acute lymphoblastic leukemia accounts for 80 % of child

    leukemia’s. Treatment is mainly chemotherapy in various combinations, which

    more or less have side effects that affects the child. More recently research has led

    to increased rate of survival, which means other challenges to satisfy the needs of

    children and promote the child's perspective and perception of his/hers quality of

    life.

    Aim: To describe the quality of life in children diagnosed with acute

    lymphoblastic leukemia.

    Method: A literature review based on 15 scientific articles by quantitative and/or

    qualitative approach from the databases CINAHL and PubMed.

    Results: Children who were under treatment for acute lymphoblastic leukemia had

    impact on their mental and physical quality of life aswell as their sleep. It was

    normal for the children to have sleep disturbances, fatigue, exhaustion, worry and

    anxiety, which affected the child's perceived quality of life. The quality of life

    were mainly affected initially at the treatment but were improved within time,

    despite the negative experiences of illness and treatment.

    Conclusion: Children under treatment experienced poorer quality of life.

    Gradually during the time of treatment the experience in quality of life improved

    and at the end of treatment most had reached a similar quality of life as children of

    the same age.

  • 286.
    Eriksson, Tobias
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Landberg, Zackarias
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Illamående vid Palliativ Vård: En Litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Symptom management is an important part in palliative care. Nurses have a central role in this care. Previous research highlights pain management, this literature review aims to shed light on the importance of nausea management in palliative care.  Aim: To examine the prevalence of nausea in palliative patients and to compile nurses’ knowledge about management of these patient’s nausea in healthcare.  Method: A literature review based on 16 articles.  Result: Prevalence of nausea in palliative patients in the literature review was between 7-40%. The result shows that nurses rate their knowledge high when it comes to symptom estimation, treating symptoms and evaluate treatment of nausea in palliative care. Nurses knowledge of palliative care differed depending on their work experience. It also showed that symptom estimation doesn’t always occur and validated tools to estimate nausea are not always used. Some palliative care patients are medically undertreated for nausea and evaluation of nausea-treatment isn’t always done. The result also showed discrepancies of treatment between gender and age.  Conclusion: Nurses’ had more knowledge about symptom management the more work experience they had. There is a need for further education in how to manage nausea both in nursing school and at the workplace. Additional research is needed to identify exactly what knowledge nurses’ lack. There is also a need for research that examines how nurses determines the cause of nausea.

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  • 287.
    Erkers, Sofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rupertsson, Elisabet
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Missbruk och beroende hos legitimerad vårdpersonal – En enkätstudie.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    : The purpose was to investigate what awareness and management of routines as well as the preventive work that registered healthcare personnel in leadership position in primary care have regarding abuse and addiction to employee- registered healthcare personnel.

    Method:

    The study has been conducted as a descriptive survey. A quantitative method was chosen to reach a larger population for a short period of time.

    Result:

    The study found that the majority of respondents in leadership positions had leadership training and most of them had education about addiction and abuse. The study shows that they work more or less preventively with addiction and abuse to their staff. It appears that legitimate healthcare personnel in management positions consider themselves sufficiently knowledgeable about addiction and abuse. They highlight the importance of further training in the field and that they are needed to discuss more at workplace meetings about addiction and abuse.

    Conclusion:

    The study shows that they work preventively by using the local policy regarding alcohol and addiction. The local routines are different between council and the communities and differences are that the council has a common policy for the whole of Dalarna, while the communities have their own policies. Furthermore, it appears that registered healthcare personnel in management positions have knowledge of addiction and abuse.

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  • 288.
    Erlandsson, Emma
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johnson, Marit
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskans arbete med, och erfarenhet av livsstilsförändringar hos patienter med pre-diabetes: En kvalitativ intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The Aim of this study was to describe the Community Health Care nurse´s work and experience with lifestyle changes in patients with pre-diabetes, within the primary health care. The Method was an empirical interview study with a qualitative approach. Eight semi structured interviews were accomplished, the interview material were analyzed with Graneheim and Lundmans qualitative content analysis. The Results showed that the patients with pre-diabetes was discovered during the annual check-up for hypertension, or when the patients sought care for other symptoms. Blood glucose were checked on all patients with risk factors. It was the diabetes nurse who informed the patients about pre-diabetes, type 2- diabetes, and gave advice about lifestyle changes. They used different pedagogic tools and methods in the preventive work. The follow-up was adapted individually. It was a challenge to get the patients to understand that lifestyle changes were needed. Recourses and lack of time were an obstacle in the preventive work. Still the opportunities were seen as many. The Conclusion is that patients with pre-diabetes would be found earlier if structured routines for discovery of pre-diabetes and prevention of type 2-diabetes excited in the primary health care. Therefore, unnecessary suffering for the patient, and social costs would decrease.

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  • 289.
    Erlandsson, Katarina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Wahlström, Maria
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Längtan efter att bli mamma: Kvinnors upplevelser av ofrivillig barnlöshet ur ett globalt perspektiv - en kvalitativ metasyntes2020Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Involuntary childlessness is a disability and a global problem affecting 10–15 percent of the population. Women's sexual and reproductive health looks different in the world and is affected by discrimination and gender inequality. Involuntary childlessness is seen in some parts of the world as a condition with medical cause and in other parts as a stigma and plays a significant role for women who are involuntarily childless.

    Purpose: The aim of this essay was to describe women´s experiences of involuntary childlessness from a global perspective.

    Methods: The method used in this essay was a qualitative metasynthesis with metaethnographic analysis method. A total of 17 articles were quality checked and used in the result.

    Results: Five main categories with several subcategories were identified. The categories that were created were Psychological impact, Changing relationships, Support and the importance of health care services, Managing the new life situation and Thoughts about the future.

    Conclusion: Involuntary childlessness affected women emotionally through grief, guilt, anxiety and lost identity. Childlessness affects women's relationships and could lead to isolation, exclusion and violations. Women perceived support from the partner important, found support from other infertile women and lacked support from the healthcare system. The life situation was handled through a religious belief or emotional handling.

    Clinical applicability: The study could show an increased understanding of involuntary childlessness and sustained support for the midwife, who work globally with women and family planning. The work of midwives globally is also about strengthening women's rights. An understanding of women's experiences of involuntary infertility gives the midwife a tool to support women in their sexual and reproductive health.

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  • 290.
    Erlandsson, Kerstin
    et al.
    Karolinska Institutet; Mälardalen University.
    Christensson, Kyllike
    Dsilna, Ann
    Jonsson, Baldvin
    Do caregiving models after caesarean birth influence the infant's breathing adaptation and crying? A pilote study2008In: Journal of Children's and Young People's Nursing, ISSN 1753-1594, Vol. 2, no 1, p. 7-12Article in journal (Refereed)
  • 291.
    Erlandsson, Kerstin
    et al.
    Karolinska institutet.
    Christensson, Kyllike
    Fagerberg, Ingegerd
    Fatherhood as taking the child to oneself: A phenomenological observation study after caesarean birth2006In: Indo-Pacific Journal of Phenomenology, ISSN 2079-7222, E-ISSN 1445-7377, Vol. 6, no 2, p. 1-9Article in journal (Refereed)
  • 292.
    Erlandsson, Kerstin
    et al.
    Mälardalen University.
    Christensson, Kyllike
    Fagerberg, Ingegerd
    Fathers' lived experience of getting to know their baby while acting as primary caregivers immediately following birth2008In: Journal of Perinatal Education, ISSN 10581243, Vol. 17, no 2, p. 28-36Article in journal (Refereed)
  • 293.
    Erlandsson, Kerstin
    et al.
    Karolinska Institutet.
    Dsilna, Ann
    Fagerberg, Ingegerd
    Christensson, Kyllike
    Skin-to-skin with the father after cesarean birth and its effect on newborn crying and prefeeding behavior2007In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 34, no 2, p. 105-114Article in journal (Refereed)
  • 294.
    Erlandsson, Kerstin
    et al.
    Mälardalen University.
    Fagerberg, Ingegerd
    Mothers' lived experiences of co-care and part-care after bith, and their strong desire to be close to their baby2005In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 21, no 2, p. 131-138Article in journal (Refereed)
  • 295.
    Erlandsson, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Häggström-Nordin, Elisabet
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Prenatal parental education from the perspective of fathers with experience as primary caregiver immediately following birth: a phenomenographic study2010In: The Journal of Perinatal Education, ISSN 1058-1243, Vol. 19, no 1, p. 19-28Article in journal (Refereed)
    Abstract [en]

    The aim of this phenomenographic study was to capture fathers' conceptons of parental educatio topics illuminated by their experiences as primary caregiver of their child immediately following bith. Fifteen fathers were interviewed between 8 days and 6 weeks after the birth of their child. For further information go to abstract in the article.

  • 296. Estabrooks, Carole A
    et al.
    Derksen, Linda
    Winther, Connie
    Lavis, John N
    Scott, Shannon D
    Wallin, Lars
    Karolinska Institutet.
    Profetto-McGrath, Joanne
    The intellectual structure and substance of the knowledge utilization field: a longitudinal author co-citation analysis, 1945 to 20042008In: Implementation science : IS, ISSN 1748-5908, Vol. 3, p. 49-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It has been argued that science and society are in the midst of a far-reaching renegotiation of the social contract between science and society, with society becoming a far more active partner in the creation of knowledge. On the one hand, new forms of knowledge production are emerging, and on the other, both science and society are experiencing a rapid acceleration in new forms of knowledge utilization. Concomitantly since the Second World War, the science underpinning the knowledge utilization field has had exponential growth. Few in-depth examinations of this field exist, and no comprehensive analyses have used bibliometric methods.

    METHODS: Using bibliometric analysis, specifically first author co-citation analysis, our group undertook a domain analysis of the knowledge utilization field, tracing its historical development between 1945 and 2004. Our purposes were to map the historical development of knowledge utilization as a field, and to identify the changing intellectual structure of its scientific domains. We analyzed more than 5,000 articles using citation data drawn from the Web of Science. Search terms were combinations of knowledge, research, evidence, guidelines, ideas, science, innovation, technology, information theory and use, utilization, and uptake.

    RESULTS: We provide an overview of the intellectual structure and how it changed over six decades. The field does not become large enough to represent with a co-citation map until the mid-1960s. Our findings demonstrate vigorous growth from the mid-1960s through 2004, as well as the emergence of specialized domains reflecting distinct collectives of intellectual activity and thought. Until the mid-1980s, the major domains were focused on innovation diffusion, technology transfer, and knowledge utilization. Beginning slowly in the mid-1980s and then growing rapidly, a fourth scientific domain, evidence-based medicine, emerged. The field is dominated in all decades by one individual, Everett Rogers, and by one paradigm, innovation diffusion.

    CONCLUSION: We conclude that the received view that social science disciplines are in a state where no accepted set of principles or theories guide research (i.e., that they are pre-paradigmatic) could not be supported for this field. Second, we document the emergence of a new domain within the knowledge utilization field, evidence-based medicine. Third, we conclude that Everett Rogers was the dominant figure in the field and, until the emergence of evidence-based medicine, his representation of the general diffusion model was the dominant paradigm in the field.

  • 297. Estabrooks, Carole A
    et al.
    Midodzi, William K
    Cummings, Greta G
    Wallin, Lars
    Karolinska Institutet.
    Predicting research use in nursing organizations: a multilevel analysis2007In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 56, no 4 Suppl, p. 7-23Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: No empirical literature was found that explained how organizational context (operationalized as a composite of leadership, culture, and evaluation) influences research utilization. Similarly, no work was found on the interaction of individuals and contextual factors, or the relative importance or contribution of forces at different organizational levels to either such proposed interactions or, ultimately, to research utilization.

    OBJECTIVE: To determine independent factors that predict research utilization among nurses, taking into account influences at individual nurse, specialty, and hospital levels.

    DESIGN: Cross-sectional survey data for 4,421 registered nurses in Alberta, Canada were used in a series of multilevel (three levels) modeling analyses to predict research utilization.

    METHODS: A multilevel model was developed in MLwiN version 2.0 and used to: (a) estimate simultaneous effects of several predictors and (b) quantify the amount of explained variance in research utilization that could be apportioned to individual, specialty, and hospital levels.

    FINDINGS: There was significant variation in research utilization (p <.05). Factors (remaining in the final model at statistically significant levels) found to predict more research utilization at the three levels of analysis were as follows. At the individual nurse level (Level 1): time spent on the Internet and lower levels of emotional exhaustion. At the specialty level (Level 2): facilitation, nurse-to-nurse collaboration, a higher context (i.e., of nursing culture, leadership, and evaluation), and perceived ability to control policy. At the hospital level (Level 3): only hospital size was significant in the final model. The total variance in research utilization was 1.04, and the intraclass correlations (the percent contribution by contextual factors) were 4% (variance = 0.04, p <.01) at the hospital level and 8% (variance = 0.09, p <.05) at the specialty level. The contribution attributable to individual factors alone was 87% (variance = 0.91, p <.01).

    CONCLUSIONS: Variation in research utilization was explained mainly by differences in individual characteristics, with specialty- and organizational-level factors contributing relatively little by comparison. Among hospital-level factors, hospital size was the only significant determinant of research utilization. Although organizational determinants explained less variance in the model, they were still statistically significant when analyzed alone. These findings suggest that investigations into mechanisms that influence research utilization must address influences at multiple levels of the organization. Such investigations will require careful attention to both methodological and interpretative challenges present when dealing with multiple units of analysis.

  • 298. Estenberg, Ida
    et al.
    Gillberg, Amanda
    Hur sjuksköterskor kan främja egenvård hos vuxna patienter med hypertoni: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att belysa hur sjuksköterskan kan främja egenvård hos vuxna patienter med hypertoni.

    Metod: Studien genomfördes som en litteraturöversikt. Databaserna PubMed och CINAHL användes och tolv vetenskapliga artiklar ligger till grund för resultatet, varav nio kvantitativa artiklar och tre kvalitativa artiklar.

    Resultat: Som svar på frågeställningen bildades fem kategorier: Sjuksköterskans förhållningssätt, information och utbildning, stödja och motivera, uppföljning och regelbundenhet samt engagera anhöriga. En av sjuksköterskans arbetsuppgifter är att främja patienter till egenvård vid hypertoni. Patienternas delaktighet och egna vilja är av betydelse för utförandet av egenvården. Sjuksköterskan ska skapa ett förtroende hos patienterna samt stödja, motivera, informera och utbilda patienterna om egenvård. Sjuksköterskan ska ge uppföljning så patienterna inte skall tappa motivationen till att utföra egenvård. Även anhörigas delaktighet främjar till egenvård vid hypertoni.

    Slutsats: Sjuksköterskan behöver sätta patienten i fokus samt i första hand utgå från patientens egna behov för att kunna främja till egenvård. Sjuksköterskan behöver aktivt arbeta med att informera och utbilda patienter med hypertoni för att öka patienters förståelse för sjukdomen och dess behandling. Genom att öka patienters förståelse kan sjuksköterskan främja till egenvård hos patienterna med hypertoni.

  • 299.
    Etnell, Ulrika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Liedbäck, Sofia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelser av sjuksköterskors information ochstöd i samband med hjärtkirurgi – en litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim:The aim was to describe patients’experiencesof the information and support given by nurses in relationtocardiac surgery.

    Method: The literature reviewwas conducted as a literature review based on 17 scientific articles, eight of them with qualitative approach, eightwith quantitative approachand one with mixed approach.

    Result: The results showed thatpatientsoverall felt satisfied with the information they received. Deficiencies were seen regarding information on recovery after surgery and emotional effects that may occur due tocardiac surgery. Italso showed that patients received a good support, bothbefore and during admission to hospital. Patients experienced respect and percipiencefrom the nurses. It also showedthat high workload of the nurses affected patient'sperception of information and support. Lack of information and support was connected with worry and anxiety of the patient.

    Conclusion:It turned out that most of the patients were satisfied with the information and support from nurses. Deficiencies in the nurse's information was perceived not as big as deficiencies in the nurse's support. This meant that patients sought support from relatives and other patients. The patient's experience of care is affected by the nurse's information and support.

  • 300.
    Evbjer, Grim
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Heide, Nina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans hälsofrämjande stöd till patienter med cancer ur ett patientperspektiv: en litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Lifestyle factors like diet, physical activity, smoking and alcohol consumption have a large effect in terms of the risk of getting cancer, cancer recurrence and life expectancy. The patient is in need of information and support regarding lifestyle factors in order to perform healthy changes in their lifestyle. It is within the nurses´ responsibility to support the patient by giving this kind of information.

    Purpose: The purpose of this literature review is to describe nurses´ health promotion to patients with cancer from the patients´ perspective.

    Method: The study was conducted as a literature review. It identified 17 articles from the data collection in the databases CINAHL and PubMed.

    Result: Three categories were identified: Nurses´ information and advice regarding lifestyle factors, Patient´s perception of information and advice regarding lifestyle factors and Barriers. Barriers are split up into six subcategories: Lack of knowledge, Lack of time, Risks and patient´s health, Lack of routines and guidelines, Lack of information material and training programs and Other factors. The study shows that nursing staff in general are not offering patients with cancer enough support regarding lifestyle factors by giving information and advice according to evidence-based guidelines. Many patients experience a lack of information and advice regarding lifestyle factors in relation to their disease. Barriers were identified by both nursing staff and patients which affect their ability to give and receive health improving support.

    Conclusion: The nursing staff´s health promotion is of big importance and arrangements should be made to guarantee a systematic approach so all patients can receive the support and information they need. Possible measures could be education and training of the nursing staff, introduction of new routines and guidelines and implementation of health promotion into cancer treatment.

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