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  • 301.
    Bogren, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Byrskog, Ulrika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    What prevents midwifery quality care in Bangladesh? A focus group enquiry with midwifery students2018In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 18, no 1, article id 639Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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  • 304.
    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.

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  • 305. 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.

  • 306.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Alfredsson, Lars
    Hallqvist, Johan
    Vingård, Eva
    Skillgate, Eva
    The influence of self-reported leisure time physical activity and the body mass index on recovery from persistent back pain among men and women: a population-based cohort study.2013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, article id 385Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 307.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Alfredsson, Lars
    Jensen, Irene
    Hallqvist, Johan
    Vingård, Eva
    Skillgate, Eva
    Does a healthy lifestyle behaviour influence the prognosis of low back pain among men and women in a general population? A population-based cohort study2014In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 4, no 12, article id e005713Article in journal (Refereed)
    Abstract [en]

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

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

    SETTINGS: General population in Stockholm County, Sweden.

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

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

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

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

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  • 308.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Bottai, Matteo
    Björklund, Martin
    Predictive models for short-term and long-term improvement in women under physiotherapy for chronic disabling neck pain: a longitudinal cohort study.2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e024557Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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

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  • 309.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Côté, Pierre
    Boyle, Eleanor
    Cassidy, J David
    Carroll, Linda J
    Skillgate, Eva
    Prognosis of patients with whiplash-associated disorders consulting physiotherapy: development of a predictive model for recovery2012In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 13, article id 264Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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  • 310.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Tegern, Matthias
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Concurrent validity of an isokinetic lift test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 11, article id e0207054Article in journal (Refereed)
    Abstract [en]

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

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  • 311.
    Bohman, Tony
    et al.
    Karolinska institutet.
    Tegern, Matthias
    Halvarsson, Alexandra
    Broman, Lisbet
    Larsson, Helena
    Reliability and agreement of the IsoKai isokinetic lift test - a test used for admission to the Swedish Armed Forces2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 12, article id e0209419Article in journal (Refereed)
    Abstract [en]

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

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  • 312.
    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.

  • 313.
    Boltenstern, Rebecca
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Granath, Ingrid
    Dalarna University, School of Health and Social Studies, Caring Science.
    Mammors upplevelser i samband med beskedet att det väntade barnet dött i livmodern2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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  • 314.
    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.

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  • 315.
    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.

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  • 316.
    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.

  • 317.
    Borch, Ellen
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Sörensen Duppils, Gill
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Hov, Reidun
    Athlin, Elsy
    Group supervision to strengthen nurses in their preceptor role in the bachelor nursing education: Perceptions before and after participation2013In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 13, no 2, p. 101-105Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 318. Borg, Johan
    Assistive technology - A facilitator of human freedoms for people with disabilities?2011Conference paper (Other academic)
  • 319.
    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)
  • 320.
    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)
  • 321.
    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.

  • 322.
    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.

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  • 323.
    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.

  • 324.
    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.

  • 325.
    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.

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  • 326.
    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.

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  • 327.
    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)
  • 328.
    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.

  • 329.
    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.

  • 330.
    Borg, Sixten
    et al.
    Lund University, Department of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, SE-223 81 Lund, Sweden.
    Eeg-Olofsson, Katarina
    University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, SE-413 46 Gothenburg, Sweden and Sahlgrenska University Hospital, Gothenburg, Sweden.
    Palaszewski, Bo
    Region Västra Götaland, Department of Data Management and Analysis, SE-405 44 Gothenburg, Sweden.
    Svedbo Engström, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, SE-413 46 Gothenburg, Sweden.
    Gerdtham, Ulf-G
    Lund University, Department of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, SE-223 81 Lund, Sweden; The Swedish Institute for Health Economics (IHE), Box 2127, SE-220 02 Lund, Sweden; Department of Economics, School of Economics and Management, Box 7082, SE-220 07 Lund, Sweden.
    Gudbjörnsdottir, Soffia
    University of Gothenburg, Sahlgrenska Academy, Institute of Medicine, SE-413 46 Gothenburg, Sweden and Centre of Registers Västra Götaland, SE-413 45 Gothenburg, Sweden.
    Patient-reported outcome and experience measures for diabetes: development of scale models, differences between patient groups and relationships with cardiovascular and diabetes complication risk factors, in a combined registry and survey study in Sweden2018In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 1, article id e025033Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

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  • 331.
    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.

  • 332.
    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.

  • 333.
    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)
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  • 334.
    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.

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  • 335. 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.

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  • 336. 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.

  • 337. 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.

  • 338. 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.

  • 339. Boström, Anne-Marie
    et al.
    Wallin, Lars
    Karolinska Institutet.
    Estabrooks, Carole A
    Kajermo, Kerstin Nilsson
    Commentary on Brown CE, Ecoff L, Kim SC, Wickline MA, Rose B, Klimpel K and Glaser D (2010) Multi-institutional study of barriers to research utilisation and evidence-based practice among hospital nurses. Journal of Clinical Nursing 19, 1944-1951.2012In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 21, no 19-20, p. 2995-6Article in journal (Refereed)
  • 340. 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.

  • 341. 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.

  • 342.
    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.

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  • 343.
    Bouchiba Testouri, Sabrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Ögren, Emilia
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Kvinnors upplevelse av sexuell hälsa efter barnafödande: En kvalitativ metasyntes2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Sexuell hälsa definieras som ett tillstånd av fysiskt, psykiskt, emotionellt och socialt välbefinnande i relation till sexualitet. Att uppnå god sexuell hälsa är viktigt för kvinnors livskvalitet. Barnafödandet innebär en stor omställning i kvinnan och hennes parters liv. Det finns önskemål från kvinnor att samtala mer om den sexuella hälsan med sin barnmorska. Syfte: Syftet med denna studie var att beskriva kvinnors upplevelse av sexuell hälsa efter en förlossning, oavsett förlossningssätt. Metod: Kvalitativ metasyntes med metaetnografisk ansats. Datainsamling utfördes i databaserna CINAHL, PubMed och Web of Science. 15 artiklar kvalitetsgranskades och ingick i metasyntesens resultat. Resultat: Fyra huvudkategorier: Påverkad kroppsuppfattning, Sexuellt umgänge efter förlossning, Barnet i fokus samt Stöd och information. Till dessa följde sex underkategorier: Förändrad självbild, Bröstens tudelade syfte, Tidpunkt för återupptagande, Problem som uppstår, Från barnmorska och annan vårdpersonal och Från närstående. Slutsats: Kvinnors sexuella hälsa påverkas efter barnafödande. Kvinnors fysiska och psykiska mående påverkas, men även relationen till partnern. Kvinnor upplever brist på stöd och information från barnmorskor och annan vårdpersonal. Klinisk tillämpbarhet: Resultatet kan användas för att skapa en ökad förståelse och kunskap hos barnmorskor om vikten av kvinnors sexuella hälsa efter barnafödande.

  • 344. 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)
  • 345. 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)
  • 346. 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)
  • 347. Brehmer, Lovisa
    et al.
    Alexanderson, Kristina
    Schytt, Erica
    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.

  • 348. 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.

  • 349.
    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.

  • 350.
    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.

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