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  • 501. Craftman Gransjöm, Å
    et al.
    Swall, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Marmstål Hammar, Lena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Outcomes of education in using music and caregivers singing as a tool to person centered care when working with persons with dementia2018Conference paper (Refereed)
  • 502. Craftman, ÅG.
    et al.
    Swall, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Båkman, K.
    Grundberg, Å.
    Hagelin, C. L.
    Caring for older people with dementia reliving past trauma2019In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989Article in journal (Refereed)
  • 503.
    Craftman, Åsa
    et al.
    Sophiahemmet Högskola.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    von Strauss, Eva
    Hillerås, Pernilla
    Sophiahemmet Högskola.
    Westerbotn, Margareta
    Sophiahemmet Högskola.
    Unlicensed personnel administering medications to older persons living at home: a challenge for social and care services2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 201-210Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.

    AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.

    METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.

    RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.

    CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients.

    IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

  • 504.
    Craftman, Åsa
    et al.
    Sophiahemmet Högskola.
    Westerbotn, Margareta
    Sophiahemmet Högskola.
    von Strauss, Eva
    Hillerås, Pernilla
    Sophiahemmet Högskola.
    Marmstål Hammar, Lena
    Mälardalens högskola.
    Older people's experience of utilisation and administration of medicines in a health- and social care context2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 760-768Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.

    AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.

    DESIGN: A qualitative descriptive study.

    METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.

    FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.

    CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.

    RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.

  • 505.
    Crona, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Bengtsson, Johanna
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskor och undersköterskors behov av stöd vid möten med föräldrar som föder barn som inte lever: En kvalitativ intervjustudie med fokusgrupper2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    According to research health professionals are feeling grief, guilt and stress when they meet parents giving birth to stillborn babies. They are in need of support but research about what kind of support is limited.

    Aim:

    To identify midwives’ and assistant nurses’ need of support and what kind of support they need meeting parents giving birth to stillborn babies.

    Method:

    Eight midwives and five assistant nurses were interviewed and distributed in three focus groups. They were asked semi-structured questions based on a questionnaire. The analysis method was qualitative content analysis.

    Results:

    One theme and five categories were identified. The theme was: The will to do good. The categories were: Collegial support, Education, Support from the hospital management, Tutorial and Reflection and To be inexperienced.

    Conclusion:

    The need of support varied but all participants considered they were there for each other as a support and a need of continuity and education in their meetings with parents. They also wished for tutorials with regular occasions where they could meet with different professions in a group. Those participants with longer experience from childbirth care felt more secure in their meetings with parents giving birth to stillborn babies, compared with those with shorter experience.

    Clinical application:

    The study could lead to support being implemented in maternity units, which in the end could lead to better treatment for the affected parents.

  • 506. Cummings, Greta G
    et al.
    Estabrooks, Carole A
    Midodzi, William K
    Wallin, Lars
    Karolinska Institutet.
    Hayduk, Leslie
    Influence of organizational characteristics and context on research utilization2007In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 56, no 4 Suppl, p. 24-39Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite three decades of empirical investigation into research utilization and a renewed emphasis on evidence-based medicine and evidence-based practice in the past decade, understanding of factors influencing research uptake in nursing remains limited. There is, however, increased awareness that organizational influences are important.

    OBJECTIVES: To develop and test a theoretical model of organizational influences that predict research utilization by nurses and to assess the influence of varying degrees of context, based on the Promoting Action on Research Implementation in Health Services (PARIHS) framework, on research utilization and other variables.

    METHODS: The study sample was drawn from a census of registered nurses working in acute care hospitals in Alberta, Canada, accessed through their professional licensing body (n = 6,526 nurses; 52.8% response rate). Three variables that measured PARIHS dimensions of context (culture, leadership, and evaluation) were used to sort cases into one of four mutually exclusive data sets that reflected less positive to more positive context. Then, a theoretical model of hospital- and unit-level influences on research utilization was developed and tested, using structural equation modeling, and 300 cases were randomly selected from each of the four data sets.

    RESULTS: Model test results were as follows--low context: chi2= 124.5, df = 80, p <. 001; partially low: chi2= 144.2, p <. 001, df = 80; partially high: chi2= 157.3, df = 80, p <. 001; and partially low: chi2= 146.0, df = 80, p <. 001. Hospital characteristics that positively influenced research utilization by nurses were staff development, opportunity for nurse-to-nurse collaboration, and staffing and support services. Increased emotional exhaustion led to less reported research utilization and higher rates of patient and nurse adverse events. Nurses working in contexts with more positive culture, leadership, and evaluation also reported significantly more research utilization, staff development, and lower rates of patient and staff adverse events than did nurses working in less positive contexts (i.e., those that lacked positive culture, leadership, or evaluation).

    CONCLUSION: The findings highlight the combined importance of culture, leadership, and evaluation to increase research utilization and improve patient safety. The findings may serve to strengthen the PARIHS framework and to suggest that, although it is not fully developed, the framework is an appropriate guide to implement research into practice.

  • 507.
    Custerson, Ann-Louise
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jansson, Monika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Effekter av massage/beröring hos dementa respektive icke dementa äldre personer: Systematisk litteraturstudie med empiriskt tillägg2009Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Föreliggande systematiska litteraturstudie syftade till att kartlägga vad som fanns beskrivet i litteraturen om effekter av massage/beröring hos dementa respektive icke dementa äldre personer. Syftet var även att kartlägga personalens inställning till massage/beröring och denna omvårdnads- åtgärds effekter empiriskt. Artiklarna har sökts i Högskolan Dalarnas fulltextdatabas ELIN för vidare granskning. Artiklarna som valdes var från åren 1999-2009. Sökorden som användes var massage, older, elder, old*, geriatric, demen*, touch, effects, tactil. Av resultatet framkom att i större delen av studierna har massage/beröring en positiv effekt på välmående hos äldre dementa och icke dementa människor. Särskilt kunde noteras att massage kunde vara en metod att minska agiterat beteende och vandrande hos dementa personer. Personalens inställning till massage/beröring sågs som positiv i den bemärkelsen att massage/beröring gynnade patientens välmående och att personalen kunde interagera med patienten på ett mer positivt sätt. I det empiriska tillägget var huvudfyndet att massage/ beröring hade bättre effekt för sömnen för dementa än för icke dementa. Uttryckt i Martinsens omvårdnadsteoretiska termer måste omvårdnaden ha som utgångspunkt den andres bästa. För att komma fram till vad som är bäst för den andre måste man vara öppen och närvarande hos honom samt sträva efter att tolka hans situation och behov. Föreliggande studies resultat bidrar till kunskap om massage/beröring som metod för äldre med särskild betoning på demens.

  • 508. Dahl, Kari Elisabeth
    et al.
    Wang, Nina J.
    Skau, Irene
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life and associated factors in Norwegian adults2011In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 69, no 4, p. 208-214Article in journal (Refereed)
    Abstract [en]

    Objective. To investigate associations between oral health-related quality of life assessed with the Oral Health Impact Profile (OHIP)-14 and demographic factors, number of teeth present, dental visits, dental health behaviour and self-rated oral health in a representative sample of 20-80-year-old Norwegians.

    Material and methods. The study was conducted in a stratified random sample of 3538 individuals. Questionnaires including questions on demographic factors, number of remaining teeth, dental visits, dental health behaviour, self-rated oral health and OHIP-14 were mailed to the sample. Bivariate and multivariate analyses were performed.

    Results. The response rate was 69%. The mean OHIP-14 score was 4.1 (standard deviation = 6.2). No problem was reported by 35% of the respondents. The most frequently reported problems were: physical pain (56%), psychological discomfort (39%) and psychological disability (30%). When the effect of all independent variables was analysed in multivariate analysis, self-rated oral health, frequency of dental visits, number of teeth, age and sex were significantly (P < 0.05) associated with the prevalence of having problems and frequent problems. Self-rated oral health had the strongest association with having problems [ odds ratio (OR) 4.5; 95% confidence interval (CI) 3.4-6.0] and with having frequent problems (OR 4.0; 95% CI 2.7-5.8). Dental health behaviour, use of floss and toothpicks and oral rinsing were not associated with having problems related to oral quality of life in multivariate analyses.

    Conclusion. In this Norwegian adult sample, self-rated oral health, frequency of dental visits, number of teeth, age and sex were associated with having problems as estimated using the OHIP-14.

  • 509. Dahl, KE
    et al.
    Wang, N
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Does oral health matter in people’s daily life?: Oral health-related quality of life in adults 35–47 years of age in Norway2012In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 10, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to assess the effect of oral health on aspects of daily life measured by the Dental Impact Profile (DIP) in 35- to 47-year-old individuals in Norway, and to study associations between reported effects and demographic variables, subjectively assessed oral health, general health, oral health behaviour and clinical oral health.

    Material and methods: A stratified randomized sample of 249 individuals received a questionnaire regarding demographic questions, dental visits, oral hygiene behaviour, self-rated oral health and general health and satisfaction with oral health. The DIP measured the effects of oral health on daily life. Teeth present and caries experience were registered by clinical examination. Bi- and multivariate analyses and factor analysis were used.

    Results: Items most frequently reported to be positively or negatively influenced by oral health were chewing and biting, eating, smiling and laughing, feeling comfortable and appearance. Only 1% reported no effects of oral health. Individuals with fewer than two decayed teeth, individuals who rated their oral health as good or practised good oral health habits reported more positive effects than others on oral quality of life (P = 0.05). When the variables were included in multivariate analysis, none was statistically significant. The subscales of the DIP were somewhat different from the originally suggested subscales.

    Conclusions: This study showed that most adults reported oral health to be important for masticatory functions and confirmed that oral health also had impacts on other aspects of life.

  • 510. Dahl, KE
    et al.
    Wang, NJ
    Holst, D
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral health-related quality of life among adults 68-77 years old in Nord-Tröndelag, Norway2011In: International Journal of Dental Hygiene, ISSN 1601-5029, E-ISSN 1601-5037, Vol. 9, no 1, p. 87-92Article in journal (Refereed)
    Abstract [en]

    Dental health has mostly been measured by dental staff disregarding patient’s experiences. However, clinical conditions alone do not fully indicate how people feel affected by their oral status. The aim of this study was to investigate how clinical recorded dental health, self-rated dental health, satisfaction with dental health were related to oral health-related quality of life (OHRQoL) assessed by Oral Health Impact Profile (OHIP-14) in 68–77 years old. A total of 151 individuals completed a questionnaire on self-rated dental health, satisfaction with dental health and the short form of OHIP-14. Clinical examination was performed registering number of teeth and dental caries. In total 63% of the individuals rated their dental health as good, and 59% were satisfied with their dental health. Using the OHIP-14 42% reported no problems or oral discomfort at all. The proportion of individuals reporting problems or discomfort varied between 13% and 43% according to the dimensions of OHIP-14. The most frequently reported problems were physical pain (43%), psychological discomfort (28%) and psychological disability (28%). Individuals who rated their dental health as poor and those who were dissatisfied with their dental health had significantly lower OHRQoL than other individuals. The study showed relationship between self-evaluations of dental health and OHRQoL in 68–77 years old. Individuals with few teeth reported lower OHRQoL than others, but no association between clinical caries status and OHRQoL could be found.

  • 511. Dahlberg, ER
    et al.
    Spets, E
    Svedbo Engström, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Sahlgrenska Academy, Institute of Medicine, University of Gothenburg.
    Larshans, M
    Leksell, Janeth
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Department of Medical Sciences, Uppsala University.
    Experiences of Hypoglycaemia in Adults with Diabetes Mellitus2017In: Journal of Diabetes and Treatment, article id J111Article in journal (Refereed)
    Abstract [en]

    Aims: To describe adults’ experiences of hypoglycaemia in diabetes mellitus, and the consequences of hypoglycaemia in daily life.

    Methods: This study was conducted using qualitative content analysis with an inductive approach. It was performed as a secondary analysis of semi-structured interviews. A total of 29 people participated in the study: 15 with type 1 diabetes and 14 with type 2 diabetes.

    Results: The theme that emerged was: Hypoglycaemia is an ever-present risk that manifests itself in different ways. The following categories were identified: Symptoms of hypoglycaemia can appear like a bolt from the blue. Knowledge comes from life experiences. Training and exercise today often have consequences tomorrow. Self-management may be perceived as a feeling of not being free. Family support can provide security in the illness.

    Conclusion: Hypoglycaemia is perceived as an ever-present risk that can come like a bolt from the blue, which in turn causes fear and problems in the daily life of people with diabetes. Better support, help and information from specialist nurses is needed. Family members should also be given more knowledge and information, in order to reduce the fear and discomfort of hypoglycaemia.

  • 512.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work. Karolinska Institutet; Stockholm University.
    Ageing in a changing place: a qualitative study of neighbourhood exclusion2019In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779Article in journal (Refereed)
    Abstract [en]

    An inclusive neighbourhood is a key facilitator enabling older adults to age in place. Neighbourhoods have been identified as a dimension of social exclusion important to older adults, and it has been argued that older adults are particularly vulnerable to neighbourhood change. The aim of this study was to explore older adults’ experiences of neighbourhood exclusion within the context of neighbourhood change. Focus groups were undertaken in the urban and rural areas of a metropolitan borough in England involving a total of 41 older adults, with data analysed via thematic analysis. Urban areas in the borough studied have transformed following the closure of the mining industry, with a high level of deprivation in many areas, while some rural areas have undergone gentrification. Within the context of structural neighbourhood change, four themes were identified: community cohesion, political agency, feelings of safety and the physical environment. The themes were interlinked, which calls for collaboration across traditional lines of professional responsibility, and for research that encompasses different aspects of neighbourhood exclusion. This study contributes with knowledge on older adults’ experiences of exclusion, including novel findings on the importance of political agency and collective memory, and identifies actions to combat exclusion. An active involvement of older adults in the development of initiatives to tackle social exclusion is recommended.

  • 513.
    Dahlberg, Råger
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Spets, Ewa
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erfarenheter och upplevelser av hypoglykemi hos vuxna med diabetes mellitus: En kvalitativ intervjustudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Approximately one third of people with diabetes suffer episodes of hypoglycaemia with a loss of consciousness as a result. The incidence of hypoglycaemia is unpleasant and patients attempt to avoid this event, which often results in higher plasmaglucose values. Dedicated nursing care involves helping people to cope with unpleasant experiences of hypoglycaemia in daily life.

    Aim: To describe adults' experiences of hypoglycaemia in diabetes mellitus, and the consequences hypoglycaemia leads to daily life.

    Method: This study was conducted with a qualitative content analysis with an inductive approach. The study was conducted as a secondary analysis of semi-structured interwievs. The number of study participants were a total of 29 of which 15 with Type 1 diabetes and 14 with Type 2 diabetes.

    Results: The theme that emerged was: Hypoglycaemia is an ever present risk and is shaped differently with the following categories. Symptoms of hypoglycaemia could come as a bolt from the blue. Knowledge comes from life experiences. Training and exercise today - often have consequences tomorrow for patients. Self management could be perceived as a feeling of not being free. Family support – could mean security in illness.

    Conclusion: The incidence of hypoglycaemia is a common event and is perceived as unpleasant and unsafe event and causing fear in people suffering from diabetes. Undertreatment was seen as a consequence. Better support, help and information from the specialist nurses were needed. Knowledge and information, even to family members, was considered important to reduce the fear and discomfort of hypoglycaemia.

  • 514.
    Dahlberg, Tom
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Kroppsideal via Instagram2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective

    The advanced technology of today’s society has brought on a heavy uprising of social media where images of training and bodies are a common phenomenon. The aim of this study was to examine how body ideals are created on the internet, with focus on social media. Two questions were used to help with this objective: How do male fitness profiles portrait themselves and their bodies on the net based service Instagram? Do connections exist between these profiles portraits of the body and specific body ideologies? (Rosenmann & Kaplan, 2014).

    Method

    The study was carried out with a nethnographic method, a method specifically focused on qualitative research regarding the internet. Three male fitness profiles and five of their images each were selected based on popularity on Instagram to be examined and analyzed in relation to body ideal.

    Results

    The images had similar attributes which included that they, often in a gym environment, showed undressed, extremely muscular bodies with emphasized focus on the upper body. Differences were present in the images but not to any significant extent. The profiles were defined by the body ideology of metrosexuality and consumer masculinity (Rosenmann & Kaplan, 2014).

    Conclusion

    The representation of the images of these fitness profiles translate well into the current muscular body ideal that contains a lean, muscular, well defined body. Clear connections could be made to Rosenmann’s och Kaplan’s (2014) body ideology of metrosexuality and consumer masculinity.

  • 515.
    Dahlgren, Gereon
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Vinnare tack vare tidigt födelsedatum: En studie om relativa ålderseffekten inom svensk juniorishockey medfokus på TV-pucken2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 516. Dahlin Ivanoff, Synneve
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ekdahl, Anne
    Eklund Grönberg, Annika
    Oredsson, Sven
    Sjöstrand, Fredrik
    Stavenow, Lars
    Wisten, Aase
    Akutvården måste klara också sköra åldringar2014In: Dagens Nyheter, ISSN 1101-2447, no 2014-01-03Article in journal (Other (popular science, discussion, etc.))
  • 517.
    Dahlkvist, Sara Erica
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Molinder, Rosa-Lill Eleonor
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Nepali men’s perceptions of the role of the man in family planning, during pregnancy and childbirth: A qualitative interview study2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Nepal has a rich culture and tradition in which family life and marriage are generally controlled by patriarchal norms, sanctions, values and gender differences. Despite global efforts to initiate midwifery education beneficial to women’s reproductive health in Nepal, the initiation is still pending.

    Objective: To describe Nepali men´s perceptions of the role of the man in family planning, during pregnancy and childbirth.

    Methods: A qualitative interview study with open questions was conducted with 15 Nepalese men in urban and rural areas. The material was analyzed by inductive content analysis.

    Results: The main category was, `He leads – She follows´. Six subcategories were presented under the category `supporting women in family planning, during pregnancy and childbirth´. Six subcategories formed the category `withdraw from supporting women in family planning, during pregnancy and childbirth´.

    Conclusion: The role of the man in Nepal was supportive and yet support was withdrawn in maybe the woman’s most vulnerable time of life.

    Clinical implications: With men playing such an important role in family planning, during pregnancy and childbirth, inviting him to knowledge sessions might improve women’s and girls’ sexual and reproductive health and rights.

    Further research: Proposal for further research that could capture the whole picture should be implemented with a more extensive quantitative research in Nepal.

  • 518.
    Dahlqvist Jönsson, Patrik
    et al.
    Region Halland.
    Sandlund, Mikael
    Umeå Universitet.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svedberg, Petra
    Högskolan i Halmstad, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    The meaning of Shared decision making for persons with long-term mental illness2013Conference paper (Refereed)
  • 519.
    Dahlqvist-Jönsson, Patrik
    et al.
    Region of Halland; Halmstad University.
    Schön, Ulla-Karin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Rosenberg, David
    Umeå University.
    Sandlund, Mikael
    Umeå University.
    Svedberg, Petra
    Halmstad University.
    Service users’ experiences of participation in decision making in mental health services2015In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 22, no 9, p. 688-697Article in journal (Refereed)
    Abstract [en]

    Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core category that emerged in the analysis described a ‘struggle to be perceived as a competent and equal person’ while three related categories including being the underdog, being controlled and being omitted described the difficulties of participating in decisions. The data analysis resulted in a model that describes internal and external conditions that influence the promotion of participation in decision making. The findings offer new insights from a user perspective and these can be utilized to develop and investigate concrete methods in order to promote user's participation in decisions.

  • 520. Dahlström, Ann-Charlotte
    et al.
    Mulder, Linn
    Sjuksköterskors erfarenheter av hot och våld på akutmottagningar: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att beskriva sjuksköterskor erfarenheter av hot och våld på akutmottagningar, sett ur ett internationellt perspektiv.

    Metod: Studien har genomförts som en litteraturstudie. Databassökningar har utförts på databaserna PubMed och CINAHL, originalpublicerade kvantitativa och kvalitativa forskningsstudier har kvalitetsgranskats och sammanställts.

    Resultat: Studien visade att sjuksköterskor hade erfarenhet av verbalt och fysiskt hot och våld i stor utsträckning. De verbala hoten och våldet bestod av svordomar och kränkningar. Det fysiska våldet visade sig genom att sjuksköterskorna blev spottade på, får knuffar, slag och sparkar. De som utövade hot och våld kunde vara patienten själv, närstående eller andra anhöriga.

    Slutsats: Sjuksköterskor på akutmottagningar världen över drabbas av olika typer av hot och våld. Detta påverkar både övriga patienter och övrig personal negativt. Ur arbetsmiljösynpunkt inkräktar hot och våld på patientsäkerheten. Bristande kommunikation som även kan feltolkas kan leda till hot och våld från patienter. Genom att genomföra förbättringsåtgärder och skapa strategier för bättre kommunikation kan hot och våld förebyggas.

  • 521.
    Dahné, Ylva
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Thorin, Emma
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskan och patienter med strokeinduceradafasi – En litteraturöversikt om kommunikation ochpersoncentrering2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Stroke is a collective term for cerebral infarction and cerebral

    hemorrhage. Stroke often causes lifelong detrimental effects, such as aphasia.

    Aphasia means a reduced ability to understand spoken/written language and/or a

    reduced ability to express oneself adequately. To enable a good and person-centred

    care for the patients, an effective communication is a prerequisite.

    Aim: The aim of

    this study is to describe the factors that influence the person-centred care and

    communication between the nurse and patients affected by stroke induced aphasia.

    Method:

    The study is a literature review on bachelor level. The study is based on 15

    scientific articles that have been red and analyzed and where common themes have

    been identified.

    Result: The results revealed a number of strategies that promoted

    and hindered good communication between the nurse and people affected by stroke

    induced aphasia. These strategies concern seven areas:

    Verbal communication, Nonverbal

    communication, Seeing the patient as a competent and unique individual,

    Attention and involvement, The time aspect of communication with patients with

    aphasia, The importance of the surrounding environment for communication

    and The

    personnel's education and skills

    . Conclusion: There is no standard answer to how

    communication shall be achieved, each individual is unique and every situation

    requires a different solution. However, there are a number of aspects and methods

    that are important and useful when communicating with aphasic people. These are

    used to different degrees in health care.

  • 522. Dalmar, Abdirisak Ahmed
    et al.
    Hussein, Abdullahi Sheik
    Walhad, Said Ahmed
    Ibrahim, Abdirashid Omer
    Abdi, Abshir Ali
    Ali, Mohamed Khalid
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Osman, Fatumo
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wall, Stig
    Rebuilding research capacity in fragile states: the case of a Somali-Swedish global health initiative2017In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 10, no 1, article id 1348693Article in journal (Refereed)
    Abstract [en]

    This paper presents an initiative to revive the previous Somali-Swedish Research Cooperation, which started in 1981 and was cut short by the civil war in Somalia. A programme focusing on research capacity building in the health sector is currently underway through the work of an alliance of three partner groups: six new Somali universities, five Swedish universities, and Somali diaspora professionals. Somali ownership is key to the sustainability of the programme, as is close collaboration with Somali health ministries. The programme aims to develop a model for working collaboratively across regions and cultural barriers within fragile states, with the goal of creating hope and energy. It is based on the conviction that health research has a key role in rebuilding national health services and trusted institutions.

  • 523.
    Dammgård, Emelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pernhall, Lina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskors erfarenheter av att främja hälsosamma levnadsvanor hos patienter med diabetes typ 2: En empirisk studie med kvalitativ ansats2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Diabetes is a people's disease that increases in society and in the world. Diabetes type 2 can be prevented, delayed or alleviated using healthy living habits, such as diet and exercise. Lifestyle treatment is therefore essential for achieving this.

    Purpose:

    To describe the district nurse's experience of promoting healthy living habits, diet and exercise, in type 2 diabetes patients.

    Method:

    An empirical study with qualitative interview method where seven district nurses participated in interviews.

    Results:

    The study highlighted the importance of district nurses' experiences and views on promoting healthy living habits, diet and exercise, to help and motivate patients with type 2 diabetes. To promote healthy living habits, in type 2 diabetes patients, are described as the basis of treatment. A very important task that is necessary to prevent as well as reduce the risk of complications to the disease. District nurses have experience and opportunities to promote healthy living habits in a variety of ways. Work on promoting healthy living habits is done individually, in groups and with the help of written information. District nurses also have experience and are aware of various obstacles to promote healthy living habits.

    Conclusion:

    District nurses should see each patient as a unique individual and then adjust the work to promote healthy living habits. Follow-up and continuity are needed to give the patient motivation for lifestyle changes and maintain them.

  • 524. Danehorn, Emil
    Sjuksköterskors uppfattningar av patienters lidande vid psykossjukdom: En fenomenografisk studie2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att beskriva sjuksköterskors uppfattningar av lidande hos

    patienter med psykossjukdom. Metod: Fenomenografisk ansats med semistrukturerade

    intervjuer. Resultat: Analysen av det insamlade materialet visade att sjuksköterskorna i

    studien uppfattade lidande hos patienter med psykossjukdom på tre kvalitativt skilda sätt.

    Med synen observerade sjuksköterskorna patientens fysiska förändringar, förändringar i

    aktivitet och självdestruktiva handlingar. Genom hörseln uppfattade sjuksköterskan hur

    patienten talar, ber om hjälp eller ger uttryck för att inte förstå sin sjukdom. Med sitt luktsinne

    uppfattade sjuksköterskorna att patienten hade slutat sköta sin hygien. Konklusion: En

    psykossjukdom kan medföra lidande för en patient, samtidigt som förmågan att kommunicera

    och uttrycka sig verbalt kan vara nedsatt till följd av psykosens symtom, vilket kan leda till

    svårigheter för patienten att förmedla lidande på ett sätt som kan förstås av sjuksköterskan.

    Det finns skäl att anta att lidande, när det inte kan förmedlas med ord, tar andra skepnader och

    uttryck, som kan uppfattas genom att sjuksköterskan är uppmärksam på synbara, hörbara och

    luktbara förändringar hos patienten, genom dessa förändringar kan sjuksköterskan identifiera

    och få en uppfattning om patientens lidande.

  • 525.
    Danielsson, Charlotta
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustavsson, Malin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som kan försvåra möjligheten för sjuksköterskor att ge personcentrerad vård – en litteraturöversikt.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: According to the new patient law, patients' involvement in their own care will be expanded and strengthened further. As part of this work, personcentred care has been introduced in several Swedish regions and county councils. Positive effects of person-centred care have been proven to exist for both patients and healthcare providers. Aim: To describe factors that can complicate the ability for nurses to provide person-centred care. Methods: The thesis project was conducted as a literature review. Ten scientific articles published between 2010-2016 were included in the study. The articles were searched in the CINAHL and PubMed databases, as well as through Google Scholar free text search. Results: There were several themes with associated factors that could complicate the possibility for nurses to provide a person-centred care. Prominent factors include the attitude of the nurse and his or her view of the profession and the patient, lack of patient participation, lack of teamwork and communication, weak support from organization and management, poor environment and education, and high workload. Conclusion: Several factors that could make it difficult for the nurse to provide person-centred care were discovered, some of which were perceived to be more crucial than others. In order for nurses to be able to provide care based on patient participation, it is very important that awareness of these aggravating factors is increased. By working with a person-centred approach already during nursing education, the likelihood of successful implementation of person-centred care in Swedish healthcare increases

  • 526. Danielsson, Evelina
    et al.
    Oddsson, Kristjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Fredriksson, Mårten
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Ovendal, Alexander
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Ekblom, Örjan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Wahlgren, Lina
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Hultgren, Staffan
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Andersson, Eva
    Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap.
    Hälsoprojekt med ledarledd fysisk aktivitet för äldre2012Conference paper (Other academic)
    Abstract [sv]

    Bakgrund och syfte. Syftet med hälsoprojektet under 8-12 veckor för äldre är att ge ledarledd fysisk aktivitet 2 gånger/vecka samt att utvärdera upplevd hälsa, förändring av livsstilssvanor samt fysisk kapacitet. Hälsoprojektet är ett fortlöpande samarbete mellan Solna stad och Gymnastik- och idrottshögskolan (GIH) och utförs under vårterminerna sedan ett flertal år.

    Metod. Individerna anmäler sitt deltagande själva. Det kostnadsfria hälsoprojektet utförs inom undervisningen i Folkhälsa i regi av GIH-studenter under handledning av verksamhetschefen i Solna stad och lärare/läkare på GIH. Den ledarledda fysiska aktiviteten utgörs primärt av stavgång, motionsgymnastik, vattengymnastik samt styrketräning. Initialt och i slutet av perioden besvarar deltagarna en hälsoenkät angående upplevd hälsa och livsstilsvanor om fysisk aktivitet, kost, sömn, rökning och alkohol samt utför några olika fysiologiska tester i samband med ett hälsosamtal.

    Resultat. Exempel på sammanställda resultat ges här för de 117 äldre som fullföljde hela projektet under en vårtermin (för kvinnorna var antalet samt medelvärden för ålder och BMI 99, 74år och 26 respektive för männen 18, 73år och 25). Efter avslutat projekt sågs för gruppen som helhet generellt en signifikant förbättrad upplevd fysisk och mental hälsa, kondition och styrka i buk-, ben- och armmuskulatur. För kvinnorna observerades även en ökad balansförmåga och uthållighet i ryggmusklerna. Enkätfrågorna angående fysiska aktivitetsvanor och stillasittande visade på, efter avslutat projekt, en förändring till en mer aktiv livsstil.

    Slutsats/Diskussion. Således kan utvärderade 8-12 veckors hälsoprojekt med ledarledd fysisk aktivitet för äldre bidra till förbättrad upplevd hälsa, ökade fysiska aktivitetsvanor, minskat stillasittande och bättre fysiska kapaciteter såsom kondition, styrka och balans som är positivt korrelerade till ökad livslängd och minskad förekomst av en mängd olika folksjukdomar och skador. Fler projekt och studier behövs framöver med ytterligare uppföljningar, jämförelser och för att vidareutveckla olika fysiologiska tester och andra hälsoparametrar som kan ha positiva samband med ökad hälsa.

  • 527.
    Danielsson, Johan
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Nykvist, Karin
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Mäns upplevelser av miktionsproblem och erektil dysfunktion efter radikal prostatektomi: En litteraturöversikt2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet var att beskriva hur män upplever att de påverkats av miktionsproblem och erektil dysfunktion efter radikal prostatektomi. Metod: Examensarbetet utfördes som en litteraturöversikt med tio vetenskapliga studier. Resultat: Upplevelsen av förlorad kontroll vid miktionsproblem var det som främst påverkade männen samt medförde att det sociala livet blev lidande. Männen beskrev hur de var tvungna att planera inför olika sociala tillställningar, vilket upplevdes som stressande och ångestfyllt. Det framkom också att männen oroade sig för urinläckage, stark odör och upplevde möten med oförstående människor som frustrerande. Erektil dysfunktion var den vanligaste komplikationen efter behandling, men miktionsproblem var det som orsakade mest besvär. Det upplevdes som att männen förlorat sin självständighet. Det framkom även att erektil dysfunktion upplevdes av vissa män som den komplikation som gav störst besvär. Erektil dysfunktion påverkade männen och var mycket svårt att hantera. Det var svårt att finna en acceptans för att den erektila dysfunktion kunde vara bestående. Många av männen beskrev att en viktig del i deras liv förlorats, en del av deras maskulinitet. De kände sig ofullständiga och det fanns en rädsla för att förlora sin partner. Slutsats: Studier visar att erektil dysfunktion och miktionsproblem i samband med radikal prostatektomi ger upphov till stress, oro, ångest samt en känsla av ofullständighet.

  • 528.
    Danielsson, Madeleine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Lind, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskors strategier för att främja fysisk aktivitet under graviditeten: En Kvalitativ Intervjustudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Physical activity should be recommended to all women during pregnancy. Midwives have an important role in the health promotion practice. There are recommendations about physical activity during pregnancy, although studies show that few pregnant women actually follow them. The midwife experience difficulties in counselling and there is a need to find strategies that can be used to promote physical activity. The aim of this study was to describe the midwives strategies to promote physical activity during pregnancy. The study was conducted by qualitative method and semistructured interviews were used to collect data. The data was analysed by thematic analysis. Several strategies emerged that the midwives used to promote physical activity during pregnancy; To advice, To motivate, To seek support in the surroundings, To individualize, To take care of the relationship and To elaborate. Another finding in the study was that promotion of physical activity was perceived as important but difficult by the midwives. These strategies can be used by midwives and other healthcare providers to promote physical activity during pregnancy.

  • 529.
    Dannberg, Isabella
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Ivarsson, Emma
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Alkoholutbildning på svenska riksskidgymnasium: En kvalitativ undersökning om hur skidgymnasietränare arbetar med att utbilda sina adepter i alkoholfrågor2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose The purpose of the study is to examine whether and if so how special sports teachers / trainers on the cross-country high schools are working to educate trainees about alcohol. The study results to promote the Swedish cross-country operations and, if possible, spreading good educational example to other sports college. Method A qualitative study has been carried out through a half-structured telephone interview. The sample covered a total survey of all 16 national ski school coaches in Sweden in the sport cross-country skiing. Participants were contacted through an information letter and then determined time for the interview. The results were then analyzed using a content analysis. Results The results showed that all RIG-ski school in Sweden conducting some form of education through theory lessons in a more or less degree. Two of the ski high schools had a specific lecture on the effects of alcohol on performance. Besides this, the result could indicate that the ski school coaches educate their students to a much greater extent through the open dialogue between coach and trainee than through theory lessons. This by having individual assessment interview, which the coach informs in a deeper way what alcohol intake has consequences on athletic performance, thus coaches are trying to create an environment where students themselves take the decision to refrain alcohol. Conclusions The results showed that all RIG-ski school in Sweden is working to educate their adepts in alcohol matters through theory lessons, but mostly in the open dialogue between student and coach. Theory lessons are something that exists in the curriculum for special sports and effects of alcohol on performance. In the open dialogue coaches educates students in a deeper way about alcohol, for example, through individual assessment interview.

  • 530.
    Das, Lucky
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Chowdhury, Merry
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mapping of eight education sites and exploration of feasible requirements in an accreditation tool to ensure quality midwifery education in Bangladesh: A questionnaire study in Barisal, Chittagong and Sylhet divisions2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    An important component to ensure sustainable quality midwifery education is to have a country specific accreditation tool in place, based on evidence. In Bangladesh with a recently initiated new cadre of professional midwives, the accreditation system is in process of being developed. Objective: The objective of this thesis is twofold. First, to map eight midwifery education sites in Barisal, Chittagong and Sylhet divisions prior the development of an accreditation tool. Second, to explore requirements for the accreditation tool from the perspective of the midwifery faculty to ensure quality midwifery education in Bangladesh. Methods: This study is part of a national wide study. Thirty-six participants filled a semi-structured questionnaire with both open and closed response alternatives. Data were analyzed through essentially non-parametric statistics and qualitative descriptions. Results: The mapping showed that the proportion theory in relation to practice was 40% theory and 60% practice at the eight education sites. The content of a midwifery education that should be delivered in clinical placement by a midwifery clinical teacher or preceptor, mentoring the midwifery students, was identified as a main challenge. The possible solutions were having sufficient amount of well-trained midwifery teacher; negotiating with Gynecology and Obstetrics department and the policy makers on how mentoring of midwifery students could happen smoothly; and negotiating the need for training of trainers to head nurses of all labor wards. The relation between the education site and the clinical site was suggested to be included in an accreditation tool to improve the fulfillment of a midwifery education. Conclusion: The need of an accreditation tool was, perceived by midwifery faculty, as important in order to ensure sufficient standard in the midwifery education. Clinical implications: The clinical implication of this study lies in the development of strategies to increase the number of clinical mentors and trained midwifery teachers, and provision of training of trainers to the clinical nurse midwifes at all labor wards.

  • 531. de Alwis, M. P.
    et al.
    Lo Martire, Riccardo
    Äng, Björn
    Garme, K.
    Development and validation of a web-based questionnaire for surveying the health and working conditions of high-performance marine craft populations2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 6, article id e011681Article in journal (Refereed)
  • 532. de Alwis, M.P.
    et al.
    Garme, K:
    Lo Martire, Riccardo
    Kåsin, J.I.
    Äng, Björn
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Centre for Clinical Research Dalarna, Falun, Sweden; Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.
    Crew acceleration exposure, health and performance in high-speed operations at sea2017Conference paper (Refereed)
    Abstract [en]

    The presented research program investigates the association between working conditions aboard High-Speed Craft (HSC) and its outcomes in terms of acceleration exposure and crew health and systems performance respectively. The aim is to identify the related risk factors and further, to use them to improve the assessment criteria in a simulation-based-design framework. The investigation initially document a seaborne population by a web-based questionnaire tailored for High-Performance Marine Craft Personnel (HPMCP) and similar populations. Then data is collected during regular service by measuring craft acceleration and through another questionnaire especially resolute on perceived work-exposure, health and performance. Exposure and performance data is collected daily and health data weekly, depending on seaborne frequency. The population repeats the prevalence questionnaire about a year later enabling a longitudinal follow-up for identifying long-term effects of exposure. The paper reports the two questionnaires´ development and pilot test as well as the first application for baseline data collection in the target group. The results indicate health and performance characteristics of the study population and data shows a promising correlation between the self-reported subjective exposure and the measured objective acceleration. Data indicates a comparatively higher prevalence of musculoskeletal pain in the study population than that of the general population.

  • 533.
    Dellbrant, AnnaSofia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Thunfors, Cristina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    BHV-sjuksköterskans upplevelse av att bemöta och vägleda föräldrar som är tveksamma till vaccination av sitt barn: En kvalitativ intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of the study was to highlight the child health care nurse’s experience of responding and guiding vaccine hesitant parents. Method: An empirical interview study with a qualitative approach was carried out. The study was based on semi-structured interviews with six child health care nurses. The analysis was formed as a manifest content analysis. Results: The analysis resulted in four main categories: Guiding by informing, Requirements to guide, Approaches to respond in a good way and The Child Health Care Nurse’s experiences of responding hesitant parents as well as thirteen subcategories. The main results showed that child health care nurse’s ways of guiding hesitant parents were quite similar to each other, but differences also occured. The key to guiding parents was to inform them about vaccination. It was important to individualize the information and guide after discussion about risks versus benefits and that parents were guided to take a considered decision. Conditions to guide parents in a good way was time, knowledge and support. The child health care nurse sought a good relationship with the parents through genuine consideration and respect for the decision that the parents made. The child health care nurse experienced emotions such as frustration, anxiety, nervousness, and that responding could feel awkward. It could even be difficult to responding hesitant parents, but that varied with the parent’s attitude. Conclusion: The child health care nurse can increase the possibility that parents may choose to vaccinate their child, through individualized guidance and responding hesitant parents in consideration and respect.

  • 534.
    Dent, Jessica R.
    et al.
    Massey Univ, Sch Sport & Exercise, Palmerston North, New Zealand.;Auckland Univ Technol, Sch Sport & Recreat, SPRINZ, Auckland, New Zealand..
    Edge, Johann A.
    Massey Univ, Sch Sport & Exercise, Palmerston North, New Zealand.;Univ Auckland, Dept Sport & Exercise Sci, Auckland 1, New Zealand..
    Hawke, Emma
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    McMahon, Christopher
    AgResearch Ltd, Ruakura Res Ctr, Hamilton, New Zealand..
    Muendel, Toby
    Massey Univ, Sch Sport & Exercise, Palmerston North, New Zealand..
    Sex differences in acute translational repressor 4E-BP1 activity and sprint performance in response to repeated-sprint exercise in team sport athletes2015In: Journal of Science and Medicine in Sport, ISSN 1440-2440, E-ISSN 1878-1861, Vol. 18, no 6, p. 730-736Article in journal (Refereed)
    Abstract [en]

    Objectives: The physiological requirements underlying soccer-specific exercise are incomplete and sex-based comparisons are sparse. The aim of this study was to determine the effects of a repeated-sprint protocol on the translational repressor 4E-BP1 and sprint performance in male and female soccer players.

    Design: Cross-over design involving eight female and seven male university soccer players.

    Methods: Participants performed four bouts of 6x 30-m maximal sprints spread equally over 40 min. Heart rate, sprint time and sprint decrement were measured for each sprint and during the course of each bout. Venous blood samples and muscle biopsies from the vastus lateralis were taken at rest, at 15 min and 2 h post-exercise. R

    esults: While males maintained a faster mean sprint time for each bout (P < 0.05) females exhibited a greater decrement in sprint performance for each bout (P < 0.05), indicating a superior maintenance of sprint performance in males, with no sex differences for heart rate or lactate. Muscle analyses revealed sex differences in resting total (P< 0.05) and phosphorylated (P< 0.05) 4E-BP1 Thr37/46, and 15 min post-exercise the 4E-BP1 Thr37/46 ratio decreased below resting levels in males only (P < 0.05), indicative of a decreased translation initiation following repeated sprints.

    Conclusions: We show that females have a larger sprint decrement indicating that males have a superior ability to recover sprint performance. Sex differences in resting 4E-BP1 Thr37/46 suggest diversity in the training-induced phenotype of the muscle of males and females competing in equivalent levels of team-sport competition.

  • 535. Desmond, Deirdre
    et al.
    Layton, Natasha
    Bentley, Jacob
    Boot, Fleur Heleen
    Borg, Johan
    Lunds universitet.
    Dhungana, Bishnu Maya
    Gallagher, Pamela
    Gitlow, Lynn
    Gowran, Rosemary Joan
    Groce, Nora
    Mavrou, Katerina
    Mackeogh, Trish
    McDonald, Rachael
    Pettersson, Cecilia
    Scherer, Marcia J.
    Assistive technology and people: a position paper from the first global research, innovation and education on assistive technology (GREAT) summit2018In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 13, no 5, p. 437-444Article in journal (Refereed)
    Abstract [en]

    Assistive technology (AT) is a powerful enabler of participation. The World Health Organization’s Global Collaboration on Assistive Technology (GATE) programme is actively working towards access to assistive technology for all. Developed through collaborative work as a part of the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit, this position paper provides a “state of the science” view of AT users, conceptualized as “People” within the set of GATE strategic “P” s. People are at the core of policy, products, personnel and provision. AT is an interface between the person and the life they would like to lead. People’s preferences, perspectives and goals are fundamental to defining and determining the success of AT. Maximizing the impact of AT in enabling participation requires an individualized and holistic understanding of the value and meaning of AT for the individual, taking a universal model perspective, focusing on the person, in context, and then considering the condition and/or the technology. This paper aims to situate and emphasize people at the centre of AT systems: we highlight personal meanings and perspectives on AT use and consider the role of advocacy, empowerment and co-design in developing and driving AT processes.

  • 536. Dicker, Daniel
    et al.
    Nguyen, Grant
    Abate, Degu
    Abate, Lkidan Hassen
    Abay, Solomon
    Abbafati, Cristiana
    Abbasi, Nooshin
    Abbastabar, Hedayat
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Murray, Christopher J. L
    Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 20172018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 392, no 10159, p. 1684-1735Article in journal (Refereed)
    Abstract [en]

    Background Assessments of age-specific mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Affairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. 

    Methods The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systetns, sample registration systetns, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specific mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in different components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. 

    Findings Globally, 18.7% (95% uncertainty interval 18.4-19.0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58.8% (58.2-59.3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48.1 years (46.5-49.6) to 70.5 years (70.1-70.8) for men and from 52.9 years (51.7-54.0) to 75.6 years (75.3-75.9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49.1 years (46.5-51.7) for men in the Central African Republic to 87.6 years (86.9-88.1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216.0 deaths (196.3-238.1) per 1000 livebirths in 1950 to 38.9 deaths (35.6-42.83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5.4 million (5.2-5.6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult tnales, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. 

    Interpretation This analysis of age-sex-specific mortality shows that there are remarkably complex patterns in population mortality across countries. The findings of this study highlight global successes, such as the large decline in under-5 mortality, which reflects significant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, wotnen, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing.

  • 537. Dindic, Azemina
    et al.
    Jonsson, Johanna
    Information och stöd anhöriga vill erhålla av sjuksköterskan vid den sena fasen av palliativ vård: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att ta reda på vad för information och vilket stöd anhöriga önskar erhålla av sjuksköterskan i den sena fasen av palliativ vård. Metod: Litteraturöversikt med urval av 13 artiklar av kvalitativ och kvantitativ ansats från databaserna Cinahl, PubMed och Medline. Resultat: Forskning visar att anhöriga önskar erhålla flera former av stöd och information i den sena fasen av palliativ vård. Den information som är mest önskvärd är information om sjukdomen, information om vårdandet samt att informationen ges både skriftligt och verbalt. Det stöd anhöriga anser som viktigast är familjecentrerad vård och stöd för delaktighet i vårdandet, gruppstöd och efterlevandestöd. Slutsats: Anhöriga med en närstående som vårdas i den sena fasen av palliativ vård önskar erhålla tydlig skriftlig och verbal information om sjukdomen och om vårdandet. De vill även erhålla stöd före, under och efter dödsfallet. Kunskap om anhörigas önskemål av stöd och information i den sena fasen av palliativ vård kan hjälpa sjuksköterskan att bättre bistå med hjälp i en tid som är svår för både patient och anhöriga. Detta ställer krav på sjuksköterskan att inkludera både patient, i denna studie benämnd som närstående, och dess anhöriga i vårdandet.

  • 538.
    Dittrich, Nick
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Akupressurens effekter och möjlig användninginom vård och omvårdnad: En litteraturöversikt2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The need for health care and nursing is increasing and new

    complementary approaches to address these are needed.

    Objective:

    To compile studies using acupressure and study the effects of

    acupressure on various symptoms, disorders and ill-health conditions.

    Method:

    The study was conducted as a literature review where 20 different

    articles were compiled.

    Result:

    Categorization was made in the three main headings: effects of

    acupressure

    , patient’s experience of acupressure and acupressure in health care

    and nursing

    . The application of acupressure was mainly threw fingers with a great

    variety of acupoints distributed over the entire body. Acupressure has a wide range

    of applications both in health care and nursing, and provides a non-invasive,

    uncomplicated, economical, simple and effective complementary intervention that

    nurses and patients can use. Identified areas where fatigue, sleep, depression,

    anxiety, stress, cognitive and functional recovery, agitated behavior,

    gastrointestinal function, hypertension, pain, thirst, incontinence, quality of life

    and health. Generally was acupressure an effective intervention that also patients

    experienced as positive.

    Conclusion:

    Acupressure proves to be a usable intervention in health care and

    nursing with different uses, although the effect is partly explained by placebo.

    Nevertheless acupressure offers a complementary intervention for patients, nurses

    and other health care professionals to relieve discomfort and to promote health and

    quality of life.

  • 539. Djarv, T
    et al.
    Axelsson, C
    Herlitz, J
    Strömsöe, Anneli
    School of Health, Care and Social Sciences, Mälardalen University, Västerås.
    Israelsson, J
    Claesson, A
    Traumatic cardiac arrest in Sweden 1990-2016 - a population-based national cohort study.2018In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, no 1, article id 30Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Trauma is a main cause of death among young adults worldwide. Patients experiencing a traumatic cardiac arrest (TCA) certainly have a poor prognosis but population-based studies are sparse. Primarily to describe characteristics and 30-day survival following a TCA as compared with a medical out-of-hospital cardiac arrest (medical CA).

    METHODS: A cohort study based on data from the nationwide, prospective population-based Swedish Registry for Cardiopulmonary Resuscitation (SRCR), a medical cardiac arrest registry, between 1990 and 2016. The definition of a TCA in the SRCR is a patient who is unresponsive with apnoea where cardiopulmonary resuscitation and/or defibrillation have been initiated and in whom the Emergency Medical Services (EMS, mainly a nurse-based system) reported trauma as the aetiology. Outcome was overall 30-day survival. Descriptive statistics as well as multivariable logistic regression models were used.

    RESULTS: In all, between 1990 and 2016, 1774 (2.4%) cases had a TCA and 72,547 had a medical CA. Overall 30-day survival gradually increased over the years, and was 3.7% for TCAs compared to 8.2% following a medical CA (p < 0.01). Among TCAs, factors associated with a higher 30-day survival were bystander witnessed and having a shockable initial rhythm (adjusted OR 2.67, 95% C.I. 1.15-6.22 and OR 8.94 95% C.I. 4.27-18.69, respectively).

    DISCUSSION: Association in registry-based studies do not imply causality but TCA had short time intervals in the chain of survival as well as high rates of bystander-CPR.

    CONCLUSION: In a medical CA registry like ours, prevalence of TCAs is low and survival is poor. Registries like ours might not capture the true incidence. However, many individuals do survive and resuscitation in TCAs should not be seen futile.

  • 540.
    Domeij, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Lennström, Charlotte
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskans erfarenhet av handläggning vid uppkommen grad II-bristning: Kvalitativ intervjustudie med barnmorskor verksamma vid förlossningsavdelning2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Many women sustain a second-degree tear when giving birth vaginally. The work field of a midwife includes managing these injuries. There is limited research regarding this field and the focus tend to be on third- and fourth-degree tears, even though second-degree tears may also result in long-term complications.

    Aim:

    The aim was to investigate the midwife’s experience of managing second-degree tears.

    Method:

    Eight semi-structured individual interviews were conducted with midwives working at a medium large maternity ward located in the middle of Sweden. Qualitative content analysis was used to analyze the material.

    Results:

    Four categories and two subcategories were identified. The categories were: Information, The support of colleagues, The need for follow-ups and Physical examination and the subcategories were: Feedback strategies and Documentation.

    Conclusion:

    The result show that midwives feel insecure when managing second-degree tears, especially the midwives with less experience. The midwives also requested more feedback from the women they sutured regarding their second-degree tears and the midwives also wished for a better follow-up for the women with second-degree tears. The result also showed that the midwives give different information to women regarding their tears. No pronounced routines were found regarding what information to give and in what way.

    Clinical application:

    The results of the study aim to increase the knowledge and to develop routines regarding second-degree tears. More knowledge is needed about information given about the tear and when it is the best time to give information.

  • 541.
    Dragsten, Mirjam
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Salmonsson, Ingela
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Vårdpersonalens kunskapsläge i hjärtlungräddning samt följsamhet till det svenska hjärtlungräddningsregistret på ett länssjukhus i Mellansverige: En kvantitativ tvärsnittsstudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: To identify the healthcare professional´s knowledge and training frequency of cardiopulmony resuscitation in a county hospital in central Sweden, and compliance of the Swedish Register of cardiopulmony resuscitation.

    Method: Survey with quantitative approach consisting of 177 respondents, as well as a retrospective observational study.

    Main results: Individuals answered correctly to all knowledge questions, but as a group, there were deficiencies in the knowledge of cardiopulmonary resuscitation. When comparing healthcare professional´s knowledge it was demonstrated that in four of the seven knowledge questions it was a significant difference in knowledge between the health professionals who have more regular training than those with fewer. Those who had more regular education had more right answers. A significant difference was also detected depending on when they had their latest CPR training, where those who have had their education more recently also had more right answers. Compliance of healthcare professional´s to register patients treated for cardiac arrest in hospital at the Swedish CPR registry, can be summarized by the deficiencies in reporting. Conclusion: It is important to create conditions for frequent training to health professionals to increase the knowledge and preparedness in CPR, which can also be seen as a quality assurance work. An improvement is necessary in order to improve compliance to registration.

  • 542.
    Drmac, Marijana
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jörgensen, Angelica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnad vid smärta: En litteraturöversikt om könsskillnader2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Pain is a common cause to seek healthcare. Pain is a subjective feeling; however, the interpretation of "male" and "female behavior" could interfere with the healthcare staff judgement and care – even though quality of care should be given person-centered and on equal terms.

    Aim:

    The aim of the study was to examine the differences in care, that may exist, between men and women with pain and highlight the gender´s meaning in quality of care.

    Method:

    This study was conducted as a literature review investigating the existing literature within this area. Seventeen scientific articles from the PubMed and Cinahl databases were analyzed and compiled into a result.

    Results:

    This review brings out the differences between the treatment and ease for men and women in pain with regards to their gender. Often women have a tendency to be undervalued when they are being cared for compared to men. Physical symptoms are often regarded as psychosomatic. Even the age of the patients was a contributing factor.

    Conclusion:

    This literature study reveals differences between genders pain care. Gender differences were identified in many sections of care. Men’s pain is treated better than women, and the women generally needs to wait longer in receiving treatment. Registered nurses should utilize person-centered treatment in order to decrease this gender gap. Increased equality in care can support a sustainable future.

  • 543. Duc, Duong M
    et al.
    Bergström, Anna
    Eriksson, Leif
    Selling, Katarina
    Thi Thu Ha, Bui
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam2016In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, article id 31572Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low- and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items.

    OBJECTIVE: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam.

    DESIGNS: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots).

    RESULTS: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability.

    CONCLUSIONS: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

  • 544. Dunn, Emma
    et al.
    Felthous, Alan R.
    Gagné, Pierre
    Harding, Tim
    Kaliski, Sean
    Kramp, Peter
    Lindqvist, Per
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Nedopil, Norbert
    Ogloff, James R. P.
    Skipworth, Jeremy
    Thomson, Lindsay
    Yoshikawa, Kazuo
    Forensic psychiatry and its interfaces outside the UK and Ireland2014In: Forensic psychiatry: clinical, legal and ethical issues / [ed] Gunn, John C & Taylor, Pamela J, Boca Raton, FL: CRC Press, 2014, 2, p. 112-146Chapter in book (Refereed)
  • 545. Duong, Duc M.
    et al.
    Bergström, Anna
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bui, Ha T. T.
    Eriksson, Leif
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Exploring the influence of context in a community-based facilitation intervention focusing on neonatal health and survival in Vietnam: a qualitative study2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, no 15, article id 814Article in journal (Refereed)
    Abstract [en]

    Background

    In the Neonatal health – Knowledge into Practice (NeoKIP) trial in Vietnam, local stakeholder groups, supported by trained laywomen acting as facilitators, promoted knowledge translation (KT) resulting in decreased neonatal mortality. In general, as well as in the community-based NeoKIP trial, there is a need to further understand how context influences KT interventions in low- and middle-income countries (LMICs). Thus, the objective of this study was to explore the influence of context on the facilitation process in the NeoKIP intervention.

    Methods

    A secondary content analysis was performed on 16 Focus Group Discussions with facilitators and participants of the stakeholder groups, applying an inductive approach to the content on context through naïve understanding and structured analysis.

    Results

    The three main-categories of context found to influence the facilitation process in the NeoKIP intervention were: (1) Support and collaboration of local authorities and other communal stakeholders; (2) Incentives to, and motivation of, participants; and (3) Low health care coverage and utilization. In particular, the role of local authorities in a KT intervention was recognized as important. Also, while project participants expected financial incentives, non-financial benefits such as individual learning were considered to balance the lack of reimbursement in the NeoKIP intervention. Further, project participants recognized the need to acknowledge the needs of disadvantaged groups.

    Conclusions

    This study provides insight for further understanding of the influence of contextual aspects to improve effects of a KT intervention in Vietnam. We suggest that future KT interventions should apply strategies to improve local authorities’ engagement, to identify and communicate non-financial incentives, and to make disadvantaged groups a priority. Further studies to evaluate the contextual aspects in KT interventions in LMICs are also needed.

  • 546.
    Durbeej, N.
    et al.
    Karolinska institutet.
    Gumpert, C. H.
    Karolinska institutet.
    Alm, C.
    Karolinska institutet.
    Eriksson, Å.
    Karolinska institutet.
    Berman, A. H.
    Karolinska institutet.
    Kristiansson, M.
    Karolinska institutet.
    Lindqvist, Per
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Palmstierna, T.
    Karolinska institutet.
    S13-01 - Substance abuse treatment as a predictor of criminal recidivism among psychiatrically examined Swedish offenders2010In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 25, no Supplement 1, p. 32-32Article in journal (Refereed)
    Abstract [en]

    Background: Substance abuse is clearly associated with criminal recidivism among offenders with and without mental disorder. Treatment for substance abuse correlates with lower rates of re-offending among participants in outpatient-based as well as institution-based substance abuse treatment programs. However, for offenders with mental disorder, research on the possible preventive effect of substance abuse treatment on criminal recidivism is sparse. This paper reports from on an ongoing naturalistic and prospective interview study on the relationship between post-release outpatient substance abuse treatment and re-offending. Methods: The Stockholm county sample comprises 246 offenders of both genders subjected to a forensic psychiatric assessment, who screened positive for substance abuse problems. Eighty-five percent (n=210) agreed to participate in the study. Baseline data and follow-up interview data, collected immediately on release from incarceration (prison/forensic hospital) and 6 and 12 months later, include self-reported substance abuse, treatment involvement and criminality. By February 2010, data will be available from the first follow-up for 150 participants, from the second follow-up for 80 individuals and from the third follow-up for 10 subjects. Results and conclusions: The focus of the presentation will be recidivism comparisons between substance abuse treatment utilizers and those who decline treatment. Data on ongoing levels of substance abuse, mental health problems and offending will serve as dependent variables. Additional analyses will present perceived benefit from and reasons for accepting or rejecting treatment.

  • 547.
    Durbeej, N.
    et al.
    Karolinska institutet.
    Hellner Gumpert, C.
    Karolinska institutet.
    Alm, C.
    Karolinska institutet.
    Eriksson, Å.
    Karolinska institutet.
    Hephzibah Berman, A.
    Karolinska institutet.
    Kristiansson, M.
    Karolinska institutet.
    Lindqvist, Per
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Palmstierna, T.
    Karolinska institutet.
    P02-54 - Is outpatient-based substance abuse treatment a predictor of re-offending and other outcomes among Swedish offenders subjected to psychiatric assessment?2010In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 25, no Supplement 1, p. 674-674Article in journal (Refereed)
    Abstract [en]

    Introduction: Substance abuse is associated with criminal recidivism. Substance abuse treatment has been found to correlate negatively with re-offending among treatment utilizers. However, for offenders with mental health problems and substance abuse, research on how substance abuse treatment affects re-offending is sparse. Objectives: The study aimed to examine the relationship between self-reported outpatient-based substance abuse treatment and self-reported a) re-offending, b) substance use and c) psychiatric problems among offenders with mental health and substance use problems. Methods: Data were gathered from a naturalistic follow-up study with 208 participants, subjected to a court-ordered psychiatric assessment. This analysis covers 91 individuals who were followed-up after an average study period of 17 months. Among these, 68% had been sentenced to institutional imprisonment or forensic psychiatric care. Results: Offences, substance use and psychiatric problems declined between baseline and follow-up. However, the reduction was not associated with self-reported treatment utilization. Among participants who were sentenced to non-institutional corrections, more individuals had utilized outpatient-based treatment compared to individuals who were sentenced to imprisonment or forensic psychiatric care. Conclusions: A definitive conclusion about the effect of treatment is difficult to draw. For instance, self-reported data may not reflect actual treatment consumption. However, one interpretation is that participants naturally recovered over time. Institutional correction might also have resulted in positive outcomes equivalent to outpatient-based treatment.

  • 548.
    Dusinkiewicz, Fenja
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Liss-Back, Amanda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Barnens upplevelser av att ha föräldrar som tidigt insjuknar i en demenssjukdom- en litteraturöversikt2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Objective: The purpose of this study was to describe research on children’s experiences of being a relative of a parent with early-onset dementia. Method: The study was conducted as a literature review where nine qualitative and two quantitative scientific articles were included in the analysis. Databases that were used to search for articles was Cinahl and Web of science. Results: The result was identified in four categories: Diagnosis, Role changes, Impact on daily life and Support. The result showed that the children felt that it was important to get information about the parent's diagnosis and that this information would be individualized. Furthermore, the children had negative experiences on the role changes within family. It was not unusual for the children to experience concern, grief and anxiety out of the role changes that occurred as a result of dementia. The children also expressed a need for time alone where they could do things such as spending time with friends, exercise or go on a vacation. The need to meet other children who were in similar situations was experienced by the children as an important part of being able to handle being a relative of a parent with early-onset dementia. Conclusion: The children experienced changes within the family. The nurse needs to pay attention to the childrens’ needs. However, this requires further research in the area to develop an adapted support for the children.

  • 549.
    Dykes, Fiona
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom; Chinese University of Hong Kong, Hong Kong; University of Western Sydney, Australia .
    Flacking, RenéeDalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chinese University of Hong Kong, Hong Kong; Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom.
    Ethnographic research in maternal and child health2015Collection (editor) (Other academic)
  • 550.
    Dykes, Fiona
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom; Chinese University of Hong Kong, Hong Kong; University of Western Sydney, Australia .
    Flacking, Renée
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chinese University of Hong Kong, Hong Kong; Maternal and Infant Nutrition and Nurture Unit (MAINN), University of Central Lancashire, United Kingdom.
    Introducing the theory and practice of ethnography2015In: Ethnographic Research in Maternal and Child Health / [ed] Fiona Dykes and Renée Flacking, Taylor & Francis, 2015, p. 1-14Chapter in book (Other academic)
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