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  • 51.
    Andersson, Linda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Martinsson, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Beröringens effekter inom palliativ vård: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att se vilken effekt beröring har som

    omvårdnadsåtgärd för patienter inom palliativ vård. Metod: Studien är genomförd

    som en litteraturstudie. Huvudresultat: I de flesta studierna framgick att massage

    eller beröring hade positiv effekt på smärta, oro/ångest, sömn och på

    välbefinnandet Resultatet utmynnade i sex kategorier: smärtlindrande effekt,

    lugnande effekt, effekt på välbefinnandet och livskvaliteten, effekt på sömnen,

    effekt över tid och effekt beroende på terapiform. En av studierna visade inte

    någon signifikant skillnad på välbefinnandet hos grupper som fått

    massagebehandling eller vänligt besök av vårdpersonal. Slutsats: Resultatet visar

    att man kan använda beröring som ett komplement till traditionell vård för att

    bland annat minska smärta samt nå ökat välbefinnande hos patienter inom palliativ

    vård.

  • 52.
    Andersson, Linda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ols Åström, Frida
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Smärtskattning och smärtlindring vid förlossning samt förlossningsupplevelse bland normalviktiga och överviktiga kvinnor2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 53.
    Andersson, Madeleine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Forslund, Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar patientens följsamhet tillkompressionsbehandling av venösa bensår – Enlitteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    The incidence of venous leg ulcers in the adult population in the

    EU countries are estimated to be between 490,000 and 1.3 million. The main

    treatment for the prevention of recurrent leg ulcers is compression stockings. For

    those patients who don´t use compression stockings, the recurrence has been

    calculated to be 100% and for those who used the socks 16%. Patient's quality of

    life is affected by the fact that it is usually required long care and treatment of the

    leg and that it is usually a recurring problem.

    Aim

    :

    To describe factors that affect patient compliance with compression therapy

    to prevent and treat venous leg ulcers.

    Methods:

    The study has been carried out as a litterature review. Data collection

    has been done through searches in the CINAHL and PubMed databases.

    Results:

    In summary, the result shows that there are several factors that

    affected the patient's compliance. Patient compliance decreased as a result of

    the pain caused by the compression bandage or by the wound dressing. At

    new inexperienced nurses were lacking in knowledge of how the compression

    bandage should be applied, in several patients there was a lack of knowledge and

    understanding why compression treatment was important to prevent new venous

    leg ulcers. Difficulty in applying and removing the compression socks, trust

    in the nurse and the appearance of the compression socks / bandage were other

    factors that affected compliance.

    Conclusion:

    The patient's adherence to compression treatment is affected by

    both inhibitory and promotional factors. What the nurse can do, among other

    things to influence the patient's adherence to compression therapy is to inform

    about how compression treatment helps with the healing and self-care advice to

    prevent recurrence.

  • 54.
    Andersson, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lundén, Johanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att leva med diabetes typ 1- En litteraturöversikt om barn och ungdomar samt deras föräldrars upplevelser2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes typ 1 ökar bland barn och ungdomar, Sverige har den näst högsta insjuknandefrekvensen i hela världen. Diabetes typ 1 är en kronisk autoimmun sjukdom vilket innebär att kroppens immunförsvar angriper de egna insulinproducerande cellerna i pankreas. Patienter med diabetes typ 1 löper stor risk att drabbas av komplikationer och följdsjukdomar.

    Syfte: Syftet med denna studie är att beskriva barn och ungdomar samt deras föräldrars upplevelser av att leva med diabetes typ 1.

    Metod: En litteraturstudie genomfördes med totalt 15 artiklar utifrån studiens syfte, sökningarna har skett i databaserna Cinahl och PubMed. Artiklarna poängsattes med hjälp av Högskolan Dalarnas modifierade version av granskningsmallar för kvantitativa och kvalitativa artiklar.

    Resultat: Analysen av artiklarna resulterade i fyra kategorier som beskriver barn och ungdomars upplevelser: begränsningar i vardagen, stöd från föräldrar och sjukvården var centralt, rädsla för komplikationer samt att vara annorlunda. Två kategorier beskriver föräldrarnas upplevelser: oro rädsla och frustration samt att våga släppa kontrollen.

    Slutsats: Barn och ungdomar med diabetes typ 1 upplevde sitt liv som begränsat. Sjukdomen påverkar dem i skolan, under fysisk aktivitet, tillsammans med vänner, och i sociala sammanhang. Föräldrar till barn och ungdomar med diabetes typ 1 upplevde rädsla och oro över sitt barns sjukdom.

  • 55.
    Andersson, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjöberg, Cristina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Egenvård och faktorer som påverkar följsamheten till egenvård för att minska risken för recidiv av venösa bensår: - En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    One percent of Sweden’s population suffers from venous leg ulcers. The risk of recurrence is high at a 70 % recurrence rate. The compliance to performing recommended self-care activities is often low.

    The aim of this study was to highlight evidence based self-care activities, and what factors that influenced the adherence to follow the recommended self-care activities in order to minimize the risk of recurrence in patients with venous leg ulcers. The Method was a literature study based on 15 research articles. The result showed that wearing compression hosiery, performing leg exercises, physical activity and resting with the legs elevated was evidence based methods that lowers the risk of recurrence of venous leg ulcers. Factors found that influenced the compliance to self-care activities among patients with venous leg ulcers were: Information, trust, pain, body image, depression, self-efficacy and restricted mobility. The conclusion was that recommending individualized evidence-based self-care activities to patients with on-going or previous venous leg ulcers lowers the risk of recurrence. A trusting relationship should be established between the nurse and the patient, and interventions aimed towards increasing the patient compliance to recommended self-care activities should be prioritized. By adapting a preventive approach in order to decrease recurrences of venous leg ulcers, the suffering of the patients are minimized as well as the health-care costs of society.

  • 56.
    Andersson, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskors erfarenheter av andliga och existentiella frågor i palliativ vård: En litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Spiritual and existential issues increasingly end up at healthcare

    personnel. The palliative approach emphasizes the importance of providing good

    care regarding existential and spiritual issues. The nurse's role is through good

    relationships create a customized and balanced care to improve the wellbeing of

    the patient, at the end of life.

    Aim: The aim of the literature review was to compile the spiritual and existential

    issues described in the research based on nurses' experiences of palliative care.

    Methods: A literature review that compiles current research in the chosen nursing

    field.

    Results: In the result time appeared as the most common obstacle and education

    promotes giving of spiritual and existential care. To establish a relationship and

    communicate is important aspects in the art of nursing. Characteristics that the

    nurse should possess in order to facilitate the giving of spiritual and existential

    care is; good self-knowledge, empathy, intuition and observation ability.

    Conclusion: To be able to ameliorate spiritual and existential care time is needed

    for the external conditions to enable the meeting between nurse and patient. The

    care environment should be organized so this is made possible, teamwork applied

    and education provided.

  • 57.
    Andersson, Maribel
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Vestling, Jonas
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar anhörigas upplevelse av vårdpersonalens bemötande vid palliativ vård oavsett vårdmiljö: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: With an aging population while chronic diseases increases forecasts

    show that the need for palliative care will increase in the future. The aim of

    palliative care is to improve quality of life for patients and their families. Research

    in this area is needed when there is little evidence that shows which form of

    support that is most relevant to families in different situations. Aim: The aim of

    the study was to illuminate relatives experiences of care attitudes made by health

    personnel associated with palliative care. Method: The study was conducted as a

    literature review and was based on 17 scientific articles. Of these, 15 were

    qualitative and 2 of mixed design. The articles were published between the years

    2006-2016. Results: The results were presented in three main categories. These

    were: treatment through communication and information, treatment through

    trusting relationships and factors influencing relative’s management of their life

    situation. Conclusion: The results highlighted the negative and positive

    experiences of healthcare personnel’s attitude towards relatives. Areas that were

    revealed and that had bearing on whether relatives felt the response as good or

    poor were communication, the need to be informed and supported, establishing a

    trusting relationship and nursing staff characteristics. The result further revealed

    that good and inadequate treatment led to consequences in the form of suffering or

    alleviated suffering for the relatives.

  • 58.
    Andersson, Matilda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Waern, Sara
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Distriktssköterskans erfarenhet av att motivera patienter med diabetes mellitus typ 2 till livsstilsförändringar: Kvalitativ intervjustudie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Diabetes mellitus type 2 is a disease that is increasing in the population worldwide. The disease can cause severe complications that affect patient health. An important part is to change unhealthy habits. Purpose: The aim was to describe the district nurse's experience of how they motivate patients with type 2 diabetes to lifestyle changes. Method: A qualitative approach with semistructured interviews were conducted and five district nurses were interviewed. The material was analyzed according to Graneheim and Lund's content analysis. Results: The study revealed that it was important that the district nurse created a good relationship with the patient to motivate lifestyle changes. Study participants highlighted the importance of support in the patient's environment by involving family and other patients. It also emerged that the participants motivated by being a good teacher and to work with other professionals. Personalized information and different kinds of pedagogical methods were used to increase the patient's motivation. Conclusion: To be able to motivate their patients to lifestyle changes the district nurse must provide information individually to their patients which can be done through various teaching methods. It´s also important to create a good relationship with their patients by establish trust.

  • 59.
    Andersson, Nadezda
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Övergång från att vara vårdgivare i demensvård till att bli nära anhörig till person med demens: En kvalitativ studie2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte med studien var att undersöka hur sjukvårdpersonal inom demensvård upplever ”transition” från att vara en vårdgivare inom demensvård till en ny roll: att vårda en anhörig med demens. Metod. Empirisk studie med kvalitativ deskriptiv ansats användes. En teori om ”transition” användes som teoretisk referensram för studien. Resultatet visade att sjukvårdpersonal kunde upptäcka tydliga tecken på demens hos sina nära anhöriga i tidigt skede. Professionella kunskaper upplevdes både som stor hjälp och som en börda. Det var svårt att vara nära anhörig till en person med demens på grund av personliga relationer till den nära anhöriga och på grund av egna professionella kunskaper. Oro, trötthet och dåligt samvete var de känslor som övervägande upplevdes av studiens respondenter gentemot sina nära anhöriga. Andra familjemedlemmarnas beteende upplevdes av studiens respondenter både som stödjande och som problematiska i vissa situationer. Alla attribut tillhörande ”transitionsprocessen” blev identifierade. Slutsats. Sjukvårdspersonalens medvetenhet om förändringar i deras nära anhörigas tillstånd innebär att nära anhöriga snabbare kan får diagnos, behandling och all nödvändig hjälp. Anhöriga med professionell bakgrund är en stor resurs i demensvården. Den höga engagemangnivån kan vara mycket påfrestande och bidra till utmattning hos anhöriga med professionell backgrund. Det är svårare för sjukvårdspersonalen att acceptera förändringar hos sina nära anhöriga på grund av egna professionella kunskaper. Därför risken att drabbas av fysisk och psykisk ohälsa är högre för anhöriga med professionell bakgrund än för anhöriga utan erfarenhet från vården. Det är viktigt att anhöriga med professionell bakgrund får stöd båda från egna arbetsgivare, andra familjemedlemmar och från kommunen. Ett adekvat stöd kan hjälpa dem att inse att efter alla förändringar och instabilitet kommer en period av stabilitet. Kritiska punkter och händelser kan hjälpa att skapa en struktur i en transition och ge en känsla av kontroll över situationen.

  • 60.
    Andersson, Olga
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strand, Marianne
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelser av vilka faktorer som har betydelse i vården på specialistsjuksköterskeledda hjärtsviktsmottagningar.: En kvalitativ studie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Heart failure is a common and serious condition with high mortality rate, morbidity and impaired quality of life. It is estimated that about a quarter of a million Swedish people have chronic heart failure. The creation of a specialist nurse-led heart failure clinic with medical assistance has improved the treatment of patients with heart failure.

    Aim: The aim of this study was to examine patients’ perceptions of the factors that are important in the care on specialist nurse-led heart failure clinics.

    Method: Interviews with semi- structured questions were used. A qualitative manifest content analysis was used to analyze the material found during the interviews. The informants were selected through a strategic selection.

    Results: The result showed that a functional relationship between patient and specially trained nurses at the heart failure clinic, and sufficient information to manage their own care, was of the most importance to the patients. A good healthcare relationship are described by the patients as containing continuity, trust to the nurse, friendly treatment, cooperation’s with healthcare staff and availability as needed.

    Conclusion: The care of a specialist nurse-led heart failure clinics are important for patient safety. It seems important to know whom heart failure patients should contact if necessary help and support to deal with their situation. To have the ability to contact a nurse when needed was very meaningful. The informants found the information on how to handling their own care as important and as a support in their daily life.

  • 61.
    Andersson, Sofia
    Dalarna University, School of Health and Social Studies, Sport and Health Science.
    Möjligheter till motivation för fysisk aktivitet: En interventionsstudie avsedd att motivera elever till fysisk aktivitet genom självbestämmande2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med studien var att under en femveckorsperiod undersöka möjligheterna till att förändra elevers motivation till fysisk aktivitet. Utifrån detta syfte formulerades följande frågeställning:

    • Vad sker med elevers motivation till fysisk aktivitet om den praktiska undervisningen utformas efter self-determination theory?

    För att utforma den praktiska undervisningen efter self-determination theory valdes Engstöms praktiker som en grund och stöttepelare i planeringen och genomförandet av lektionerna. Vilket gav en underliggande frågeställning till den ovanstående:

    - Vilka praktiker finns representerade i underökningsgruppen?

    Studien har genomförts på en högstadieskola i mellersta Sverige, där två klasser i årskurs (åk) 8 valdes ut att delta i studien. I undersökningsgruppen blev urvalet 14 elever och i kontrollgruppen 9 elever. Undersökningsgruppen genomförde en praktikenkät innan interventionen, vilken låg till grund i planeringen och genomförandet av lektionerna. De två klasserna genomförde en motivationsenkät före och efter interventionen för att mäta motivationsnivån. Resultatet av interventionsstudien visar att det skedde en viss förändring i de olika motivationsnivåerna. Det fanns dock ingen statistisk signifikant skillnad mellan test ett och test två på någon av motivationsnivåerna, varken hos undersökningsgrupp eller hos kontrollgrupp.

  • 62.
    Andersson, Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Vestin, Jenny
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Fysisk aktivitets effekt på depressiva symtom2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    To this day there’s approximately 350 million people in the world who are suffering from depression. The World Health Organization predicts that depression will be the number one public health problem in the world by the year 2030. Depressive symptoms form the basis of depression. To get the diagnoses depression the symptoms must have been ongoing for more than two weeks. Psychotherapy and antidepressants is the treatment as standard for depression to this day. As early as the year 1905, the idea was raised whether physical activity had an impact on depressive symptoms. Dorothea Orem’s nursing theory is about self-care and only when the person is motivated enough to perform physical activity the self-care can be possible.

    Aim:

    To compile scientific studies regarding physical activity and its impact on depressive symptoms in adults and the elderly.

    Method:

    A literature review which is based on 15 quantitative articles, one qualitative and one mixed method which all used different scales to estimate the degree of depressive symptoms. The article searches have been made in the databases CINAHL, PsycINFO and PubMed.

    Results:

    The results in the quantitative studies showed that physical activity has an impact on depressive symptoms which reflects their decreases according to the scales used for estimation. The studies also showed that intensity, frequency and type of physical activity have an effect on the impact on the depressive symptoms and an individual adjustment is required. The qualitative study showed that the participants felt satisfied after the exercise, that they gained self-confidence and a better self-esteem.

    Conclusion:

    According to the research, physical activity has an impact on depressive symptoms, which means that the depression alleviates or that the person even recovers from the depression which is shown when the score on the used scale doesn’t meet the criteria for the diagnosis depression.

  • 63.
    Andersson, Susanne
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Barn och ungdomars copingstrategier när en förälder har cancer: En litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet var att redogöra för vilka copingstrategier barn och ungdomar kan

    använda för att hantera en förälders cancersjukdom. Metod: Examensarbetet

    genomfördes som en litteraturstudie. Vetenskapliga artiklar söktes i Högskolan

    Dalarnas biblioteksdatabaser PubMed och CINAHL. Elva vetenskapliga artiklar med

    kvalitativ ansats, tre med kvantitativ ansats samt en vetenskaplig artikel med mixad

    metod låg till grund för resultatet. Resultat: Analysen av artiklarnas resultatdelar

    visade att barn och ungdomar hade behov av att få fortlöpande information gällande

    förälderns situation. Barn och ungdomars olika sätt att hantera känslor samt behov av

    socialt stöd från den egna familjen och omgivningen påvisades. Stöd efterlystes från

    hälso- och sjukvården men upplevdes bristfälligt. Vidare försökte informanterna att

    skapa en mening i tillvaron genom att normalisera vardagen, existentiella och andliga

    funderingar samt att prioritera familjen mer än tidigare. Slutsats: Barn och

    ungdomar behöver få information och känna delaktighet för att kunna förstå och

    hantera situationen när en förälder drabbats av cancer. Att leva med en förälder med

    cancer väcker många känslor vilket medför att barn och ungdomar behöver stöd.

    Hälso- och sjukvårdspersonal bör sträva efter att skapa en vårdrelation, inte bara med

    patienten utan även med de närstående, inklusive barn och ungdomar i familjen. En

    fungerande vårdrelation möjliggör för sjukvårdspersonal att stötta hela familjen i den

    svåra situationen.

  • 64.
    Andersson, Therese
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Ollas, Maja
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Barnmorskors erfarenheter och strategier i mötet med nyanlända kvinnor på förlossningsavdelning, med fokus på interaktion, tillit och sammanhang: En kvalitativ intervjustudie2018Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Supporting the woman and her partner is a major part of the midwifery role during delivery. As the number of newly arrived women increases in Sweden, with varied backgrounds and languages, the demands on midwives’ skills increase. Both migration and childbirth can be described as transitions, which can lead to positive development but also to increased challenges. Migration can be a stressful life process for newly arrived woman and the situation of childbirth can contribute to further vulnerability and uncertainty. The midwife has to understand the needs of newly arrived women in order to support and contribute to a positive experience.

    Aim:

    The aim of this study is to describe midwives' experiences and strategies in the meeting with newly arrived women at childbirth, focusing on interaction, trust and context.

    Method

    : Semi-structured interviews with eight midwives analyzed with qualitative content analysis with deductive approach.

    Results:

    The results of the study provided information on strategies that the midwives use to create interaction, trust and context, as well as their experiences. Common to all midwives was that they experienced that good communication with the patient was very important for creating interaction. Ahead of the meeting with a newly arrived woman, the midwives made sure of that they were well prepared. Strategies used to create trust were to show consideration, be present and take time to listen to the woman. By listening to the woman's wishes, providing information and trying to make the woman feel active and making active choices during her childbirth, midwife creates a context for the woman.

    Conclusion:

    The study has shown that midwives have conscious strategies for meetings with immigrated women. There is, however, a need for clearer routines

    regarding the work of immigrated women in the delivery room, increased cultural skills of midwives and more resources to allow more time for these women.

    Clinical application:

    This study, through the strategies of midwives, can guide other midwives to support newly arrived women during childbirth. The study provides suggestions for areas of improvement and aids to improve the meeting and hence the quality of care for these women.

  • 65.
    Anderstedt, Chatrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Icke farmakologiska omvårdnadsåtgärder för att lindraagitation hos personer med demens –2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet var att beskriva vilka icke farmakologiska omvårdnadsåtgärder en sjuksköterska kan användaför att lindra agitation hos äldre personer med demens. Metod Designen som har använts, är enlitteraturöversikt. Artiklar söktes via Cinahl och PubMed, med sökorden dementia, nonpharmacological,nursing och agitation. Sammanställning av sökord, antal träffar, urval,inklusionskriterier och exklusionskriterier återgavs genom text och tabeller. Till resultatsdelenvaldes 11 artiklar ut efter att granskats med granskningsmallar för kvalitetsbedömning. Bådekvantitativa och kvalitativa artiklar valdes ut i resultatet.Resultatet visade att de icke farmakologiska omvårdnadsåtgärderna, har en positiv verkan påpersoner med demens agitation. Litteraturöversiktns slutsats är att speciellt musik och beröringfungerar bra som icke farmakologisk omvårdnadsåtgärd. Den positiva effekten är dock kortvarig.Slutsats Det behövs lite nytänkande kring de icke farmakologiska omvårdnadsåtgärderna.Metoderna är bra. Det som behövs, är att komma på hur man får en långvarig effekt av dessa.

  • 66.
    Andresen,, My
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Oljans, Maja
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Venösa bensår, en litteraturstudie om att främjaegenvård2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Venous leg ulcer is the most common and accounts for about 70%

    of all leg ulcers. Today, approximately 50.000 people in Sweden have venous leg

    ulcers. The incidence increases with increasing age, predominantly over 65 years

    and is more common among women than men. After the occurrence of an ulcer it

    follows by a slow treatment until the wound is healed and requires good compliance

    from both the healthcare and the patient. Self-care usually does not end after the

    wound has healed but can last out a lifetime to prevent recurrence.

    Aim:

    Enlighten the factors that promote self-care in patients with venous leg ulcers.

    Method:

    A literature review based on 17 scientific articles with both quantitative

    and qualitative approach found in the databases CINAHL and PubMed. The result

    was analyzed with inspiration from Friberg (2012).

    Result:

    Several factors that can promote self-care in patients with venous leg ulcers

    have been found in the articles. In order for self-care to be promoted, patients must

    receive information and instruction on the cause and treatment. The relationship

    with the nurse should consist of trust and confidence. Patients wanted the

    recommendations to be clearly stated and ordained instead of obtaining a general

    recommendation. In order to integrate self-care as part of everyday life, it was

    beneficial with routines, aids and assistance. Setting goals and motivating as well as

    giving continuous follow-up were other significant factors for promoting self-care.

    Conclusion:

    Important factors for promoting self-care were a good relationship

    between nurse and patient. That the nurse should strengthen the patient's ability to

    perform self-care on her own and to regularly follow up and support the patient

  • 67. Angsmo, Ewa
    et al.
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Midböe, Lars
    Nilsson, Gunilla
    Fogelberg-Dahm, Marie
    Ehnfors, Margareta
    Björvell, Catrin
    Wärn-Hede, Gunnel
    Östlinder, Gerthrud
    Nursing informatics in Sweden: the agenda for the future2009In: Connecting Health and Humans - Proceedings of NI2009, Helsinki, 2009, Vol. 146, p. 866-867Conference paper (Other academic)
    Abstract [en]

    With the purpose of getting an overview of the current research and development in information systems and terminology for nursing practice and outline strategies for the future, an initiative for a workshop was taken at the national level in Sweden by the Section for Nursing Informatics, the Society of Nursing and the Association of Health Professionals in 2007. For the workshop around 30 nurses were invited, representing clinical practice, education, and research. The workshop resulted in recommendations for future strategies to support the development of nursing informatics in Sweden.

  • 68.
    Anna, Klerby
    et al.
    Dalarna University, School of Technology and Business Studies, Economics.
    Osika, Ingrid
    Intersektionalitet och psykosomatik: Sociala positioners roll i relation till psykisk ohälsa2013In: Psykosomatik i teori och praktik / [ed] Walter Osika, Lund: Studentlitteratur AB, 2013, 1, p. 59-80Chapter in book (Other academic)
    Abstract [sv]

    Det här kapitlet handlar om hur kön och andra sociala kategorier som t.ex. klass, ålder, etnicitet, religiös tillhörighet och sexualitet, påverkar processerna som skapar psykosomatiska problem, liksom för vägen till tillfrisknande. De nu mest tongivande teorierna beskrivs, liksom de specifika utmaningar forskare inom detta område möter, samt framtida forsknings- och utvecklingsområden. Exempelvis saknas konsensus för hur psykosomatiska tillstånd ska dokumenteras och klassificeras vilket medför svårigheter i att beräkna förekomsten av tillstånden, och därmed även att exempelvis göra hälsoekonomiska analyser. Vi som skriver detta kapitel är nationalekonomer och hoppas att du som läsare kan se vårt tvärvetenskapliga synsätt som en möjlighet att berika och utveckla medicinsk diagnostik, klinisk tillämpning och forskning.

  • 69.
    Anåker, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Hållbarhet och omvårdnad: en begreppsanalys av hållbarhet i dess relation till ämnet omvårdnad.2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med examensarbetet var att analysera begreppet hållbarhet i dess relation till ämnet omvårdnad. Designen var en begreppsanalys. Som analysmodell har Walker och Avants modell för begreppsanalys använts. Till grund för analysen låg en lexikal analys och en analys av vetenskapliga artiklar. Resultatet av den lexikala analysen visade på stora skillnader mellan svenska och engelska definitioner av begreppet. Analysen av de vetenskapliga artiklarna visade att omvårdnadsforskare använder sig av begreppet hållbarhet inom tre olika områden; ekologi och holism, FN´s definition av hållbar utveckling, samt att möjliggöra en fortsättning under en viss tid. Centrala ord vid definitionen av begreppet hållbarhet inom omvårdnad blev; ekologi, framtid, global, holism, miljö och upprätthålla.

  • 70.
    Anåker, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nurses' perceptions of climate and environmental issues2015Conference paper (Refereed)
  • 71.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Design quality in a healthcare context – time to operationalize the concept2016Conference paper (Refereed)
    Abstract [en]

    We present a review of the concept of design quality in healthcare. The aim of review was to define the concept of design quality in order to be able to operationalize the concept for future research. In recent years, several studies have shown that the design of the physical environment affects the patient's health and wellbeing and how different models of care can be implemented, for example, person-centered care. Design quality in architecture has long been the subject for theoretical discussion. From the Roman architect Vitruvius to contemporary design quality following tangible and intangible properties such as utility, durability and beauty. In dictionaries, the general design quality is described as a standard for something when it is compared to other things; how good or bad something is to be of good / bad / the highest quality. Design quality can be described as a measure of a high standard, a plan or an intention of design in the way that it will work and look like. However, until recently, the meaning of design quality in healthcare has been vague and merely described as a subjective experience of the environment. In order to be useful the concept need to be connected to quality indicators of healthcare. In this presentation, we discuss the concept of design quality and its relation to evidence-based design i.e. design decisions based on the best available results from credible research and evaluation of completed building projects.

  • 72.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sustainability – a question for the leadership?2014Conference paper (Refereed)
    Abstract [en]

    Background The overall issue for the health sector during the coming century will be the climate change and its implication for human health. We argue that awareness of nurse’s experience and knowledge in climate and environmental issues is a crucial question for the health sector and their leadership in the process with a sustainable development.

    Aim The aim of this study was to explore nurse’s experience and knowledge of climate and environmental issues in relation to a health perspective and how nurses can contribute to the process of sustainable development.

    Method/design The study was conducted as an interview study with qualitative approach. Eight individual and two focus groups with registered nurses who represented hospitals, primary care and emergency medical services participated in the study and were analyzed with content analysis.

    Result One of the results that appeared in the study showed that there is a sense of responsibility to work on climate and environmental issues, but this is overshadowed by care task in daily work at the clinic.

    Conclusion The leadership has an enormously important role to integrate climate and environmental change issues in their daily work. The leadership needs to avoid that the question of sustainability becomes an imposition to be made after all other work. This study has shown the importance of knowledge concerning climate and environmental issues in the health sector and the importance of knowledge about a sustainable development within leadership.

  • 73.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sustainability in nursing: a concept analysis2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 2, p. 381-389Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to describe, explore and explain the concept of sustainability in nursing.

    Background. Although researchers in nursing and medicine have emphasised the issue of sustainability and health, the concept of sustainability in nursing is undefined and poorly researched. A need exists for theoretical and empirical studies of sustainability in nursing.

    Design. Concept analysis as developed by Walker and Avant.

    Method. Data were derived from dictionaries, international healthcare organisations and literature searches in the CINAHL and MEDLINE databases. Inclusive years for the search ranged from 1990 to 2012. A total of fourteen articles were found that referred to sustainability in nursing.

    Results. Sustainability in nursing involves six defining attributes: ecology, environment, future, globalism, holism and maintenance. Antecedents of sustainability require climate change, environmental impact and awareness, confidence in the future, responsibility and a willingness to change. Consequences of sustainability in nursing include education in the areas of ecology, environment and sustainable development as well as sustainability as a part of nursing academic programs and in the description of the academic subject of nursing. Sustainability should also be part of national and international healthcare organisations. The concept was clarified herein by giving it a definition.

    Conclusion. Sustainability in nursing was explored and found to contribute to sustainable development, with the ultimate goal of maintaining an environment that does not harm current and future generations' opportunities for good health. This concept analysis provides recommendations for the healthcare sector to incorporate sustainability and provides recommendations for future research.

  • 74.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Heylighen, Ann
    KU Leuven, Belgium.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Design quality in the context of healthcare environments: a scoping review2017In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 10, no 4, p. 136-150Article in journal (Refereed)
    Abstract [en]

    Objective:

    We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare.

    Background:

    High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects.

    Method:

    The basic principles of Arksey and O’Malley’s model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context.

    Results:

    Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition.

    Conclusions:

    Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.

  • 75.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nilsson, Maria
    Umeå universitet.
    Holmner, Åsa
    Umeå universitet.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nurses’ perceptions of climate and environmental issues: a qualitative study2015In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 71, no 8, p. 1883-1891Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to explore nurses' perceptions of climate and environmental issues and examine how nurses perceive their role in contributing to the process of sustainable development. 

    Background: Climate change and its implications for human health represent an increasingly important issue for the healthcare sector. According to the International Council of Nurses Code of Ethics, nurses have a responsibility to be involved and support climate change mitigation and adaptation to protect human health. 

    Design: This is a descriptive, explorative qualitative study. 

    Methods: Nurses (n=18) were recruited from hospitals, primary care and emergency medical services; eight participated in semi-structured, in-depth individual interviews and 10 participated in two focus groups. Data were collected from April-October 2013 in Sweden; interviews were transcribed verbatim and analysed using content analysis. 

    Results: Two main themes were identified from the interviews: (i) an incongruence between climate and environmental issues and nurses' daily work; and (ii) public health work is regarded as a health co-benefit of climate change mitigation. While being green is not the primary task in a lifesaving, hectic and economically challenging context, nurses' perceived their profession as entailing responsibility, opportunities and a sense of individual commitment to influence the environment in a positive direction. 

    Conclusions: This study argues there is a need for increased awareness of issues and methods that are crucial for the healthcare sector to respond to climate change. Efforts to develop interventions should explore how nurses should be able to contribute to the healthcare sector's preparedness for and contributions to sustainable development.

  • 76.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Inst, Solna, Sweden..
    von Koch, L.
    Karolinska Inst, Solna, Sweden..
    Eriksson, G.
    Karolinska Inst, Solna, Sweden..
    Sjostrand, C.
    Karolinska Inst, Solna, Sweden..
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Multi-professional teamwork in stroke units - time to understand the impact of the built environment on the work of staff2018In: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 13, p. 59-59Article in journal (Other academic)
  • 77.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    von Koch, Lena
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Designing Inclusive Architecture: Facilitators and Barriers of the Healthcare Environment for Rehabilitation at Stroke Units2016In: Designing Around People: CWUAAT 2016 / [ed] Pat Langdon, Jonathan Lazar, Ann Heylighen, Hua Dong, Springer London, 2016, p. 229-230Chapter in book (Refereed)
  • 78.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    von Koch, Lena
    Karolinska Institutet.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    “Det är ensamt”– patienternas upplevelse av den fysiska miljön på en nybyggd strokeenhet2018Conference paper (Refereed)
  • 79.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    von Koch, Lena
    Karolinska institutet.
    Heylighen, Ann
    Katholieke Universiteit Leuven, Leuven, Belgium.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet; Chalmers.
    "It's lonely": Patients' experiences of the physical environment at a newly built stroke unit2018In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    The aim of this study was to explore patients' experiences of the physical environment at a newly built stroke unit.

    BACKGROUND:

    For a person who survives a stroke, life can change dramatically. The physical environment is essential for patients' health and well-being. To reduce infections, a majority of new healthcare facilities mainly have a single-room design. However, in the context of stroke care, knowledge of how patients experience the physical environment, particularly their experience of a single-room design, is scarce.

    METHOD:

    This study used a qualitative design. Patients ( n = 16) participated in semistructured individual interviews. Data were collected in December 2015 and February 2017 in Sweden; interviews were transcribed verbatim and analyzed using content analysis.

    RESULTS:

    Two main themes were identified: (i) incongruence exists between community and privacy and (ii) connectedness with the outside world provides distraction and a sense of normality. In single rooms, social support was absent and a sense of loneliness was expressed. Patients were positively distracted when they looked at nature or activities that went on outside their windows.

    CONCLUSIONS:

    The physical environment is significant for patients with stroke. This study highlights potential areas for architectural improvements in stroke units, primarily around designing communal areas with meeting places and providing opportunities to participate in the world outside the unit. A future challenge is to design stroke units that support both community and privacy. Exploring patients' experiences could be a starting point when designing new healthcare environments and inform evidence-based design.

  • 80.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    von Koch, Lena
    Sjöstrand, Christina
    Bernhardt, Julie
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet; Chalmers University of Technology.
    A comparative study of patients’ activities and interactions in a stroke unit before and after reconstruction – the significance of the built environment2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 7, article id e0177477Article in journal (Refereed)
    Abstract [en]

    Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients’ activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients’ lounge was located in a far corner of the unit with a smaller entrance than the patients’ lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients’ activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines.

  • 81.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    von Koch, Lena
    Sjöstrand, Christina
    Heylighen, Ann
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet; Chalmers.
    The physical environment and patients' activities and care. A comparative case study at three newly built stroke units2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74Article in journal (Refereed)
    Abstract [en]

    AIM: To explore and compare the impact of the physical environment on patients' activities and care at three newly built stroke units.

    BACKGROUND: Receiving care in a stroke unit instead of in a general ward reduces the odds of death, dependency and institutionalized care. In stroke units, the design of the physical environment should support evidence-based care. Studies on patients' activities in relation to the design of the physical environment of stroke units are scarce.

    DESIGN: This work is a comparative descriptive case study.

    METHOD: Patients (N=55) who had a confirmed diagnosis of stroke were recruited from three newly built stroke units in Sweden. The units were examined by non-participant observation using two types of data collection: behavioral mapping analyzed with descriptive statistics and field note taking analyzed with deductive content analysis. Data were collected from April 2013 - December 2015.

    RESULTS: The units differed in the patients' levels of physical activity, the proportion of the day that patients spent with health professionals and family presence. Patients were more physically active in a unit with a combination of single and multi-bed room designs than in a unit with an entirely single room design. Stroke units that were easy to navigate and offered variations in the physical environment had an impact on patients' activities and care.

    CONCLUSIONS: Patients' activity levels and interactions appeared to vary with the design of the physical environments of stroke units. Stroke guidelines focused on health status assessments, avoidance of bed-rest and early rehabilitation require a supportive physical environment. 

  • 82.
    AQiff, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans erfarenheter av akut konfusion hos äldre i akutsjukvård – En kvalitativ intervju studie2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title:

    Nurses experience of acute confusion in elderly patients in acute emergency care- A qualitative interview study.

    Background:

    The elderly cared for in emergency care have an incidence between 11–51% to develop acute confusion during the care period. The condition is related to increased morbidity and mortality among the elderly. Multifactorial causes lie behind the elderly being affected. Acute confusion is a clinical diagnosis, at present there are not biomarkers or examinations that can identify the condition. Acute confusion requires early awareness, swift investigation, medical care and well adapted health care environment in order for the patient to recover.

    Purpose:

    To describe nurses experiences in detecting, preventing and caring for patients suffering from acute confusion in emergency care.

    Design:

    A qualitative interview with five nurses working within geriatric emergency care at two hospitals in the south of Sweden.

    Result:

    Three categories emerged in the result; strategies to identify and assess signs of acute confusion, strategies and hinders for preventative measures and good nursing upon acute confusion, and improvement proposals for the care of elderly suffering from acute confusion. Nurses used observation, communication, and gathering of information from medical records and relatives in order to identify acute confusion. A comprehensive view in care, continuity in contacts, adaption of health care environment and relatives engagement were important factors to prevent acute confusion and provide good nursing. Hindering factors were a result of shortcomings in the health care environment, insufficient resources and time, and lack of knowledge among other requisite staff regarding appropriate reception and approach.

    Conclusion:

    An evidence-based screening instrument which identifies various states of confusion would render assessment and documentation easier for nurses. Personal centered care built upon that such is planned based on a comprehensive view and continuity in contacts, and that relatives are more engaged in care, is advocated by the nurses. Health care environment shall be adapted, be calm and supportive in form. Staff that work with confused patients need more sufficient knowledge regarding appropriate reception and approach to render patient recovery easier.

  • 83.
    Ara Akther, Hasne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Khatoon, Zohra
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Social, economic and professional barriers for midwives to provide quality midwifery care in Bangladesh: A focus group discussion study with midwifery faculty members in Bangladesh2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Midwifery is central in addressing maternal and newborn health. Social, economic and professional barriers prevent midwives from providing quality midwifery care, which in the end can lead to poor maternal and newborn health. The midwifery profession is under development in Bangladesh and midwifery teachers’ perspective on barriers towards quality midwifery care is vital to identify the barriers preventing quality midwifery care in this country.

    Aim:

    To describe midwifery teacher’s perceptions on midwives’ realities in Bangladesh from social, economic and professional perspectives.

    Methods:

    A qualitative deductive design in which three focus group discussions were held with 17 midwifery teachers in total. Data was analyzed with qualitative content analysis.

    Results:

    Social barriers hampering quality midwifery care include lack of female empowerment, gender inequality permeating education, child birth, workplaces and negative attitudes in society towards women. Low income, inadequate housing and unsafe accommodation are among economic barriers. Professionally, little opportunities to participate in policy dialogue, to raise midwives’ voices and contribute to decisions, little public awareness about the midwifery profession, heavy workload, inadequate staffing and workplace environments hamper quality care.

    Conclusion and clinical application:

    Quality maternal health depends on enhanced midwifery workforce. Minimizing the identified barriers may elevate the confidence level of midwives and enable them to provide evidence based up-to-date care freely and independently. Revising economic benefits for midwives and taking initiatives to establish separate midwifery education facilities countrywide is a good start. This thesis provides a platform for further research focusing on improvements in quality of midwifery care after the deployment of newly introduced midwifery cadre service in Bangladesh.

  • 84.
    Ara Begum, Arshe
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Yesmin, Farida
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nursing and midwifery educators’ self-assessed compliance to midwifery educators’ core competences: A questionnaire survey based on international standards prior the development of a mentorship program in Bangladesh2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Building midwifery educators’ capacity has been identified as an important component to ensure quality midwifery education in Bangladesh.

    Objective:

    To describe midwifery educators self-assessed compliance with capabilities’ according to international standards for nursing- and midwifery educators in order to strengthen their capacity in the development of a mentorship program.

    Methods:

    This study was conducted at 25 of the 38 colleges/institutes, with 59 midwifery educators. Data were collected through a structured questionnaire with open and closed response options; both qualitative and quantitative analysis was used for analysis of data.

    Result

    : The midwifery educators’ self-assessed capabilities were scored high regarding midwifery knowledge, orientation to research, the ability to facilitate positive change for effective clinical teaching environment, and in the area of midwifery practice. Mentorship could be used in various ways. It could be used for capacity building of clinical mentors/staffs, for capacity building of nursing and midwifery faculty, for capacity building at policy level in planning, policy making, budgeting and in research initiatives. If challenges with for example electricity, internet and access to computers were met, mentorship programs could be net-based and thereby facilitating expertise from all over the world. However, face-to-face meetings were also important and more blended mode might be more effective. The focus would be to improve clinical practice, skill lab practice, and evidence-based knowledge in the field of midwifery.

    Conclusion:

    Mentorship programs could be net-based if challenges were managed, but face-to-face meetings was also seen as important. The recommendations regarding the content of a mentorship program were that areas to be included could be professionalism, skills lab and evidence based knowledge.

    Clinical applicability and further research:

    All colleges/institutions with clinical sites connected to them in Bangladesh, would benefit from mentorship to faculty and clinical supervisors. Institutional collaboration is suggested to provide peer-mentoring of midwifery faculty and clinical supervisors. As half of all pre-registration midwifery programs are embedded in the practice setting, the necessity of mentorship programs involves both faculty and clinical supervisors became evident. More research in these areas to guidance approaches to build midwifery educator’s capacity is required.

  • 85. Arefalk, Gabriel
    et al.
    Hergens, Maria-Pia
    Ingelsson, Erik
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Michaëlsson, Karl
    Lind, Lars
    Ye, Weimin
    Nyrén, Olof
    Lambe, Mats
    Sundström, Johan
    Smokeless tobacco (snus) and risk of heart failure: results from two Swedish cohorts2010In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 28, no suppl.A, p. E48-E49Article in journal (Refereed)
  • 86. Arefalk, Gabriel
    et al.
    Hergens, Maria-Pia
    Ingelsson, Erik
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Michaëlsson, Karl
    Lind, Lars
    Ye, Weimin
    Nyrén, Olof
    Lambe, Mats
    Sundström, Johan
    Smokeless tobacco (snus) and risk of heart failure: results from two Swedish cohorts2012In: European Journal of Cardiovascular Prevention & Rehabilitation, ISSN 1741-8267, E-ISSN 1741-8275, Vol. 19, no 5, p. 1120-1127Article in journal (Refereed)
    Abstract [en]

    Background: Oral moist snuff (snus) is discussed as a safer alternative to smoking, and its use is increasing. Based on its documented effect on blood pressure, we hypothesized that use of snus increases the risk of heart failure.

    Design: Two independent Swedish prospective cohorts; the Uppsala Longitudinal Study of Adult Men (ULSAM), a community-based sample of 1076 elderly men, and the Construction Workers Cohort (CWC), a sample of 118,425 never-smoking male construction workers. Methods: Cox proportional hazards models were used to investigate possible associations of snus use with risk of a first hospitalization for heart failure.

    Results: In ULSAM, 95 men were hospitalized for heart failure, during a median follow up of 8.9 years. In a model adjusted for established risk factors including past and present smoking exposure, current snus use was associated with a higher risk of heart failure [hazard ratio (HR) 2.08, 95% confidence interval (CI) 1.03-4.22] relative to non-use. Snus use was particularly associated with risk of non-ischaemic heart failure (HR 2.55, 95% CI 1.12-5.82). In CWC, 545 men were hospitalized for heart failure, during a median follow up of 18 years. In multivariable-adjusted models, current snus use was moderately associated with a higher risk of heart failure (HR 1.28, 95% CI 1.00-1.64) and non-ischaemic heart failure (HR 1.28, 95% CI 0.97-1.68) relative to never tobacco use.

    Conclusion: Data from two independent cohorts suggest that use of snus may be associated with a higher risk of heart failure.

  • 87. Areteg, Helena
    et al.
    Johansson, Lisa
    “Nipple shield” A link or a barrier? – Experiences of staff and parents of preterm infants in neonatal units (NICUs)2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Infants born before 37 gestational weeks are defined as being prematurely born.

    Breast milk is considered to be the best nutrition for preterm infants. However, they have an

    immature sucking behavior and the capacity for breastfeeding at the breast will likely be

    affected. The nipple shield has been used, and still is in some contexts, as a device to help the

    immature infant to attach to the breast. Among researchers and health professionals there are

    divergent opinions on the benefits and the negative aspects of using nipple shields.

    Objective: To explore perceptions and experiences of using a nipple shield among parents

    and staff in neonatal units in Sweden and England.

    Design: A qualitative study with an ethnographic approach. Observations and interviews were

    conducted in four neonatal units in Sweden and England. The data were analyzed using a

    thematic analysis and the result was presented in thematic networks.

    Result: Two global themes were identified. One theme with parents’ experiences “A tool?”

    was identified which include organizing themes; “Technical issues”, “Support from staff” and

    “Feeling of something in between”. Technical issues including both how it facilitates and

    technical problems when using it. Parents felt confused when they got different advice and

    mothers experienced an unnatural feeling when using the nipple shield. Experiences from

    staff was summarized in the second global theme; “Contentious tool” with the organizing

    themes; “Positive aspects” and “Negative aspects”. The nipple shield can be used as “a

    shortcut” to breastfeeding and some used it too easily and others not at all.

    Conclusion: This study demonstrates parents’ and staffs’ perceptions of nipple shield both as

    a link to help initiating breastfeeding and as a barrier between the mother and infant.

  • 88.
    Arin, Nassrin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som är väsentliga för sjuksköterskors bedömning av smärta hos patienter med medelsvår till svår demens En litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Syfte

    Detta examensarbete är en litteraturöversikt som syftar till att beskriva vilka faktorer som är

    väsentliga för sjuksköterskors bedömning av smärta hos patienter med medelsvår till svår

    demens

    Metod

    Litteratur hittades via databaserna PubMed och Medline. Sjutton stycken artiklar som

    motsvarade syftet i studien hittades och analyserades. De sjutton artiklarna var publicerade

    mellan 2004 och 2014

    Resultat

    Analysen av de sjutton artiklar som ligger till grund för resultaten av studien visade tre

    kategorier; Känna igen smärta, Instrument för bedömning av smärta samt Kunskap och

    förhållningssätt. I kategorin att Känna igen smärta visar sig att det är en svår, viktig och

    komplicerad uppgift för sjuksköterskan att bedöma smärta hos patienter med demens. Detta

    beror på att de ofta inte kan uttrycka det verbalt, men i stället anger sjuksköterskan annat

    beteende av demens som skulle kunna vara ett tecken på underliggande smärta. Resultaten

    visade också att detta ledde till osäkerhet bland sjuksköterskor. I kategorin Instrument för

    bedömningen av smärta visade det sig att det fanns ett antal bedömningsverktyg som kan

    hjälpa sjuksköterskan i sin bedömning och tolkning av smärta hos patienter med demens. I

    kategorin Kunskap och attityd visade att sjuksköterskor som har utbildningar hade lättare att

    dechiffrera smärta hos patienter med demens och smärta hos patienter med demens kan ofta

    misstolkas som ett tecken på bara oro. Resultatet visar att det är viktigt med fastställda rutiner

    och rätt inställning sjuksköterskan för att kunna göra en bra och rättvis bedömning av smärta

    hos patienter med demens så att de får rätt behandling för smärta.

    Slutsatser

    Studien visar att det är en svår och komplex uppgift för sjuksköterskan att bedöma smärta hos

    patienter med demens. Det är lättare att bedöma smärtan hos en patient som sjuksköterskan

    har en god relation till och känner sedan tidigare. Bedömningsinstrument kan vara ett bra sätt

    och fungera som ett hjälpmedel för sjuksköterskan att tyda och tolka smärtan hos patienter

    med demens. Fortbildning av vårdpersonal i att tyda smärta hos patienter med demens är att

    rekommendera eftersom att litteraturen visade att långvarig erfarenhet leder till större

    skicklighet att upptäcka smärta och kan dessutom vålla desensibilisering. Det råder en stor

    osäkerhet hos vårdpersonal när det kommer till bedömning av smärta hos patienter med

    demens.

  • 89. Arking, Dan E
    et al.
    Pulit, Sara L
    Crotti, Lia
    van der Harst, Pim
    Munroe, Patricia B
    Koopmann, Tamara T
    Sotoodehnia, Nona
    Rossin, Elizabeth J
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Newton-Cheh, Christopher
    Genetic association study of QT interval highlights role for calcium signaling pathways in myocardial repolarization2014In: Nature Genetics, ISSN 1061-4036, E-ISSN 1546-1718, Vol. 46, no 8, p. 826-836Article in journal (Refereed)
    Abstract [en]

    The QT interval, an electrocardiographic measure reflecting myocardial repolarization, is a heritable trait. QT prolongation is a risk factor for ventricular arrhythmias and sudden cardiac death (SCD) and could indicate the presence of the potentially lethal mendelian long-QT syndrome (LQTS). Using a genome-wide association and replication study in up to 100,000 individuals, we identified 35 common variant loci associated with QT interval that collectively explain similar to 8-10% of QT-interval variation and highlight the importance of calcium regulation in myocardial repolarization. Rare variant analysis of 6 new QT interval-associated loci in 298 unrelated probands with LQTS identified coding variants not found in controls but of uncertain causality and therefore requiring validation. Several newly identified loci encode proteins that physically interact with other recognized repolarization proteins. Our integration of common variant association, expression and orthogonal protein-protein interaction screens provides new insights into cardiac electrophysiology and identifies new candidate genes for ventricular arrhythmias, LQTS and SCD.

  • 90.
    Arnesson, Jesper
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Enberg, Anton
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Resultatinriktad idrott – ett problem för längdskidsporten: En studie om avhopp inom längdskidåkning2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The aim of the study is to examine the dropout from cross-country skiing after high school and how elite associations with connection to university, attractive cities and support to elite athletes can prevent it.

    Design

    This study has a qualitative orientation where totally nine persons was interviewed. The study had four different target audiences which where dropouts, coaches from Dala Sports Academy, representatives from Falun and Borlange community and the Swedish ski association. Questions about dropout have been answered by all participants in the study but the questions about elite associations on senior levels were only answered by coaches, representatives of the communities and the Swedish ski association.

    Results

    All participants showed that bad results, interests beside the sport and that the conditions and support gets smaller at senior level was reasons for dropout. The dropouts also showed that lack of motivation was a reason for leaving cross-country skiing. The coaches, communities and the Swedish ski association intended that the enviroment in Falun and Borlange was good for running an elite association on senior level for cross-country skiing. They also provided that the economical part is important for an elite association on senior level.

    Conclusions

    The main reason for dropout in cross-country skiing is when the sport gets to serious and the focus only is on results. This leads to lack of motivation if the athletes don’t get the results they want. Only the best skiers can today participate in elite associations on senior level. To give more athletes an opportunity to train and compete in a high level as a senior the clubs can be more active with sponsorship so the resources expands.

  • 91.
    Aronsson, Andreas
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Riskfaktorer för självmord bland män över 65 år och självmordspreventiva omvårdnadsinsatser2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Självmord är ett folkhälsoproblem bland äldre världen över. I takt med en globalt ökad medellivslängd och en större population äldre individer förväntas antalet självmord bland äldre öka. Män över 65 år genomför cirka 5-6 gånger fler självmord än kvinnor i samma ålder. Syfte: Att kartlägga de orsaker som ligger till grund för att män över 65 år begår självmord, samt beskriva preventiva omvårdnadsinsatser. Metod: Studien genomfördes som en litteraturstudie, sökningar gjordes i Pubmed, Cinahl och Medline. Totalt inkluderades 27 artiklar. Resultat: Riskfaktorer för självmord hos äldre män var depression, förluster, fysisk funktionsnedsättning, misstro mot sjukvården samt att de var beslutsamma och använde våldsamma metoder. Självmordsprevention bör ske med gemensamma insatser i vården och i socialsektorn. Utbildning av vårdpersonal leder till ökat självförtroende, ökad kunskap och mer kompetens att identifiera individer i riskzonen. Utbildning leder även till förändrade attityder och förhållningssätt hos vårdpersonal vilket leder till mindre risk för känsla av förlorad autonomi hos patienten. Slutsats: Utbildning av vårdpersonal är av stor vikt för att förmedla kunskaper och förmågor att bemöta självmordsbenägna individer och för att påverka de attityder som råder i samhället. Ju tidigare insatser som görs för hälsa och välmående desto bättre, vilket indirekt ger självmordsprevention på köpet.

  • 92.
    Aronsson, Jennifer
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Grandin, Simone
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Långvarig smärta efter cancerbehandling - En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Cancer is increasing among the population, which can lead to an increased number of complications as chronic pain, not only from the cancer treatment but from the disease itself. Patients have also been found to feel that their pain problems are not taken seriously by the healthcare professionals. The nurses should work to relieve any suffering which is caused by pain. Suffering is a unique experience that is different for everyone. As suffering may be due to the overall life situation, the nurses need a greater understanding of the situation in order to fulfill their responsibilities. Aim: The aim of this literature review was to compile research on chronic pain after cancer treatment. Method: An integrative literature review with 11 included articles. Result: Two main themes were identified; daily life and quality of life, and six subthemes regarding how the chronic pain influences and impacts the following; physical activities, daily activities, the professional life, drug use, general wellbeing, and sex life. Conclusion: Many patients experienced a negative impact on their daily life in both mental, physical and social dimensions. Patients felt that work, physical activity and daily tasks were limited due to the chronic pain. This varied in all aspects depending on the type of cancer and which treatment the patients received.

  • 93. Arouca, Aline B
    et al.
    Santaliestra-Pasías, Alba M
    Moreno, Luis A
    Marcos, Ascensión
    Widhalm, Kurt
    Molnár, Dénes
    Manios, Yannis
    Gottrand, Frederic
    Forsner, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Umeå universitet.
    Michels, Nathalie
    Diet as a moderator in the association of sedentary behaviors with inflammatory biomarkers among adolescents in the HELENA study2018In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215Article in journal (Refereed)
    Abstract [en]

    AIM: To assess if a healthy diet might attenuate the positive sedentary-inflammation relation, whereas an unhealthy diet may increase the effect of sedentary behaviors on inflammatory biomarkers.

    METHODS: In 618 adolescents (13-17 years) of the European HELENA study, data were available on body composition, a set of inflammation markers, and food intake assessed by a self-administered computerized 24 h dietary recall for 2 days. A 9-point Mediterranean diet score and an antioxidant-rich diet z-score were used as dietary indices and tested as moderators. A set of low-grade inflammatory characteristics was used as outcome: several cytokines in an inflammatory ratio (IL-6, IL-10, TNF-α, TGFβ-1), C-reactive protein, three cell-adhesion molecules (sVCAM-1, sICAM-1, sE-selectin), three cardiovascular risk markers (GGT, ALT, homocysteine) and three immune cell types (white blood cells, lymphocytes, CD3). Sedentary behaviors were self-reported and analyzed as total screen time. Multiple linear regression analyses tested moderation by diet in the sedentary behaviors-inflammation association adjusted for age, sex, country, adiposity (sum of six skinfolds), parental education, and socio-economic status.

    RESULTS: Both diet scores, Mediterranean and antioxidant-rich diet, were significant protective moderators in the effect of sedentary behaviors on alanine-transaminase enzyme (P = 0.014; P = 0.027), and on the pro/anti-inflammatory cytokine ratio (P = 0.001; P = 0.004), but not on other inflammatory parameters.

    CONCLUSION: A higher adherence to the Mediterranean diet or an antioxidant-rich diet may attenuate the onset of oxidative stress signs associated by sedentary behaviors, whereas a poor diet seems to increase inflammation.

  • 94.
    Artikulova, Gulnara
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Martinez Vasquez, Susan
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strategier och hjälpmedel som kan förbättra munhälsan hos äldre personer inom äldreomsorg: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet är att belysa vilka strategier och hjälpmedel som kan förbättra

    munhälsan hos äldre personer inom äldreomsorg. Metod: En

    litteraturöversiktsstudie baserad på befintlig kunskap. Studien innefattade 15

    artiklar med såväl kvalitativ som kvantitativ ansats och söktes i databaserna Cinahl

    och Pubmed. Resultat: Resultatet visade att de strategier som framkom till följd av

    bearbetning av de femton valda vetenskapliga artiklar i denna studie var

    munvårdsutbildning till vårdgivarna, uppföljning av befintliga rutiner samt

    införandet av nya rutiner och anpassad kommunikation. Dessa strategier visade sig

    vara mycket effektiva för förbättrad munhälsa hos vårdtagarna inom äldreomsorg.

    I studien beskrivs även effekter av användning av hjälpmedel som elektrisk

    tandborste och munvårdskort. Konklusion: Resultatet visade att bland annat

    munvårdsutbildning ger ett bättre munvårdsresultat.

  • 95.
    Arvidsson, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ivarsson, Thérèse
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans känslor och upplevelser av att tvångsvårda patienter inom psykiatrisk vård- En litteraturöversikt2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    In psychiatric care, coercion is a reality that can affect the patient's self-determination, which can lead to ethical dilemmas for nurses in different areas of work and in threats and violence. The demands are high on the nurses to be able to create trust and confidence in the patient. And to show empathy and understanding when a conflict arises. Clear guidelines and laws exist to support compulsion and forced measures.

    Aim:

    aim of this literature review is to investigate the nurse's feelings and experiences of compulsive care and to perform forced measures in psychiatric care. Method: The study was conducted as a literature review. The articles were searched within the databases Cinahl, Pubmed and PsycINFO. A total of 15 qualitative scientific articles were selected. Result: The result showed that the nurse's have mixed feelings and experiences of forced measures. Feelings like stress, fear, anxiety and insufficiency. The nurses associate these feelings as insufficient knowledge and experience and threatening and violent situations. Forced measures often contributed to negative feelings as well as ethical dilemmas of the nurse. Conclusion: This literature review shows that nurses experienced insufficient knowledge about the treatment and management of threats and violence, as well as alternative treatment methods for forced measures. The nurse was often faced with ethical dilemmas that may damage the therapeutic relationship.

  • 96.
    Arvidsson, Madelene
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sellström, Sandra
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans stöd till personer med psykiska funktionsnedsättningar i utövandet av fysisk aktivitet och dess hälsoeffekter Litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    It has been researched a lot of physical activity beneficial effects on the human

    body physically. Previously, there has been a natural part of treatment in psychiatry, which

    made the authors curious about how it can be highlighted in the care of people with mental

    disabilities.

    Aim: The purpose of this study was to describe the health benefits of physical activity for

    people with mental disabilities and nurse support through tutoring.

    Methodology: During the compilation of the results revealed that nurses can provide

    support through the Motivational Interviewing (MI) was of central importance. When the

    patient heard and build up their goals to be measurable with trained medical staff, but also

    through support of patient self-education and knowledge of the physical activity's positive

    impact on mental health.

    Conclusion: The nurse's approach to support and motivate people with mental disabilities to

    exercise physical activity was found to be several. Then it was important to the ruled and

    knew the different ways to motivate people with mental disabilities. Other important

    approaches were good care relationship, individualized exercise programs, and support and

    training in the health benefits that physical activity gave.

  • 97.
    Arvidsson, Malin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jansson, Susanne
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Stress hos sjuksköterskor och utövandet av personcentrerad vård: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Working person-centered is an important part of the profession as a nurse, not least because the nurse's ethical rules suggest that, but also because every person is unique, and that care should therefore be adapted to each individual. As part of this degree project, the person-centered care and the work environment in hospitals has been overlooked for how the person centered care is affected by the nurse's experience of stress.

    Aim: The aim is to describe how stress in the nurse's work environment affects the personcentered care of patients in hospitals.

    Methods: The degree project was conducted as a literature review based on 17 scientific articles with publication between 2009 and 2018. The database used was Cinahl.

    Results: The results show that despite a stressful working environment for the nurse, the emotional part does not affect the patient's care. However practical care may cause damage, which in turn can affect patient safety. The result also shows that management has a major responsibility in setting up guidelines for person-centered care, as well as preventing burnout of the nurse and patient safety.

    Conclusion: There is a clear link between the working environment and the psychologist's nurse, despite this, the nurses do not receive the opportunity to participate in decisions made by the management. More studies need to be done about the work environment and the impact on the nurse in terms of stress and burnout. The concept of person-centered care is wide and extensive, therefore, clear guidelines for the practice of person-centered care need to be made in practice to ensure the results of how the work environment affects person-centered care.

  • 98.
    Arwidson, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Pettersson, Rose-Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientens upplevelse av att leva med Multipel Skleros och hur sjuksköterskan kan stödja dessa patienter.: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna litteraturstudie var att belysa patientens upplevelse av att

    leva med Multipel Skleros, samt hur sjuksköterskan kan stödja dessa patienter.

    Metod: Studien genomfördes som en litteraturöversikt och artiklarna söktes i

    databaserna CINAHL och PubMed. Vi hittade 14 artiklar som utgjorde grund för

    resultatet. 6 kvantitativa och 8 kvalitativa artiklar. Resultat: Sjukdomen MS

    upplevdes av patienterna som en förlust av sin friska identitet. En rädsla och oro

    inför framtiden. Trötthet var det som ofta påverkade det dagliga livet. Patienterna

    ville ha mer information om sjukdomen och en bra kommunikation med

    sjuksköterskan. Slutsats: Att leva med MS gav stora förändringar psykiskt och

    fysiskt. Trötthet gav minskad energi att klara vardagen. Patienterna kände skuld,

    nedstämdhet och oro. Informationen och kunskapen från sjuksköterskan var

    bristfällig.

  • 99.
    Askling, Carl
    et al.
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Nilsson, Johnny
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    Thorstensson, Alf
    Gymnastik- och idrottshögskolan, GIH, Laboratoriet för biomekanik och motorisk kontroll (BMC).
    A new hamstring test to complement the common clinical examination before return to sport after injury2010In: Knee Surgery, Sports Traumatology, Arthroscopy, ISSN 0942-2056, E-ISSN 1433-7347, Vol. 18, no 12, p. 1788-1803Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim was to introduce and evaluate the reliability and validity of an active hamstring flexibility test as a complement to common clinical examination when determining safe return to sport after hamstring injury.

    METHODS: Eleven healthy subjects (28 years) were tested on repeated occasions, and 11 athletes (21 years) with MRI-verified acute hamstring strain were tested when common clinical examination revealed no signs of remaining injury, i.e. there was no differences between the legs in palpation pain, manual strength tests, and passive straight leg raise. Flexibility, i.e. highest range of motion of three consecutive trials, was calculated from electrogoniometer data during active ballistic hip flexions and conventional passive slow hip-flexions in a supine position. A VAS-scale (0-100) was used to estimate experience of insecurity during active tests.

    RESULTS: No significant test-retest differences were observed. Intra-class correlation coefficients ranged 0.94-0.99 and coefficients of variation 1.52-4.53%. Active flexibility was greater (23%) than passive flexibility. In the athletes, the injured leg showed smaller (8%) active, but not passive, flexibility than the uninjured leg. Average insecurity estimation was 52 (range 28-98) for the injured and 0 for the uninjured leg, respectively.

    CONCLUSION: The new test showed high reliability and construct validity; furthermore, it seems to be sensitive enough to detect differences both in active flexibility and in insecurity after acute hamstring strains at a point in time when the commonly used clinical examination fails to reveal injury signs. Thus, the test could be a complement to the common clinical examination before the final decision to return to sport is made.

  • 100.
    Assarsson, Hannes
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Skillnader och likheter i fartstrategi hos manliga- och kvinnliga- samt unga- och gamla skidlöpare i Vasaloppet2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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