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  • 51.
    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.

  • 52.
    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.

  • 53.
    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.

  • 54.
    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.

  • 55.
    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.

  • 56.
    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.

  • 57.
    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.

  • 58.
    Andersson, Rikard
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Larsson, Ida
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters erfarenheter av fysisk aktivitet som behandling vid depression: en litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Mental illness is a fast-growing health issue all over the world. Around 350 million people suffers from depression and depression is on the boarder of becoming one of the biggest health care issues in the world. Depression is a complex disease and is treated with behavioral therapy, electroconvulsive therapy and anti-depressive medications. Physical activity is also recommended as an additional treatment for depression and has in studies shown to have positive effects on depression and the reducing of depressive symptoms.

    Aim: The aim of the study is to describe patients experiences of physical activity as a treatment for depression.

    Method: The thesis was conducted as a literature review based on 15 scientific articles. The articles were collected from databases Cinahl, PubMed and PsycINFO and were publicized between 2010-2019.

    Result: The patients experiences of physical activity showed improved mental health, increased self-confidence and self-esteem and a feeling of more energy. Motivating factors to perform physical activity were, among other things, support from relatives and occupational groups in the health care sector. Barriers to perform physical activity were fatigue, lack of motivation, low mood and poor self confidence and self-esteem.

    Conclusion: The results of the literature study showed that experiences of physical activity were predominantly positive among people with depression, with reduced depressive symptoms, increased well-being and health. Physical activity could be applied as a useful and appropriate nursing intervention and treatment method in the care of people with depression where the nurse has an important role in supporting and motivating the patient.

  • 59.
    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.

  • 60.
    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.

  • 61.
    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.

  • 62.
    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.

  • 63.
    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.

  • 64.
    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

  • 65. 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.

  • 66.
    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.

  • 67.
    Anåker, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Fysisk miljö på strokeenheter: betydelse för vården2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [sv]

    Bakgrund: Den fysiska miljön har betydelse för människors hälsa och välbefinnande. Rehabilitering som påbörjas på strokeenheter i ett tidigt skede, kan förbättra återhämtning och minska risken för funktionshinder. Hur den fysiska miljön på en strokeenhet ska vara utformad för att utgöra ett stöd för patientens aktiviteter och vård är i begränsad omfattning studerat. Vidare är kunskapen begränsad gällande hur utformningen av den fysiska miljön kan påverka det multidisciplinära teamets arbete på en strokeenhet.

    Syfte: Det övergripande syftet var att generera kunskap om den fysiska miljön på strokeenheter och den komplexa relationen mellan utformningen av miljön, vården och användarens erfarenhet av den fysiska miljön.

    Metod: Avhandlingen baserades på fyra delstudier. Delstudierna hade en beskrivande och explorativ design. Tre nybyggda strokeenheter studerades, varav en strokeenhet följdes från den ursprungliga, via den temporära till den nybyggda enheten. I delstudie I, II och IV användes strukturerade observationer för att dokumentera patientens aktivitetsnivå, det fysiska rummet för aktiviteten, samt vilken eller vilka personer som var med patienten i rummet. I delstudie I, II och IV användes även icke-strukturerade observationer. De icke-strukturerade observationerna syftade till att utforska stöd och hinder i den fysiska miljön för patienter och det multidisciplinära teamet. För delstudie III användes en kvalitativ metod som med hjälp av intervjuer syftade till att studera patienternas erfarenheter av den fysiska miljön.

    Resultat: Delstudie I visade att på den nybyggda strokeenheten tillbringade patienterna mer tid på sina rum, hade lägre aktivitetsnivå och hade färre interaktioner med personal och anhöriga, än på den gamla strokeenheten. Förändringar av den fysiska miljön kan ha påverkat patienternas aktiviteter och interaktioner. Delstudie II visade att strokeenheterna skilde sig åt gällande patienternas aktivitetsnivå och proportion av dagen som patienterna var ensamma på sina rum. Patienterna hade högre aktivitetsnivå på en strokeenhet med en kombination av enkelrum och flerbäddsrum jämfört med en strokeenhet med uteslutande enkelrum. En flexibel, lättorienterad och omväxlande miljö utgjorde ett stöd för vård och aktiviteter. I delstudie III framkom två teman: (i) inkongruens mellan gemenskap och avskildhet och (ii) förbindelse med världen utanför ger distraktion och en känsla av normaltillstånd. I enkelrummen upplevde patienterna ensamhet och en frånvaro av social gemenskap. Patienterna blev positivt distraherade när de tittade på natur eller på aktiviteter som fortgick utanför deras fönster. Delstudie IV visade att det multidisciplinära teamet inte arbetade tillsammans i mötet med patienten. Vidare framkom i resultatet olika stöd och hinder i den fysisk miljö som påverkade teamets aktiviteter, exempelvis hinder i form av en fysiskt uppdelad miljö för teamet.

    Konklusion: Denna avhandling har bidragit till att öka förståelsen och kunskapen om den fysiska miljön på strokeenheter. Att använda ett evidensbaserat kunskapsunderlag när det gäller planering och design av nya strokeenheter är centralt. Den fysiska miljön kan vara ett stöd både för den person som insjuknat i en stroke och för det multidisciplinära teamet. Den fysiska miljön bör utformas för att minska inaktiviteten och upplevelsen av ensamhet, samt bidra till att det multidisciplinära teamet har lämpliga lokaler där teamet kan arbeta tillsammans.

  • 68.
    Anåker, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nurses' perceptions of climate and environmental issues2015Conference paper (Refereed)
  • 69.
    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.

  • 70.
    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.

  • 71.
    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.

  • 72.
    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.

  • 73.
    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)
  • 74.
    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)
  • 75.
    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 unit2019In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, no 3, p. 141-152Article 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.

  • 76.
    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.

  • 77.
    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. 

  • 78.
    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.

  • 79.
    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.

  • 80.
    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.

  • 81.
    Arebratt, Christian
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hashi, Amina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelser av språkbarriärer inom somatisk vård: en litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In 2018, more than 130 000 people migrated to Sweden. The big migration has affected the amount of languages spoken in Sweden. The literature describes that in Sweden, more than 150 languages are spoken. Furthermore, language is described as a fundament for individuals to express their experiences and feelings as well as an obstacle in communication between different parties. A big part of health care is constituted by communication, and 70 percent of all healthcare injuries are because of communication deficiencies. The nurse is obligated by law to provide information, which is adapted to the patient’s spoken language, and should work accordingly to person-centered care, in which the patient’s presuppositions and desires are considered.

    Aim: To describe the nurse’s experiences of language barriers in situations with patients in somatic care.

    Method: A literature review with a qualitative design, based on 14 scientific articles found in the two databases CINAHL and PubMed.

    Results: Three main categories were identified in the result. These main categories were the experience of time impact and workload, the experience of difficulties in providing good quality care and safe care, and the experience of challenges and competence development.

    Conclusion: Nurses’ experienced language barriers to complicate the provision of person-centered, excellent and safe care because language barriers caused difficulties to take part in the patient story, build a partnership, and to document. Positive experiences, such as individual competence development among the nurses are also described in the result.

  • 82.
    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.

  • 83. Arkkukangas, Marina
    et al.
    Cederbom, Sara
    Tonkonogi, Michail
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Umb Carlsson, Õie
    Older adults’ experiences with mHealth for fall prevention exercise: usability and promotion of behavior change strategies2020In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Background: With the rapidly growing aging population, older adults need to stay healthy and active for a longer time. Mobile health (mHealth) solutions could help support, prevent, or delay functional decline and falls in old age.Purpose: The aim was to explore older persons? experiences of a mobile application for fall prevention exercise, and to identify what possible behavior change techniques to include in the further development of the application.Methods: Two focus groups were conducted with 12 older adults (seven women and five men) 70 to 83 years of age. A qualitative content analysis was performed.Results: Two main results emerged: 1) external facilitators for using the application; and 2) internal facilitators for using the application and perceived gains, in addition 10 behavior change techniques were identified.Conclusion: With support, an application could be adapted for older adults to manage, motivate, and adhere to fall prevention exercise. To achieve long-term adherence to health behavior changes, behavior change strategies and techniques are recommended to be included in further development of the fallprevention application.

  • 84. Arkkukangas, Marina
    et al.
    Johnson, Susanna Tuvemo
    Hellström, Karin
    Anens, Elisabeth
    Tonkonogi, Michail
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Larsson, Ulf
    Fall prevention exercises with or without behavior change support for community-dwelling older adults: a two-year follow-up of a randomized controlled trial2019In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, p. 1-26Article in journal (Refereed)
    Abstract [en]

    This study investigates the effectiveness of two fall prevention exercise interventions targeting physical performance, activity level, fall-related self-efficacy, health-related quality of life, and falls: the Otago Exercise Programme (OEP) with and the OEP without behavior change support. In this randomized controlled trial (RCT), 175 participants were randomised into two intervention groups and one control group. A total of 124 community-dwelling older adults over the age of 75 who needed walking aids or home support participated in the two-year follow-up. The OEP with and the OEP without support for behavior change displayed no long-term benefits on physical performance, fall-related self-efficacy, health-related quality of life, and falls compared to a control group. Although no significant differences were detected between the groups, the results implied the control group's physical activity level decreased compared to the intervention groups at two-year follow up.

  • 85.
    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.

  • 86.
    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.

  • 87.
    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.

  • 88. 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 study2019In: European Journal of Nutrition, ISSN 1436-6207, E-ISSN 1436-6215, Vol. 58, no 5, p. 2051-2065Article 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.

  • 89.
    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.

  • 90.
    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.

  • 91.
    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.

  • 92.
    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.

  • 93.
    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.

  • 94.
    Asp, Caroline
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Annica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientens upplevda smärta i samband med en höftfraktur: En litteraturstudie2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden, approximately 18,000 people suffer from hip fractures each year. Suffering from a hip fracture is often a painful experience and great suffering for the patient, not only at the time of injury but also during the care taking period as well as during the rehabilitation and in the recovery phase.

    Aim: The purpose was to illustrate the patient's experience of pain in association with hip fracture.

    Method: This study was conducted as a literature review where the databases CINAHL, PubMed and PsycINFO were used in the article searches. The searches resulted in 16 articles, 11 qualitative and five with mixed method studies.

    Results: Patients had different ways of describing and putting words on experienced pain. The pain affected their thoughts and sleep and was evident in connection with displacement/ movement. It was found that patients expected to have pain after the hip operation. They tried to find a balance between pain and painkillers, as side effects negatively affected many patients. The patients had a positive experience despite the pain through the professional approach of the healthcare staff, as well as encouragement of participation and communication during the care period. During the rehabilitation phase, the patients experienced pain and that the rehabilitation took longer than expected. There was also the fear of going home, as they felt uncertain how they would handle the pain at home and in everyday life.

    Conclusion: Various factors affected patients' experience of pain in association with a hip fracture. It was shown that good communication created good conditions for the patient to manage the pain. The pain experience also decreased when the nurse created a good care environment when the patient's own experience of ill-health and illness was confirmed, but also when the nurse acted professionally or allowed the patient to participate in their own care.

  • 95.
    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
  • 96.
    Astrakos, Alexander
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Kadergran, Robin
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Articles from Google rarely contains high qualityinformation about rapid weight loss for martial artsperformers: Critical review of articles on rapid weight-loss in martial artsperformers2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose

    The purpose of the study is to investigate the quality and credibility of the articles collected from Google - describing fast weight loss methods as well as diets for martial arts.

    Method

    The method started with five search phrases related to weight loss pre-competition at martial arts. The five phrases where applied to the Google search engine and for each phrase the first five search results were selected. Search results were analysed with content analysis criteria analysing Credibility, Accuracy, Reasonability and Support. Detailed descriptions of how these quality parameters were assessed can be found below in text

    Result

    The results from the study showed that the articles analysed in this study with content analysis criteria do not have the desired credibility because only 12 % of the articles are based on facts. The results also showed that 35 % of the authors claimed to be experts and 41 % of the websites associated with the articles have a responsible publisher. Furthermore the study showed that the articles have low accuracy because no article is peer reviewed and only 6 % of the authors use scientific structure in their articles. Some of the articles even included contradictions. The study showed that the web pages have a low reasonableness because 53 % of the articles and web pages have a partial message to promote their products and education. The study shows that web sites associated with the articles has more than 76 % support.

    Conclusion

    Martial art athletes should understand that not all of the rapid weight loss information that appears in Google search results is based on science or facts, most of the information is no more than opinions that lack reference. None of the articles in the study were previewed by peers and few articles were written by experts. This means that accuracy and credibility are low according to the study's criteria. In addition, many authors try to sell either their products or training through their articles, but this is not a standard indicator that makes the quality low.

  • 97.
    Atilgan, Josefine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Vikström, Nicole
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar sjuksköterskans hälsofrämjande åtgärder vid överviktsproblematik: Litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Overweight and obesity are a growing issue, from 1980 to 2014 have the global presence of overweight and obesity more than doubled. People with overweight and obesity have an increased risk of developing sequelae such as high blood pressure, type 2 diabetes and cardiovascular disease, even the risk of dying beforehand increases. Aim: The aim was to describe factors that affect the nurses’ health promotion to adult with overweight and obesity in primary and somatic care. Method: The study was conducted as a literature review where data was collected thru the databases CINAHL and Pubmed. The result was based on 14 articles with both quantitative and qualitative approach. Results: The results

    show five categories that affect the nurses health promotion: Lack of time and non-adapted equipment, Knowledge and skills, Attitudes of the nurses, Confidence in the conversation and own ability and The nurses own lifestyle.

    Conclusion: This literature review provides an understanding of what factors that affect the nurses’ work with health promotion towards patients with overweight or obesity. Nurses have good opportunities to work preventively with weight problems and they have a significant role in how patients with overweight and obesity are treated.

  • 98. Atuhairwe, Susan
    et al.
    Byamugisha, Josaphat
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Cleeve, Amanda
    Hanson, Claudia
    Tumwesigye, Nazarius Mbona
    Kakaire, Othman
    Danielsson, Kristina Gemzell
    Evaluating the safety, effectiveness and acceptability of treatment of incomplete second-trimester abortion using misoprostol provided by midwives compared with physicians: study protocol for a randomized controlled equivalence trial2019In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 20, no 1, article id 376Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A large proportion of abortion-related mortality and morbidity occurs in the second trimester of pregnancy. The Uganda Ministry of Health policy restricts management of second-trimester incomplete abortion to physicians who are few and unequally distributed, with most practicing in urban regions. Unsafe and outdated methods like sharp curettage are frequently used. Medical management of second-trimester post-abortion care by midwives offers an advantage given the difficulty in providing surgical management in low-income settings and current health worker shortages. The study aims to assess the safety, effectiveness and acceptability of treatment of incomplete second-trimester abortion using misoprostol provided by midwives compared with physicians.

    METHODS: A randomized controlled equivalence trial implemented at eight hospitals and health centers in Central Uganda will include 1192 eligible women with incomplete abortion of uterine size > 12 weeks up to 18 weeks. Each participant will be randomly assigned to undergo a clinical assessment and treatment by either a midwife (intervention arm) or a physician (control arm). Enrolled participants will receive 400 μg misoprostol administered sublingually every 3 h up to five doses within 24 h at the health facility until a complete abortion is confirmed. Women who do not achieve complete abortion within 24 h will undergo surgical uterine evacuation. Pre discharge, participants will receive contraceptive counseling and information on what to expect in terms of side effects and signs of complications, with follow-up 14 days later to assess secondary outcomes. Analyses will be by intention to treat. Background characteristics and outcomes will be presented using descriptive statistics. Differences between groups will be analyzed using risk difference (95% confidence interval) and equivalence established if this lies between the predefined range of - 5% and + 5%. Chi-square tests will be used for comparison of outcome and t tests used to compare mean values. P ≤ 0.05 will be considered statistically significant.

    DISCUSSION: Our study will provide evidence to inform national and international policies, standard care guidelines and training program curricula on treatment of second-trimester incomplete abortion for improved access.

    TRIAL REGISTRATION: ClinicalTrials.gov, NCT03622073 . Registered on 9 August 2018.

  • 99.
    Avelin, Pernilla
    et al.
    Karolinska Institutet.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Hildingsson, Ingegerd
    Mid Sweden University.
    Davidsson-Bremborg, Anna
    Lund University.
    Rådestad, Ingela
    Sophiahemmet University College.
    Make the stillborn baby and the loss real for the sibling: parents' advice on how the siblings of a stillborn baby can be supported2012In: Journal of Perinatal Education, ISSN 1058-1243, Vol. 21, no 2, p. 90-98Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate parents' advice to other parents on the basis of their own experiences of siblings' taking leave of a stillborn sister or brother. The study was a Web questionnaire study of 411 parents. The thematic content analysis resulted in two categories: "Make the stillborn baby and the loss real for the siblings" and "Take the siblings' resources and prerequisites into account." Parents' advised that siblings should see and hold the stillborn baby and, thus, be invited and included into the leave-taking process with respect to the siblings' feelings, resources, and prerequisites. Based on these findings, professional caregivers can usefully be proactive in their approach to facilitate and encourage the involvement of siblings.

  • 100.
    Avelin, Pernilla
    et al.
    Karolinska institutet.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Hildingsson, Ingegerd
    Mittuniversitetet.
    Rådestad, Inegla
    Sophiahemmet högskola.
    Swedish parents' experiences of parenthood and the need for support to siblings when a baby is stillborn2011In: Birth, ISSN 0730-7659, E-ISSN 1523-536X, Vol. 38, no 2, p. 150-158Article in journal (Refereed)
    Abstract [en]

    Background:

    It has been argued that having a stillborn baby in the family affects older siblings more than parents realize. The aim of this study was to describe parenthood and the needs of siblings after stillbirth from the parents' perspective.

    Methods:

    Six focus groups were held with 27 parents who had experienced a stillbirth and who had had children before the loss. The discussion concerned parents' support to the siblings, and the sibling's meeting, farewell, and memories of their little sister or brother. Data were analyzed using qualitative content analysis.

    Results:

    The overall theme of the findings was parenthood in a balance between grief and everyday life. In the analysis, three categories emerged that described the construction of the theme: support in an acute situation, sharing the experiences within the family, and adjusting to the situation.

    Conclusions:

    The siblings' situation is characterized by having a parent who tries to maintain a balance between grief and everyday life. Parents are present and engaged in joint activities around the stillbirth together with the siblings of the stillborn baby. Although parents are aware of the sibling's situation, they feel that they are left somewhat alone in their parenthood after stillbirth and therefore need support and guidance from others.

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