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  • 551.
    Eilegård, Alexandra
    Karolinska Institutet.
    Betydelsen av kommunikation före och efter förlusten av en bror eller syster i cancer – En nationell långtidsuppföljning2012Conference paper (Other academic)
  • 552.
    Eilegård, Alexandra
    Karolinska Institutet.
    Betydelsen av kommunikation före och efter förlusten av en bror eller syster i cancer – En nationell långtidsuppföljning2012Conference paper (Other academic)
  • 553.
    Eilegård, Alexandra
    Karolinska Institutet.
    Betydelsen av kommunikation före och efter förlusten av en bror eller syster i cancer – En nationell långtidsuppföljning2012Conference paper (Other academic)
  • 554.
    Eilegård, Alexandra
    Karolinska Institutet.
    From interview to a nationwide study on siblings having lost a brother or sister to cancer2009Conference paper (Other academic)
  • 555. Eilegård, Alexandra
    From interviews to a nationwide study on siblings having lost a brother or sister to cancer2009Conference paper (Other academic)
  • 556.
    Eilegård, Alexandra
    Karolinska Institutet.
    Förlustdrabbade syskons upplevelse av deltagande i en forskningsstudie om deras erfarenheter av att ha mist en bror eller syster i cancer.2012Conference paper (Other academic)
  • 557.
    Eilegård, Alexandra
    Karolinska Institutet.
    Förlustdrabbade syskons upplevelse av deltagande i en forskningsstudie om deras erfarenheter av att ha mist en bror eller syster i cancer.2012Conference paper (Other academic)
  • 558.
    Eilegård, Alexandra
    Karolinska Institutet.
    Förlustdrabbade syskons upplevelse av deltagande i en forskningsstudie om deras erfarenheter av att ha mist en bror eller syster i cancer.2012Conference paper (Other academic)
  • 559.
    Eilegård, Alexandra
    Karolinska Institutet.
    Long-Term Consequences of Unresolved Grief In Siblings After Losing a Brother or Sister to Cancer.2012Conference paper (Other academic)
  • 560.
    Eilegård, Alexandra
    Karolinska Institutet.
    Psychological health in siblings who lost a brother or sister to cancer two to nine years earlier.2012Conference paper (Other academic)
  • 561.
    Eilegård, Alexandra
    Karolinska Institutet.
    Psychological Health in Siblings Who Lost a Brother or Sister to Cancer Two to Nine Years Earlier2012Conference paper (Other academic)
  • 562.
    Eilegård, Alexandra
    Karolinska Institutet.
    Sibling perceptions about participation in research regarding the loss of a brother or sister to cancer2010Conference paper (Other academic)
  • 563.
    Eilegård, Alexandra
    Karolinska Institutet.
    The impact of communication prior to and following the loss of a brother or sister to cancer – A nationwide long-term follow-up.2012Conference paper (Other academic)
  • 564.
    Eilegård, Alexandra
    Karolinska Institutet.
    The impact of communication prior to and following the loss of a brother or sister to cancer – A nationwide long-term follow-up.2012Conference paper (Other academic)
  • 565. Eilegård, Alexandra
    To lose a brother or sister to cancer2007Conference paper (Other academic)
  • 566. Eilegård, Alexandra
    To lose a brother or sister to cancer2008Conference paper (Other academic)
  • 567.
    Eilegård, Alexandra
    et al.
    Karolinska Institutet.
    Kreicbergs, Ulrika
    Ersta Sköndal Högskola ; Karolinska Institutet.
    Risk of parental dissolution of partnership following the loss of a child to cancer: a population-based long-term follow-up2010In: Archives of pediatrics & adolescent medicine, ISSN 1538-3628, Vol. 164, no 1, p. 100-101Article in journal (Refereed)
  • 568.
    Eilegård, Alexandra
    et al.
    Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden ; Sophiahemmet University College, Stockholm, Sweden ; Department of Oncology Pathology, Karolinska Institutet, Division of Clinical Cancer Epidemiology, Stockholm, Sweden.
    Steineck, Gunnar
    Department of Oncology Pathology, Sahlgrenska Academy, Division of Clinical Cancer Epidemiology, Gothenburg, Sweden ; Department of Oncology Pathology, Karolinska Institutet, Division of Clinical Cancer Epidemiology, Stockholm, Sweden.
    Nyberg, Tommy
    ology, Gothenburg, Sweden ; Department of Oncology Pathology, Karolinska Institutet, Division of Clinical Cancer Epidemiology, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden ; Sophiahemmet University College, Stockholm, Sweden ; Department of Oncology Pathology, Sahlgrenska Academy, Division of Clinical Cancer Epidemiology, Gothenburg, Sweden.
    Bereaved siblings' perception of participating in research--a nationwide study.2013In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 22, no 2, p. 411-6Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The objective of the present study is to examine bereaved siblings' perception of research participation.

    METHODS: A Swedish nationwide study on avoidable and modifiable health care-related factors in paediatric oncology among bereaved siblings who lost a brother or sister to cancer between the years 2000 and 2007 was conducted. Data are presented as proportions, and the differences between groups were statistically tested at the 5% significant level using Fisher's exact test.

    RESULTS: Out of 240 eligible siblings, 174 responded (73 %). None of the siblings (0/168) thought their participation would affect them negatively in the long term. However, 13% (21/168) stated it was a negative experience to fill out the questionnaire, whereas 84% (142/169) found it to be a positive experience. Women were more likely to report their participation as positive in a long-term perspective compared with men (p = 0.018).

    CONCLUSIONS: None of the bereaved siblings in this Swedish nationwide study anticipated any long-term negative effect from their research participation. A majority reported it as positive to revisit their needs and experiences throughout their brother or sister's illness and death 2-9 years following the loss. We believe that the stepwise approach used in this study contributed to the high acceptance.

  • 569.
    Eilegård, Alexandra
    et al.
    Karolinska Inst, Div Womens & Childs Hlth, Childhood Canc Res Unit, Stockholm, Sweden ; Sophiahemmet Univ Coll, Stockholm, Sweden ; Karolinska Inst, Div Oncol Pathol, Dept Clin Canc Epidemiol, Stockholm, Sweden.
    Steineck, Gunnar
    Univ Gothenburg, Sahlgrenska Acad, Div Oncol, Dept Clin Canc Epidemiol, Gothenburg, Sweden ; Karolinska Inst, Div Oncol Pathol, Dept Clin Canc Epidemiol, Stockholm, Sweden.
    Nyberg, Tommy
    Karolinska Inst, Div Oncol Pathol, Dept Clin Canc Epidemiol, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Karolinska Inst, Div Womens & Childs Hlth, Childhood Canc Res Unit, Stockholm, Sweden ;Sophiahemmet Univ Coll, Stockholm, Sweden; Karolinska Inst, Div Womens & Childs Hlth, Childhood Canc Res Unit, Stockholm, Sweden.
    Psychological health in siblings who lost a brother or sister to cancer 2 to 9 years earlier.2013In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 22, no 3, p. 683-91Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The objective of this study was to assess long-term psychological distress in siblings who lost a brother or sister to cancer 2 to 9 years earlier, as compared with a control group of non-bereaved siblings from the general population.

    METHODS: During 2009, we conducted a nationwide follow-up study in Sweden by using an anonymous study-specific questionnaire. Siblings who had lost a brother or sister to cancer between the years 2000 and 2007 and also a control group of non-bereaved siblings from the general population were invited to participate. The Hospital Anxiety and Depression Scale (HADS) was used to measure psychological distress, and to test for differences in the ordinal outcome responses between the groups, we used Wilcoxon-Mann-Whitney rank-sum test.

    RESULTS: Among the bereaved siblings, 174/240 (73%) participated and 219/293 (75%) among the non-bereaved. Self-assessed low self-esteem (p = 0.002), difficulties falling asleep (p = 0.005), and low level of personal maturity (p = 0.007) at follow-up were more prevalent among bereaved siblings. However, anxiety (p = 0.298) and depression (p = 0.946), according to HADS, were similar.

    CONCLUSION: Bereaved siblings are at increased risk of low self-esteem, low level of personal maturity and difficulties falling asleep as compared with non-bereaved peers. Yet, the bereaved were not more likely to report anxiety or depression.

  • 570.
    Eilegård Wallin, Alexandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    Steineck, Gunnar
    Nyberg, Tommy
    Kreicbergs, Ulrika
    Insufficient communication and anxiety in cancer-bereaved siblings: a nationwide long-term follow-up2016In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. October, p. 488-494Article in journal (Refereed)
    Abstract [en]

    Objective: The purpose of this study was to examine siblings’ long-term psychological health in relation to their perception of communication with their family, friends, and healthcare professionals during a brother or sister's last month of life.

    Method: A nationwide questionnaire study was conducted during 2009 in Sweden of individuals who had lost a brother or sister to cancer within the previous two to nine years. Of the 240 siblings contacted, 174 (73%), participated. The Hospital Anxiety and Depression Scale (HADS) was employed to assess psychological health (anxiety). The data are presented as proportions (%) and relative risks (RR) with a 95% confidence interval (CI 95%).

    Results: Siblings who were not satisfied with the amount they talked about their feelings with others during their brother or sister's last month of life were more likely to report anxiety (15/58, 26%) than those who were satisfied (13/115, 11%; RR = 2.3(1.2–4.5)). The same was true for those who had been unable to talk to their family after bereavement (RR = 2.5(1.3–4.8)). Avoiding healthcare professionals for fear of being in their way increased siblings’ risk of reporting anxiety at follow-up (RR = 2.2(1.1–4.6)), especially avoidance in the hospital setting (RR = 6.7(2.5–18.2)). No such differences were seen when the ill brother or sister was cared for at home.

    Significance of results: Long-term anxiety in bereaved siblings might be due to insufficient communication. Avoiding healthcare professionals, especially when the brother or sister is cared for at the hospital, may also increase the risk of anxiety.

  • 571.
    Eilegård Wallin, Alexandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke högskola.
    Lövgren, Malin
    Ersta Sköndal Bräcke högskola.
    Cancer-bereaved siblings advice to peers: A nationwide follow-up survey2019Conference paper (Refereed)
  • 572.
    Eilegård Wallin, Alexandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Kreicbergs, Ulrika
    Ersta Sköndal Bräcke Högskola.
    Lövgren, Malin
    Ersta Sköndal Bräcke Högskola.
    Cancer-bereaved siblings' advice to peers: a nationwide follow-up survey2019In: Death Studies, ISSN 0748-1187, E-ISSN 1091-7683Article in journal (Refereed)
    Abstract [en]

    The aim of this nationwide survey was to explore, based on an open-ended question, cancer-bereaved siblings’ advice to peers with a brother or sister with cancer. Half of the advice related to being with the ill sibling and cherishing the time together. Other advice related to the value of communicating about the situation, letting go of guilt, and living life as usual. The results highlight the importance of health care professionals, family, and others facilitating for siblings to spend time together and communicate openly.

  • 573. Eilertsen, Mary
    et al.
    Lövgren, Malin
    Eilegård Wallin, Alexandra
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kreicbergs, Ulrika
    Cancer-bereaved siblings' positive and negative memories and experiences of illness and death: A nationwide follow-up2018In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 16, no 4, p. 406-413Article in journal (Refereed)
    Abstract [en]

    Objective: Our aim was to explore bereaved siblings' positive and negative memories and experiences of their brother's or sister's illness and death.

    Method: In our nationwide Swedish study, 174 of 240 (73%) bereaved siblings participated, and 70% responded to two open-ended statements, which focused on siblings' positive and negative memories and experiences of illness and death. The data were analyzed using systematic text condensation. Results:: The bereaved siblings' responses were categorized into four different themes: (1) endurance versus vulnerability, (2) family cohesion versus family conflicts, (3) growth versus stagnation, and (4) professional support versus lack of professional support. The first theme expressed endurance as the influence that the ill siblings' strong willpower, good mood, and stamina in their difficult situation had on healthy siblings, whereas vulnerability was expressed as the feeling of emptiness and loneliness involved with having an ill and dying sibling. In the second theme, family cohesion was expressed as the bonds being strengthened between family members, whereas family conflicts often led siblings to feel invisible and unacknowledged. In the third theme, most siblings expressed the feeling that they grew as individuals in the process of their brother's or sister's illness and death, whereas others experienced stagnation because of the physical and mental distress they bore throughout this time, often feeling forgotten. In the last theme—professional support—most siblings perceived physicians and staff at the hospital as being warm, kind, and honest, while some siblings had negative experiences.

    Significance of results: The study shows that bereaved siblings can have positive memories and experiences. The significance of the positive buffering effect on bereaved siblings' own endurance, personal growth, family cohesion, and social support should be noted. This knowledge can be valuable in showing healthcare professionals the importance of supporting the siblings of children with cancer throughout the cancer trajectory and afterwards into bereavement. 

  • 574.
    Eilertsen, Mary-Elizabeth Bradley
    et al.
    Sør-Trøndelag University College, Trondheim, Norway.
    Eilegård, Alexandra
    Karolinska Institutet, Stockholm, Sweden.
    Steineck, Gunnar
    Karolinska Institutet, Stockholm, Sweden ; Gothenburg University, Gothenburg, Sweden.
    Nyberg, Tommy
    Karolinska Institutet, Stockholm, Sweden.
    Kreicbergs, Ulrika
    Karolinska Institutet, Stockholm, Sweden ; Sophiahemmet University College, Stockholm, Sweden.
    Impact of social support on bereaved siblings' anxiety: a nationwide follow-up2013In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 30, no 6, p. 301-10Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To assess adolescent and young adult siblings' perception of social support prior to and following the loss of their brother or sister to cancer, 2 to 9 years earlier, and their anxiety at follow-up.

    METHOD: In 2009, 174 (73%) bereaved siblings (12-25 years) participated in a nationwide, long-term follow-up study in Sweden using an anonymous study-specific questionnaire. The Hospital Anxiety and Depression Scale was used to measure self-assessed anxiety.

    RESULTS: Siblings had a higher risk of anxiety if they perceived their need for social support was unsatisfied during their brother or sisters' last month before death, relative risk (RR) = 3.6 (95% confidence interval [CI] = 1.8-7.3); time after death, RR = 2.9 (95% CI = 1.5-5.6); and at follow-up, RR = 3.8 (95% CI = 2.0-7.2). Furthermore, a higher risk for anxiety was shown for siblings if they did not perceive that their parents and neighbors cared for them after their brother or sisters' death, RR = 2.7 (95% CI = 1.3-5.5), RR = 5.4 (95% CI = 1.3-21.9), respectively.

    CONCLUSION: Bereaved siblings had a greater probability to report self-assessed anxiety if they perceived that their need for social support was not satisfied prior to and following death. Information from both nurses and other health care professionals to families about the impact of social support may contribute to lessen the siblings' risk of anxiety.

  • 575.
    Einarsson, Julia
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Johanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Personcentrerad vård vid demenssjukdom: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Approximately160 000 people in Sweden suffer from dementia. Behavioral and psychological symptoms of dementia (BPSD) affect about 90 % of all the people with dementia. These symptoms may reduce the quality of life of the person who suffers and be difficult to handle for staff and relatives. Care for people with dementia should be person-centered, which could be complicated by the fact that people with dementia may have difficulty in communication and being involved in their care. Hence, it is considered important to get an overview of existing knowledge about person-centered care for people with dementia.

    Aim:

    To describe person-centered care for people with dementia.

    Method:

    A literature review where 12 articles where included.

    Results:

    Staff gained understanding and knowledge of dementia through education. A personal environment and activities adapted to the person’s ability were of importance. Seeing the person behind dementia by taking part in their life story and involving relatives in the care, could staff provide important information which could be used in care to handle BPSD.

    Conclusion:

    Person-centered care is of importance to people with dementia. Person-centered care can reduce the incidence of BPSD, which is beneficial to both the person with dementia, relatives and staff. Person-centered care should be implemented in dementia care and focus should be on education to staff about dementia and person-centered care.

  • 576.
    Ek, Ann-Christin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Larsson, Gina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Personcentrerad omvårdnad vid demens: En deskriptiv kvalitativ studie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Dementia is one of the major diseases and health professionals

    encounter these people with dementia both in emergency care and municipal care.

    At the end of life most people affected by dementia live in institutions. Personcentered

    care is described to be beneficial in the care of people with dementia and

    staff's experience of this is of great importance.

    Purpose: The aim was to study nurses, unit managers and staff nurses'

    experience of person-centered care in local health care.

    Method: The design was a descriptive study with qualitative approach which

    has been analyzed by means of an inductive content analysis. Participants enrolled

    in the interview study came from the same municipality. There were ten people

    and consisted of four registered nurses, four enrolled nurses and two managers for

    the organization. They were chosen by business manager and had worked with

    people with dementia in at least five years

    Results: The result showed four categories and 12 subcategories. Personcentered

    care was considered relevant in the context of good nursing care of

    people with dementia. In the process of person-centered care was the focus

    to; adapt to the person with dementia, to ensure the identity and personality.

    Furthermore, it was stressed relatives' participation, treatment and a common

    approach, which consisted of identifying the needs and sees the person

    Conclusion: The results showed that most interviewees had similar experiences

    in working with people with dementia. It emerged from the study that the patient

    specific approach had positive outcomes when caring for a person with dementia.

    Person-centered care was considered very important and necessary to ensure that

    people with dementia have good and dignified life after being diagnosed with the

    disease.

  • 577.
    Ekborn, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Att föda barn i vatten: Kvinnors upplevelse av utdrivningsskedet när det sker i vatten. En kvalitativ intervjustudie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To give birth in water is still and has for a long time been questioned regarding the benefits and safety in many countries. In Sweden there is no longer any a restriction or recommendations about water births. The aim of this study was to investigate women´s experience of the second stage of labour in water.

    Method: Interviews were conducted with six women three to four months after the water birth. The interviews were analyzed qualitative.

    Result: Four categories were identified; Handle the pain, kept integrity, feeling secure and natural childbirth.

    None of the women had planned for a water birth but all had a wish to avoid medical pain relief and have a natural birth if possible. Their experience was that the bath made it easier to support natural child birth and the women were positive to stay in the bath as long as the midwife told them everything was fine. The primiparas expressed the pain in the second stage of labour as mainly positive. The multiparas thought the pain was equal as previous experience. The most psychological benefit was the experience of kept integrity in the bath. The women felt less exposed in the water compared with previous experiences or ideas. Women´s opinion of the midwife as skilled and calm had importance for the choice of a water birth.

    Conclusions: The women experienced the water as protective and a way to support natural birth. The primiparas expressed the pain in the second stage of labour as mainly positive. The multiparas thought the pain was equal as previous experience. The women expressed the kept integrity as most beneficial about water birth. High confidence with the midwife had importance for feeling safe in with the water birth.

  • 578. Ekdahl, Anne
    et al.
    Dahlin-Ivanoff, Synneve
    Ehrenberg, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Oredsson, Sven
    Sjöstrand, Fredrik
    Stavenow, Lars
    Wisten, Aase
    Vård av sköra äldre patienter: evidensbaserad metod finns2014In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, no 7Article in journal (Other academic)
  • 579. Ekdahl, Anne
    et al.
    Sjöstrand, Fredrik
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Oredsson, Sven
    Stavenow, Lars
    Wisten, Aase
    Wårdh, Inger
    Dahlin-Ivanoff, Synneve
    Frailty and comprehensive geriatric assessment organized as CGA-ward or CGA-consult for older adult patients in the acute care setting: a systematic review and meta-analysis2015In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 6, no 6, p. 523-540, article id 6Article in journal (Refereed)
    Abstract [en]

    Background: With worldwide population aging, increasing numbers of people need hospital care. Evidence suggests comprehensive geriatric assessment (CGA) is superior to usual care. 

    Objective: To summarize the evidence for the effects of CGA in frail and moderately frail patients compared with usual care in acute care settings. 

    Data sources: CINAHL, PsycInfo, Cochrane Library, EMBASE, and PubMed were searched in October 2011, January 2013, and February 2015. 

    Study eligibility: Randomized controlled trials. Participants: Older adults aged >= 65 years who were admitted to hospital with a complex condition, divided into frail and moderately frail groups. 

    Intervention: CGA. 

    Control: Usual care. 

    Outcomes: Change in housing, personal activities of daily living (PADL), instrumental activities of daily living (IADL), readmission, cognitive function, depression, quality-of-life care-giver burden, and mortality. 

    Study appraisal and synthesis: The grading of recommendations assessment development and evaluation (GRADE) system to assess the quality of evidence and PRISMA-guidelines for meta-analyses and reviews. Continuous data were presented as standardized mean differences and dichotomous data were presented as risk differences. 

    Results: Twenty-nine articles based on 17 unique studies (6005 patients in total). CGA was categorized as CGA-ward or CGA-consult. In the frail group, CGA-ward was superior to usual care for change in housing, PADL, and depression. CGA-consult was superior to usual care for PADL and IADL in the moderately frail group. 

    Conclusion: There was a stronger effect for frail older adults and CGA-ward compared with usual care. This highlights the importance of detecting frailty. However, the degree of evidence was limited.

  • 580.
    Ekdahl, Victor
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Lindblom, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Behandling av iliotibialbandssyndrom hos löpare: En strukturerad litteraturstudie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Running is a popular form of exercise around the world. Iliotibial band syndrome (ITBS) is one of the most common overuse injuries in runners. Several different conservative treatment methods have been studied, but evidence is limited and not sufficient enough to support a specific treatment method. Objective: To describe through a structured literature review the conservative treatment methods studied on runners with ITBS and the effect these treatment methods have on pain. Method: A search to identify relevant articles was carried out in the PubMed, Cinahl, Scoupus and Web of Science databases. The search terms used were iliotibial band syndrome, iliotibial band friction syndrome and iliotibial band strain. A screening of titles and abstracts was made. Potentially relevant articles were obtained in full text, and then a relevance assessment was performed. The methodological quality of the included articles was examined. An ethical review was conducted on all included articles. Results: Four randomized controlled trials and two cohort studies were included. The interventions studied in the articles were correction of the supposed aetiological factors for running related injuries, anti-inflammatory / analgesic drugs, deep transverse friction massage, hip strengthening rehabilitation program, corticosteroid injection and shockwave treatment compared to manual therapy. Many of the interventions reduced pain, however, to varying degrees. In two of the studies there was no significant difference in decrease of pain between intervention and control group. The articles had varied methodological quality. Conclusion: Although ITBS is common in runners, relatively few studies have investigated it’s conservative treatment methods. Several of the studies indicated positive results in the form of pain reduction but there are difficulties in drawing conclusions about effect from the treatment methods due to methodological weaknesses.

  • 581.
    Ekenberg, Linda
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Löwegren, Linda
    Dalarna University, School of Health and Social Studies, Caring Science.
    Tidig föräldrastress hos mammor med för tidigt födda barn2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: When an infant is born preterm (<37 gestational weeks) unexpected stresses affect the whole family. Significant improvements in the perinatal care has been made in the recent decades and now the chance of survival is high. To become a mother in a Neonatal Intensive Care Unit (NICU) entail consequences for the mother emotionally and in her care for her infant. Aim: To investigate parental stress and describe factors associated to early parenting stress in mothers of preterm infants at two months of corrected age. Method: The study was conducted in four NICUs in Sweden. The inclusion criteria were that the infant was born prematurely and had a hospital stay for at least 72 hours. To measure perceived parental stress, the mothers (n=276) answered the Swedish Parental Stress Questionnaire (SPSQ) at two months of corrected age. Results: Mothers whose infants were not cared for in a NICU with co-care, whose infants were cared for in an incubator, who were multiparous, older, who smoked and/or who were breastfeeding exclusively, experienced more stress than their counterparts in various dimensions explored. Conclusion: The study shows that factors relating to the environment and the mother are associated to parental stress among mothers’ of preterm infants. These findings show the need for improved support, both during the NICU stay and after discharge. These findings also highlight the need for improvements in the physical environment of the NICUs to reduce the risk for parental stress. 

  • 582.
    Ekendahl, Sigrid
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Johansson, Lovisa
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Barnmorskors erfarenheter av att stödja kvinnor i deras sexualitet första året efter förlossning: Intervjustudie med kliniskt verksamma barnmorskor i mödrahälsovården2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To apply knowledge on sexuality and relationships and providing support by dialogue is part of sexual and reproductive health, and part of the midwives’ competence.

    Research shows that women experience transition in their sexuality up to one year post partum, and that women express the need for support on the subject from health professionals.

    Aim: The aim of this study was to describe midwives’ experiences of giving support to women in their sexuality in the first year post partum.

    Method: The study was conducted through a qualitative method with an inductive approach.

    Data was collected from semi-structured individual interviews with eight midwives. The data was processed by qualitative inductive content analysis.

    Results: The result of the study showed that the midwives provided support in sexuality the first year post partum to women by dialogue, where the midwives approach was important. The dialogue support was provided by information and normalisation, investigation and consulting. The informants felt that further education in sexology was needed to give support to women in their sexuality the first year post partum.

    Clinical application: Through the experiences of the midwives in supporting women in their sexuality the first year post partum, this study might be used as inspiration for other midwives active in the field.

  • 583.
    Ekersund, Madeleine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Effekter, upplevelser och erfarenheter av SBAR: En litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    In today's healthcare the lack of communication between healthcare professionals is a big

    reason to care injuries. Communication between healthcare professionals can burst at several

    levels and occur throughout the whole healthcare system. To prevent communication failures

    and care injuries various communication tools can be used. SBAR is a nationally recommended

    communication tool that can be used by all healthcare professionals, throughout the whole

    healthcare system.

    Aim

    The aim of this literature review was to investigate the effects of SBAR in healthcare and

    healthcare professionals experiences from using SBAR.

    Method

    This degree project was conducted as a literature review and is based on 17 scientific articles

    published between the years 2006-2016. The search for articles was made in the databases

    SBAR and CINAHL.

    Result

    SBAR provided structure to the communication and improved communication between

    healthcare professionals, which led to increased patient safety. The use of SBAR also led to a

    increased professionalism among the healthcare professionals, which among other things

    supported new staff to report with the same quality as experienced ones. SBAR also flattened

    hierarchies and differences in communication styles between professional groups.

    Conclusion

    SBAR can be used to structure and improve communication between healthcare professionals

    and to increase patient safety.

  • 584.
    Ekholm, Katinka
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Oscarsson, Cecilia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans hälsofrämjande arbete för vuxna patienter med övervikt och fetma:: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med denna litteraturöversikt var att undersöka vilka hälsofrämjande omvårdnadsåtgärder sjuksköterskan kan vidta för patienter med övervikt och fetma. Ytterligare ett syfte var att undersöka möjligheter och hinder som sjuksköterskan kan möta i sitt hälsofrämjande arbete.

    Metod: Studien genomfördes som en litteraturöversikt med sökning i Pub Med, SweMed+ och CINAHL. 9 kvantitativa och 5 kvalitativa artiklar valdes ut.

    Resultat: Sjuksköterskans hälsofrämjande arbete för vuxna patienter med övervikt och fetma innebär att försöka få till stånd en livsstilsförändring genom kost och ökad fysisk aktivitet. Till sin hjälp har sjuksköterskan de nationella riktlinjerna i förebyggande hälsoarbetet. Vidare i det förebyggande häsloarbetet möter sjuksköterskan möjligheter och hinder i form av olika faktorer som kan påverka . De faktorer som belyses i den här litteraturöversikten är motivation, utbildning både ur sjuksköterskans och patientens synvinkel. Även sjuksköterskan som förebild och hur dennes attityder och fördomar speglas i arbetet.

    Slutsats: Sjuksköterskans hälsofrämjande omvårdnadsåtgärder för vuxna patienter med övervikt och fetma innebär att försöka få till stånd en livsstilsförändring. För att kunna nå en livsstilsförändring behöver sjuksköterkan vara medveten om de möjligheter som främjar patienten mot ett sådant mål. Det kan vara att ta till vara på patientens egna resurser och erfarenheter.

    Sjuksköterksan bör också vara medveten om de hinder som föreligger vid häslofrämjande omvårdnadsåtgärder för vuxna patienter med övervikt och fetma. Det som var ett tydligt och återkommande tema i denna litteraturöversikt var hur sjuksköterskans, men även patientens attiyd och föreställning kom att påverka det förebyggande hälsoarbetet.

    Vidare framkom även att det saknas kunskap, utbildning och tydliga riktlinjer i klinisk praxis vad gäller hälsofrämjande omvårdnadsåtgärder för vuxna patienter med övervikt och fetma.

  • 585.
    Ekholm, Katinka
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Storm, Erica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Skolsköterskans erfarenheter och upplevelser av att arbeta med barn med övervikt i grundskolan: En kvalitativ intervjustudie2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Overweight and obesity in children and adolescents is an increasing public health problem around the world, where prevalence increases and has doubled since 1980. Research has shown that the increase in overweight and obesity in children has remained in Sweden, but despite this, too many children still have problems with overweight. Within the healthcare system, the school nurse is a very important player in the early detection of trends in overweight and obesity among pupils.

    Aim:

    To describe the school nurse's experience of working with overweight in primary school children. Method: A qualitative interview study with semi structured interview questions was made using an interview guide. 10 school nurses were interviewed with open questions. The material was analyzed with qualitative content analysis according to Graneheim and Lundman (2004). Result: The analysis resulted in three main categories and six subcategories. School nurses felt that it was a difficult and sensitive topic to talk about, especially with the child's parents. Misconceptions occured often and easily and the parents did not want to face the problem. The school nurses experiences was that the overweight children often had low self- esteem and were ashamed of themselves and their bodies. The health call was a major and important part of the overweight work. The school nurses felt that they had little knowledge of the subject. School nurses described a lack of cooperation between school and school health care, which many of the school nurses felt frustrating. School nurses said that cooperation could promote children's health and influence school outcomes positively. Conclusion: It is important that nurses receive more education in the subject overweight and related communication strategies to more effectively be able to work with overweight children, that better cooperation between school and school health care is developed and the subject needs to be played-down, in order for the work of overweight children to progress..

  • 586.
    Eklund, Emelie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jackson, Stina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar livskvaliteten hos personermed hjärtsvikt: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : Heart failure is viewed as a public health issue which costs many

    people their life every year. Of those who are affected, approximately a 50 percent

    mortality is estimated. Living with heart failure imply suffering from inconvenient

    physical symptoms, but also having to extensively adapt ones lifestyle.

    Aim

    :

    To examine different factors that affects the perception of quality of life in

    people with heart failure.

    Method

    :

    A literature review has been done where 16 scientific articles were

    included.

    Results

    :

    Reduced mental health showed a greater influence on the percepted

    quality of life than reduced physical ability. An explicit correlation between

    mental health and quality of life was found, as well as the fact that quality of life

    being more important than a long lifetime. Having a close relationship with family

    and relatives was of great importance to feel comfort. However, the meaning of

    receiving information was shown to have less influence than expected.

    Conclusion

    :

    Heart failure leads to reduced physical-, as well as mental function

    and intrudes on the persons social wellbeing, which therefore also comes to affect

    their quality of life. This review presents the importance of an early addressing of

    persons with reduced mental health to enhance their well-being and quality of life.

  • 587.
    Eklund, Klara
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ström, Martina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som påverkar vårdmötet mellan sjuksköterskan och föräldrar till överviktiga barn: Litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Overweight and obesity among children and adolescents has

    increased dramatically over the past 20 years. In Sweden, the prevalence of obesity

    increased from 1 % to 4 %. There are several causes of overweight and obesity in

    children and adolescents. Some of them are genetic factors, food consumption,

    environmental factors and lifestyle factors.

    Aim: The aim is to describe the factors that affect health care encounter between

    the nurse and the parents of children and adolescents who are overweight or obese.

    Method: The study was conducted as a literature review and consisted of 13

    articles, 10 with qualitative approach and three with quantitative approach. These

    were brought from the databases CINAHL and PubMed.

    Results: Both obstacles and opportunities that may arise in the care encounter

    between the nurse and the patients was identified. These obstacles and

    opportunities were presented in two categories with a total of five subcategories;

    Guilt and shame of the parents, denial by the parents regarding the child's weight,

    raising of the awareness of the benefits from weight loss, long-term trust facilitates

    care meetings, and customized care in the meeting between the nurse and parent.

    Conclusion: Several factors were identified which are important for the care

    encounter between nurses and parents. The factors that preclude the health care

    encounter, both parties may influence for the better.

  • 588.
    Eklöf, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lissel, Therese
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelse av att ta emot telefonsamtal från självmordsnära patienter: På callcentra i Sverige2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To describe the experiences of nurses who receive phone calls from suicidal persons at call centers in Sweden.

    Method: Empirical qualitative interview-based study with a phenomenological hermeneutical approach.

    Results: The study resulted in eight themes and two subcategories. There were striking similarities and sizeable differences alike among the respondents’ experiences concerning receiving phone calls from suicidal persons. The calls were perceived as different, demanding focus and difficult to handle. The respondents describe a need for increased internal education in psychiatry. The interaction with psychiatric care is perceived as lacking and handling the patient call simultaneously while maintaining contact with a third party was perceived as frustrating. Regardless of the individual experiences regarding the process during the suicidal calls, it was unanimously described as only making use of the listening phase.

    Conclusion: The suicidal calls are clearly distinct from the somatic. The respondents unanimously describe entering a different state of mind when the patient expresses suicidal thoughts. The respondents also experience that the psychiatry works poorly, regardless of where in the country they work. Approaching patients with suicidal tendencies is becoming increasingly requested within psychiatry. This is reinforced by some of the respondents also subscribing to the myths surrounding suicide.

  • 589. Ekman, Björn
    et al.
    Borg, Johan
    Lunds universitet.
    Provision of hearing aids to children in Bangladesh: costs and cost-effectiveness of a community-based and a centre-based approach2017In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 12, no 6, p. 625-630Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study is to provide evidence on the costs and health effects of two alternative hearing aid delivery models, a community-based and a centre-based approach. The study is set in Bangladesh and the study population is children between 12 and 18 years old. Methods: Data on resource use by participants and their caregivers were collected by a household survey. Follow-up data were collected after two months. Data on the costs to providers of the two approaches were collected by means of key informant interviews. Results: The total cost per participant in the community-based model was BDT 6,333 (USD 79) compared with BDT 13,718 (USD 172) for the centre-based model. Both delivery models are found to be cost-effective with an estimated cost per DALY averted of BDT 17,611 (USD 220) for the community-based model and BDT 36,775 (USD 460) for the centre-based model. Conclusions: Using a community-based approach to deliver hearing aids to children in a resource constrained environment is a cost-effective alternative to the traditional centre-based approach. Further evidence is needed to draw conclusions for scale-up of approaches; rigorous analysis is possible using well-prepared data collection tools and working closely with sector professionals.

  • 590.
    Ekman Källkvist, Isabella
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Rothman, Hanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Arbetsrelaterade stressfaktorer hos sjuksköterskor– En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Working as a nurse is a stressful job today, where nurses meet work-related stress

    factors in their daily work. Regardless of the fact that work

    requirements have increased, the

    nurse must be able to carry out good care and have knowledge in several areas. It is important

    to highlight which stress factors affect the nurse's work in order to provide good and safe care

    and to reduce the stress of nurses.

    Purpose: The purpose was to describe work-related stress

    factors in nurses.

    Method: A literature study was conducted using quantitative and qualitative

    articles, fifteen articles were included.

    Results: Work-related stress factors in nurses were

    identified as high workloads, collaborative problems and conflicts, and emotional stressors,

    which negatively affected the nurse's nursing work.

    Conclusion: It is important to highlight

    work-related stress factors to prevent stress at work and to give nurses a better working

    environment.

  • 591.
    Ekstam, Bodil
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Familjecentrerad omvårdnad till familjer med barn som har funktionsnedsättning2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The health of children with disabilities is worse than other children.

    The state is influenced by the family that the child live in and the surrounding

    environment. The families have many partners in health care and the child needs

    more support and care than children in general need of their parents. It is important

    to find ways to reduce stress and prevent illness in the family.

    Purpose: The purpose of this study was to describe parents, children and healthcare

    experience of family-centered care, the FCC, which is aimed at families who have

    children with disabilities.

    Method: Literature review was elected as a method and is based on 16 scientific

    articles with both qualitative and quantitative approach analyzed.

    Results: The FCC defined in the Articles in terms of quality and availability, but

    also as a parent to be listened to, given enough time, be treated with respect, have a

    joint decision between parents and professionals and to get information, if necessary,

    adapted. Through flexible approaches that are tailored to the child and family's needs

    both in inpatient and outpatient care, and in rehabilitation, stress can reduce both the

    family and the health professionals. However, there are groups with disabilities who

    perceive health care as a less family-centered than other families.

    Conclusion: The cornerstone of family-centered care is the collaboration between

    caregivers and family, which is promoted by the health care provider will take into

    account and respect the family's culture and background. Articles in the study shows

    that family-centered care provides support to be a success factor in health care. FCC

    promotes child and family health, which benefits the economy in the long term.

  • 592.
    Ekström, Annika
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Beskrivning av en kulturellt anpassad kurs för blivande mödrar med familjer i Nepal: En kvalitativ intervjustudie med sjukvårdspersonal2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Since poverty and lack of transportation make it hard for people to have access to hospital care, it is common that a pregnant woman deal with her pregnancy, childbirth and postpartum time on her own or with help of family members. This is the most vulnerable period of a woman life and knowledge about danger signs and signs of complications could be life-saving to women who are affected. Antenatal education is therefore suggested in various studies and relevant topics for such courses are expected to be reviled through the results of this study. Aim: The aim of this study was to describe topics and outline of a culturally tailored antenatal education to families in Nepal, illuminated by healthcare providers experiences. Methods: A qualitative design with semi-structured interviews was chosen. An interview guide was prepared beforehand with topics inspired by the Swedish antenatal education guide. A total of 26 interviews with healthcare providers including midwives, skilled birth attendants (SBA’s), medical doctors, village nurses or nurses, were conducted in both urban and rural areas in Nepal form province 3, 4 and 5. Findings: This study identified health care providers’ perceptions of what to include in a country contextual adjusted antenatal education/family support program to Nepali parents and potentially to other family members of the extended family. The descriptions of what to include in the parental education/family support program, provide a wide range of areas, this in a context where parental education does not exist. Five main themes were found; Course format and content, Pregnancy, Birth preparedness, Childbirth and postpartum. Conclusion: Increased knowledge and more involvement of fathers in pregnancy, childbirth and in the care of the child will promote equality between men and women in Nepal. Furthermore, it may empower women with self-confidence and their decision-making power regarding their own and their children’s health and wellbeing. Clinical application: This study may be used as an underlying document in the design of antenatal education for expectant parents and possibly extended family members in Nepal.

  • 593. Ekström, Klas
    et al.
    Pulkkinen, Mari-Anne
    Carlsson-Skwirut, Christine
    Brorsson, Anna Lena
    Karolinska institutet.
    Ma, Zhulin
    Frystyk, Jan
    Bang, Peter
    Tissue IGF-I Measured by Microdialysis Reflects Body Glucose Utilization After rhIGF-I Injection in Type 1 Diabetes2015In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 100, no 11, p. 4299-306Article in journal (Refereed)
    Abstract [en]

    CONTEXT: Type 1 diabetes is associated with portal insulin deficiency and disturbances in the GH-IGF axis including low circulating IGF-I and GH hypersecretion. Whether peripheral hyperinsulinemia and GH hypersecretion, which are relevant to the development of vascular complications, result in elevated tissue IGF-I remains unknown.

    OBJECTIVE: The purpose of this study was to determine the relationship between whole-body glucose uptake and tissue IGF-I measured by microdialysis.

    DESIGN: This was a single-blind placebo-controlled crossover study.

    SETTING: The setting was a tertiary pediatric endocrine referral center.

    PARTICIPANTS: The participants were seven young male adults with type 1 diabetes.

    INTERVENTION: After an overnight fast, a 6-h lasting euglycemic clamp was performed (constant insulin infusion at 0.5 mU/kg × minute and variable glucose infusion rate [GIR]) and a subcutaneous injection of recombinant human (rh) IGF-I (120 μg/kg) or saline was given after 2 hours. In parallel, tissue IGF-I levels were determined by microdialysis (md-IGF-I).

    MAIN OUTCOME MEASURES: md-IGF-I levels in muscle and subcutaneous fat, and GIR were determined.

    RESULTS: md-IGF-I levels were detectable but unchanged after saline. After rhIGF-I, muscle and subcutaneous fat md-IGF-I increased during the second and third hour and then reached a plateau up to 10-fold higher than baseline (P < .001). GIR was unchanged after saline, whereas it increased 2.5-fold concomitantly with the increase in md-IGF-I (P < .0001). In contrast, serum IGF-I was increased already at 30 minutes after rhIGF-I and reached a plateau 2-fold above baseline (P < .0001).

    CONCLUSION: We demonstrate that md-IGF-I measurements are valid and physiologically relevant by reflecting rhIGF-I-induced glucose uptake. Future studies should be conducted to elucidate the role of local tissue IGF-I in diabetic vascular complications.

  • 594.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Delaktighet och gemenskap2014In: Omvårdnadens grunder: Hälsa och ohälsa / [ed] Anna-Karin Edberg, Helle Wijk, Lund: Studentlitteratur AB, 2014, 2Chapter in book (Refereed)
  • 595.
    Eldh, Ann Catrine
    Örebro universitet, Hälsovetenskapliga institutionen.
    Patient participation: what it is and what it is not2006Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In general, patient participation is regarded as being informed and partaking in decision making regarding one’s care and treatment. This interpretation is common in legislation throughout the Western world and corresponding documents guiding health care professionals, as well as in scientific studies. Even though this understanding of the word participation can be traced to a growing emphasis on individuals’ autonomy in society and to certain dictionary defi nitions, there are other ways of understanding participation from a semantic point of view, and no trace of patients’ descriptions of what it is to participate can be found in these definitions.

    Hence, the aim of this dissertation was to understand patients’ experience of the phenomenon of patient participation. An additional aim was to understand patients’ experience of non-participation and to describe the conditions for patient participation and non-participation, in order to understand the prerequisites for patient participation.

    The dissertation comprises four papers. The philosophical ideas of Ricoeur provided a basis for the studies: how communication can present ways to understand and explain experiences of phenomena through phenomenological hermeneutics. The first and second studies involved a group of patients living with chronic heart failure. For the fi rst study, 10 patients were interviewed, with a narrative approach, about their experience of participation and non-participation, as defi ned by the participants. For the second study, 11 visits by three patients at a nurse-led outpatient clinic were observed, and consecutive interviews were performed with the patients and the nurses, investigating what they experience as patient participation and non-participation. A triangulation of data was performed to analyse the occurrence of the phenomena in the observed visits. For paper 3 and 4, a questionnaire was developed and distributed among a diverse group of people who had recent experience of being patients. The questionnaire comprised respondent’s description of what patient participation is, using items based on findings in Study 1, along with open-ended questions for additional aspects and general issues regarding situations in which the respondent had experienced patient participation and/or non-participation.

    The findings show additional aspects to patient participation: patient participation is being provided with information and knowledge in order for one to comprehend one’s body, disease, and treatment and to be able to take self-care actions based on the context and one’s values. Participation was also found to include providing the information and knowledge one has about the experience of illness and symptoms and of one’s situation. Participation occurs when being listened to and being recognised as an individual and a partner in the health care team. Non-participation, on the other hand, occurs when one is regarded as a symptom, a problem to be solved. To avoid non-participation, the information provided needs to be based on the individual’s need and with recognition of the patient’s knowledge and context.

    In conclusion, patient participation needs to be reconsidered in health care regulations and in clinical settings: patients’ defi nitions of participation, found to be close to the dictionaries’ description of sharing, should be recognised and opportunities provided for sharing knowledge and experience in two-way-communication.

  • 596.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strategier for behandling av urininkontinens i äldreomsorg2014In: Implementering av evidensbaserad praktik / [ed] Nilsen Per, Malmö: Gleerups Utbildning AB, 2014Chapter in book (Refereed)
  • 597.
    Eldh, Ann Catrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Almost, Joan
    DeCorby-Watson, Kara
    Gifford, Wendy
    University of Ottawa.
    Harvey, Gill
    University of Adelaide.
    Hasson, Henna
    Karolinska Institutet.
    Kenny, Deborah
    Moodie, S
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Yost, J
    Clinical interventions, implementation interventions, and the potential greyness in between - a discussion paper2017In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 17, no 1, article id 16Article in journal (Refereed)
    Abstract [en]

    Background: There is increasing awareness that regardless of the proven value of clinical interventions, the use of effective strategies to implement such interventions into clinical practice is necessary to ensure that patients receive the benefits. However, there is often confusion between what is the clinical intervention and what is the implementation intervention. This may be caused by a lack of conceptual clarity between 'intervention' and 'implementation', yet at other times by ambiguity in application. We suggest that both the scientific and the clinical communities would benefit from greater clarity; therefore, in this paper, we address the concepts of intervention and implementation, primarily as in clinical interventions and implementation interventions, and explore the grey area in between. Discussion: To begin, we consider the similarities, differences and potential greyness between clinical interventions and implementation interventions through an overview of concepts. This is illustrated with reference to two examples of clinical interventions and implementation intervention studies, including the potential ambiguity in between. We then discuss strategies to explore the hybridity of clinical-implementation intervention studies, including the role of theories, frameworks, models, and reporting guidelines that can be applied to help clarify the clinical and implementation intervention, respectively. Conclusion: Semantics provide opportunities for improved precision in depicting what is 'intervention' and what is 'implementation' in health care research. Further, attention to study design, the use of theory, and adoption of reporting guidelines can assist in distinguishing between the clinical intervention and the implementation intervention. However, certain aspects may remain unclear in analyses of hybrid studies of clinical and implementation interventions. Recognizing this potential greyness can inform further discourse.

  • 598.
    Eldh, Ann Catrine
    et al.
    Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden ; School of Health and Medical Sciences, Orebro University.
    Carlsson, Eva
    Department of Quality and Patient safety, Lindesberg hospital and Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Seeking a balance between employment and the care of an ageing parent2011In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 25, no 2, p. 285-293Article in journal (Refereed)
    Abstract [sv]

    Rationale:  A growing number of middle-aged people are engaged in informal care of their parents while employed. To provide support as employers, co-workers or staff, health care professionals need insight into the experiences of people managing these responsibilities.

    Aim:  To elucidate the experience of providing informal care to an ageing parent while managing the responsibilities of a working life.

    Methods:  Narrative interviews were performed with 11 persons with experience of the phenomenon. Transcribed interviews were analysed with phenomenological hermeneutics.

    Ethics:  Informed consent was given prior to the interviews. The study was approved by a research ethics committee.

    Findings:  Providing informal care to an ageing parent while also pursuing a working life implies seeking balance: a balance between providing support to the parent’s needs and one’s responsibilities at work. Being employed supports this balance as it provides both fulfilment and refuge. Being capable of managing both roles grants a sense of satisfaction, supporting one’s sense of balance in life. The balance can be supported by sharing the responsibility of caring for the ageing parent with others.

    Study limitations:  Despite perceived saturation and an effort to provide for the possibility to consider internal consistency, the findings should be considered as a contribution to the understanding of the phenomenon, as experienced by individuals in their life world.

    Conclusions:  It is essential to recognise the impact that providing care for an ageing parent may have on the lives of a growing number of people, particularly if they have employment responsibilities. Acknowledgement by others supports one’s ability to attain balance; as co-workers and managers, we can acknowledge the efforts of an informal caregiver and as health care staff recognise the valuable contribution made by people in mid-life who provide informal care for their ageing parents.

  • 599.
    Eldh, Ann Catrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Örebro universitet.
    Ehnfors, M
    Örebro universitet.
    Ekman, I
    Göteborgs universitet.
    Inconsistent meanings to ‘patient participation’ impacts conditions for education2005Conference paper (Refereed)
  • 600.
    Eldh, Ann Catrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Örebro universitet.
    Ehnfors, M
    Örebro universitet.
    Ekman, I
    Göteborgs universitet.
    The right to participate in my own health care. How patients attending a nurse-led clinic for chronic heart failure experience the meaning of participation2004Conference paper (Refereed)
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