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  • 851.
    Thomson, Gill
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Balaam, Marie-Clare
    International insights into peer support in a neonatal context: a mixed-methods study2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 7, article id e0219743Article in journal (Refereed)
    Abstract [en]

    Peer support is a widely used intervention that offers information and emotional support to parents during their infant's admission to the neonatal unit and/or post-discharge. Despite its widespread use, there are no comprehensive insights into the nature and types of neonatal-related peer support, or the training and support offered to peer supporters. We aimed to bridge these knowledge gaps via an international study into neonatal peer support provision. A mixed-methods study comprising an online survey was issued to peer support services/organisations, and follow-up interviews held with a purposive sample of survey respondents. Survey/interview questions explored the funding, types of peer support and the recruitment, training and support for peer supporters. Descriptive and thematic analysis was undertaken. Thirty-one managers/coordinators/trainers and 77 peer supporters completed the survey from 48 peer support organisations/services in 16 different countries; with 26 interviews undertaken with 27 survey respondents. We integrated survey and interview findings into five themes: 'background and infrastructure of peer support services', 'timing, location and nature of peer support', 'recruitment and suitability of peer supporters', 'training provision' and 'professional and emotional support'. Findings highlight variations in the types of peer support provided, training and development opportunities, supervisory and mentoring arrangements and the methods of recruitment and support for peer supporters; with these differences largely related to the size, funding, multidisciplinary involvement, and level of integration of peer support within healthcare pathways and contexts. Despite challenges, promising strategies were reported across the different services to inform macro (e.g. to facilitate management and leadership support), meso (e.g. to help embed peer support in practice) and micro (e.g. to improve training, supervision and support of peer supporters) recommendations to underpin the operationalisation and delivery of PS provision.

  • 852.
    Thomson, Gill
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. University of Central Lancashire.
    Crossland, N.
    University of Central Lancashire.
    Using the behaviour change wheel to explore infant feeding peer support provision; Insights from a North West UK evaluation2019In: International Breastfeeding Journal, ISSN 1746-4358, E-ISSN 1746-4358, Vol. 14, no 1, article id 41Article in journal (Refereed)
    Abstract [en]

    Background: Breastfeeding peer support is advocated in national and international guidelines, but the evidence base is mixed. In the UK, breastfeeding peer support was found to be ineffective in randomised controlled trials, while women report positive impacts on breastfeeding experiences in qualitative studies. A key criticism levied against breastfeeding peer support is the lack of theory underpinning intervention design. Here we use the Behaviour Change Wheel to structure the analysis of evaluation data from an infant feeding peer support service in one area in North West England. We aimed to provide theoretically informed insights into how peer support can be operationalised to influence women’s breastfeeding experiences.

    Methods: A 2 year mixed-methods evaluation (2014–2016) comprised surveys and interviews (individual or group) with peer supporters, health and community professionals, project leads and women, and routinely collected infant feeding data. We used the three layers (policies, intervention functions and behaviour-related components) of the Behaviour Change Wheel to structure and interpret the data.

    Results: Overall data comprised 23 interviews (n = 14 - individual; n = 9 - group) and 409 completed surveys. The findings are presented in three sections. First, the ‘policies’ (outer) layer of the Behaviour Change Wheel provides insights into the existing context, infrastructure and resources that underpinned peer support delivery. Then the second (intervention functions) and inner (behaviour components) layers of the Behaviour Change Wheel are used to present three themes, ‘developing capabilities for infant feeding’, ‘motivating guidance and support’ and ‘opportunities for support’. These findings highlight that a peer support service delivered in a context of effective interdisciplinary partnerships, Baby Friendly Initiative accreditation, and flexible service planning, with peer support provided via different types of instrumental, social, practical and emotional support was perceived to be highly beneficial on women’s breastfeeding experiences. In the final section key challenges faced by the service are outlined.

    Conclusion: While gaps and areas for development were highlighted, the service enhanced women’s capabilities, motivations and opportunities for breastfeeding. These theoretically informed insights into an organic and responsive peer support service help build the evidence base for breastfeeding peer support and to identify positive delivery features for future testing.

  • 853.
    Thor, Jessica
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsåtgärders effekter påcytostatikarelaterade biverkningar2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: To evaluate the impact of the nurse's suggested nursing interventions on chemotherapy-related side effects in cancer patients undergoing chemotherapy treatment. Method: The work was conducted as a literature review. The results are based on 13 quantitative articles. For data collection the databases PubMed and Cinahl was used. Results: The results showed that nurses can perform nursing interventions that reduce patients' experience of chemotherapy-related side effects. The effects that emerged from the nursing interventions are presented under the headings; oral cryotherapy for oral mucositis, person-centered patient education with the subtitle education from a theoretical perspective, self-care, automated and nurses assisted symptom management, music therapy, imagery and relaxation. Conclusion: Nurses can through various nursing interventions help patients to relieve symptoms from chemotherapy-related side effects.

  • 854. Thoroddsen, Asta
    et al.
    Sigurjonsdottir, G
    Ehnfors, Margareta
    Ehrenberg, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Accuracy, completeness and comprehensiveness of information on pressure ulcers recorded in the patient record2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 1, p. 84-91Article in journal (Refereed)
    Abstract [en]

    Aim:  To describe the accuracy, completeness and comprehensiveness of information on pressure ulcers documented in patient records.

    Design and setting:  A cross-sectional descriptive study performed in 29 wards at a university hospital in Iceland. The study included skin assessment of patients and retrospective audits of records of patients identified with pressure ulcers.

    Participants:  A sample of 219 patients was inspected for signs of pressure ulcers on 1 day in 2008. Records of patients identified with pressure ulcers were audited (n = 45) retrospectively.

    Results:  The prevalence of pressure ulcers was 21%. Information in patient records lacked accuracy, completeness and comprehensiveness. Only 60% of the identified pressure ulcers were documented in the patient records. The lack of accuracy was most prevalent for stage I pressure ulcers.

    Conclusions:  The purpose of documentation to record, communicate and support the flow of information in the patient record was not met. The patient records lacked accuracy, completeness and comprehensiveness, which can jeopardise patient safety, continuity and quality of care. The information on pressure ulcers in patient records was found not to be a reliable source for the evaluation of quality in health care. To improve accuracy, completeness and comprehensiveness of data in the patient record, a systematic risk assessment for pressure ulcers and assessment and treatment of existing pressure ulcers based on evidence-based guidelines need to be implemented and recorded in clinical practice. Health information technology, including the electronic health record with decision support, has shown promising results to facilitate and improve documentation of pressure ulcers.

  • 855.
    Thureson, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hellberg, Jonas
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnad av patienter med smärta vid misstänkt höftfraktur i akutsjukvård. En litteraturstudie.2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: The number of elderly people with hip fracture is increasing in line with the increased life expectancy. Elderly often suffer from osteoporosis and hip fractures are mostly caused by a slight fall accident. Hip fractures cause suffering, patients need careful care and adequate pain relief in prehospital care.     Objective: To compile evidence of what is important in the care of patients with pain in suspected hip fracture in acute medical care.   Method: This study is a literature review, an overview of scientific literature that describes the care of patients with hip fracture in emergency medical care. Data collection from PubMed and CINAHL was conducted, 18 articles were selected, both qualitative and quantitative. The quality of the articles was reviewed. The material was organized into categories and then synthesized.  Results: Pain relief was often inadequate and more individualized care was needed. Patients felt that the nurses lost patient focus. Patient’s and nurse’s experiences of nursing care differed, mainly in communication, information and participation. The most common pain relief was morphine, regional nerve blockade was less common. Elderly patients or patients with cognitive impairment received less pain relief that could be explained by the lack of behavioral-based pain assessment tools.   Conclusion: Patient involvement, clearly structured patient information and communication is important for good interaction between patient and nurse. Pain relief methods, pain assessment and documentation need to be developed and improved, especially for patients with cognitive impairment.

  • 856.
    Tinnerholm Hultman, Liselott
    et al.
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Westman, Alexandra
    Dalarna University, School of Education, Health and Social Studies, Sexual Reproductive Perinatal Health.
    Förstföderskors förlossningsupplevelse och deras uppfattning av barnmorskans stöd2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim

    The aim of this study was to describe primiparas birth experience, their perception of the midwives support and describe correlation between birth experience and midwifery support.

    Method

    The study was carried out as a quantitative cohort study where chosen variables was studied and described in relation to the aim and question formulations. The data was obtained from an earlier performed survey and was presented in charts and within the text of the study. The analysis was done in SPSS programme of statistics.

    Results

    The result showed that half of the women included in the study felt mixed feelings about their labour, closely followed by women with a positive birth experience. Almost all women (98,7%) had a positive perception of the midwife and felt support from the midwife. Within the results there is no significant correlation between primiparas positive and negative birth experience and the perception of the midwives attributes and support.

    Conclusion

    The results indicate that the midwives attributes and support contributed to a positive birth experience for primiparas. The midwives support was also important for women regardless of feelings related to their birth experience. However, no significant correlation was found between primiparas birth experience and their perception of the midwives support. Further studies are needed to explore potential association between negative birth experience and midwifery support.

  • 857.
    Toivainen, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östlund, Maja
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelser av personcentrerad vård inom demensomsorgen – En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Dementia is a common disease which is expected to extent in the coming years. In today´s society people with dementia are stigmatized and the perception of dementia are often negative. In order to improve the person-centered care for people with dementia, the nurse´s difficulties in working with this needs to be explored.

    Aim:

    The purpose of this literature review was to describe the difficulties nurses experience working with person-centered care in care of people with dementia.

    Method:

    A literature review with a result based on 15 scientific articles. The articles were searched on the databases PubMed and CINAHL with the keywords Person centered, Dementia, Nursing and Approach. The articles were quality checked using quality review templates. The result sections of the articles were analyzed by searching for differences and similarities. These differences and similarities were sorted into categories.

    Results:

    The results is based on these four categories: Nurse´s difficulties in communication to the person with dementia, Nurse´s and other career´s negative attitudes, Lack of experience and knowledge, and How the nurse are affected by the structure of the organization – such as lack of time and lack of organizational support.

    Conclusion:

    This literature review has identified what difficulties the nurse experience in the work of person-centered care in dementia care. The difficulties identified were at individual-, team- and organizational levels. The conclusion of this is that it requires a change in these levels to improve person-centered care in dementia care.

  • 858. Tranback, A.J.
    et al.
    Dickens, Stina
    Mattsson, Janet
    Karolinska Institutet.
    Karling, Mats
    Umeå Universitet.
    Ljungman, Gustav
    Uppsala Universitet.
    Forsner, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    My child suffers pain: a narrative exploration of how parents perceive and manage children’s pain at home2012Conference paper (Refereed)
  • 859.
    Tranlund, Kim
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ismail, Mahabat
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att leva med kroniska sår En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Bakground: Chronic wound comprises of leg ulcer, foot ulcer, decubitus, diabetic ulcer,

    damaged ulcer, tumors, rheumatic wounds and care damage with complications after surgical

    intervention, which hasn't healed within six weeks. Research gives the results of showing

    that, even though prevention of strategies are used, the ulcer is still developing and needs

    treatment. In the meeting with the healthcare, it is important to have a good nursing and a

    good relationship care. Lack of this often leads to suffering that the individual must endure

    with the aid of coping strategies.

    Aim: The aim of this study was to explore the persons experience of living with a chronic

    ulcer.

    Method: In this study a literature review was done, with 15 scientific articles, which

    consisted of both quantitative and qualitative methods.

    Results: 3 main categories where identified: restriction, pain and coping. The participants felt

    that it was lack of information and limitations in everyday life which affected the individual's

    social life and physical activity. Pain, shame and fear led to depression. To get the capability

    to handle the situation, the individuals turned to their families and care provider for support.

    Conclusion: As it is stated, the individuals where affected in their everyday life due to the

    chronic ulcer. The constant pain which is caused the sleeping disturbances in the individual´s

    made coping the pain and everyday life harder. Continuity with the healthcare provider and

    treatment gave an understanding and safety for the individuals for their condition. It was

    important that the health professionals not only put their focus on the healing of the wound

    and the treatment, they must also put attention to the individual with the wound.

  • 860.
    Tripkou, Agnes
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ölén, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Psykisk hälsa uttryckt genom barns och unga vuxnas beskrivning av sin livssituation: – en kvalitativ intervjustudie2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att belysa psykisk hälsa utifrån hur barn och unga vuxna beskriver sin livssituation.

    Metod: Kvalitativ innehållsanalys av 65 telefonintervjuer med barn och unga vuxna från en jämförelsegrupp till en undersökningsgrupp av unga som överlevt cancer. Jämförelsegruppen hämtades från Statens personadressregister (SPAR) som omfattar svenska medborgare.

    Resultat: Det visade sig att den psykiska hälsan hos de barn och unga vuxna som medverkade i studien var framträdande och uttrycktes som att: vara med och få stöd från andra, kunna hantera stress, vara delaktig i skola eller arbete, ta hand om sig själv, kunna se framåt och ha en positiv självbild.

    Slutsats: Utifrån denna studie kan slutsatsen dras att barn och unga vuxna uttrycker god psykisk hälsa. Resultatet kan tolkas som trovärdigt, då ett stort antal barn och unga vuxna har intervjuats och deras beskrivningar om sin livssituation som helhet beskrevs positivt avseende psykisk hälsa. Tidigare mätningar har visat på en ökad psykisk ohälsa bland barn och unga vuxna medan andra studier visat att den har avstannat på senare år. Vidare forskning med djupare intervjuer bör därför genomföras.

  • 861.
    Trolle-Lindgren, Åsa
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lundholm, Stina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelse av personcentrerad vård i omvårdnadsarbetet på äldreboende: En kvalitativ intervjustudie2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The concept of person-centered care characterizes by care recipients and relatives are seen and understood as unique persons, with individual needs, resources, values and expectations.  Aim: To describe the nurses' experiences of what can affect the integration of person-centered care in housing fpr the elderly. Method: A qualitative study with semi-structured interviews with nine nurses working in nursing homes in Sweden was analyzed by qualitative content analysis. Result: The analysis identified twenty-three subcategories, which were divided into the main categories; The approach to the older person, Participation in healthcare, Competence in nursing, Cooperation in teamwork, Opportunity for dialogue, Impact of housing environment, Structuring of nursing, Impact of work environment and Influence of the management. Conclusion: Supervision is an important part of the implementation of person-centered care in housing for the elderly. Nurses have an important role in setting a good example to encourage other colleagues to adopt a person-centered approach. In order for nurses to have the opportunity to influence other health care personnel, the management's support is of great importance, where the opportunity for education and further development of the healthcare staff needs more attention. The organization also need to work for an environment that promotes a person-centered care, which includes a good basic staffing, continuity of staff within all occupational groups and time to respond to the needs of each older person.  

  • 862.
    Tunander, Frida
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Gustafsson, Cecilia
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Kvinnors upplevelser av att leva med bröstcanceren litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common cancer amongst women and

    the amount is increasing. Diagnosed by cancer leads to many emotional changes.

    To be a nurse it’s very important to be knowledge about the disease and to

    understand the patient’s experience during the cancer period in order to give good

    treatment.

    Objective: The purpose of this literature study is to describe women’s

    experiences on how to live with breast cancer.

    Method: The databases PubMed and Cinahl are used in the search of articles.

    The results have been analyzed through an analyzed method for qualitative studies

    and the result of the literature is based on 14 science articles of qualitative

    approach.

    Results: The women experienced negative changes in their everyday life related

    to the disease when it comes to physical, mental and social experiences. They

    experienced a change in their role both as a mother and as a women. Which and

    how much information the women wished to retain regarding their status varied.

    The women got a new outlook on life and they appreciated life more than they did

    before the disease.

    Conclusion: The women experienced many difficulties because of the breast

    cancer and these experiences are important to keep in mind when treating breast

    cancer diagnosed patient.

  • 863.
    Turunen, Päivi
    et al.
    Linköpings universitet.
    Marusarz, Marika
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Framtidsutmaningar för alternativ omsorg i glesbygder2017In: Social omsorg i socialt arbete: Grunder och fördjupningar / [ed] Stina Johansson, Malmö: Gleerups Utbildning AB, 2017, 1, p. 217-237Chapter in book (Refereed)
  • 864.
    Tång, Anna-Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Anhörigas upplevelser av vård i livets slutskede på särskilt boende: En litteraturstudie2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Purpose:

    The purpose of this literature study was to describe the relatives experience of care in the final stages of life in nursing homes.

    Method

    :

    A literature study that included fifteen scientific articles. Method of analysis according to Evans (2002) were used. The study was conducted during the spring of 2018.

    Results:

    Data analysis resulted in 4 categories; Feeling of burden, Desire to be seen, Need for participation and Need for support. The majority of the results were based on articles from Europe.

    Conclusions:

    More knowledge is required regarding relatives' perceptions of care in the final stages of life. The 6 S can be a tool that can contribute to planning, thus increasing the number of relatives who can participate and it that way improve the care of the patient.

  • 865.
    Törnberg, Sofie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lidegran, Ebba
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelser av omvårdnaden till patienter inom palliativ vård på vårdavdelning: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Nurses essential responsibilities are to promote health, prevent disease, restore health and relieve suffering. In palliative care, when a cure is no longer possible, the goal is to promote health and relieve suffering. Caring for a patient at the end of life is a major challenge for the nurse, who plays a crucial role in palliative care of the patient.

    Aim

    To describe the nurse’s experiences of nursing patients in palliative care in the ward.

    Method

    A literature review based on 12 scientific articles, both quantitative and qualitative. Searches of the articles was made in databases Cinahl and PubMed. Analysis of the articles' results was based on Forsberg and Wengström's (2016) method.

    Results

    Nurses experiences formed four categories with belonging subcategories: Communication difficulties: cooperation, care relationship, Time- and resource shortages: impact on nursing, planning and prioritization, Knowledge: accepting death and Education.

    Conclusion

    Nurses felt that the mentioned experiences were significant in the nursing work of patient in palliative care. They ment that lack of knowledge and time- and resource shortage complicated nursing work, which created a sense of insufficiency. Communication was considered to be an important factor for cooperation and care relationship, but in many cases it was difficult to master. Education in the field was requested to enable the development of knowledge for the nurse in the care of patients in palliative care.

  • 866.
    Törnkvist, Karin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Sandra
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som förhindrar nutritionsvårdsprocessen för att förebygga malnutrition hos äldre: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    Sweden has about 2 million older people, of whom about 60 percent are at risk for malnutrition. The care provider has the ultimate responsibility for establishing routines for when and how care recipients will be investigated and treated. Risk assessment with a validated nutrition assessment instrument is the first step in the nutrition care process. Routine monitoring and follow up can prevent older people from developing malnutrition. The aim was to investigate factors which prevented the nutrition care process in older people. Method: The study was conducted as a literature review including 13 articles. The result was divided into categories which highlighted organizational, - personnel, - and patient related factors. The demonstrated factors were reported to prevent the nutrition care process in different ways and sometimes in relation to each other. Conclusion: The described barriers to the nutrition care process are important for quality assurance. Support and strategies at several levels are needed to overcome the barriers that hinder nutritional care.

  • 867.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work. CKF, Centrum för Klinisk Forskning.
    The concept and relevance of existential issues in healthcare encounters2014Conference paper (Refereed)
    Abstract [en]

    Rationale: Existential issues are relevant, not only in healthcare research, but also in healthcare practice as patients express needs relating to emotional and/or existential aspects of the new and often unexpected life situation they find themselves in. In critical situations, such as being diagnosed with a life-threatening illness, where a previously envisioned future and one’s basic security come under threat, existential issues often arise. Therefore, as a threat to existence, medical problems also become existential problems involving suffering and issues of life and death. Healthcare professionals need to be prepared for this. Thus, there is a need for clarification of what existential issues might.

    Aim: To illuminate and clarify the concept of existential issues in relation to nursing research and nursing practice.

    Method: Literature was searched in philosophical literature, PubMed, Cinahl and Psycinfo.

    Results: The concept of existential has its origin in philosophy and is common for all humans regardless of culture or religion. Existential issues often concern meaning, death, existential isolation and freedom. Although healthcare professionals are often aware of what existential issues may be, they feel unsure to communicate with patients and their loved ones about existential issues.

    Conclusion: Although acting in the professional capacity, the healthcare encounter is still primarily a human encounter where existential issues must be acknowledged and handled in order to support the patient to find meaning and thus relieve suffering. Further education with reflective discussions for healthcare professionals on challenging and difficult caring situations is important to support a deeper understanding of existential issues and to facilitate integration between phronesis-based and episteme-based knowledge. This in turn seems to enable communication about existential issues in caring situations.

  • 868.
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    The concept and relevance of existential issues in nursing2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 4, p. 347-354Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to illuminate and clarify the concept existential issues in relation to nursing research and nursing practice.

    Methods: This article is a theoretical analysis of existential issues in relation to nursing.

    Results: Existential issues are becoming more commonly discussed and investigated in nursing research. Thus, it is important to clarify the concept.

    Conclusions: A clarification of existential issues may contribute to health care quality by increasing awareness of what existential issues are and drawing attention to the importance of discussing and reflecting on these issues, since practitioners in a caring profession will most likely encounter them.

  • 869.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Mittuniversitetet, Institutionen för hälsovetenskap; Karolinska institutet.
    Danielson, Ella
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Melin Johansson, Christina
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Existential Reflections among Nurses in Surgical Care2010In: Journal of Palliative Care, ISSN 0825-8597, Vol. 26, no 3, p. 228-229Article in journal (Refereed)
    Abstract [en]

    Objectives: To gain a deeper understanding of surgical nurses’ experiences of existential issues in cancer care.

    Methods: Written critical incidents were used to collect nurses’ descriptions and reflections of critical care situations involving existential issues. Individual face-to-face interviews were conducted as follow-up using semi-structured questions which were analysed with hermeneutical analysis.

    Preliminary results: The analysis showed that nurses in surgical care experience caring from different positions. Nurses either focus on the patient as a whole in the caring process or nurses focus more on medical information in the caring process. When focusing on the patient as a whole existential issues are considered to be a natural part of the caring process and nurses’ personal experiences help to enable encounters with the patients. When focusing more on the medical information in the caring process there was a transfer of responsibility to others, mainly the physicians.

    Preliminary conclusions: This study highlights that existential issues are indeed part of surgical cancer care derived from existential care situations. Nurses’ focus in the caring process differs. Nurses express different positions in caring and not all acknowledge patients’ existential issues as part of nurses’ responsibility. When lacking common strategies in the organization nurses derive existential caring strategies from personal experiences.

  • 870.
    Udo, Camilla
    et al.
    Department of Health Sciences, Mid Sweden University, Östersund, Sweden, and Health Care Sciences Post Graduate School at Karolinska Institute, Stockholm, Sweden.
    Danielson, Ella
    Mittuniversitetet, Inst. för Hälsovetenskap; Sahlgrenska Akademien, Götebrogs universitet.
    Melin-Johansson, Christina
    Mittuniversitetet, Inst. för Hälsovetenskap.
    Existential issues among nurses in surgical care - a hermeneutical study of critical incidents2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 3, p. 569-577Article in journal (Refereed)
    Abstract [en]

    Aims.

    To report a qualitative study conducted to gain a deeper understanding of surgical nurses’ experiences of existential care situations.

    Background.

    Existential issues are common for all humans irrespective of culture or religion and constitute man’s ultimate concerns of life. Nurses often lack the strategies to deal with patients’ existential issues even if they are aware of them.

    Design.

    This is a qualitative study where critical incidents were collected and analysed hermeneutically.

    Methods.

    During June 2010, ten surgical nurses presented 41 critical incidents, which were collected for the study. The nurses were first asked to describe existential care incidents in writing, including their own emotions, thoughts, and reactions. After 1–2 weeks, individual interviews were conducted with the same nurses, in which they reflected on their written incidents. A hermeneutic analysis was used.

    Findings.

    The majority of incidents concerned nurses’ experiences of caring for patients’ dying of cancer. In the analysis, three themes were identified, emphasizing the impact of integration between nurses’ personal self and professional role in existential care situations: inner dialogues for meaningful caring, searching for the right path in caring, and barriers in accompanying patients beyond medical care.

    Conclusion.

    Findings are interpreted and discussed in the framework of Buber’s philosophy of the relationships I-Thou and I-It, emphasizing nurses’ different relationships with patients during the process of caring. Some nurses integrate their personal self into caring whereas others do not. The most important finding and new knowledge are that some nurses felt insecure and were caught somewhere in between I-Thou and I-It.

  • 871.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Lövgren, Malin
    P033 Physicians’ Perceptions of End-of-Life Breakpoint Communication: A Focus Group Study2016In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 52, no 6, p. e73-e74Article in journal (Refereed)
  • 872.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Center for Clinical Research Dalarna, Falun.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    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. Karolinska Institutet; Chalmers University of Technology.
    A qualitative study of assistant nurses’ experiences of palliative care in residential care2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 4, p. 527-535Article in journal (Refereed)
    Abstract [sv]

    Aim

    To explore assistant nurses' experiences and perceptions of both positive and negative aspects of providing palliative care for older people in residential care facilities.

    Design

    A qualitative explorative study.

    Methods

    Critical incidents were collected through semi‐structured face‐to‐face interviews and analysed by performing a qualitative content analysis.

    Results

    A total of 40 critical incidents from daily work was described by assistant nurses. The results showed that close cooperation between unlicensed and licensed professionals was crucial to provide good care but was sometimes negatively affected by the organizational structure. The availability of professionals was identified as a critical factor in providing good care at the end of life in a consultative organization. The most prominent findings were those that indicated that, especially in a consultative organization, there seems to be a need for clear roles, comprehensive and clear care plans and a solid support structure to ensure continuity of care.

  • 873.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    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.
    Assistant nurses’ experiences and perceptions of palliative care situations in residential care2016Conference paper (Refereed)
  • 874.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    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.
    P177 Assistant Nurses’ Experiences and Perceptions of Palliative Care Situations in Residential Care2016In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 52, no 6Article in journal (Refereed)
  • 875.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Center for Clinical Research Dalarna.
    Svenningsson, Irene
    Björkelund, Cecilia
    Hange, Dominique
    Jerlock, Margareta
    Petersson, Eva-Lisa
    An interview study of the care manager function: Opening the door to continuity of care for patients with depression in primary care2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 974-982Article in journal (Refereed)
    Abstract [en]

    Aim: To explore experiences among patients with depression of contact with a care manager at a primary care centre.

    Design: A qualitative explorative study.

    Methods: During spring and summer 2016, 20 individual face-to-face interviews were conducted with patients with experience of care manager contact. The material was analysed using systematic text condensation.

    Results: The participants described that having contact with a care manager was a support in their recovery process. Care became more available, and the structured continuous contact and the care manager's availability contributed to a trusting relationship. Having someone to share their burden with was a relief. However, it was described as negative when the care manager was perceived as inflexible and not open to issues that the participants felt a need to discuss. For the care manager contact to be successful, there is a need for flexibility and individually tailored contact.

  • 876.
    Ullgren, Evelina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Tervo, Rebecka
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patientdelaktighet i vården vid bedsiderapportering: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : Participation and person-centered care are key concepts in the care that are being given today. In order for the patient to participate, they must be involved in the daily work such as shift reporting. At each shift, reporting occurs from one nurse to another which often lacks patient involvement. A reporting model is bedside report, which means reporting takes place in the patient's presence.

    Aim

    : The aim of this study was to describe patient’s participation in care during bedside report.

    Method

    : A literature review.

    Results

    : Bedside report made patients feel more involved in their care, partly because they felt valued as a participant in the report. The patients were considered a person in the first hand. Both patients and nurses felt that the reporting method was crucial for the participation. Most patients appreciated being included in the reporting and that they received valuable information that they considered justifiable. However, not all patients wanted to participate, which was due, among other things, to the fact that the report was considered for the nurses.

    Conclusion

    : Bedside report increased patient involvement in care, according to both the patient and the nurse. However, not all patients wanted to participate and the reporting method were important for the level of participation.

  • 877.
    Ullén, Matilda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bivesjö, Linda
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans erfarenheter kring omvårdnad av patienter med psykisk ohälsa på akutmottagningar: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    : Mental illness is increasing among the population and is today an extensive and serious public health problem. In nursing a patient with mental illness, it’s important that the nurse's first meeting with the patient is characterized by the patient being able to feel trust and hope towards the nurse. It is common for a patient with mental illness to have their first meeting within healthcare in the emergency department. The emergency department has a high rate of work that can make it difficult for the nurse to set aside time to build a relationship with the patient and the nursing requirements are different from nursing in psychiatric care.

    Aim:

    To describe nurses' experience in nursing patients with mental illness in the emergency department.

    Method:

    A literature review.

    Finding:

    There were five themes that had significance for the nurses' experiences: environment, time, attitudes, communication, knowledge and education. The findings showed that a busy environment was considered unsuitable for the care of patients. Furthermore, the results showed that a lack of time and lack of nurse’s knowledge affected communication and attitudes towards their patients.

    Conclusion:

    The literature review shows that nurses requires shortcomings in nursing patients with mental illness in emergency departments.

  • 878.
    Usuda, Mie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Stöd till patienter med stomi:: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att studera vad stomiopereradepatienter får för stöd och vad de saknar för stöd för att

    patienten ska kunna anpassa sig till sitt nya liv med stomi.

    Metod: Studien är en litteraturöversikt som byggs på vetenskapliga artiklar som har tagits

    fram i databaserna CINAHL och PubMed.

    Resultat: Stöd som stomiopererade patienter får för att effektivt anpassa sig till sin stomi var

    psykosocialt stöd bland annat gruppbaserad interaktiv undervisning i stomivård samt stöd

    efter utskrivning bland annat stomiterapeutledd telefonuppföljning. Stöd som stomiopererade

    patienter saknar för att effektivt anpassa sig till sin stomi var framförallt pre- och postoperativ

    information samt information om sexualliv med stomi.

    Slutsats: Det fanns både befintligt och bristande stöd för stomiopererade patienter att

    effektivt anpassa sig till sin stomi. Sjuksköterskan har ett viktigt ansvar för att öka kunskap

    om var fokus för omvårdnaden för tarmstomiopererade patienter bör ligga för att effektivt

    hjälpa patienten att anpassa sig till sitt nya liv med stomi.

  • 879.
    Vahtera, Elin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Einarsson, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Vuxna personers upplevelse av hälsorelaterad livskvalité efter en gastric bypass operation: –En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Obesity and overweight have become more frequent in recent years and is

    today a major health problem worldwide. A lot of people find it difficult to lose weight on

    their own which has made surgery become more common in recent years. Gastric bypass

    surgery is currently the most common surgical method of weight loss and have shown good

    results. However, the health-related quality of life is affected as the operation demand a

    major lifestyle change.

    Purpose: The purpose of this study was to describe adults’ experience of health-related

    quality of life after a gastric bypass surgery.

    Method: The study contains 11 quantitative and 3 qualitative scientific articles describing

    the adults’ experience of health-related quality of life after a gastric bypass surgery.

    Results: Health-related quality of life (HRQOL) has shown an improvement in all studies

    after a gastric bypass surgery. HRQOL has had its peak after 1 month in all scales based on

    the SF-36 questionnaire.

    Conclusion: The major lifestyle change that people go through after a gastric bypass

    surgery has shown improvements in HRQOL in both long and short term. Contributing

    factors that may affect the improved health-related quality of life can among other things be

    fulfilled expectations of the surgery and physical activity.

  • 880.
    van der Zijpp, T.
    et al.
    Fontys University.
    Niessen, T.
    Fontys University.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Hawkes, C.
    McMullan, C.
    Mockford, C.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McCormack, B.
    Rycroft-Malone, J.
    Seers, K.
    A bridge over turbulent waters: Illustrating the interaction between managerial leaders and facilitators when implementing research evidence2016In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 13, no 1, p. 25-31Article in journal (Refereed)
    Abstract [en]

    Background: Emerging evidence focuses on the importance of the role of leadership in successfully transferring research evidence into practice. However, little is known about the interaction between managerial leaders and clinical leaders acting as facilitators (internal facilitators [IFs]) in this implementation process.

    Aims: To describe the interaction between managerial leaders and IFs and how this enabled or hindered the facilitation process of implementing urinary incontinence guideline recommendations in a local context in settings that provide long-term care to older people.

    Methods: Semistructured interviews with 105 managers and 22 IFs, collected for a realist process evaluation across four European countries informed this study. An interpretive data analysis unpacks interactions between managerial leaders and IFs.

    Results: This study identified three themes that were important in the interactions between managerial leaders and IFs that could hinder or support the implementation process: "realising commitment"; "negotiating conditions"; and "encouragement to keep momentum going." The findings revealed that the continuous reciprocal relationships between IFs and managerial leaders influenced the progress of implementation, and could slow the process down or disrupt it. A metaphor of crossing a turbulent river by the "building of a bridge" emerged as one way of understanding the findings.

    Linking evidence to action: Our findings illuminate a neglected area, the effects of relationships between key staff on implementing evidence into practice. Relational aspects of managerial and clinical leadership roles need greater consideration when planning guideline implementation and practice change. In order to support implementation, staff assigned as IFs as well as stakeholders like managers at all levels of an organisation should be engaged in realising commitment, negotiating conditions, and keeping momentum going. Thus, communication is crucial between all involved.

  • 881.
    Vildebrandt, Ems
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Omvårdnadsdiagnoser hos militärpersonal i relation till militärt etos – En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background The International Council of Nurses (ICN) states in it’s ethical code that the nurse practitioner is responsible for giving each patient correct and culturally adapted care. Military culture is unique and comes with its own challenges and needs of nursing care. Aim The aim is to find the prominent nursing diagnoses in military personnel in relation to the military ethos. Method A literature review of twenty articles found through searches in PubMed, Cinhal and Summon. Results The prominent nursing diagnoses were risk-prone health behavior together with pain issues and sleep disturbances. Two thirds of military personnel consumed high amounts of alcohol, pain issues was the most prevalent, up to half of all personnel experienced sleep disturbances and willingness to seek care was low. Stress, depression, consequences of pain and effects on the family process was also found. Result of military duty could also be infections, wounds, dermatological problems, hearing impairment and diarrhea. Conclusion Military culture is unique and reports health differently than the civilian population. Because of this it is important to know the prominent diagnoses to be able to give this patient group appropriate nursing interventions and competent care.

  • 882.
    Vildelöt, Sandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Edman, Karin
    Dalarna University, School of Education, Health and Social Studies, Caring Science.
    Personalens förväntningar inför sammanslagning av förlossnings-, BB- och neonatalavdelningen och att samtidigt införa samvård: Kvalitativ studie med fokusgruppsintervjuer2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The bonding between child and parent is aided when child and parent can be together as soon as possible from delivery. Teamwork improves quality and contributes to a holistic-perspective on nursing. A good work environment and good cooperation between staff is important for the efficiency of family-centered care. It is significant to investigate the expectations of the staff before introducing a new way of working, since it may reflect in the quality of care later given.The aim of this study was to illustrate the staffs’ expectations on the fusion of care units and whilst introducing family-centered care.The method was a qualitative method, with three focusgroup interviews of a total of 14 participants. Data was analyzed using qualitative content analysis.The result was summarized with the theme “safe and common or new and uncertain – the balance of change” that described the feelings of the staff before the fusion. The categories “achieving a good environment for parents and staff”, “to cooperate focusing on the family”, “uniting two clinics and cultures” and “to experience a change in establishment” described the expectations and fears of the staff.Conclusions: Results showed expectations of improved care- and work environment, and that the cooperation between clinics would become more efficient. It was important having a clear flow of information, to feel participant and to have a straight-forward management in order to create a functioning way of work in family-centered care.

  • 883. Vogel, G
    et al.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Evidence as a basis for clinical practice guidelines on mechanical ventilation in intensive care in Sweden.2012Conference paper (Refereed)
  • 884.
    Von Baltzer, Camilla
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att vårda palliativa hjärtsviktspatienter inom kommunal hemsjukvård - Distriktsköterskors upplevelser: - En kvalitativ studie2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:

    District nurses in the community health service are one of the main providers of palliative care. Chronic heart failure patients could suffer from lack of treatment or correct care in comparison to other groups of palliative care patients. Lack of experience, education in health professionals and the leadership within the organisation are one of several factors for palliative chronic heart failure patients to not receive tailor dressed care

    Aim:

    To explore district nurses view of caring for palliative chronic heart failure patients in community health service

    Method

    : Quality design and interviews were analyzed by a quality content analysis.

    Result:

    The results resulted in two categories; The organizations influence public health nurses daily work with two subcategories, The competence, development and team work of the public health nurses and the palliative care organisations and leadership. The second category was, Public health care nurses’ professional approach with subcategories Public health care nurse’s treatment of patients and relatives and Public health care nurse’s experiences of care plans.

    Conclusion:

    District nurses need continuously education enabling to feel secure and satisfaction in the care and reception of palliative heart failure patients and relatives. It´s important to enhance the teamwork to create a positive work environment for the District nurses. Care plan systems must be suitable and user friendly to improve the palliative care for chronic heart failure patients.

  • 885.
    Välilä, Jaana
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskornas beskrivning av sväljbedömninghos äldre personer med misstänkt dysfagi inomkommunal hälso- och sjukvård: En kvalitativ intervjustudie2016Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim:

    The aim of this study was to investigate Registered Nurses’ (RNs) description of swallowing

    assessments in older people with suspected dysphagia in municipal health care.

    Method:

    The method was a qualitative interview study.

    Results:

    The results demonstrated the following categories “ Observation of symtoms”, "A practical

    assessment", "Attendance at mealtime", ”Adapting food", "Adaptation of care", “Supervision of staff

    " , "Team meetings had significance for planning of health care" ,

    and "Lack of knowledge and assessment

    instruments".

    Conclusion:

    RNs describe that swallowing assessment is an important task in the daily work. The

    RNs presence and collaboration will help to guide staff so that no inappropriate methods are used, as

    well as to attend meals and observing a patient's swallowing function. RNs who work in municipal

    health care need more knowledge about swallowing assessments and management of an assessment

    instrument.

  • 886.
    Wadensten, Barbro
    et al.
    Örebro universitet, Hälsoakademin.
    Engholm, Rosa
    Örebro universitet, Hälsoakademin.
    Fahlström, Gunilla
    Örebro universitet, Hälsoakademin.
    Hägglund, Doris
    Örebro universitet, Hälsoakademin.
    Nursing staff's description of a good encounter in nursing homes2009In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, no 3, p. 203-210Article in journal (Refereed)
    Abstract [en]

    Background. It has been stated that there is too little research on what constitutes good communication and good encounters in nursing homes.

    Aim and objectives. The aim of the present study was to examine nursing staff members’ views on what is important in caring encounters with older people living in nursing homes.

    Design. A qualitative descriptive study using focus group interviews with staff in a nursing home in Sweden.

    Method. Focus group interviews, analysed using qualitative content analysis.

    Results. Three main themes emerged describing nursing staff members’ opinions about the content of good encounters: ‘Caring encounters from the perspective of equality’, ‘Caring encounters from the perspective of integrity’ and ‘Caring encounters from the perspective of promoting security’.

    Conclusions. The nursing staff had theoretical knowledge of what constitutes a good caring encounter, but they seemed to need more supervision and training to develop their ways of encountering older people as well as to become stronger in their professional role. When performing such training with staff, the methodology of appreciative inquiry could be a powerful tool.

    Relevance to clinical practice. It is important to help staff become empowered and to help them develop and improve their encounters with older care recipients.

  • 887.
    Waldfelt, Anne
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wallin, Helena
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Vårdpersonalens erfarenheter av att använda levnadsberättelsen inom särskilda boenden för personer med demenssjukdomEmpirisk studie med kvalitativ ansats2018Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In order to create as good quality of life as possible for the person with dementia, care need to be given based on a person-centered approach with the person in focus instead of the dementia itself. The life-story is important for getting to know the person with dementia. Purpose: To describe the health professionals experience of using the life-story in nursing homes for people with dementia. Method: Qualitative interview study with healthcare professionals experience of using life-stories in nursing homes for people with dementia. Results: The life-story was important in order to get to know the person, which was important for planning nursing and responding to the person in the best way. It could help maintain functions and habits as well as help in conversations that could stimulate and wake up memories. The life-story could also help to prevent and alleviate BPSD. Education and good leadership were seen as success factors for a well-functional work with the life-story. Conclusion: The life-story is a prerequisite for being able to conduct personal care in nursing homes for people with dementia. It is a help to respect the person's will and wishes, and by acting on the basis of the life-story, then plan the care. Education of health professionals and good management skills has been seen as success factors for successful work with the life-story.

  • 888.
    Walladbegi, Java
    et al.
    Department of Oral Medicine and Pathology, Institute of Odontology at Sahlgrenska Academy, University of Gothernburg.
    Svanberg, Anncarin
    Uppsala University.
    Jontell, Mats
    Department of Oral Medicine and Pathology, Institute of Odontology at Sahlgrenska Academy, University of Gothernburg.
    Efficacy of a novel intraoral cooling device2015Conference paper (Refereed)
    Abstract [en]

    Background: Oral mucositis (OM) is a common debiliating adverse effect following high dose chemotherapy prior to bone marrow transplantation. OM often interferes with food intake and lead to malnutrition, weight loss and impaired quality of life. These adverse effects may require intravenous morphine for pain alleviation, Although uncomfortable to the patient, oral cryotherapy with ice chips has been shown to reduce the grade and extent of OM. Purpose: The purpose of the present study is to evaluate whether an intraoral cooling device has the same effectiveness as ice chips when it comes to cooling the oral mucosa. Method: Five healthy volunteers (mean age 36.2 years) chewed ice under surveillance for 30 minutes. Before the start of and immediately after the termination of the ice chewing, the intraoral mucosal temperature was measured using a modified thermometer. The same protocol was used to asses the cooling efficacy obtained by the newly developed intraoral device. Results: No statistical significant differences in cooling of teh oral mucosa (p=0.12) were obtained. The mean surface temperature following cooling was 25.7 degrees Celcius with ice chips and 24.7 degrees Celcius with the cooling device. Conclucion: The cooling device is as effective as ice chips in terms of cooling the oral mucosa. The next step in this research is to use the cooling devise to establish the highest surface temperature of the oral mucosa, during infusion of chemotherapy, that will still result in prevention of oral mucositis.

  • 889.
    Wallenberg, Solveig
    et al.
    Dalarna University, School of Health and Social Studies, Caring Science.
    Östlund, Lena
    Dalarna University, School of Health and Social Studies, Caring Science.
    HUr ungdomar med självskadebeteende upplever vårdpersonals bemötande2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att beskriva hur ungdomar med självskadebeteende upplever bemötandet från vårdpersonalen. Metod: Studien genomfördes som en litteraturöversikt där sju kvalitativa vetenskapliga artiklar samt en kvantitativ vetenskaplig artikel användes. Datainsamlingen gjordes i databaserna PubMed, Psyc INFO och CINAHL Resultat: Resultatet av denna studie visade på att de flesta av ungdomarna med självskadebeteende inte sökte vård då de antingen var rädda för att förvärra sina problem eller för att de inte visste vart de skulle vända sig. De valde att i första hand söka hjälp hos sina vänner. Resultatet visade på tre kategorier. Dessa var: rädsla för vården, negativa upplevelser av bemötandet och positiva upplevelser av bemötandet. I resultatet framkom att av de som sökte hjälp inom sjukvården kände sig många missnöjda. Dessa ungdomar upplevde att det största problemet under vårdtiden var negativa attityder och dåligt bemötande från personalen. De ungdomar som tagit överdoser var övervägande positiva till det bemötande och den vård de fått till skillnad från de som inte tagit överdoser. Slutsats: Studien visade att ungdomar inte söker hjälp av sjukvården för sitt självskadebeteende då de är rädda för att deras problem ska förvärras eller att de inte ska bli förstådda eller tagna på allvar. De som ändå söker hjälp upplever att de får en annan hjälp än den de önskar.

  • 890.
    Wallgren, Amanda
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Olsson, Elinor
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Massage, beröring och aromaterapi som symtomlindring hos patienter som lever med cancer: En litteraturöversikt2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Receiving a cancer diagnosis can for some be seen as getting a

    death sentence. It often evokes strong feelings of both the patients and their

    relatives. Living with cancer is often experienced as stressful both physically and

    mentally from the symptoms and side effects from treatments such as

    chemotherapy and radiation. However, hope often survive, only in different

    degrees before it find its way back.

    Aim: The purpose of this study was to describe massage and touch as a method for

    symptom relief in cancer patients.

    Method: This study has been designed as a litterature review consisting of 13

    qualitative and quantitative articles. Data was collected in the databases CINAHL,

    PubMed and by searching manually.

    Results: The results were presented in two main categories: symptomatic effect of

    massage and touch and impact of the quality of life by means of massage and

    touch. The underlying categories were: pain and nausea, and anxiety, sleep and

    relationships. Massage, touch and aromatherapy could help reduce pain, nausea

    and anxiety, although the effect waned when treatment ended. Sleep quality

    improved and touch could in some cases be seen as a way of deepen relationships.

    Conclusion: Different types of touchtherapy are some among the oldest methods

    in history and are being used more in health care. Massage, touch and

    aromatherapy can provide a good symptomatic effect both physically and

    mentally, and increase quality of life when receiving treatment continuously.

  • 891.
    Wallin, Lars
    Karolinska Institutet.
    A descriptive feast but an evaluative famine: implementation research in nursing2008In: Canadian Journal of Nursing Research, ISSN 0844-5621, E-ISSN 1705-7051, Vol. 40, no 2, p. 17-23Article in journal (Refereed)
  • 892.
    Wallin, Lars
    University of Alberta.
    Clinical practice guidelines in nursing: a straightforward route to evidence-based practice?2005In: AWHONN lifelines / Association of Women's Health, Obstetric and Neonatal Nurses, ISSN 1091-5923, Vol. 9, no 3, p. 248-51Article in journal (Refereed)
  • 893. Wallin, Lars
    Evidence-based practice in a global context: the case of neonatal mortality2008In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 5, no 4, p. 167-9Article in journal (Refereed)
  • 894.
    Wallin, Lars
    Karolinska Institutet.
    Knowledge translation and implementation research in nursing2009In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 46, no 4, p. 576-87Article in journal (Refereed)
  • 895.
    Wallin, Lars
    et al.
    University of Alberta.
    Ehrenberg, Anna
    Dalarna University, School of Health and Social Studies, Caring Science/Nursing.
    Evidence-based nursing-views from the Swedish horizon2004In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 1, no 3, p. 158-160Article in journal (Refereed)
  • 896.
    Wallin, Lars
    et al.
    Karolinska Institutet.
    Eriksson, Mats
    Newborn Individual Development Care and Assessment Program (NIDCAP): a systematic review of the literature2009In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 6, no 2, p. 54-69Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Important advancements have been made in the care of preterm infants. Health services have introduced various methods aimed at promoting attachment, breastfeeding, and neurological development. The Newborn Individualized Developmental Care and Assessment Program (NIDCAP), developed to stimulate preterm infants at levels adapted to the child's degree of neurological maturity, is increasingly being used.

    OBJECTIVES: The aim was to investigate the impact of NIDCAP on the psychomotor development, neurological status, medical/nursing care outcomes, and parental perceptions. A further aim was to evaluate the cost-related effects of NIDCAP.

    DATA EXTRACTION AND ANALYSIS: A literature search up to September 2007 was performed. The reviewed papers were assessed for methodological quality and only statistically significant findings were extracted.

    FINDINGS: The evidence compiled on the effects of NIDCAP is based on 12 articles from six randomized controlled trials that included approximately 250 children. Each of the studies was assessed as having medium quality. Most of the studies were small and many investigated a huge number of outcome variables, which decreased their scientific strength. On outcome variables in which a significant difference was found between the intervention (NIDCAP) and control groups, most studies showed better results for the NIDCAP group. This was particularly valid for cognitive and psychomotor development. Four studies also showed a reduced need for respiratory support for the NIDCAP group. No studies were identified that weighed the total cost of NIDCAP against its effects.

    CONCLUSIONS: Despite promising findings, primarily on cognitive and motor development, the scientific evidence on the effects of NIDCAP is limited. Shortcomings in design and methods in the reviewed studies hamper far-reaching claims on the effectiveness of the method. Scientific grounds for assessing the effects of NIDCAP would be substantially enhanced by a sufficiently comprehensive study with extended follow-up and a clear focus on a few important outcome variables.

  • 897.
    Wallin, Lars
    et al.
    University of Alberta.
    Estabrooks, Carole A
    Midodzi, William K
    Cummings, Greta G
    Development and validation of a derived measure of research utilization by nurses2006In: Nursing Research, ISSN 0029-6562, E-ISSN 1538-9847, Vol. 55, no 3, p. 149-60Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Theoretical models are needed to guide strategies for the implementation of research into clinical practice. To develop and test such models, including analyses of complex theoretical constructs and causal relationships, rich datasets are needed. Working with existing datasets may mean that important variables are lacking.

    OBJECTIVE: The aim of this study was to derive a nursing research utilization variable and validate it using the Promoting Action on Research Implementation in Health Services (PARIHS) conceptual framework on research implementation.

    METHODS: This study was based on data from two surveys of registered nurses. The first survey (1996; N = 600) contained robust research utilization variables but few organizational variables. The second (1998; N = 6,526) was rich in organizational variables but contained no research utilization variables. A linear regression model with predictors common to both datasets was used to derive a research utilization variable in the 1998 dataset. To validate these scores, four separate procedures based on the hypothesis of a positive relationship between context and research utilization were completed. Mutually exclusive groups reflecting various levels of context were created to accomplish these procedures.

    RESULTS: The derived research utilization variable was successfully mapped onto the cases in the 1998 dataset. The derived scores ranged from 0.21 to 21.40, with a mean of 10.85 (SD = 3.23). The mean score per subgroup ranged from 8.28 for the lowest context group to 12.75 for the highest context group. One of the validation procedures showed that significant differences in mean research utilization existed only among four conceptually unique context groups (p < .001). These groups showed a positive incremental relationship in research utilization (p < .001; the better the context, the higher the research utilization score). The validity of the derived variable was supported by using the three remaining validation procedures.

    DISCUSSION: The successful creation and validation of a derived research utilization variable will enable advanced modeling of the relationships between research utilization and individual and organizational characteristics. The findings also support the construct validity of the context element of the PARIHS theoretical framework.

  • 898.
    Wallin, Lars
    et al.
    Karolinska Institutet.
    Ewald, Uwe
    Wikblad, Karin
    Scott-Findlay, Shannon
    Arnetz, Bengt B
    Understanding work contextual factors: a short-cut to evidence-based practice?2006In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 3, no 4, p. 153-64Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: It has become increasingly clear that workplace contextual factors make an important contribution to provider and patient outcomes. The potential for health care professionals of using research in practice is also linked to such factors, although the exact factors or mechanisms for enhancing this potential are not understood. From a perspective of implementing evidence-based nursing practice, the authors of this article report on a study examining contextual factors.

    AIM: The objective of this study was to identify predictors of organizational improvement by measuring staff perceptions of work contextual factors.

    METHOD: The Quality Work Competence questionnaire was used in a repeated measurement survey with a 1-year break between the two periods of data collection. The sample consisted of 134 employees from four neonatal units in Sweden.

    FINDINGS: Over the study period significant changes occurred among staff perceptions, both within and between units, on various factors. Changes in staff perceptions on skills development and participatory management were the major predictors of enhanced potential of overall organizational improvement. Perceived improvement in skills development and performance feedback predicted improvement in leadership. Change in commitment was predicted by perceived decreases in work tempo and work-related exhaustion.

    CONCLUSIONS AND IMPLICATIONS: These findings indicate the potential for organizational improvement by developing a learning and supportive professional environment as well as by involving staff in decision-making at the unit level. Such initiatives are also likely to be of importance for enhanced use of research in practice and evidence-based nursing. On the other hand, high levels of work tempo and burnout appear to have negative consequences on staff commitment for improving care and the work environment. A better understanding of workplace contextual factors is necessary for improving the organizational potential of getting research into practice and should be considered in future implementation projects.

  • 899.
    Wallin, Lars
    et al.
    Karolinska Institutet.
    Målqvist, Mats
    Nga, Nguyen T
    Eriksson, Leif
    Persson, Lars-Åke
    Hoa, Dinh P
    Huy, Tran Q
    Duc, Duong M
    Ewald, Uwe
    Implementing knowledge into practice for improved neonatal survival: a cluster-randomised, community-based trial in Quang Ninh province, Vietnam2011In: BMC health services research, ISSN 1472-6963, Vol. 11, p. 239-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Globally, almost 4 million newborns die during the first 4 weeks of life every year. By increased use of evidence-based knowledge in the healthcare system a large proportion of these neonatal deaths could be prevented. But there is a severe lack of knowledge on effective methods for successful implementation of evidence into practice, particularly in low- and middle-income countries. Recent studies have demonstrated promising results with increased survival among both mothers and newborns using community-based approaches. In Vietnam evidence-based guidelines on reproductive health were launched in 2003 and revised in 2009. The overall objective of the current project is to evaluate if a facilitation intervention on the community level, with a problem-solving approach involving local representatives if the healthcare system and the community, results in improvements of neonatal health and survival.

    METHODS/DESIGN: The study, which has been given the acronym NeoKIP (Neonatal Health - Knowledge Into Practice), took place in 8 districts composed by 90 communes in a province in northern Vietnam, where neonatal mortality rate was 24/1000 in 2005. A cluster randomised design was used, allocating clusters, as defined as a commune and its correponding Commune Health Center (CHC) to either intervention or control arm. The facilitation intervention targeted staff at healthcare centres and key persons in the communes. The facilitator role was performed by lay women (Women's Union representatives) using quality improvement techniques to initiate and sustain improvement processes targeting identified problem areas. The intervention has been running over 3 years and data were collected on the facilitation process, healthcare staff knowledge in neonatal care and their behaviour in clinical practice, and reproductive and perinatal health indicators. Primary outcome is neonatal mortality.

    DISCUSSION: The intervention is participatory and dynamic, focused on developing a learning process and a problem-solving cycle. The study recognises the vital role of the local community as actors in improving their own and their newborns' health, and applies a bottom-up approach where change will be accomplished by an increasing awareness at and demand from grass root level. By utilising the existing healthcare structure this intervention may, if proven successful, be well suited for scaling up.

    TRIAL REGISTRATION: Current Controlled Trials ISRCTN44599712.

  • 900. Wallin, Lars
    et al.
    Profetto-McGrath, Joanne
    Levers, Merry Jo
    Implementing nursing practice guidelines: a complex undertaking2005In: Journal of Wound, Ostomy and Continence Nursing (WOCN), ISSN 1071-5754, E-ISSN 1528-3976, Vol. 32, no 5, p. 294-301Article in journal (Refereed)
    Abstract [en]

    Clinical practice guidelines have been proposed to significantly reduce the gap between available scientific evidence and clinical practice. Evidence-based guidelines are also being produced at an ever-increasing pace. However, guidelines do not implement themselves, and the research to support implementation does not provide straightforward answers. What works in one setting does not necessarily work in another. In short, guideline implementation and change of practice is complex and messy. The purpose of this article is to discuss the implementation of clinical practice guidelines using the Promoting Action on Research Implementation in Health Services framework. More specifically, 3 key components are highlighted: (1) the evidence base for guideline recommendations, (2) the clinical context where guidelines are to be implemented, and (3) the nature of facilitation needed to ensure a successful change process. An overview of the literature in the field is provided, and the authors' experiences are shared, and a few recommendations are tentatively provided.

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