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  • 1.
    Aalhuizen, Therése
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Per
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Språkbarriärer och tolkanvändning i vården ur sjuksköterskans perspektiv: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: During 2014 over 200 different languages were spoken in Sweden, and by the end of 2017 approximately 20 % of the population was foreign born. 110 000 healthcare injuries, many of them due to failure in communication were reported by the nursing association (2017). The evident language barriers create a lack of trust and confidence between patient and nurse. To overcome the identified language barriers interpreters have become a necessary tool in order to exchange information and create a trusting relationship between patients and nurses.

    Aim: To explore the nurses experiences and perceptions of existing language barriers and the use of interpreters within healthcare.

    Method: A literature review of fifteen scientific articles. These were identified in the databases PubMed and Cinahl through searches for relevant articles with appropriate keywords.

    Results: Nurses consider language barriers to be the biggest obstacle to good communication, which often lead to misunderstandings and misinterpretations. The identified problem of communication is experienced as time consuming and the nurses perceive more planning to be needed when dealing with patients with a different mother tongue. Furthermore, it presents a severe challenge to maintain good care and establish an understanding of the patient’s story. Nurses prefer to use an interpreter on site, however interpreters by phone are more accessible. More than one underlying cause is linked to nurse’s skepticism to use interpreters. To mention one many nurses doubt the accuracy of the interpretation. Moreover, nurses acknowledge their need of further training and education in the use of interpreters.

    Conclusion: The result identified is based upon nurse’s first hand experiences of language barriers and the use of interpreters. The literature review has provided insightful knowledge and increased the understanding of language barriers and the use of interpreters in health care. The research will be an asset in future careers and provide help in overcoming set problem.

  • 2. Aasheim, V
    et al.
    Waldenström, U
    Hjelmstedt, A
    Rasmussen, S
    Pettersson, H
    Schytt, Erica
    Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.
    Associations between advanced maternal age and psychological distress in primiparous women, from early pregnancy to 18 months postpartum2012In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 119, no 9, p. 1108-16Article in journal (Refereed)
    Abstract [en]

    Please cite this paper as: Aasheim V, Waldenström U, Hjelmstedt A, Rasmussen S, Pettersson H, Schytt E. Associations between advanced maternal age and psychological distress in primiparous women, from early pregnancy to 18 months postpartum. BJOG 2012;119:1108-1116. Objective  To investigate if advanced maternal age at first birth increases the risk of psychological distress during pregnancy at 17 and 30 weeks of gestation and at 6 and 18 months after birth. Design  National cohort study. Setting  Norway. Sample  A total of 19 291 nulliparous women recruited between 1999 and 2008 from hospitals and maternity units. Methods  Questionnaire data were obtained from the longitudinal Norwegian Mother and Child Cohort Study, and register data from the national Medical Birth Register. Advanced maternal age was defined as ≥32 years and a reference group of women aged 25-31 years was used for comparisons. The distribution of psychological distress from 20 to ≥40 years was investigated, and the prevalence of psychological distress at the four time-points was estimated. Logistic regression analyses based on generalised estimation equations were used to investigate associations between advanced maternal age and psychological distress. Main outcome measures  Psychological distress measured by SCL-5. Results  Women of advanced age had slightly higher scores of psychological distress over the period than the reference group, also after controlling for obstetric and infant variables. The youngest women had the highest scores. A history of depression increased the risk of distress in all women. With no history of depression, women of advanced age were not at higher risk. Changes over time were similar between groups and lowest at 6 months. Conclusion  Women of 32 years and beyond had slightly increased risk of psychological distress during pregnancy and the first 18 months of motherhood compared with women aged 25-31 years.

  • 3. Abarca-Goméz, Leandra
    et al.
    Abdeen, Ziad A
    Abdul Hamid, Zargar
    Abu-Rmeileh, Niveen M
    Acosta-Cazares, Benjamin
    Acuin, Cecilia
    Adams, Robert J
    Aekplakorn, Wichai
    Forsner, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Ezzati, Majid
    Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults.2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 390, no 10113, p. 2627-2642Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.

    METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).

    FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.

    INTERPRETATION: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.

    FUNDING: Wellcome Trust, AstraZeneca Young Health Programme.

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  • 4.
    Abdalle Hussein, Suaado
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Moreira, Melissa Silva
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Äldre personers och anhörigas upplevelser av besök på akutmottagningar: en litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background.  Older people currently constitute the largest patient group visiting emergency departments worldwide and are often accompanied by carers and/or relatives. The aging part of the population is increasing which leads to a greater strain on the health care system. While emergency departments offer acute care services to the general population, they are not well suited for the particular needs of older people and their relatives. Being aware of the issues older people and their relatives face during visits to the emergency department can help to deliver better suited care for this growing part of the population.  Aim. The aim of this literature review is to investigate older peoples’ and relatives’ experiences of visiting emergency departments.  Methods. The method of this study is a literature review of 14 articles from Australia, Europe, North America and South America. The databases used to find the articles were CINAHL and PubMed. Results. Results were divided into positive and negative themes. The six negative themes that emerged were: Lack of communication; Lack of patient involvement; Long waiting times; Lack of attentiveness; Inadequate physical environment and inadequate management of needs and symptoms. The positive theme that emerged was that emergency departments as reliable and easily accessible health care facilities. Conclusions. Older people and their relatives see their emergency department experience as mostly negative, exposing a need for better communication practices, positive person-centred interactions between health care staff and patients as well as their relatives and changes to the physical environment and health care system of the emergency department.

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  • 5.
    Abdikadir, M. Bisharo
    et al.
    Dalarna University, School of Health and Welfare.
    Ubah, Warsame H.
    Dalarna University, School of Health and Welfare.
    Vuxna patienters upplevelse i samband med palliativ vård - en litteraturöversikt2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background:Palliative care is about relieving the suffering of patients with incurable diseaseand meeting their physical, psychosocial and existential needs to promote the patient's quality of life. Palliative care should be built on four cornerstones: symptom relief, cooperation, communication and support for relatives. The care staff must have enough knowledge about palliative care in order to perform the practical nursing care to the patients in the palliative phase.Aim: The aim of this study is to describe adult patients' experience in connection with palliative care.Method: The literature review contains 17 scientific articles with qualitative, quantitative and mixed methods. The data search was performed in the databases CINAHL and PubMed.Results: The result showed six categories that are knowledge of palliative care, loss of self-esteem and vulnerability, existential support, empathy and sympathy, feelings of security and communication and self-determination. The results showed that several patients missing knowledge about palliative care and those patients have different perceptions of palliative care, for example, some patients believe that palliative care means the end of life while other patients describe that palliative care for them is more than the end of life. For example, patients express that it is a supportive care to improve their quality of life.Conclusion: Patients need more knowledge about palliative care and therefore it is important that care staff offer information to patients. This is important for patients to be well informed about their care. To increase patient participation and knowledge of palliative care, it is important that there is good communication between patients and care staff.

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  • 6.
    Abdillahi, Ayan Ismail
    et al.
    Dalarna University, School of Health and Welfare.
    Catindoy, Cyna Remonida
    Dalarna University, School of Health and Welfare.
    Sjuksköterskans upplevelser av att vårda patienter med annan kulturell bakgrund: en litteraturöversikt2022Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background The increasing migration in Sweden increases the demands on nurses to meet and care for patients with a different cultural background. Culture is a decisive factor that affects the patient, and the nurse needs to take this into account with the help of cultural competence. Having cultural competence means that the nurse has knowledge and understanding of the patient's culture and adapts care to the patient's cultural background. The patients feel that cultural and linguistic differences between them and the nurses affect the care and reduce the quality of care.

    Aim The purpose of the literature review is to explore the nurse's experiences of caring for patients with a different cultural background.

    Method The method for the work is a structured literature study with elements of the methodology used in systematic reviews. It consists of 14 qualitative articles collected from the databases CINAHL, PubMed and PsycInfo. The articles were analysed using Friberg's analysis model in three steps and the quality of the articles was reviewed using Ulrika Nilsson's review template.

    Results The results were presented in three main categories: experiences of communication; cultural differences and cultural competence and its strategies for improving the care of patients with different cultural backgrounds. The results showed that language differences made patient care more difficult, that the nurses faced discrimination and that a lack of cultural competence caused feelings of uncertainty and fear.

    Conclusions The nurses experienced challenges that included cultural differences, language differences, lack of cultural competence and meeting and being met by patients. Despite these challenges, the nurses were able to navigate different situations and use different strategies to overcome the challenges.

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  • 7. Abdillahi, Hamda A
    et al.
    Hassan, Khadra A
    Kiruja, Jonah
    Osman, Fatumo
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Egal, Jama A
    Klingberg-Allvin, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Erlandsson, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    A mixed-methods study of maternal near miss and death after emergency cesarean delivery at a referral hospital in Somaliland2017In: International Journal of Gynecology & Obstetrics, ISSN 0020-7292, E-ISSN 1879-3479, Vol. 138, no 1, p. 119-124Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To explore maternal near miss and death after emergency cesarean delivery in Somaliland, including the impact of the prerequisite for family consent.

    METHODS: A facility-based, mixed-methods study was conducted to assess all maternal near misses and deaths recorded at a referral hospital that provided services to women from all regions of Somaliland. The data sources comprised a quantitative prospective cross-sectional study using the WHO near-miss tool (performed from August 1 to December 31, 2015) and qualitative interviews with 17 healthcare providers working at the referral hospital who were in direct contact with the women in labor (performed from January 15 to March 15, 2015).

    RESULTS: Of the 138 maternal near misses and deaths recorded, 50 (36%) were associated with emergency cesarean delivery. The most frequent maternal complication was severe pre-eclampsia (n=17; 34%), and the most frequent underlying causes were hypertensive disorders (n=31; 62%) and obstetric hemorrhage (n=15; 30%). Healthcare providers were often prevented from performing emergency cesarean delivery until the required consent had been received from the woman's extended family.

    CONCLUSION: Maternity care in Somaliland must be improved, and the issue of legal authority for consent examined, to ensure both safe and timely provision of emergency cesarean delivery. This article is protected by copyright. All rights reserved.

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  • 8. Abdullahi, A.
    et al.
    Kalid, Mohamed
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Kipchumba, E.
    Sulaiman, M.
    Supporting Micro-enterprise in Humanitarian Programming: Impact Evaluation of Business Grants versus Unconditional Cash Transfer2023In: Journal of African Economies, ISSN 0963-8024, E-ISSN 1464-3723, Vol. 32, no 4, p. 415-437Article in journal (Refereed)
    Abstract [en]

    Humanitarian programming in fragile economies often use unconditional cash transfers (UCTs) to offset food insecurity. However, there is an increasing focus on using cash transfers to boost household incomes beyond the short-term through micro-enterprise start-up and growth. This paper conducts a randomised control trial to measure the impact of three different sizes of business grants against UCT in Somalia. We find that giving the same amount of money as a lump sum business grant results in higher likelihood of business ownership and income compared with UCT in the short run (3-4 months after the transfers). However, the impacts are larger and persist 3 years later only for those who received larger amount of grants. The results indicate our 'medium'-sized grant being more cost-effective. © 2022 The Author(s).

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  • 9.
    Abdullahi, Mahamed Abdiwali
    et al.
    Dalarna University, School of Health and Welfare.
    Roopkhomsan, Phimnirin
    Dalarna University, School of Health and Welfare.
    Patienters upplevelse av egenvård vidnydiagnostiserad typ 2 diabetes - en litteraturöversikt2024Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BackgroundType 2 diabetes is a disease that is constantly increasing and leads to many complications. Self-care is a major part of treatment, requiring patients to have the insight and ability to perform the self-care measures in order to live with type 2 diabetes, which can be challenging for many patients. Therefore, the nurse has a great part in the treatment of type 2 diabetes as these patients need a lot of education about the disease.

    AimTo describe patients ' experience of self-care in newly diagnosed Type 2 diabetes.

    MethodThe study is a literature review that answers a purpose with the help of scientific articles. The databases PubMed and CINAHL were used to find the articles. Results in this literature review were based on Eleven articles published between 2014–2024.

    ResultsThe results of the study came to three main categories, disease acceptance, challenges to change in living habits and self-care promoting factors. Disease acceptance had a major impact in how patients engaged in the self-care interventions, and challenges lead to lackof self-care. Health care support was considered important in patients with type 2 diabetes.

    ConclusionsThe results of the literature study showed that the patients experienced that self-care as newly diagnosed type 2 diabetes was challenging. This because of the disease required great effort from the patients and knowledge in order to be able to live with the disease. Processing the emotional reactions associated with the disease had a major impact on how the patients followed the self-care measures. Support was important for patients as it promoted patient self-care.

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  • 10.
    Abdulrahman, Mjilan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Johansson, Emelie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters upplevelser och positiva effekter av komplementär och alternativmedicin vid smärta: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Eighteen of Sweden's population suffers from long-term pain. The unmeasured data in the presence is not known. Among the older population, 54% of women and 38% prevalence of men, have long-term pain. The pain affects several factors, everything from inferior well-being and physical fatigue, to the impact on social life and work. The costs for society are estimated to cost SEK 87.5 billion annually in direct and indirect costs. Complementary and alternative medicine is a collective term for treatments that are not part of the traditional medical treatment. Examples of treatments include massage, acupuncture, transcutaneous electrical nerve stimulation (TENS), cognitive behavioral therapy (KBT) and meditation/yoga. Aim: To describe patients' experiences and the positive effect of alternative and complementary medicine of long-term pain. Method: A literature review based on 14 scientific articles with qualitative or quantitative approach. Searches have been conducted in CINAHL and PubMed. Results: Three main themes emerged in the result, which was increased wellbeing, pain relief and increased mobility. The studies indicate that the patients experienced good pain relief and increased quality of life both physically and mentally during treatment with complementary and alternative medicine. Patients who have not achieved pain relief through traditional care, experienced good pain relief with complementary and alternative medicine. Conclusion:  Complementary and alternative medicine can be an alternative to traditional treatment and sometimes even a first alternative for several reasons, among other things to avoid side effects from drugs.

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  • 11.
    Abelström, Kim
    et al.
    Dalarna University, School of Health and Welfare.
    Mulamba, Carmine
    Dalarna University, School of Health and Welfare.
    Sjuksköterskans upplevelser av transkulturell omvårdnad: en litteraturöversikt2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Due to various circumstances, more and more people are forced to flee their countries of origin, which leads to more and more countries becoming multicultural. A multicultural society is in turn reflected in health care. Nurses are faced with great challenges in the care of patients who have other cultural backgrounds. Therefore, it is important that nurses are culturally competent and able to communicate with patients who do not share the same language and culture.

    AimThe purpose was to describe the nurse's experiences of transcultural nursing among adult patients.

    MethodA literature review based on 15 scientific articles was conducted. The collection of data was done by using databases PubMed and CINAHL

    ResultsThe results of the study showed that nurses face several challenges in the field of transcultural nursing which include lack of cultural competence, communication barriers, prejudices, and individual values. It became clear that sufficient cultural competence, effective communication, respect, and a welcoming attitude are significant and decisive factors in being able to provide meaningful and dignified care to patients with a different cultural background.

    ConclusionsNurses face challenges in caring for patients from different cultural backgrounds, which can lead to uncertainty and misunderstanding. To ensure quality care, nurses need to increase their knowledge of transcultural nursing and develop effective communication strategies.

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  • 12.
    Abrahamsson, Caroline
    et al.
    Dalarna University, School of Health and Welfare.
    Westerin, Björn
    Dalarna University, School of Health and Welfare.
    Effekter av shoulder dislocation exercise för styrkelyftstränande vuxna med subacromiell smärta: en single subject studie2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Subacromial pain is a common problem within sports. Exercise is the treatment of choice with subacromial pain. However, there is a lack of consensus regarding optimal exercise, doses and load. The shoulder dislocation exercise can be seen on social media as an effective treatment on subacromialpain, but without scientific backing.

    Purpose: To investigate the effect on mobility, activity limitations, general shoulder health and pain of the shoulder dislocation exercise on adult recreational powerlifters with subacromial pain.

    Method: A single subject study with A-B design were conducted on five individuals with subacromial pain syndrome who regularly trains powerlifting. Baseline phase (A) consisted of three measurements sessions for one week. Outcome measures for mobility was Apley’s scratch test; grade of activity limitation was evaluated with PSFS, pain was evaluated with number of positive provocation tests and the general shoulder health by the SRQ-S. The intervention phase (B) was during six weeks, performing the intervention three times a week split into three sets of ten repetitions. The results were analyzed using the 2SDband method and presented narratively for each participant.

    Results: Four of five participants significantly improved their mobility. Four offive participants clinically significantly improved their self-assessed activity limitations. No one improved their general shoulder health, but all five participants decreased number of positive provocation tests for subacromial pain.

    Conclusion: The shoulder dislocation exercise seems to improve mobility, activity limitations and number of positive provocation tests for subacromial pain, but not the general shoulder health in the population of adult recreationally powerlifters with subacromial pain. 

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  • 13. Abrahamsson, Kajsa
    et al.
    Öhrn, Kerstin
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Hakeberg, Magnus
    Dental beliefs: factor structure of the revised dental beliefs survey in a group of regular dental patients2009In: European Journal of Oral Sciences, ISSN 0909-8836, E-ISSN 1600-0722, Vol. 117, no 6, p. 720-727Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS-R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS-R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS-R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four-factor solution with one second-order factor (i.e. a hierarchical CFA). Thus, the latent second-order variable, 'dental beliefs', explains the variance from all DBS-R items through the four first-order factors labeled 'ethics', 'belittlement', 'communication and empathy', and 'control and anxiety'. The results suggest a somewhat different factor structure of DBS-R than previously reported for dental-fear patients. Hence, the underlying factor structure of the DBS-R may differ between different patient groups. The results point towards the use of the original 28-item DBS-R and interpreting the scale as measuring an overall construct of 'dental beliefs' and thus patients' attitudes and feelings related to dentists and dentistry.

  • 14.
    Abshir, Hamdiya
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Användning av information och kommunikationsteknologi för att främja egenvård på distans för patienter med diabetes typ 2 En litteraturöversikt2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Diabetes Mellitus is a chronic disease that is linked to suffering

    and lack of quality of life. Self-care is essential to reduce the negative

    consequences. Less than half of all patients achieve good self-care. Some of the

    reasons are limited knowledge of diabetes and poor self-care compliance. The

    introduction of ICT in diabetes care was started to improve clinical outcomes and

    quality of life for patients with diabetes type 2. Aim: To describe how information

    and communication technology can promote self-care in distance for patients with

    diabetes mellitus type 2. Methods: Literature study, in which the articles were

    searched in CINAHL, PubMed and Web of Science. Articles included were 15

    articles with a quantitative, qualitative and mixed method. Results: The results

    showed that information and communication technology such as internet,

    computer and mobile phone-based self-care program promoted self-care in patients

    with diabetes type 2 by increasing knowledge, awareness, motivation and

    improving lifestyle change. Conclusion: Information and communication

    technology can facilitate the daily challenges for patients with type 2 diabetes

    because it covers the knowledge gap and increases patient awareness and

    motivation for self-care.

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  • 15. Abshir, Juweria N L
    et al.
    Osman, Fatumo
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Somali National University, Mogadishu, Somalia; Uppsala University, Uppsala.
    Dahir, Gallad
    Somali National University, Mogadishu, Somalia.
    Dahlberg, Anton
    Uppsala University, Uppsala.
    Parental burnout among Somali mothers: Associations with mental health, perceived social support, and sociodemographic factors2023In: PLOS Global Public Health, E-ISSN 2767-3375, Vol. 3, no 10, article id e0002501Article in journal (Refereed)
    Abstract [en]

    Parenthood can be defined by the contradiction that it is one of the most satisfying yet stressful experiences in life. Many parents experience stress during parenthood, and some to the extent that they display symptoms of parental burnout. Nevertheless, research on parental burnout is scant and many studies have only examined the condition in Western settings. The aim of this study was to examine parental burnout among Somali mothers in Mogadishu, Somalia, and its association with certain psychological, psychosocial, and sociodemographic factors. In this cross-sectional study, questionnaire data were collected through the measurements Parental Burnout Assessment and Patient Health Questionnaire 9, as well as through social and demographic questions. A total of 882 Somali mothers in Mogadishu participated. The analysis methods used were univariate, bivariate, and multiple linear regression analysis. The results revealed that the mean parental burnout score was low in the sample. Additionally, a significant association was found between higher levels of parental burnout and higher levels of depression, perceived lack of social support, being unmarried, having a low monthly household income, and when the youngest child was of school-age.

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  • 16. Abzhandadze, Tamar
    et al.
    Reinholdsson, Malin
    Palstam, Annie
    Institute of Neuroscience and Physiology, Rehabilitation Medicine, University of Gothenburg.
    Eriksson, Marie
    Sunnerhagen, Katharina S
    Transforming self-reported outcomes from a stroke register to the modified Rankin Scale: a cross-sectional, explorative study.2020In: Scientific Reports, E-ISSN 2045-2322, Vol. 10, no 1, article id 17215Article in journal (Refereed)
    Abstract [en]

    The aim was to create an algorithm to transform self-reported outcomes from a stroke register to the modified Rankin Scale (mRS). Two stroke registers were used: the Väststroke, a local register in Gothenburg, Sweden, and the Riksstroke, a Swedish national register. The reference variable, mRS (from Väststroke), was mapped with seven self-reported questions from Riksstroke. The transformation algorithm was created as a result of manual mapping performed by healthcare professionals. A supervised machine learning method-decision tree-was used to further evaluate the transformation algorithm. Of 1145 patients, 54% were male, the mean age was 71 y. The mRS grades 0, 1 and 2 could not be distinguished as a result of manual mapping or by using the decision tree analysis. Thus, these grades were merged. With manual mapping, 78% of the patients were correctly classified, and the level of agreement was almost perfect, weighted Kappa (Kw) was 0.81. With the decision tree, 80% of the patients were correctly classified, and substantial agreement was achieved, Kw = 0.67. The self-reported outcomes from a stroke register can be transformed to the mRS. A mRS algorithm based on manual mapping might be useful for researchers using self-reported questionnaire data.

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  • 17.
    Abzhandadze, Tamar
    et al.
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Westerlind, Emma
    rg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Palstam, Annie
    Dalarna University, School of Health and Welfare, Medical Science. Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Sunnerhagen, Katharina S
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Persson, Hanna C
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Sahlgrenska University Hospital, Gothenburg.
    Sick leave one year after COVID-19 infection: a nationwide cohort study during the first wave in Sweden2024In: Scientific Reports, E-ISSN 2045-2322, Vol. 14, no 1, article id 572Article in journal (Refereed)
    Abstract [en]

    This study aimed to investigate the patterns of sick leave, as well as factors associated with sick leave due to COVID-19 during one year after the COVID-19 diagnosis, and sex-related aspects on sick leave. This nationwide study involved 11,902 individuals who received sickness benefits for COVID-19 during the first wave of the pandemic. Data from three Swedish registries were analyzed for sick leave that commenced between March 1 and August 31, 2020, with a follow-up period of 12 months. Sick leave due to COVID-19 was counted as the number of days with sickness benefits and required to include at least one registered COVID-19 diagnosis. The median duration of sick leave was 35 days, and 347 (2.9%) individuals continued their sick leave during the entire follow-up period. Furthermore, 1 year later, the cumulative incidence of sick leave was slightly higher in males (3.5%) compared to females (2.7%). Older age, being single with no children, diagnosed with the virus, medium income level, history of sick leave, and need for inpatient care were significantly associated with a higher duration of sick leave due to COVID-19, both in the total population and when stratified by sex. These results indicated that three out of 100 (3%) patients were still on sick leave 1 year after their COVID-19 diagnosis. Aspects regarding the importance of sick leave duration differed between males and females and comprised sociodemographic characteristics and need for inpatient care. The results indicated the complexity of sick leave due to COVID-19.

  • 18.
    Ackfeldt Wall, Isabelle
    et al.
    Dalarna University, School of Health and Welfare.
    Axelsson, Fanny
    Dalarna University, School of Health and Welfare.
    Att beskriva sjuksköterskors upplevelser av att möta kvinnor utsatta för våld i nära relationer: En litteraturöversikt2024Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Intimate partner violence is a global and serious problem and about a quarter of the world’s women over the age of 15 have at some point been exposed physically and/or psychologically by a male partner. The consequences of the violence can manifest themselves in both physical and psychological symptoms. The nurse should possess knowledge of intimate partner violence to pay attention to the signs and to offer adequate care.

    Aim To describe nurses’ experiences of meeting women exposed to intimate partner violence.

    Method The design of this literature review is a structured literature study with elements of the methodology used in systematic reviews and is based on 12 scientific articles from the PubMed and CINAHL databases that were published between 2015-2023. The dataanalysis is carried out according to Friberg's five-step analysis for qualitative research.

    Results The results from the analysis are presented in four main categories with ten associated subcategories.: Talking about the violence, The importance of care and society, Emotional reactions and Knowledge and experience.

    Conclusions Meeting patients exposed to intimate partner violence is challenging work. A personcentered approach is the basis for handling and identifying women exposed to intimate partner violence. There is a lack of clear guidelines in the workplace and the cooperation between different authorities/institutions is insufficient, as well as societal support for a woman who has been subjected to violence. To increase the knowledge of nurses, more and continuous education is needed.

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  • 19.
    Adamek, Caisa
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Lissars, Julia
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Sjuksköterskors upplevelser av att vårda personer med demenssjukdom inom slutenvård: En litteraturstudie2023Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Dementia is an umbrella term for illnesses that cause cognitive impairment. A person centered approach is the foundation of caring for people with dementia. The relatives to admitted patients with dementia experience the care as generally good, but with room for improvement. Aim: This literature review aims to illustrate RNs experiences in caring for persons with dementia in an inpatient hospital setting. Method: This literature review was made with a methodology similar to ones used in systematic reviews. The search engines PubMed, CINAHL and APA PsycInfo were used and the chosen articles were checked for quality according to a template for qualitative research. The results were analyzed using Fribergs five steps for qualitative analysis. Results: A large number of RNs experienced challenges in the care of PwD. Organisational pressure and a lack of interprofessional co-operation led to an increase in the use of psychotropic drugs, as the stressful environment increased the rate of responsive behaviours in PwD. Distraction was common for RNs to use to counter responsive behaviours. RNs also used person centred communication to facilitate a good relationship. Conclusions: Experienced factors like lack of time and lack of knowledge was experienced as contributing to nurses having difficulties performing person centred care. This can resultin a reduced wellbeing for people with dementia when they are in need of care.

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  • 20. Adami, C.
    et al.
    Qian, J.
    Rupp, M.
    Hintze, Arend
    Keck Graduate Institute of Applied Life Sciences, Claremont, United States; Michigan State University, East Lansing, United States.
    Information content of colored motifs in complex networks2011In: Artificial Life, ISSN 1064-5462, E-ISSN 1530-9185, Vol. 17, no 4, p. 375-390Article in journal (Refereed)
    Abstract [en]

    We study complex networks in which the nodes are tagged with different colors depending on their function (colored graphs), using information theory applied to the distribution of motifs in such networks. We find that colored motifs can be viewed as the building blocks of the networks (much more than the uncolored structural motifs can be) and that the relative frequency with which these motifs appear in the network can be used to define its information content. This information is defined in such a way that a network with random coloration (but keeping the relative number of nodes with different colors the same) has zero color information content. Thus, colored motif information captures the exceptionality of coloring in the motifs that is maintained via selection. We study the motif information content of the C. elegans brain as well as the evolution of colored motif information in networks that reflect the interaction between instructions in genomes of digital life organisms. While we find that colored motif information appears to capture essential functionality in the C. elegans brain (where the color assignment of nodes is straightforward), it is not obvious whether the colored motif information content always increases during evolution, as would be expected from a measure that captures network complexity. For a single choice of color assignment of instructions in the digital life form Avida, we find rather that colored motif information content increases or decreases during evolution, depending on how the genomes are organized, and therefore could be an interesting tool to dissect genomic rearrangements. © 2011 Massachusetts Institute of Technology.

  • 21.
    Adani Buubshe, Fartun
    et al.
    Dalarna University, School of Health and Welfare.
    Gray, Maria
    Dalarna University, School of Health and Welfare.
    Vårdmiljöns betydelse för att lindra nyopererade patienters postoperativa smärta - en litteraturöversikt2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Florence Nightingale (1820 - 1910) was a major advocate for the importance of environment for optimal patient recovery. The modern healthcare environment typically consists of two components, one physical and one psychosocial, where both parts are considered crucial for the patient’s return to health. This is particularly important to bear in mind in the postoperative context and with the experience of postoperative pain, which varies from patient to patient. Nurses are responsible for providing postoperative pain relief, chiefly by nursing, utilizing the health care environment and administering pharmacological painkillers.Aim: The purpose of the study is to describe the importance of the health care environment in relieving newly operated patients postoperative pain.Method: A literature review with qualitative design. The results of the study are based on 15 scientific articles that have been quality reviewed. The scientific articles were searched on CINAHL, PubMed, Web of Science and via manual search.Results: The literature review identified physical care environment with subcategories; patient room and contact with the external environment. In the category psychosocial care environment subcategories; sense of control, relationships and music as distraction as pain-relieving alternatives.Conclusion: The physical and psychosocial health care environment act as a distractive element on the patient and/or have a relieving effect on the postoperative pain.

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  • 22.
    Adeli, Majid
    et al.
    Dalarna University, School of Health and Welfare.
    Telles d´Utra, Mariana
    Dalarna University, School of Health and Welfare.
    Kvinnors erfarenheter av att leva med lipödem: En litteraturöversikt2022Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background Lipoedema has a prevalence of seven to eleven percent of adult women in Western countries, yet the condition remains largely unknown by both society and health professionals who often mistake it for obesity. Women with lipedema go through anaverage interval of eighteen years between the onset of symptoms and diagnosis where they experience exacerbation of various symptoms without knowing the cause or mistaking it for obesity. As lipedema is a chronic disease, it affects the lives of women with lipedema not only through disease-related symptoms, but also through fat-related stigma.

    Aim The purpose of the literature review is to investigate women´s experiences of living with lipedema.

    Method A literature search was conducted on the Cinahl and PubMed databases, resulting in ten scientific articles. These articles were quality reviewed using Ulrika Nilsson's review template and analysed using the analysis model of Forsberg & Wengström.

    Results Results show that women’s experiences can be grouped into two main categories: to be a Stranger in one's own body which were divided into three subcategories, Bodily Changes, Pain and Mental Illness. The other main category, Stigmatisation, was divided into two subcategories: Shame and Lack of care.

    Conclusions Experiences with lipedema are revealed to be potentially damaging to both physical as well as psychological health due to lack of information, reduced number of effective treatments and stigmatization coming from both healthcare actors as well as society. Wrong diagnosing, lack of information, misdiagnosis and ineffective treatments then leads these women to ineffective interventions and unnecessary suffering. Further research is needed to increase knowledge about diagnoses and treatments for lipoedema to increase the quality of life of women with lipoedema. 

  • 23.
    Adolfsson, Jonas
    Dalarna University, School of Education, Health and Social Studies, Sport and Health Science.
    Vad kännetecknar en bra idrotts- och träningsmiljö för elitsatsande inom längdskidåkning2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte

    Syftet var att ta reda på vad elitaktiva inom längdskidor anser vara en bra idrotts- och träningsmiljö.

    Metod

    Metoden som används är uppdelad i två olika ansatser. Den första ansatsen är inom den kvantitativa forskningen och utformades som en enkätstudie, där längdskidåkare har fått svara på frågor om sin träningsmiljö. Den andra delen av uppsatsen är utformad som en kvalitativ studie med semistrukturerade intervjufrågor baserat på ett mindre urval av de som svarat på enkäten. Detta skedde efter att resultatet av den kvantitativa studien blivit analyserat, för att utforma en intervjumall från enkätsvaren, i syfte att försöka få en djupare förståelse av detta problemområde.

    Resultat

    Resultatet visar att det finns en stor komplexitet i uppfattningen om vad som anses vara en bra träningsmiljö för längdskidåkare. Dock kan det urskiljas att vissa faktorer som viktigare än andra, till exempel vikten av att ha träningskamrater och god sparring för att kunna utvecklas. Värdet av att ha en tränare ansågs också viktigt. Resultaten visar även hur den elitaktive upplever sin träningsmiljö i dag och vad som efterfrågas.

    Slutsatser

    Det framkom tydligt att bristen på hjälp upplevs stor bland seniorer inom längdskidor. Att steget mellan junior och eventuellt gå på ett skidgymnasium, till att bli senior upplevs alldeles för stort, att det inte finns tillräcklig stödfunktioner, skolor eller träningsgrupper att tillgå som senior.

  • 24. Adolfsson Skinnar, Jonna
    et al.
    Österberg, Caroline
    Att vänta på organtransplantation: En litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet var att beskriva patienters upplevelse att vänta på organtransplantation.

    Metod: Studien genomfördes som en litteraturöversikt. Artiklarna har sökts i databaserna CINAHL, PubMed och Scopus. 15 artiklar valdes ut till resultatet, 3 artiklar hade kvantitativ ansats och 12 kvalitativ ansats.

    Resultat: 3 huvudkategorier presenteras i resultatet: Begränsningar innebar att vara bunden av teknisk apparatur och förhålla sig till en ny livsstil. Tiden fick nytt perspektiv och patienter upplevde att de alltid behövde vara beredda. Patienterna möttes av falskt alarm och upplevde väntan som oviss. Det fanns behov av stöd från anhöriga, patienter i samma situation och stöd från vårdpersonal. Tydlig och rak kommunikation var viktig för patienterna. Sjuksköterskan behövde finnas till hands. Trots oro fanns en känsla av en andra chans i livet.

    Slutsats: Patienter som väntar på en organtransplantation upplever att sjuksköterskan behöver vara tillgänglig, ha tydlig kommunikation, ge anpassad information utifrån individuella önskemål samt accepterar och förstår vikten av anhörigas närvaro och stöd så att varje patients enskilda behov kan bemötas.

  • 25.
    Adolfsson, Ulrika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Östlund, Titti
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Patienters erfarenhet av sårpumpsbehandling vid svårläkta sår: en litteraturöversikt2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 26.
    Aduah, Rhoda
    Dalarna University, School of Health and Welfare.
    Women’S Experiences With Digital Health Service As A Tool For Improving Awareness And Perception On Sexual Reproductive Health And Contraception. A Phenomenography Qualitative Study2021Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: Most women within reproductive ages living in Low- and Middle-Income Countries, have limited or no access to education on sexual and reproductive health and contraception, yet about 1.9 billon women in LMICs own a mobile phone. The exposure to digital health services has the potential to contribute to improving awareness, influencing positive perceptions, beliefs and promoting SRH and contraception.AIM: To explore user views and perceptions on the Grace Health’s (a digital health service) ability to improve awareness on sexual reproductive health and contraception among Ghanaian, Nigerian and Kenyan women aged 18-35.METHODOLOGY: A qualitative design using phenomenography to interview women remotely on women’s perception of digital health services through their own experience with using the Grace health chat bot and app. Also, their views were sought on how other women are gaining awareness and impacts on sexual reproductive health and contraception from the digital health services.RESULTS: Seven categories on digital health services emerged, with key findings presented as Safe days, ovulation as contraception, impacts on SRH, Avoiding or seeking pregnancy and influence on perception.CONCLUSION: This qualitative study gives insight for research community, public health professionals, app designers, health care providers, stakeholders and civil society organisations in making decisions regarding the use of digital health service as strategic, innovative instruments for interventions in major key indicators of Sexual Reproductive Health and Rights.

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  • 27.
    af Winklerfelt Hammarberg, Sandra
    et al.
    Karolinska Institutet, Stockholm, Academic Primary Health Care Centre, Region Stockholm, Stockholm.
    Björkelund, Cecilia
    Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Nejati, Shabnam
    Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Magnil, Maria
    Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Hange, Dominique
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Region Västra Götaland, Närhälsan Research and Development Primary Health Care, Gothenburg.
    Svenningsson, Irene
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Region Västra Götaland, Närhälsan Research and Development Primary Health Care, Gothenburg.
    Petersson, Eva‑Lisa
    Sahlgrenska Academy, University of Gothenburg, Gothenburg; Region Västra Götaland, Närhälsan Research and Development Primary Health Care, Gothenburg.
    Udo, Camilla
    Dalarna University, School of Health and Welfare, Social Work. Division of Health Care Science, Marie Cederschiöld University, Stockholm; Center for Clinical Research Dalarna, Uppsala University, Falun.
    Wallin, Lars
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Westman, Jeanette
    Karolinska Institutet, Stockholm; Academic Primary Health Care Centre, Region Stockholm, Stockholm; Uppsala University, Uppsala.
    Clinical effectiveness of care managers in collaborative primary health care for patients with depression: 12‑ and 24‑month follow‑up of a pragmatic cluster randomized controlled trial2022In: BMC Primary Care, E-ISSN 2731-4553, Vol. 23, no 1, article id 198Article in journal (Refereed)
    Abstract [en]

    Background: In previous studies, we investigated the effects of a care manager intervention for patients withdepression treated in primary health care. At 6 months, care management improved depressive symptoms, remission,return to work, and adherence to anti-depressive medication more than care as usual. The aim of this study wasto compare the long-term effectiveness of care management and usual care for primary care patients with depressionon depressive symptoms, remission, quality of life, self-efficacy, confidence in care, and quality of care 12 and24 months after the start of the intervention.Methods: Cluster randomized controlled trial that included 23 primary care centers (11 intervention, 12 control)in the regions of Västra Götaland and Dalarna, Sweden. Patients ≥18 years with newly diagnosed mild to moderatedepression (n = 376: 192 intervention, 184 control) were included. Patients at intervention centers co-developed astructured depression care plan with a care manager. Via 6 to 8 telephone contacts over 12 weeks, the care managerfollowed up symptoms and treatment, encouraged behavioral activation, provided education, and communicatedwith the patient’s general practitioner as needed. Patients at control centers received usual care. Adjusted mixedmodel repeated measure analysis was conducted on data gathered at 12 and 24 months on depressive symptomsand remission (MADRS-S); quality of life (EQ5D); and self-efficacy, confidence in care, and quality of care (study-specificquestionnaire).Results: The intervention group had less severe depressive symptoms than the control group at 12 (P = 0.02) butnot 24 months (P = 0.83). They reported higher quality of life at 12 (P = 0.01) but not 24 months (P = 0.88). Differencesin remission and self-efficacy were not significant, but patients in the intervention group were more confident that they could get information (53% vs 38%; P = 0.02) and professional emotional support (51% vs 40%; P = 0.05) from theprimary care center.Conclusions: Patients with depression who had a care manager maintained their 6-month improvements in symptomsat the 12- and 24-month follow-ups. Without a care manager, recovery could take up to 24 months. Patients withcare managers also had significantly more confidence in primary care and belief in future support than controls.

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  • 28. af Winklerfelt Hammarberg, Sandra
    et al.
    Hange, Dominique
    André, Malin
    Udo, Camilla
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Svenningsson, Irene
    Björkelund, Cecilia
    Petersson, Eva-Lisa
    Westman, Jeanette
    Care managers can be useful for patients with depression but their role must be clear: a qualitative study of GPs’ experiences2019In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 3, p. 273-282Article in journal (Refereed)
    Abstract [en]

    Objective: Explore general practitioners’ (GPs’) views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases.

    Design: Qualitative content analysis of five focus-group discussions.

    Setting: Primary health care centers in the Region of Västra Götaland and Dalarna County, Sweden.

    Subjects: 29 GPs.

    Main outcome measures: GPs’ views and experiences of care managers for patients with depression.

    Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases.

    Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members’ roles must be clear.

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  • 29. Afshin, A
    et al.
    Forouzanfar, M. H
    Reitsma, M. B
    Sur, P
    Estep, K
    Lee, A
    Marczak, L
    Mokdad, A. H
    Ärnlöv, Johan
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Uppsala universitet.
    Murray, C. J. L
    Health effects of overweight and obesity in 195 countries over 25 years2017In: New England Journal of Medicine, ISSN 0028-4793, E-ISSN 1533-4406, Vol. 377, no 1, p. 13-27Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

    METHODS: We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

    RESULTS: In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

    CONCLUSIONS: The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem.

  • 30. Agahi, Neda
    et al.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work. Aging Research Center.
    Carin, Lennartsson
    Social integration and alcohol consumption among older people: A four-year follow-up of a Swedish national sample2019In: Drug And Alcohol Dependence, ISSN 0376-8716, E-ISSN 1879-0046, Vol. 196, p. 40-45Article in journal (Refereed)
    Abstract [en]

    Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.

    Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.

    Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.

  • 31.
    Agdahl, Petra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Eriksson, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer som kan påverka livskvalitén hos patientermed cancersjukdom inom palliativ vård - En litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Cancers can affect both sexes at any age and it is estimated that at least one in three people will be diagnosed with cancer at some point in their lives. In the diagnosis of cancer, the care can have two orientations, curative or palliative. When curative care no longer is possible, the care is transferred to palliative care, which means that the focus is primarily on symptom relief, promoting quality of life and well-being. People may have different wishes and goals at the end of life and in order for the quality of life to be promoted, the individual wishes should be taken into account. Quality of life is individual and includes the factors that affect the individual and is a subjective assessment of the individual's social, emotional, material and physical well-being.Aim: To describe factors that can affect the quality of life of patiens with cancer in a late stage of palliative care from a patient perspective.Method: The study is conducted as a literature review based on 15 quantitative and 7 qualitative scientific articles. Data searches have been performed in the CINAHL and PubMed databases.Results: The results showed that there are 6 main categories that make up the factors that affect the quality of life, these are background factors, social factors, palliative care environment, psychological factors, physical factors and existential factors.Conclusion: Younger individuals experience a poorer quality of life than older people. Where the individual is cared for and the care environment was an important factor in promoting a good quality of life at the end of life. Depression and anxiety were factors that negatively affected the individual. The physical symptoms such as pain were strongly associated with poorer quality of life.

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  • 32.
    Agemalm, Stina
    et al.
    Dalarna University, School of Health and Welfare.
    Aldén, Maria
    Dalarna University, School of Health and Welfare.
    Identifiering av smärta och smärtlindrande omvårdnadsåtgärder vid vård av äldre personer i livets slut: En kvalitativ intervjustudie med sjuksköterskor arbetandes på särskilt boende2023Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background

    Each year approximately 1 percent of Sweden’s population dies, which corresponds to approximately 90 000 people. Of these, about 36 percent dies while living in special housing. Pain is a common symptom in older people receiving end-of-life care. Identifying pain and alleviating pain thus becomes central and an important part of the work of the nurse responsible for care.

    Aim

    The aim is to describe nurses’ experiences of identifying pain and using nursing interventions for pain relief in older people living in special housing at the end of life.

    Method

    The method used is a qualitative interview study with and inductive approach. Semistructured interviews have been used for the collection of data were nurses with at least one year of experience of working in special housing for people older than 65 years of age in end-of-life care were included as informants. Content analysis was done according to a method described by Graneheim and Lundman (2004).

    Results

    The result of the study is presented with four categories; Relationship central for end-oflife care, Identifying pain is difficult, Nursing interventions alleviate pain and A qualified team promotes nursing. All categories are presented with associated subcategories.

    Conclusions

    The results of the study show that knowledge of the person made person-centered care possible and increased the possibility to individualize nursing interventions and made it easier to identify pain in older people. Nursing staff lacked knowledge about identifying pain and alleviating pain with nursing interventions. It was nurses who had the responsibility to tutor, and competence supply the team however the results show that nurses does not follow guidelines regarding estimation instruments when identifying pain and neither do they have satisfactory knowledge of the four dimensions of pain.

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  • 33.
    Agerberg, Sandra
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Norberg, Carina
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Faktorer av betydelse för god palliativ omvårdnadsett ur ett patientperspektiv- en litteraturöversikt2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The aim of this literature review was to, from a patient point of view, identify factors within the specialized palliative care that constituted good care from the.Method: A systematic literature review was undertaken. Fifteen articles were reviewed. Thirteen of these were qualitative and two were quantitative.Results: Four categories were identified: self determination, capability of the nurse, nursing relations and maintaining dignity.The patients self determination was a central part of nursing. Delegating control and self determination from a patient to a nurse is also a form of self determination.Capable nurses instill trust and gave patients the opportunity of more alternatives when it came to choices concerning the care of the patient.A good relation with the nurse could give the patient a feeling of being important and being a part of something bigger, despite lack of family or friends. Important factors regarding patient-nurse relations were continuity and nurse accessibility.Maintaining dignity included being seen as the human being that the patient was before the terminal illness was diagnosed.Conclusion: Patients noted several factors as important for good palliative care. These could be summarized as self determination, nurse capability, nursing relations and maintaining dignity.

  • 34.
    Agha, Hassan
    Dalarna University, School of Health and Welfare.
    The Multifaceted Effects of Male Circumcision: An Integrative Review of Physical, Psychological, and Cultural Impacts2024Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Male circumcision is a widely practiced procedure with significant implications for sexual and reproductive health. Debates over its benefits and harms span various fields, necessitating a comprehensive review.

    Aim: This review aims to identify recent trends in adult circumcision research, focusing on its impact on sexual health and function, psychological and emotional effects, and cultural and social influences.

    Methodology: An integrative review of 17 articles from PubMed and PsycInfo was conducted using keywords related to male circumcision and its psychological, trauma, and health effects. The Joanna Briggs Institute Critical Appraisal Tools were used for quality assessment.

    Results: The findings are synthesized into three main themes: sexual health and function, psychological and emotional effects, and cultural and social influences. Significant medical benefits of circumcision include reduced rates of sexually transmitted infections and improvements in specific sexual conditions. Psychological impacts are noted in a small group of men, often influenced by negative societal norms.

    Conclusions: Circumcision affects individuals beyond the physical procedure, influencing psychological well-being and cultural identity. The review emphasizes the need for personalized medical advice and psychological support to address both the benefits and impacts. Future research and policies should consider these multifaceted effects for acomprehensive understanding of male circumcision.

  • 35.
    Aghaesmaili, Mahboubeh
    et al.
    Dalarna University, School of Health and Welfare.
    Hematfar, Narges
    Dalarna University, School of Health and Welfare.
    Stigmatisering av personer som lider av psykisk ohälsa utanför psykiatrin - En litteraturöversikt2021Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: People suffering from mental illness experience stigma in differentcontexts. There are various factors that affected by stigma in people suffering frommental illness, which also leads to experiences of discrimination in them. Stigma isa common problem in today's society, which has consequences in people sufferingfrom mental illness.Aim: The purpose of this study is to describe factors related to the stigma of as wellas these consequences for people suffering from mental illness outside psychiatry.Method: The thesis carried out as a literature review where 15 scientific articlessearched based on the purpose, which then analyzed and compiled into the results.The articles were of both qualitative, quantitative design and a mixed method. TheCINAHL and PsycINFO databases used as search engines.Result: The result consists of four main categories. “Quality of life” describes theconsequences of stigma on quality of life. “Cultural and socio-demographic factors”which discuss the impact of cultural perspectives on stigma and the link betweenstigma and educational attainment are described. “Social distancing,” points outfactors that cause people suffering from mental illness to withdraw from socialsituations. "Family" there describes the family as a source of stigma.Conclusion: Stigma affects the quality of life of people suffering from mentalillness. Furthermore, lack of access and level of education can increase the risk ofstigma. Stigma also leads to social distancing in people suffering from mentalillness. In addition, the family of people suffering from mental illness considered animportant source of stigma, which means that they avoid talking about mental illnessin the family.

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  • 36.
    Aghanavesi, Somayeh
    et al.
    Dalarna University, School of Technology and Business Studies, Microdata Analysis.
    Bergquist, Filip
    Nyholm, Dag
    Senek, Marina
    Memedi, Mevludin
    Motion sensor-based assessment of Parkinson’s disease motor symptoms during leg agility tests: results from levodopa challenge2020In: IEEE journal of biomedical and health informatics, ISSN 2168-2194, E-ISSN 2168-2208, Vol. 24, no 1, p. 111-119, article id 8637809Article in journal (Refereed)
    Abstract [en]

    Parkinson’s disease (PD) is a degenerative, progressive disorder of the central nervous system that mainly affects motor control. The aim of this study was to develop data-driven methods and test their clinimetric properties to detect and quantify PD motor states using motion sensor data from leg agility tests. Nineteen PD patients were recruited in a levodopa single dose challenge study. PD patients performed leg agility tasks while wearing motion sensors on their lower extremities. Clinical evaluation of video recordings was performed by three movement disorder specialists who used four items from the motor section of the Unified PD Rating Scale (UPDRS), the treatment response scale (TRS) and a dyskinesia score. Using the sensor data, spatiotemporal features were calculated and relevant features were selected by feature selection. Machine learning methods like support vector machines (SVM), decision trees and linear regression, using 10-fold cross validation were trained to predict motor states of the patients. SVM showed the best convergence validity with correlation coefficients of 0.81 to TRS, 0.83 to UPDRS #31 (body bradykinesia and hypokinesia), 0.78 to SUMUPDRS (the sum of the UPDRS items: #26-leg agility, #27-arising from chair and #29-gait), and 0.67 to dyskinesia. Additionally, the SVM-based scores had similar test-retest reliability in relation to clinical ratings. The SVM-based scores were less responsive to treatment effects than the clinical scores, particularly with regards to dyskinesia. In conclusion, the results from this study indicate that using motion sensors during leg agility tests may lead to valid and reliable objective measures of PD motor symptoms.

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  • 37.
    Aghanavesi, Somayeh
    et al.
    Dalarna University, School of Technology and Business Studies, Microdata Analysis.
    Westin, Jerker
    Dalarna University, School of Technology and Business Studies, Computer Engineering.
    Bergquist, Filip
    Nyholm, Dag
    Askmark, Håkan
    Aquilonius, Sten Magnus
    Constantinescu, Radu
    Medvedev, Alexander
    Spira, Jack
    Ohlsson, Fredrik
    Thomas, Ilias
    Dalarna University, School of Technology and Business Studies, Microdata Analysis.
    Ericsson, Anders
    Johansson Buvarp, Dongni
    Memedi, Mevludin
    A multiple motion sensors index for motor state quantification in Parkinson's disease2020In: Computer Methods and Programs in Biomedicine, ISSN 0169-2607, E-ISSN 1872-7565, Vol. 189, article id 105309Article in journal (Refereed)
    Abstract [en]

    AIM: To construct a Treatment Response Index from Multiple Sensors (TRIMS) for quantification of motor state in patients with Parkinson's disease (PD) during a single levodopa dose. Another aim was to compare TRIMS to sensor indexes derived from individual motor tasks.

    METHOD: Nineteen PD patients performed three motor tests including leg agility, pronation-supination movement of hands, and walking in a clinic while wearing inertial measurement unit sensors on their wrists and ankles. They performed the tests repeatedly before and after taking 150% of their individual oral levodopa-carbidopa equivalent morning dose.Three neurologists blinded to treatment status, viewed patients' videos and rated their motor symptoms, dyskinesia, overall motor state based on selected items of Unified PD Rating Scale (UPDRS) part III, Dyskinesia scale, and Treatment Response Scale (TRS). To build TRIMS, out of initially 178 extracted features from upper- and lower-limbs data, 39 features were selected by stepwise regression method and were used as input to support vector machines to be mapped to mean reference TRS scores using 10-fold cross-validation method. Test-retest reliability, responsiveness to medication, and correlation to TRS as well as other UPDRS items were evaluated for TRIMS.

    RESULTS: The correlation of TRIMS with TRS was 0.93. TRIMS had good test-retest reliability (ICC = 0.83). Responsiveness of the TRIMS to medication was good compared to TRS indicating its power in capturing the treatment effects. TRIMS was highly correlated to dyskinesia (R = 0.85), bradykinesia (R = 0.84) and gait (R = 0.79) UPDRS items. Correlation of sensor index from the upper-limb to TRS was 0.89.

    CONCLUSION: Using the fusion of upper- and lower-limbs sensor data to construct TRIMS provided accurate PD motor states estimation and responsive to treatment. In addition, quantification of upper-limb sensor data during walking test provided strong results.

  • 38.
    Agnas, Maja
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Holmenäs, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Egenvårdsråd vid "Non-alcoholic fatty liver disease". Effekter och följsamhet: En litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet var att undersöka vilka egenvårdsråd och effekterna av dessa som finns beskrivna i litteraturen vid NAFLD samt hur följsamheten av dessa beskrivs. Studien utfördes som en litteraturöversikt som inkluderade 16 artiklar, alla med kvantitativ ansats. Resultatet visade att livsstilsförändringar i form av fysisk aktivitet och ändrade matvanor var det bästa sättet för att minska NAFLD. Viktminskning hade en god effekt på NAFLD och även små viktminskningar reducerade mängden fett i levern. Det framkom även att fysisk aktivitet utan viktminskning var effektivt för att reducera mängden fett i levern. Vidare visade det sig att följsamheten ökade med individuellt utformade program och kontinuerlig stöttning. Förutsättningar för att uppnå livsstilsförändringar ökade med realistiskt uppsatta mål.

  • 39. Ahlberg, M.
    et al.
    Nordlund, E.
    Weichselbraun, M.
    Wiklund, Ingela
    Division of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital.
    Good obstetric care requires interdisciplinary collaboration2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112Article in journal (Refereed)
  • 40. Ahlberg, M.
    et al.
    Nordlund, E.
    Weichselbraun, M.
    Wiklund, Ingela
    Division of Obstetrics and Gynecology, Karolinska Institutet, Danderyd Hospital.
    Svenska barnmorskeförbundet: God förlossningsvård kräver tvärprofessionellt samarbete2015In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 112, no 20-21Article in journal (Refereed)
  • 41.
    Ahlblom, Annika
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Latvakoski, Sabina
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Föräldrars upplevelse av spädbarns sömn vid en och sex månaders ålder: En kvantitativ studie2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The first year of life is critical for sleep development, and the quality of sleep affects both the physical and neurological development. The sleep of infants constitutes a common cause of worry among new parents, which can lead to modifications in recommended sleep arrangements to promote both parents’ and infants’ wellbeing. Aim: To investigate parents’ experience and description of preterm (<37 weeks of pregnancy) and full-term infants’ sleeping habits at one and six months of age. Method: This was a quantitative study with a longitudinal design consisting of 923 parents to 504 infants born during 2020/2021 who received care in either the maternity- or neonatal ward in Sweden. Data was collected from questionnaires and was analyzed using descriptive statistics, Mann-Whitney U test and Cohen’s d. Results: Fathers and parents with a low educational level experienced the infant’s sleep less problematic compared to mothers and parents with a high educational level at both one and six months of age. Over time there was no difference related to educational level. One moth post-partum, parents to preterm infants experienced that the sleeping habits were more of a problem compared to parents to full term infants. Parents to breastfed infants experienced the sleeping habits as more problematic at six months of age, and co-sleeping was common during the infants’ first month of life. Conclusions: Parents’ experience of infants’ sleeping habits is affected by various factors in the immediate home environment. Hence there is a need for individualized support and interventions for new parents regarding infants’ sleep environment.

  • 42.
    Ahlenius, Victoria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Irarrazabal, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Sjuksköterskans upplevelse av att ge personcentrerad vård till personer med demenssjukdom: En litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Dementia impairs cognitive functions, such as memory and

    speech, changing a person’s life forever. Providing person-centred care to these

    persons intend to retain their identities, dignity and autonomy. Such care demands

    time, devotion and good knowledge of the caring nurse. Dementia is expected to

    increase in the future and therefore nurses will have to face new challenges.

    Aim: To describe nurses’ experience of providing person-centred care for people

    with dementia.

    Method: A literature review of 15 articles, published between 2009-2016, that

    have been read and analysed through content-analysis.

    Results: Nurses experience a positive change in their attitudes, when providing

    person-centred care to people with dementia, as they gained better understanding

    of their patients’ dignity and integrity. Education, training and support from

    management were seen as key factors for providing up-to-date care. Time was

    viewed as a hindrance for person-centred care, and often led to nurses prioritizing

    other routines. Two common outcomes of person-centred care were increased

    satisfaction as well as emotional burnout.

    Conclusion: Since dementia is increasing and nurses find person-centred care

    time-consuming, there is a risk of such care becoming poor. To prevent this nurses

    need good leadership and education.

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  • 43. Ahlm, Kristin
    et al.
    Lindqvist, Per
    Dalarna University, School of Education, Health and Social Studies, Medical Science. Karolinska institutet.
    Saveman, Britt-Inger
    Björnstig, Ulf
    Suicidal drowning deaths in northern Sweden 1992-2009: The role of mental disorder and intoxication2015In: Journal of Forensic and Legal Medicine, ISSN 1752-928X, E-ISSN 1878-7487, Vol. 34, p. 168-172Article in journal (Refereed)
    Abstract [en]

    Suicides by drowning have received limited attention by researchers. A recent finding that almost one-third of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.

  • 44.
    Ahlqvist, Jessica
    Dalarna University, School of Health and Welfare.
    Barnmorskors erfarenheter av att mätaförlossningsrädsla på barnmorskemottagning: En kvalitativ intervjustudie2022Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Förlossningsrädsla är vanligt förekommande och drabbar cirka 20 procent av alla gravida.Barnmorskan på barnmorskemottagningen möter de gravida med förlossningsrädsla i sitt arbete och har ettviktigt uppdrag i att identifiera förlossningsrädsla. I Sverige finns idag inget gemensamt och standardiserat sättatt mäta förlossningsrädsla inom klinisk vård. Fear of Birth Scale (FOBS) är emellertid ett validerat sätt attscreena för förlossningsrädsla som används inom flera regioner.Syfte: Syftet var att undersöka barnmorskor på barnmorskemottagningars erfarenheter av att använda Fear ofBirth Scale (FOBS) för att mäta förlossningsrädsla.Metod: En kvalitativ intervjustudie med induktiv ansats valdes för studiens genomförande. Totalt intervjuadesåtta barnmorskor som arbetade på barnmorskemottagningar i fem olika regioner i Sverige.Resultat: Resultatet utmynnade i två teman; Att mäta och vägleda rätt samt Dialogen som verktyg förskattning. Temat Att mäta och vägleda rätt omfattade fyra subteman; Tidpunkter och insatser, Konkretmätskala tydliggör, Dynamiken en utmaning samt Strategier vid språkbarriärer. Temat Dialogen som verktygför skattning omfattade två subteman; Öppet samtal i fokus samt Att tolka och anpassa i situationen.Slutsats: FOBS har bidragit till att sätta ämnet förlossningsrädsla på agendan hos barnmorskan på BMM.Under rätt förutsättningar kan FOBS bidra till att underlätta barnmorskans arbete med att identifiera ochbedöma förlossningsrädsla, men tid och fortbildning krävs.Klinisk tillämpbarhet: Identifiering och stöd vid förlossningsrädsla ingår i mödrahälsovårdens omfattandeuppdrag. Med rätt förutsättningar kan FOBS vara ett användbart hjälpmedel för att hitta och inleda en dialogom förlossningsrädsla, som är ett komplext ämne där vissa grupper särskilt sårbara och har ett stort stödbehov

  • 45.
    Ahlström, Evelina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Hellman, Nicklas
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Effekt av fysisk aktivitet hos äldre personer med depression och depressiva symtom: - En litteraturöversikt2020Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In today's society, depression is considered a world problem. A reduced desire for life, low self-esteem, tiredness and low energy are a few of the symptoms that a person with depression and depressive symptoms suffer from. The use of physical activity in various forms is recommended as a treatment for depression and depressive symptoms in elderly people. Person-centered care aims to ensure that the individual's own experience of health is in focus which increases the well-being of a person suffering from depression or depressive symptoms.Purpose: The purpose of the literature review is to investigate the effect of physical activity in elderly people with depression and depressive symptoms.Method: The degree project was carried out as a literature review. 14 articles were searched in the PubMed and CINAHL databases with keywords designed from the purpose. The articles were reviewed based on Dalarna University's review template and compiled based on different quality grades. Articles with medium and high quality were included. The results were categorised and compiled based on similarities and differences that emerged from the analysis.Results: The results of the literature review are shown to have an effect in depression and depressive symptoms in elderly people. Being physically active through an assigned individual exercise program, training in groups or in the form of yoga was shown to be able to positively affect the depressive symptoms and depression. The intensity of exercise and frequency may have an impact on the effect of depressive symptoms or depression.Conclusion: The effect of physical activity in various forms has been shown to reduce depressive symptoms in elderly people.

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  • 46. Ahlström, Fredrik
    et al.
    Göransson, Katarina
    Karolinska Institutet, Stockholm, Sweden.
    von Rosen, Anette
    Does gender matter at triage?2007In: Australasian emergency nursing journal, ISSN 1574-6267, Vol. 10, no 4, p. 202-203Article in journal (Refereed)
  • 47.
    Ahlström, Sara Wallin
    et al.
    Mälardalen University, Västerås; Center for Clinical Research Dalarna, Uppsala University, Falun; Habilitation Center in Falun.
    Almqvist, Lena
    Mälardalen University, Västerås.
    Janeslätt, Gunnel
    Center for Clinical Research Dalarna, Uppsala University, Falun; Habilitation Center in Falun, Dalarna; Uppsala University, Uppsala.
    Gustavsson, Catharina
    Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna, Uppsala University, Falun; Uppsala University, Uppsala.
    Harder, Maria
    Mälardalen University, Västerås.
    The experiences and the meaning of using MyTime in the preschool context from the perspective of children in need of special support, 5-6 years of age2023In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 49, no 6, p. 1096-1103Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Children in need of special support often display delays in time processing ability, affecting everyday functioning. MyTime is an intervention programme for systematic training of time processing ability. To support preschool children's development of time processing ability and everyday functioning, it is necessary to include their perspectives of the MyTime intervention programme. A previous study shows that MyTime is feasible with children in the preschool setting and shows positive effects on time processing ability for older children in special schools. Yet, there is a lack of knowledge regarding how preschool children experience the intervention programme and how they understand its meaning. The aim of this study was to explore the experiences and the meaning of using MyTime from the perspective of children with informal needs of special support (INS) 5-6 years of age in the preschool context.

    METHODS: To explore the children's perspectives, video-recorded interviews with 21 children were analysed hermeneutically. To facilitate the interview situation with the children in need of special support, the Talking Mats© was used. Both body and spoken languages were analysed.

    RESULTS: The results reveal children as active participants, willing to share their experiences of using the MyTime intervention in the preschool context. The conceptualization of the children's experiences and expressions uncovers their meaning of using the MyTime intervention as to know and to understand time by doing.

    CONCLUSIONS: When children are given the opportunity to use concrete tools to understand and measure time, they experience themselves as active participants involved and engaged in the intervention. They reveal meaningful experiences to be able to manage time that facilitate their everyday functioning and participation in the preschool context.

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  • 48. Ahmad, Shafqat
    et al.
    Hammar, Ulf
    Kennedy, Beatrice
    Salihovic, Samira
    Ganna, Andrea
    Lind, Lars
    Sundström, Johan
    Ärnlöv, Johan
    Dalarna University, School of Health and Welfare, Medical Science. Karolinska Institutet, Stockholm.
    Berne, Christian
    Fall, Tove
    Effect of General Adiposity and Central Body Fat Distribution on the Circulating Metabolome: a Multi-Cohort Non-Targeted Metabolomics Observational and Mendelian Randomization Study2022In: Diabetes, ISSN 0012-1797, E-ISSN 1939-327X, Vol. 71, no 2, p. 329-339Article in journal (Refereed)
    Abstract [en]

    Obesity is associated with adverse health outcomes, but the metabolic effects have not yet been fully elucidated. We aimed to investigate the association between adiposity with circulating metabolites and to address causality with Mendelian randomization (MR). Metabolomics data was generated by non-targeted ultra-performance liquid-chromatography coupled to time-of-flight mass-spectrometry in plasma and serum from three population-based Swedish cohorts: ULSAM (N=1,135), PIVUS (N=970), and TwinGene (N=2,059). We assessed associations between general adiposity measured as body mass index (BMI) and central body fat distribution measured as waist-to-hip ratio adjusted for BMI (WHRadjBMI) with 210 annotated metabolites. We employed MR analysis to assess causal effects. Lastly, we attempted to replicate the MR findings in the KORA and TwinsUK cohorts (N=7,373), the CHARGE consortium (N=8,631), the Framingham Heart Study (N=2,076) and the DIRECT consortium (N=3,029). BMI was associated with 77 metabolites, while WHRadjBMI was associated with 11 and 3 metabolites in women and men, respectively. The MR analyses in the Swedish cohorts suggested a causal association (p-value <0.05) of increased general adiposity and reduced levels of arachidonic acid, dodecanedioic acid and lysophosphatidylcholine (P-16:0) as well as with increased creatine levels. The replication effort provided support for a causal association of adiposity on reduced levels of arachidonic acid (p-value 0.03). Adiposity is associated with variation of large parts of the circulating metabolome, however causality needs further investigation in well-powered cohorts.

  • 49.
    Ahmad, Shafqat
    et al.
    Uppsala University, Uppsala;Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA..
    Ärnlöv, Johan
    Dalarna University, School of Health and Welfare, Medical Science. Karolinska Institutet, Stockholm.
    Larsson, Susanna C.
    Karolinska Institutet, Stockholm; Uppsala University, Uppsala.
    Genetically Predicted Circulating Copper and Risk of Chronic Kidney Disease: A Mendelian Randomization Study2022In: Nutrients, E-ISSN 2072-6643, Vol. 14, no 3, article id 509Article in journal (Refereed)
    Abstract [en]

    Elevated circulating copper levels have been associated with chronic kidney disease (CKD), kidney damage, and decline in kidney function. Using a two sample Mendelian randomization approach where copper-associated genetic variants were used as instrumental variables, genetically predicted higher circulating copper levels were associated with higher CKD prevalence (odds ratio 1.17; 95% confidence interval 1.04, 1.32; p-value = 0.009). There was suggestive evidence that genetically predicted higher copper was associated with a lower estimated glomerular filtration rate and a more rapid kidney damage decline. In conclusion, we observed that elevated circulating copper levels may be a causal risk factor for CKD. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.

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  • 50. Ahmed, Caisha Arai
    et al.
    Khokhar, Amrish Tayyibah
    Erlandsson, Kerstin
    Dalarna University, School of Health and Welfare, Sexual Reproductive Perinatal Health.
    Bogren, Malin
    Defibulated immigrant women's sexual and reproductive health from the perspective of midwives and gynaecologists as primary care providers in Sweden - A phenomenographic study.2021In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 29, article id 100644Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To capture care providers' perceptions of defibulated immigrant women's sexual and reproductive health, illuminated by their experiences as care providers for these women.

    METHODS: Individual interview study with 13 care providers at Swedish healthcare facilities: six gynaecologists and seven midwives caring for defibulated immigrant women, analysed with a phenomenographic method.

    FINDINGS: One of the care providers' perceptions of women who had been defibulated was that they had an altered genital function, meaning a wider introitus, improved vaginal intercourse, and more ease urinating and menstruating. The care providers also perceived that women who were defibulated had to balance their wellbeing, struggling between a positive self-image and handling their emotions. Existing in-between cultural values led to a fear of being excluded while at the same time having a desire to be included in the new culture.

    CONCLUSION: Defibulation affects women's sexual and reproductive health and calls for a holistic perspective when providing services, individualized according to the woman's care needs. Support and counselling, should include information about defibulation already during the adolescent years to promote sexual and reproductive health and well-being.

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