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  • 1.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Institutionen för hälsa och välfärd, Omvårdnad.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm, Sweden.
    Leksell, Janeth
    Uppsala University.
    Linder, Ebba
    Registercentrum Västra Götaland, Nationella Diabetesregistret, Göteborg.
    Eeg-Olofsson, Katarina
    Department of Molecular and Clinical MSahlgrenska Akademin, Göteborgs universitet, Göteborg, Sahlgrenska Universitetssjukhuset, Göteborg.
    Implementing the Digital Diabetes Questionnaire as a Clinical Tool in Routine Diabetes Care: Focus Group Discussions With Patients and Health Care Professionals2022Ingår i: JMIR Diabetes, ISSN 2371-4379, Vol. 7, nr 2, artikel-id e34561Artikel i tidskrift (Refereegranskat)
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  • 2.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Institutionen för hälsa och välfärd, Omvårdnad.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm, Sweden.
    Leksell, Janeth
    Uppsala University.
    Linder, Ebba
    Eeg-Olofsson, Katarina
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden; Registercentrum Västra Götaland.
    Ny artikel om Diabetesenkäten – Nya förhållningssätt och vidgade perspektiv2022Ingår i: Diabetesvård – Tidning för Svensk Förening för Sjuksköterskor i Diabetesvård, ISSN 1652-697X, nr 2, s. 19-19Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
  • 3.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Institutionen för hälsa och välfärd, Omvårdnad. Centrum för Klinisk Forskning Dalarna - Uppsala universitet.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm, Sweden.
    Linder, Ebba
    Registercentrum Västra Götaland, Nationella Diabetesregistret.
    Leksell, Janeth
    Högskolan Dalarna, Institutionen för hälsa och välfärd, Omvårdnad. Uppsala University.
    Eeg-Olofsson, Katarina
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden.
    Att implementera Diabetesenkäten som kliniskt verktyg i diabetesvården: erfarenheter från patienter, diabetessjuksköterskor och läkare2021Konferensbidrag (Refereegranskat)
  • 4. Husdal, R.
    et al.
    Thors Adolfsson, E.
    Leksell, Janeth
    Högskolan Dalarna, Institutionen för hälsa och välfärd, Omvårdnad. Uppsala University.
    Nordgren, L.
    Diabetes care provided by national standards can improve patients' self-management skills: A qualitative study of how people with type 2 diabetes perceive primary diabetes care2021Ingår i: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 24, nr 3, s. 1000-1008Artikel i tidskrift (Refereegranskat)
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  • 5.
    Nerpin, Elisabet
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala University.
    Toft, E.
    Fischier, J.
    Lindholm-Olinder, A.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    A virtual clinic for the management of diabetes-type 1: study protocol for a randomised wait-list controlled clinical trial2020Ingår i: BMC Endocrine Disorders, E-ISSN 1472-6823, Vol. 20, nr 1Artikel i tidskrift (Refereegranskat)
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  • 6.
    Forsman, Henrietta
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Jansson, Inger
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Lepp, Margret
    Sundin Andersson, Christina
    Engström, Maria
    Nilsson, Jan
    Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students.2020Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 76, s. 199-208Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To identify clusters based on graduating nursing students' self-reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students' perceptions of overall quality of the nursing programme and students' general self-efficacy.

    DESIGN: A cross-sectional study combining survey data and results from a national examination.

    METHODS: Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self-Efficacy scale and results from the National Clinical Final Examination. A Two-Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.

    RESULTS: Three clusters were identified illustrating students' different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self-assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.

    CONCLUSION: The study illustrates how nursing students' self-assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self-evaluation is a key learning outcome and is, in the long run, essential to patient safety.

    IMPACT: The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self-efficacy lower than other students. The findings illuminate the need for student-centered strategies in nursing education, including elements of self-assessment in relation to examination to make the students more aware of their clinical competence.

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  • 7. Granstam, E.
    et al.
    Rosenblad, A.
    Modher Raghib, A.
    Granström, Therese
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University Hospital, Uppsala University.
    Eriksson, J. W.
    Lindholm Olinder, A.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University Hospital, Uppsala University.
    Long-term follow-up of antivascular endothelial growth factor treatment for diabetic macular oedema: a four-year real-world study2020Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 98, s. 360-367Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    To evaluate visual acuity (VA) and central retinal thickness (CRT) on optical coherence tomography during a 4‐year period in patients treated for sight‐threatening diabetic macular oedema (DMO) at two Swedish county hospitals. Additionally, to compare health‐related quality of life and subjective visual functioning before and after 4 years of treatment.

    Methods

    Fifty‐eight patients with DMO were evaluated after 4 years of antivascular endothelial growth factor (VEGF) treatment. VA, CRT and clinical data were retrospectively reviewed. Health‐related quality of life and subjective visual functioning were evaluated with Short Form Health Survey (SF‐36) and National Eye Institute Vision Functioning Questionnaire 25 (VFQ‐25). Comparisons between independent groups were performed using Pearson's χ2 test, Fisher's exact test or Mann–Whitney U test. Spearman's ρ was used for correlation analyses. Wilcoxon signed‐rank test was used for comparison between dependent groups. Logistic regression analysis was applied for analysis of VA and CRT over 4 years.

    Results

    Follow‐up data were obtained from 37 of 58 (63.8%) patients. Baseline characteristics were similar, regardless of follow‐up. VA improvement at 1 year (mean + 4.4, SD 7.5; ETDRS letter score) was maintained over 3 years, then declined. CRT was reduced throughout the study. In the first treatment year, eyes received 5.1 (1.4) anti‐VEGF injections, followed by approximately two injections yearly. Additional treatment included laser and dexamethasone implants. SF‐36 showed no change at 4 years, compared with baseline. VFQ‐25 demonstrated improvement in near vision activities (p = 0.036).

    Conclusion

    Significant long‐term improvement in visual function was present in patients with anti‐VEGF‐treated DMO.

  • 8.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm, Sweden.
    Borg, Sixten
    Lund University, Department of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, Lund, Sweden.
    Palaszewski, Bo
    Region Västra Götaland, Department of Data Management and Analysis, Gothenburg, Sweden.
    Franzén, Stefan
    Register Center Västra Götaland, Gothenburg, Sweden.
    Gudbjörnsdottir, Soffia
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Register Center Västra Götaland, Gothenburg, Sweden.
    Eeg-Olofsson, Katarina
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden.
    New diabetes questionnaire to add patients’ perspectives to diabetes care for adults with type 1 and type 2 diabetes – Nationwide cross-sectional study of construct validity assessing associations with generic health-related quality of life and clinical variables2020Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 10, nr 11, artikel-id e038966Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives To study evidence for construct validity, the aim was to describe the outcome from the recently developed Diabetes Questionnaire, assess the associations of that outcome with clinical variables and generic health-related quality of life, and study the sensitivity to differences between clinically relevant groups of glycaemic control in adults with type 1 and type 2 diabetes in a nation-wide setting.

    Design Cross-sectional survey.

    Setting Swedish diabetes care clinics connected to the National Diabetes Register (NDR).

    Participants Among 2479 adults with type 1 diabetes and 2469 with type 2 diabetes selected at random from the NDR, 1373 (55.4%) with type 1 and 1353 (54.8%) with type 2 diabetes chose to participate.

    Outcome measures The Diabetes Questionnaire, the generic 36-item Short Form version 2 (SF-36v2) health survey and clinical variables.

    Results Related to the prespecified assumptions, supporting evidence for construct validity for the Diabetes Questionnaire was found. Supporting divergent validity, the statistically significant correlations with the clinical variables were few and weak. In relation to the SF-36v2 and in support of convergent validity, the strongest correlations were seen in the Diabetes Questionnaire scales General Well-being and Mood and Energy. In those scales, machine learning analyses showed that about 40%–45% of the variance was explained by the SF-36v2 results and clinical variables. In multiple regression analyses among three groups with differing levels of glycated haemoglobin adjusted for demographics, other risk factors, and diabetes complications, the high-risk group had, in support of sensitivity to clinically relevant groups, statistically significant lower scores than the well-controlled group in most Diabetes Questionnaire scales.

    Conclusions This nation-wide study shows that the Diabetes Questionnaire captures some generic health-related quality-of-life dimensions, in addition to adding diabetes-specific information not covered by the SF-36v2 and clinical variables. The Diabetes Questionnaire is also sensitive to differences between clinically relevant groups of glycaemic control.

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  • 9. Husdal, Rebecka
    et al.
    Thors Adolfsson, Eva
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Eliasson, Björn
    Jansson, Stefan
    Jerdén, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Stålhammar, Jan
    Steen, Lars
    Wallman, Thorne
    Svensson, Ann-Marie
    Rosenblad, Andreas
    Organisation of primary diabetes care in people with type 2 diabetes in relation to all-cause mortality: A nationwide register-based cohort study2020Ingår i: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 167, artikel-id 108352Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To examine if personnel resources and organisational features in Swedish primary health-care centres (PHCCs) are associated to all-cause mortality (ACM) in people with type 2 diabetes mellitus (T2DM).

    METHODS: A total of 187,570 people with T2DM registered in the Swedish National Diabetes Register (NDR) during 2013 were included in this nationwide cohort study. Individual NDR data were linked to data from a questionnaire addressing personnel resources and organisational features for 787 (68%) PHCCs as well as to individual data on socio-economic status and comorbidities. Furthermore, data on ACM were obtained and followed up until 30 January 2018. Hierarchical Cox regression analyses were applied.

    RESULTS: After a median follow-up of 4.2 years, 27,136 (14.5%) participants had died. An association was found between number of whole-time-equivalent (WTE) general practitioner's (GP's) devoted to diabetes care/500 people with T2DM and lower risk of early death (hazard ratio 0.919 [95% confidence interval 0.895-0.945] per additional WTE GP; p = 0.002). No other personnel resources or organisational features were significantly associated with ACM.

    CONCLUSIONS: This nationwide register-based cohort study suggests that the number of WTE GPs devoted to diabetes care have an impact on the risk of early death in people with T2DM.

  • 10. Eeg-Olofsson, Katarina
    et al.
    Johansson, Unn-Britt
    Linder, Ebba
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Patients' and Health Care Professionals' Perceptions of the Potential of Using the Digital Diabetes Questionnaire to Prepare for Diabetes Care Meetings: Qualitative Focus Group Interview Study.2020Ingår i: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 22, nr 8, artikel-id e17504Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In effective diabetes management, it is important that providers and health care systems prioritize the delivery of patient-centered care and that they are respectful of and responsive to individual patient preferences and barriers.

    OBJECTIVE: The objective of the study was to conduct focus group interviews to capture patients' and health care professionals' perceptions and attitudes regarding digital technology and to explore how the digital Diabetes Questionnaire can be used to support patient participation in diabetes care, as a basis for an implementation study.

    METHODS: A qualitative study was conducted with six focus group discussions with diabetes specialist nurses and medical doctors (n=29) and four focus group discussions with individuals with diabetes (n=23). A semistructured focus group interview guide was developed, including probing questions. The data were transcribed verbatim, and qualitative content analysis was performed using an inductive approach.

    RESULTS: Two main categories were revealed by the qualitative analysis: perceptions of digital technology and the digital questionnaire in diabetes management and care and perceptions of participation in diabetes care. An overarching theme that emerged from the focus group interviews was patients' and professionals' involvement in diabetes care using digital tools.

    CONCLUSIONS: The analysis identified important factors to consider when introducing the digital Diabetes Questionnaire in clinical use. Both professionals and patients need support and training in the practical implementation of the digital questionnaire, as well as the opportunity to provide feedback on the questionnaire answers.

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  • 11.
    Katsogiannos, Petros
    et al.
    Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University.
    Randell, Eva
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Sundbom, Magnus
    Department of Surgical Sciences, Uppsala University.
    Rosenblad, Andreas
    Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University.
    Eriksson, Jan W.
    Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Departments of Medical Science, Clinical Diabetes and Metabolism Sciences, Uppsala University.
    Quality of life after gastric bypass surgery in patients with type 2 diabetes: patients’ experiences during 2 years of follow-up2020Ingår i: Diabetology & Metabolic Syndrome, E-ISSN 1758-5996, Vol. 12, nr 1Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    To examine the effects of gastric bypass surgery on health-related quality of life (HRQoL) in obese patients with type 2 diabetes, and to investigate their experiences of life adjustments using quantitative and qualitative methods.

    Methods

    Thirteen patients with type 2 diabetes and obesity, (body mass index, BMI > 30 kg/m2), participating in a randomized clinical trial, completed this sub-study. HRQoL was evaluated before, and at 6 months and 2 years after gastric bypass surgery, using the RAND- 36-item health survey. At 2 years, interviews for in-depth analysis of HRQoL changes were performed.

    Results

    Significant improvement was observed from baseline to 6 months for 2 of the eight health concepts, general health, and emotional well-being. At 2 years, improvements were also seen in physical functioning, energy/fatigue, as well as sustained improvements in general health and emotional well-being. Multiple regression analyses showed mostly non-significant associations between the magnitude of decrease in weight, BMI, and HbA1c during follow-up and improvement in HRQoL. The analyses from qualitative interviews supported a common latent theme “Finding a balance between the experience of the new body weight and self-confidence”.

    Conclusions

    The improved HRQoL after gastric bypass surgery in obese patients with type 2 diabetes was not explained specifically by the magnitude of weight loss, but rather by the participants achieving a state of union between body and consciousness.

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  • 12.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm, Sweden.
    Borg, Sixten
    Lund University, Department of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, Lund, Sweden.
    Palaszewski, Bo
    Region Västra Götaland, Department of Data Management and Analysis, Gothenburg, Sweden.
    Franzén, Stefan
    Register Center Västra Götaland, Gothenburg, Sweden.
    Gudbjörnsdottir, Soffia
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Register Center Västra Götaland, Gothenburg, Sweden.
    Eeg-Olofsson, Katarina
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden.
    A new diabetes questionnaire to add patients’ perspectives to diabetes care: A nationwide cross-sectional study among adults with type 1 and type 2 diabetes.2019Konferensbidrag (Refereegranskat)
  • 13.
    Brorsson, Anna Lena
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Franko, Mikael Andersson
    Lindholm Olinder, Anna
    A person-centered education for adolescents with type 1 diabetes - a randomized controlled trial2019Ingår i: Pediatric Diabetes, ISSN 1399-543X, E-ISSN 1399-5448, Vol. 20, nr 7, s. 986-996Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Young people with type 1 diabetes and their parents need to receive person-centred education to be able to manage their diabetes. Guided Self-Determination-Young (GSD-Y) is a person-centred communication and reflection education model that can be used in educational programmes for young people with type 1 diabetes.

    OBJECTIVE: To evaluate whether GSD-Y leads to improved glycaemic control, increased self-perceived health and health-related quality of life, fewer diabetes-related family conflicts, and improved self-efficacy in a group-based intervention for adolescents starting continuous subcutaneous insulin infusion (CSII) and their parents.

    METHODS: This randomized controlled trial included 71 adolescents starting CSII. Participants were followed for twelve months. The intervention group (n=37) attended seven group training sessions over a period of five months, using the GSD-Y model, the control group received standard care. Variables evaluated were HbA1c, self-perceived health, health-related quality of life, family conflicts, self-efficacy, and usage of continuous glucose monitoring.

    RESULTS: When adjusted for sex and family conflicts, there was a difference in glycaemic control between the groups at twelve months, favouring the intervention group (62 vs. 70 mmol/mol, p=0.009). When analyses were performed on boys and girls separately and adjusted for family conflicts, the only difference detected was for boys after twelve months (p=0.019). The intervention showed no effect on self-perceived health, health-related related quality of life, family conflicts, or self-efficacy.

    CONCLUSIONS: An intervention with GSD-Y may have an effect on glycaemic control. The content of the GSD-Y groups may serve as a model for person-centred care in adolescents with type 1 diabetes. This article is protected by copyright. All rights reserved.

  • 14. Husdal, Rebecka
    et al.
    Thors Adolfsson, Eva
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Eliasson, Björn
    Jansson, Stefan
    Jerdén, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Centre for Clinical Research Dalarna, Uppsala University, Falun.
    Stålhammar, Jan
    Steen, Lars
    Wallman, Thorne
    Rosenblad, Andreas
    Associations between quality of work features in primary health care and glycaemic control in people with Type 2 diabetes mellitus: a nationwide survey2019Ingår i: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 13, nr 2, s. 176-186Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To describe and analyse the associations between primary health care centres' (PHCCs') quality of work (QOW) and individual HbA1c levels in people with Type 2 diabetes mellitus (T2DM).

    METHODS: This cross-sectional study invited all 1152 Swedish PHCCs to answer a questionnaire addressing QOW conditions. Clinical, socio-economic and comorbidity data for 230,958 people with T2DM were linked to data on QOW conditions for 846 (73.4%) PHCCs.

    RESULTS: Of the participants, 56% had controlled (≤52mmol/mol), 31.9% intermediate (53-69mmol/mol), and 12.1% uncontrolled (≥70mmol/mol) HbA1c. An explanatory factor analysis identified seven QOW features. The features having a call-recall system, having individualized treatment plans, PHCCs' results always on the agenda, and having a follow-up strategy combined with taking responsibility of outcomes/results were associated with lower HbA1c levels in the controlled group (all p<0.05). For people with intermediate or uncontrolled HbA1c, having individualized treatment plans was the only QOW feature that was significantly associated with a lower HbA1c level (p<0.05).

    CONCLUSIONS: This nationwide study adds important knowledge regarding associations between QOW in real life clinical practice and HbA1c levels. PHCCs' QOW may mainly only benefit people with controlled HbA1c and more effective QOW strategies are needed to support people with uncontrolled HbA1c.

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  • 15.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. University of Gothenburg, Sahlgrenska Academy.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Johansson, Unn-Britt
    Borg, Sixten
    Palaszewski, Bo
    Franzén, Stefan
    Gudbjörnsdottir, Soffia
    Eeg-Olofsson, Katarina
    Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes: a nationwide cross-sectional study2019Ingår i: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 17, nr 1, artikel-id 141Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Health-related quality of life and glycaemic control are some of the central outcomes in clinical diabetes care and research. The purpose of this study was to describe the health-related quality of life and assess its association with glycaemic control in adults with type 1 and type 2 diabetes in a nationwide setting.

    Methods: In this cross-sectional survey, people with type 1 (n = 2479) and type 2 diabetes (n = 2469) were selected at random without replacement from the Swedish National Diabetes Register. Eligibility criteria were being aged 18–80 years with at least one registered test of glycated haemoglobin (HbA1c) the last 12 months. The generic 36- item Short Form version 2 (SF-36v2) was answered by 1373 (55.4%) people with type 1 diabetes and 1353 (54.8%) with type 2 diabetes.

    Results: Correlation analyses showed weak correlations between scores on the SF-36v2 and glycaemic control for both diabetes types. After the participants were divided into three groups based on their levels of HbA1c, multivariate regression analyses adjusted for demographics, other risk factors and diabetes complications showed that among participants with type 1 diabetes, the high-risk group (≥70 mmol/mol/8.6%) had statistically significantly lower means in five out of eight domains of the SF-36v2 and the mental component summary measure, as compared with the well-controlled group (< 52 mmol/mol/6.9%). Among the participants with type 2 diabetes, the high-risk group had the lowest statistically significantly means in seven domains and both summary measures.

    Conclusions: Among people with type 1 and type 2 diabetes, adults with high-risk HbA1c levels have lower levels of health-related quality of life in most but not all domains of the SF-36v2. This finding was not explained by demographics, other risk factors, or diabetes complications. The weak individual-level correlations between HRQOL scores and levels of glycaemic control argues for the need to not focus exclusively on either HbA1c levels or HRQOL scores but rather on both because both are important parts of a complex, life-long, challenging condition.

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  • 16. Ewertzon, Mats
    et al.
    Alvariza, Anette
    Winnberg, Elisabeth
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Andershed, Birgitta
    Goliath, Ida
    Momeni, Pardis
    Kneck, Åsa
    Skott, Maria
    Årestedt, Kristofer
    Adaptation and evaluation of the Family Involvement and Alienation questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care2018Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, nr 8, s. 1839-1850Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIM: To adapt the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability.

    BACKGROUND: Involvement in the professional care has proven to be important for family members. However, they have described feelings of alienation in relation to how they experienced the professionals' approach. To explore this issue, a broad instrument that can be used in different care contexts is needed.

    DESIGN: A psychometric evaluation study, with a cross-sectional design.

    METHOD: The content validity of the Family Involvement and Alienation Questionnaire was evaluated during 2014 by cognitive interviews with 15 family members to adults in different care contexts. Psychometric evaluation was then conducted (2015-2016). A sample of 325 family members participated, 103 of whom in a test-retest evaluation. Both parametric and non-parametric methods were used.

    RESULTS: The content validity revealed that the questionnaire was generally understood and considered to be relevant and retrievable by family members in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. Furthermore, the Family Involvement and Alienation Questionnaire (Revised), demonstrated satisfactory psychometric properties in terms of data quality, homogeneity, unidimensionality (factor structure), internal consistency and test-retest reliability.

    CONCLUSION: The study provides evidence that the Family Involvement and Alienation Questionnaire (Revised) is reliable and valid for use in further research and in quality assessment in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. 

  • 17. Julin, Bettina
    et al.
    Willers, Carl
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Lindgren, Peter
    Muth, Karin Looström
    Svensson, Ann-Marie
    Lilja, Mikael
    Dahlström, Tobias
    Association between sociodemographic determinants and health outcomes in individuals with type 2 diabetes in Sweden2018Ingår i: Diabetes/Metabolism Research Reviews, ISSN 1520-7552, E-ISSN 1520-7560, Vol. 34, nr 4, s. -9, artikel-id e2984Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Concurrent multifactorial treatment is needed to reduce consequent risks of diabetes, yet most studies investigating the relationship between sociodemographic factors and health outcomes have focused on only one risk factor at a time. Swedish health care is mainly tax-funded, thus providing an environment that should facilitate equal health outcomes in patients, independent of background, socioeconomic status or health profile. This study aimed at investigating the association between several sociodemographic factors and diabetes-related health outcomes represented by HbA1c , systolic blood pressure, LDL cholesterol, predicted 5-year risk of cardiovascular disease as well as statin use.

    METHODS: This large retrospective registry-study was based on patient-level data from individuals diagnosed with type 2 diabetes mellitus during 2010-2011 (n = 416,228) in any of seven Swedish regions (~65% of the Swedish population). Health equity in diabetes care was analyzed through multivariate regression analyses on intermediary outcomes (HbA1c , systolic blood pressure, LDL), predicted 5-year risk of cardiovascular disease and process (i.e. statin use) after one-year follow-up, adjusting for several sociodemographic factors.

    RESULTS: We observed differences in intermediary risk measures, predicted 5-year risk of cardiovascular disease as well as process dependent on place of birth, sex, age, education and social setting, despite Sweden's articulated vision of equal health care.

    CONCLUSIONS: Diabetes patients' health was associated with sociodemographic prerequisites. In addition to demographics (age, sex) and disease history; educational level, marital status and region of birth are important factors to consider when benchmarking health outcomes, e.g. average HbA1c level, between organizational units or between different administrative regions.

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  • 18.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Brorsson, Anna Lena
    Uppsala University; Karolinska Institute and Hospital.
    Granstam, Elisabet
    Uppsala University/County Council of Västmanland; Västmanland County Hospital.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Patients’ experiences before starting anti-VEGF treatment for sight-threatening diabetic macular oedema: A qualitative interview study2018Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, nr 1, s. 11-17Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The diabetic complication macular oedema (DME) is a growing problem worldwide because of the increasing number of patients suffering from diabetes mellitus (DM). DME is treated with injections of anti-vascular endothelial growth factor (anti-VEGF) in the eye. This real-world study aimed to describe patients’ experiences before they received their first injection in the eye. Twenty-one men and women aged 49 to 86 years were interviewed. The interviews were analysed using qualitative content analysis. Two categories and an overall theme ‘to be at a crossroads and a crucial phase in life with an uncertain outcome’ were found. The participants expressed thoughts and concerns at different levels, practical concerns about the treatment procedure, and other existential thoughts regarding hope for improved visual acuity or fear of deterioration. Cooperation between eye clinics and diabetes clinics should be strengthened to clarify who is responsible for providing the information and support required by patients.

  • 19. Husdal, Rebecka
    et al.
    Rosenblad, Andreas
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Eliasson, Björn
    Jansson, Stefan
    Jerdén, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Centre for Clinical Research Dalarna, Uppsala University, Falun.
    Stålhammar, Jan
    Steen, Lars
    Wallman, Thorne
    Thors Adolfsson, Eva
    Resources and organisation in primary health care are associated with HbA1c level: a nationwide study of 230958 people with Type 2 diabetes mellitus2018Ingår i: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 12, nr 1, s. 23-33Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM).

    METHODS: People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.

    RESULTS: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01).

    CONCLUSIONS: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM.

  • 20. Willers, Carl
    et al.
    Iderberg, Hanna
    Axelsen, Mette
    Dahlström, Tobias
    Julin, Bettina
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Lindberg, Agneta
    Lindgren, Peter
    Looström Muth, Karin
    Lilja, Mikael
    Sociodemographic determinants and health outcome variation in individuals with type 1 diabetes mellitus: A register-based study2018Ingår i: PLOS ONE, E-ISSN 1932-6203, Vol. 13, nr 6, artikel-id e0199170Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Socioeconomic status, origin or demographic attributes shall not determine the quality of healthcare delivery, according to e.g. United Nations and European Union rules. Health equity has been defined as the absence of systematic disparities and unwarranted differences between groups defined by differences in social advantages. A study was performed to investigate whether this was applicable to type 1 diabetes mellitus (T1D) care in a setting with universal, tax-funded healthcare.

    METHODS: This retrospective registry-study was based on patient-level data from individuals diagnosed with T1D during 2010-2011 (n = 16,367) in any of seven Swedish county councils (covering ~65% of the Swedish population). Health equity in T1D care was analysed through multivariate regression analyses on absolute HbA1c level at one-year follow-up, one-year change in estimated glomerular filtration rate (eGFR) and one-year change in cardiovascular risk score, using selected sociodemographic dimensions as case-mix factors.

    RESULTS: Higher educational level was consistently associated with lower levels of HbA1c, and so was being married. Never married was associated with worse eGFR development, and lower educational level was associated with higher cardiovascular risk. Women had higher HbA1c levels than men, and glucose control was significantly worse in patients below the age of 25.

    CONCLUSION: Patients' sociodemographic profile was strongly associated with absolute levels of risk factor control in T1D, but also with an increased annual deterioration in eGFR. Whether these systematic differences stem from patient-related problems or healthcare organisational shortcomings is a matter for further research. The results, though, highlight the need for intensified diabetes management education and secondary prevention directed towards T1D patients, taking sociodemographic characteristics into account.

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  • 21. Johansson, Karin
    et al.
    Österberg, Sofia Almerud
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Berglund, Mia
    Supporting patients learning to live with diabetes: a phenomenological study2018Ingår i: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819, Vol. 27, nr 12, s. 697-704Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This article describes a study of the phenomenon of supporting patients who are learning to live with diabetes, from a diabetes specialist nurse (DSN) perspective. Guided by principles of reflective lifeworld research, data from six interviews (four in groups and two individual) with 16 DSNs were analysed. The results show that, in order to support learning, DSNs use a self-critical approach with the insight that they should not take over responsibility for their patients' diabetes. The DSNs support, encourage and challenge the patients to self-reflect and take responsibility based on patients' own goals and needs. To provide support, DSNs need to assume a tactful, critically challenging approach, dare to confront patients' fears and other emotions and have the insight to know that the responsibility for learning and integration of the condition lies with the patient. To be able to support patients in this way, it is necessary that the DSN is mentored and supported in this role.

  • 22.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Göteborgs universitet.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Johansson, Unn-Britt
    Eeg-Olofsson, Katarina
    Borg, Sixten
    Palaszewski, Bo
    Gudbjörnsdottir, Soffia
    A disease-specific questionnaire for measuring patient-reported outcomes and experiences in the Swedish National Diabetes Register: Development and evaluation of content validity, face validity, and test-retest reliability.2017Ingår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 101, nr 1, s. 139-146Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: To describe the development and evaluation of the content and face validity and test-retest reliability of a disease-specific questionnaire that measures patient-reported outcomes and experiences for the Swedish National Diabetes Register for adult patients who have type 1 or type 2 diabetes.

    METHODS: In this methodological study, a questionnaire was developed over four phases using an iterative process. Expert reviews and cognitive interviews were conducted to evaluate content and face validity, and a postal survey was administered to evaluate test-retest reliability.

    RESULTS: The expert reviews and cognitive interviews found the disease-specific questionnaire to be understandable, with relevant content and value for diabetes care. An item-level content validity index ranged from 0.6-1.0 and a scale content validity/average ranged from 0.7-1.0. The fourth version, with 33 items, two main parts and seven dimensions, was answered by 972 adults with type 1 and type 2 diabetes (response rate 61%). Weighted Kappa values ranged from 0.31-0.78 for type 1 diabetes and 0.27-0.74 for type 2 diabetes.

    CONCLUSIONS: This study describes the initial development of a disease-specific questionnaire in conjunction with the NDR. Content and face validity were confirmed and test-retest reliability was satisfactory.

    PRACTICE IMPLICATIONS: With the development of this questionnaire, the NDR becomes a clinical tool that contributes to further understanding the perspectives of adult individuals with diabetes.

  • 23.
    Brorsson, Anna Lena
    et al.
    Karolinska institutet.
    Lindholm Olinder, Anna
    Viklund, Gunnel
    Granström, Therese
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Adolescents’ perceptions of participation in group education using the Guided Self-Determination-Young method: a qualitative study2017Ingår i: BMJ Open Diabetes Research & Care, ISSN 2052-4897, Vol. 5, nr 1, artikel-id e000432Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective Guided Self-Determination (GSD) is a person-centered communication and reflection method. Education in groups may have a greater impact than the content of the education, and constructive communication between parents and adolescents has been shown to be of importance. The purpose of this study was to describe adolescents’ perceptions of participation in group education with the Guided Self-Determination-Young (GSD-Y) method, together with parents, in connection with the introduction of continuous subcutaneous insulin infusion.

    Research design and methods In the present qualitative interview study, 13 adolescents with type 1 diabetes were included after completing a GSD-Y group education program in connection with the introduction of continuous subcutaneous insulin infusion at three hospitals located in central Sweden. The adolescents were interviewed individually, and qualitative content analysis was applied to the interview transcripts.

    Results Two categories that emerged from the analysis were the importance of context and growing in power through the group process. An overarching theme that emerged from the interviews was the importance of expert and referent power in growing awareness of the importance of self-management as well as mitigating the loneliness of diabetes.

    Conclusions GSD-Y has, in various ways, mitigated experiences of loneliness and contributed to conscious reflection about self-management in the group (referent power) together with the group leader (expert power). Overall, this highlights the benefits of group education, and the GSD method emphasizes the person-centered approach.

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  • 24. Dahlberg, ER
    et al.
    Spets, E
    Svedbo Engström, Maria
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Sahlgrenska Academy, Institute of Medicine, University of Gothenburg.
    Larshans, M
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Department of Medical Sciences, Uppsala University.
    Experiences of Hypoglycaemia in Adults with Diabetes Mellitus2017Ingår i: Journal of Diabetes and Treatment, ISSN 2574-7568, artikel-id J111Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims: To describe adults’ experiences of hypoglycaemia in diabetes mellitus, and the consequences of hypoglycaemia in daily life.

    Methods: This study was conducted using qualitative content analysis with an inductive approach. It was performed as a secondary analysis of semi-structured interviews. A total of 29 people participated in the study: 15 with type 1 diabetes and 14 with type 2 diabetes.

    Results: The theme that emerged was: Hypoglycaemia is an ever-present risk that manifests itself in different ways. The following categories were identified: Symptoms of hypoglycaemia can appear like a bolt from the blue. Knowledge comes from life experiences. Training and exercise today often have consequences tomorrow. Self-management may be perceived as a feeling of not being free. Family support can provide security in the illness.

    Conclusion: Hypoglycaemia is perceived as an ever-present risk that can come like a bolt from the blue, which in turn causes fear and problems in the daily life of people with diabetes. Better support, help and information from specialist nurses is needed. Family members should also be given more knowledge and information, in order to reduce the fear and discomfort of hypoglycaemia.

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  • 25.
    Husdal, Rebecka
    et al.
    Uppsala University, Medical sciences.
    Rosenblad, Andreas
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Eliasson, Björn
    Gothenburg University .
    Jansson, Stefan
    Jerdén, Lars
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Centre for Clinical Research Dalarna, Uppsala University, Falun.
    Stålhammar, Jan
    Steen, Lars
    Wallman, Thorne
    Thors Adolfsson, Eva
    Resource allocation and organisational features in Swedish primary diabetes care: changes from 2006 to 20132017Ingår i: Primary Care Diabetes, ISSN 1751-9918, E-ISSN 1878-0210, Vol. 11, nr 1, s. 20-28Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AIMS: To compare the resource allocation and organisational features in Swedish primary diabetes care for patients with type 2 diabetes mellitus (T2DM) between 2006 and 2013.

    METHODS: Using a repeated cross-sectional study design, questionnaires covering personnel resources and organisational features for patients with T2DM in 2006 and 2013 were sent to all Swedish primary health care centres (PHCCs) during the following year. In total, 684 (74.3%) PHCCs responded in 2006 and 880 (76.4%) in 2013.

    RESULTS: Compared with 2006, the median list size had decreased in 2013 (p<0.001), whereas the median number of listed patients with T2DM had increased (p<0.001). Time devoted to patients with T2DM and diabetes-specific education levels for registered nurses (RNs) had increased, and more PHCCs had in-house psychologists (all p<0.001). The use of follow-up systems and medical check-ups had increased (all p<0.05). Individual counselling was more often based on patients' needs, while arrangement of group-based education remained low. Patient participation in setting treatment targets mainly remained low.

    CONCLUSIONS: Even though the diabetes-specific educational level among RNs increased, the arrangement of group-based education and patient participation in setting treatment targets remained low. These results are of concern and should be prioritised as key features in the care of patients with T2DM.

  • 26.
    Leksell, Janeth
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Lepp, Margret
    Institute of Health and Care Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Vårdpedagogik: Vårdens kärnkompetenser från ett pedagogiskt perspektiv2017Bok (Refereegranskat)
  • 27.
    Leksell, Janeth
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Medical Sciences Uppsala University.
    Billing, Ewa
    Medical Sciences Uppsala University.
    An evaluation of a cognitive educational program tailored for young women with mental illness: A qualitative interview study2016Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, nr 3, s. 155-160Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Mental illness is a growing problem in numerous industrialized countries. Young women in particular report problems such as anxiety, worry and depression. The aim of this study was to evaluate a cognitive educational program offered to young women with mental illness by listening to how they discussed their own social skills and capability to obtain work or education. Five women in the age range of 18–26 years, who had been unemployed for at least four months, diagnosed as suffering from mental illness, and who also participated in a cognitive educational program were interviewed. The text from the interviews was analyzed using content analysis. The analysis resulted in the construction of the following theme: ‘Being together in an inspiring educational program supports the women’s own ability to devise a holistic life puzzle’. The participants’ answers were grouped into the following categories: ‘Perceptions of the educational program’ and ‘Social network’ with four subcategories. Being together with others in the same situation would appear to support the women’s own abilities, especially in an environment characterized by strict routines and nearness. These findings indicate the need to develop interventions for young women with mental illness which encourage spaces for collective support.

  • 28.
    Iversen, Marjolein M.
    et al.
    Bergen Univ Coll, Fac Hlth & Social Sci, Ctr Evidence Based Practice, Bergen, Norway.;Stavanger Univ Hosp, Endocrinol Sect, Dept Med, Stavanger, Norway..
    Graue, Marit
    Bergen Univ Coll, Fac Hlth & Social Sci, Ctr Evidence Based Practice, Bergen, Norway.;Haukeland Hosp, Dept Pediat, Bergen, Norway..
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Smide, Bibbi
    Uppsala Univ, Dept Med Sci, Uppsala, Sweden..
    Zoffmann, Vibeke
    Rigshosp, Univ Copenhagen Hosp, Juliane Marie Ctr, Res Womens & Childrens Hlth, Copenhagen, Denmark..
    Sigurdardottir, Arun K.
    Univ Akureyri, Sch Hlth Sci, Akureyri, Iceland..
    Characteristics of nursing studies in diabetes research published over three decades in Sweden, Norway, Denmark and Iceland: a narrative review of the literature2016Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, nr 2, s. 241-249Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Similarities and differences across borders of Nordic countries constitute a suitable context for investigating and discussing factors related to the development of diabetes nursing research over the last three decades. The present study reviewed the entire body of contemporary diabetes nursing research literature originating in four Nordic countries: Norway, Sweden, Denmark and Iceland. Our aims were (i) to catalogue and characterise trends in research designs and research areas of these studies published over time and (ii) to describe how research involving nurses in Nordic countries has contributed to diabetes research overall. The larger goal of our analyses was to produce a comprehensive picture of this research in order to guide future studies in the field. We conducted a narrative literature review by systematically searching Medline, Medline in process, EMBASE, CINAHL, PsycINFO and Cochrane databases. These searches were limited to studies published between 1979 and 2009 that had an abstract available in English or a Nordic language. Two researchers independently selected studies for analysis, leading to the inclusion of 164 relevant publications for analysis. In summary, Nordic nurse researchers have contributed to the development of new knowledge in self-management of diabetes in childhood, adolescence and adulthood, and to some extent also in the treatment and care of diabetes foot ulcers. Future research may benefit from (i) larger nurse-led research programmes organised in networks in order to share knowledge and expertise across national groups and borders, (ii) more multidisciplinary collaborations in order to promote patient-centred care and (iii) further research directed towards improving the dissemination and implementation of research findings. Using complex intervention designs and a mix of research methods will enrich the research.

  • 29.
    Nilsson, Jan
    et al.
    Karlstads universitet.
    Johansson, Eva
    Karolinska institutet.
    Carlsson, M
    Uppsala universitet.
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Lepp, Margret
    Institute of Health and Care Science, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Lindholm, Christina
    Sophiahemmets högskola.
    Nordström, Gun
    Karlstad university.
    Theander, Kerstin
    Karlstad university.
    Gardulf, Ann
    The Unit for Clinical Nursing Research and Clinical Research in Immunotherapy, Division of Clinical Immunology, Department of Laboratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge.
    Disaster nursing: self-reported competence of nursing students and registered nurses, with focus on their readiness to manage violence, serious events and disasters2016Ingår i: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 17, s. 102-108Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The World Health Organization and the International Council of Nurses recognises the importance of nurses' involvement in disaster preparedness and response. The aim of this study was to describe and compare self-reported disaster nursing competence (DNC) among nursing students (NSs) and among registered nurses (RNs) with professional experience. Further to investigate possible associations between self-reported DNC and background factors. A cross-sectional study was conducted of 569 NSs and 227 RNs. All respondents completed the 88-item Nurse Professional Competence Scale, including three items assessing DNC. Significant differences were found among the NSs depending on which University/University College they had attended. RNs reported significantly higher overall DNC and better ability to handle situations involving violence, and to apply principles of disaster medicine during serious events. RNs working in emergency care reported significantly better DNC ability, compared with RNs working in other areas of healthcare. Multiple linear regression analysis showed that working night shift and working in emergency care were positively associated with high self-reported overall DNC. The results indicate that workplace experience of serious events increase the readiness of registered nurses to handle violence, to act in accordance with safety regulations, and to apply principles of disaster medicine during serious events.

  • 30.
    Eeg-Olofsson, Katarina
    et al.
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Sahlgrenska University Hospital, Gothenburg, Sweden.
    Svedbo Engström, Maria
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Borg, Sixten
    Lund University, Department of Clinical Sciences in Malmö, Health Economics Unit, Medicon Village, Lund, Sweden.
    Palaszewski, Bo
    Region Västra Götaland, Department of Data Management and Analysis, Gothenburg, Sweden.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala University.
    Johansson, Unn-Britt
    Sophiahemmet University, Stockholm, Sweden; Karolinska Institutet, Department of Clinical Sciences and Education, Södersjukhuset, Stockholm, Sweden.
    Gudbjörnsdottir, Soffia
    Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Register Center Västra Götaland, Gothenburg, Sweden.
    Glycaemic control and Patient-Reported Outcome Measures (PROMs) in type 1 diabetes2016Konferensbidrag (Refereegranskat)
  • 31.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Granstam, Elisabet
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Patient reported outcomes and visual function among patients with diabetes related macular edema2016Konferensbidrag (Refereegranskat)
  • 32.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W
    Granstam, Elisabet
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Patient-reported outcomes and visual acuity after 12 months of anti-VEGF-treatment for sight-threatening diabetic macular edema in a real world setting2016Ingår i: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 121, s. 157-165Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims

    To examine objective visual acuity measured with ETDRS, retinal thickness (OCT), patient reported outcome and describe levels of glycated hemoglobin and its association with the effects on visual acuity in patients treated with anti-VEGF for visual impairment due to diabetic macular edema (DME) during 12 months in a real world setting.

    Methods

    In this cross-sectional study, 58 patients (29 females and 29 males; mean age, 68 years) with type 1 and type 2 diabetes diagnosed with DME were included. Medical data and two questionnaires were collected; an eye-specific (NEI VFQ-25) and a generic health-related quality of life questionnaire (SF-36) were used.

    Results

    The total patient group had significantly improved visual acuity and reduced retinal thickness at 4 months and remains at 12 months follow up. Thirty patients had significantly improved visual acuity, and 27 patients had no improved visual acuity at 12 months. The patients with improved visual acuity had significantly improved scores for NEI VFQ-25 subscales including general health, general vision, near activities, distance activities, and composite score, but no significant changes in scores were found in the group without improvements in visual acuity.

    Conclusions

    Our study revealed that anti-VEGF treatment improved visual acuity and central retinal thickness as well as patient-reported outcome in real world 12 months after treatment start.

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  • 33.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Lindholm Olinder, Anna
    Gkretsis, Dimitrios
    Eriksson, Jan W.
    Granstam, Elisabet
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Patient-reported outcomes: in patients with diabetic macular oedema treated with anti-VEGF2016Ingår i: The 16th European Doctoral Conference in Nursing Science, 2016Konferensbidrag (Refereegranskat)
  • 34. Johansson, Karin
    et al.
    Österberg, Sofia Almerud
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Berglund, Mia
    Patients' experiences of support for learning to live with diabetes to promote health and well-being: A lifeworld phenomenological study2016Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, artikel-id 31330Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.

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  • 35. Kristoffersen Jahren, Nina
    et al.
    Nortvedt, Finn
    Skaug, Elin-Anne
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Källström Karlsson, Ingalill
    Praktiska grunder för omvårdnad2016 (uppl. 1)Bok (Refereegranskat)
  • 36. Gardulf, Ann
    et al.
    Nilsson, Jan
    Florin, Jan
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Lepp, Margret
    Lindholm, Christina
    Nordström, Gun
    Theander, Kersti
    Wilde-Larsson, Bodil
    Johansson, Eva
    The Nurse Professional Competence (NPC) scale: self-reported competence among nursing students on the point of graduation2016Ingår i: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 36, s. 165-171Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients.

    OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors.

    METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated.

    RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs).

    SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

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  • 37.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Göteborgs universitet.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    Johansson, Unn-Britt
    Gudbjörnsdottir, Soffia
    What is important for you? A qualitative interview study of living with diabetes and experiences of diabetes care to establish a basis for a tailored Patient-Reported Outcome Measure for the Swedish National Diabetes Register2016Ingår i: BMJ Open, E-ISSN 2044-6055, Vol. 6, nr 3, artikel-id e010249Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: There is a growing emphasis on the perspective of individuals living with diabetes and the need for a more person-centred diabetes care. At present, the Swedish National Diabetes Register (NDR) lacks patient-reported outcome measures (PROMs) based on the perspective of the patient. As a basis for a new PROM, the aim of this study was to describe important aspects in life for adult individuals with diabetes.

    DESIGN: Semistructured qualitative interviews analysed using content analysis.

    SETTING: Hospital-based outpatient clinics and primary healthcare clinics in Sweden.

    PARTICIPANTS: 29 adults with type 1 diabetes mellitus (DM) (n=15) and type 2 DM (n=14).

    INCLUSION CRITERIA: Swedish adults (≥18 years) living with type 1 DM or type 2 DM (duration ≥5 years) able to describe their situation in Swedish. Purposive sampling generated heterogeneous characteristics.

    RESULTS: To live a good life with diabetes is demanding for the individual, but experienced barriers can be eased by support from others in the personal sphere, and by professional support from diabetes care. Diabetes care was a crucial resource to nurture the individual's ability and knowledge to manage diabetes, and to facilitate life with diabetes by supplying support, guidance, medical treatment and technical devices tailored to individual needs. The analysis resulted in the overarching theme 'To live a good life with diabetes' constituting the two main categories 'How I feel and how things are going with my diabetes' and 'Support from diabetes care in managing diabetes' including five different categories.

    CONCLUSIONS: Common aspects were identified including the experience of living with diabetes and support from diabetes care. These will be used to establish a basis for a tailored PROM for the NDR.

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  • 38.
    Lindholm Olinder, Anna
    et al.
    Uppsala University.
    Fischier, Johan
    Uppsala University.
    Fries, Jenny
    Uppsala University.
    Alfonsson, Sven
    Elvingson, Veronika
    Uppsala University.
    Eriksson, Jan W
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala universitet.
    A randomized wait-list controlled clinical trial of the effects of acceptance and commitment therapy in patients with type 1 diabetes2015Ingår i: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 14, nr 61Artikel i tidskrift (Refereegranskat)
    Ladda ner fulltext (pdf)
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  • 39.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Johansson, Unn-Britt
    Gudbjörnsdottir, Soffia
    Development of a patient reported outcome measure for the Swedish National Diabetes Register2015Konferensbidrag (Refereegranskat)
  • 40.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Göteborgs Universitet.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Uppsala Universitet.
    Johansson, Unn-Britt
    Sophiahemmet Högskola och Karolinska institutet.
    Gudbjörnsdottir, Soffia
    Nationella Diabetesregistret (NDR), Registercentrum Västra Götaland och Göteborgs Universitet.
    En ny enkät för Nationella Diabetesregistret (NDR) speglar patientens perspektiv2015Konferensbidrag (Refereegranskat)
  • 41.
    Svedbo Engström, Maria
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Johansson, Unn-Britt
    Gudbjörnsdottir, Soffia
    Experiences of living with diabetes and experiences of diabetes care as a basis for a tailored patient reported outcome measure for the Swedish National Diabetes Register2015Konferensbidrag (Refereegranskat)
  • 42.
    Johansson, Karin
    et al.
    Department of Health and Care Sciences. Linnaeus University, Växjö, Sweden.
    Almerud Österberg, Sofia
    Department of Health and Care Sciences. Linnaeus University, Växjö, Sweden.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Berglund, Mia
    School of Health and Education, University of Skövde, Sweden.
    Manoeuvring between anxiety and control: Patients experience of learning to live with diabetes: a lifeworld phenomenological study2015Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, artikel-id 27147Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Research shows that people with diabetes want their lives to proceed as normally as possible, but some patients experience difficulty in reaching their desired goals with treatment. The learning process is a complex phenomenon interwoven into every facet of life. Patients and healthcare providers often have different perspectives in care which gives different expectations on what the patients need to learn and cope with. The aim of this study, therefore, is to describe the experience of learning to live with diabetes. Interviews were conducted with 12 patients afflicted with type 1 or type 2 diabetes. The interviews were then analysed with reference to the reflective lifeworld research approach. The analysis shows that when the afflicted realize that their bodies undergo changes and that blood sugar levels are not always balanced as earlier in life, they can adjust to their new conditions early. The afflicted must take responsibility for balancing their blood sugar levels and incorporating the illness into their lives. Achieving such goals necessitates knowledge. The search for knowledge and sensitivity to changes are constant requirements for people with diabetes. Learning is driven by the tension caused by the need for and dependence on safe blood sugar control, the fear of losing such control, and the fear of future complications. The most important responsibilities for these patients are aspiring to understand their bodies as lived bodies, ensuring safety and security, and acquiring the knowledge essential to making conscious choices.

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  • 43.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Quality of life among patients with diabetes macular edema2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Vision loss have a significant negative impact on quality of life. One of the most common causes of vision loss in patients with diabetes is diabetic macular edema - DME. Among DME patients, visual impairment is regarded as the most feared late diabetic complication. In January 2011 a new treatment for DME was approved, called anti-Vascular Endothelial Growth Factor, anti-VEGF- treatment. The treatment involves 3 injections every 4 weeks into the eye. The new treatment places increasing demands on the patient because of more visits and a stressful treatment. Beside that it is of great importance to learn more about the patient's experiences about the visual impairment and the new treatment.

    The aim of the study is to measure the effects of anti-VEGF treatment on vision related functioning, quality of life and sight-related variables.

    Fifty-nine patients are included in this longitudinal study at the eye clinics of two Swedish county hospitals. All patients who started anti-VEGF treatment were asked to participate.

    We have measured visual functioning with the eye-specific questionnaire - National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with the general questionnaire Short Form- 36 (SF-36). Medical variables were collected at baseline, after 4 months and one year respectively.

    A large number of patients are affected by diabetes each year and may suffer from visual impairment. These patients may be treated with this new form of treatment. Therefore it is of great importance to examine the patient's experiences of treatment and self-percieved quality of life to be able to provide the best possible information and procedures at the eye clinics.

  • 44.
    Leksell, Janeth
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Gardulf, Ann
    Department of Labaratory Medicine, Karolinska Institutet at Karolinska University Hospital, Huddinge, Stockholm, Sweden.
    Nilsson, Jan
    The Department of Health Science, Faculity of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Lepp, Margret
    The Institute of Health and Care Science, University of Gothenburg, Gothenburg, Sweden.
    Self-reported conflict management competence among nursing students on the point of graduating and registered nurses with professional experience2015Ingår i: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 5, nr 8, s. 82-89Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: It has been shown that specific competence is necessary for preventing and managing conflicts in healthcare settings. The aim of this descriptive and correlation study was to investigate and compare the self-reported conflict management competence (CMC) of nursing students who were on the point of graduating (NSPGs), and the CMC of registered nurses (RNs) with professional experience.

    Methods: The data collection, which consisted of soliciting answers to items measuring CMC in the Nurse Professional Competence (NPC) Scale, was performed as a purposive selection of 11 higher education institutions (HEIs) in Sweden. Three CMC items from the NPC Scale were answered by a total of 569 nursing students who were on the point of graduating and 227 RN registered nurses with professional experience.

    Results: No significant differences between NSPGs and RNs were found, and both groups showed a similar score pattern, with the lowest score for the item: “How do you perceive your ability to develop the group and strengthen competence in conflict management and problem-solving, based on knowledge of group dynamics?”. RNs with long professional experience (>24 months) rated their overall CMC as significantly better than RNs with short (<24 months) professional experience did (p = .05). NSPGs who had experience of international studies during their nursing education reported higher CMC, compared with those who did not have this experience (p = .03). RNs who reported a high degree of utilisation of CMC during the previous month scored higher regarding self-reported overall CMC (p < .0001).

    Conclusions: Experience of international studies during nursing education, or long professional experience, resulted in higher self-reported CMC. Hence, the CMC items in the NPC Scale can be suitable for identifying self-reported conflict management competence among NSPGs and RNs

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  • 45.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Sjuksköterskans kärnkompetenser: En kvalitativt god vård inom hälso- och sjukvård2015 (uppl. 1)Bok (Övrigt vetenskapligt)
  • 46.
    Leksell, Janeth
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Berglund, Mia
    Schools of Health and Education, University of Skövde, Sweden.
    Koinberg, Ingalill
    Institute of Health and Care Sciences, University of Gothenburg, Sweden.
    Friberg, Febe
    Department of Health/Faculty of Social Sciences, University of Stavanger, Norway.
    The growing research field of patient education and learning: the significance of a Nordic network2015Ingår i: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 35, nr 2, s. 67-70Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The research field of patient learning and patient education is growing due to the high prevalence of people living with lifelong disease and illness. The aim of the present article is to argue for and describe the building of a Nordic Network for Patient Education and Learning. The article describes the Network and the activities, theoretical framework and ongoing research within the Network. If patients’ voices are to be heard within healthcare settings, patient learning and patient education are of the utmost importance. Furthermore, it is essential to share experiences from the research we have conducted and are currently carrying out with nurses in Nordic countries as well as around the world.

  • 47.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Utbildning, lärande och stöd till anhöriga2015Ingår i: Reflektion i lärande och vård: en utmaning för sjuksköterskor / [ed] Mia Berglund och Margaretha Ekebergh, Lund: Studentlitteratur AB, 2015, 1, s. 215-223Kapitel i bok, del av antologi (Refereegranskat)
  • 48.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Jani, Siba
    Modher Raghib, Aseel
    Granstam, Elisabet
    Visual functioning and health-related quality of life in diabetic patients about to undergo anti-vascular endothelial growth factor treatment for sight-threatening macular edema2015Ingår i: Journal of diabetes and its complications, ISSN 1056-8727, E-ISSN 1873-460X, Vol. 29, nr 8, s. 1183-1190Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients about to receive anti-vascular endothelial growth factor (VEGF) treatment for diabetic macular edema (DME).

    Material and methods

    In this cross-sectional study, 59 patients with diabetes mellitus, who regularly visited the outpatient eye-clinics, were included. Sociodemographic and clinical data were collected and the patients completed PRO measures before starting anti-VEGF treatment. PRO measures assessed eye-specific outcomes (NEI-VFQ-25) and generic health-related quality of life (SF-36).

    Results

    The participants consisted of 30 men and 29 women (mean age, 68.5 years); 54 (92 %) patients had type 2 diabetes; Five (9%) patients had moderate or severe visual impairment; 28 (47 %) were classified as having mild visual impairment. Some of the patients reported overall problems in their daily lives, such as with social relationships, as well as problems with impaired sight as a result of reduced distance vision.

    Conclusions

    Further studies are needed to investigate PRO factors related to low perceived general health in this patient population. It is important to increase our understanding of such underlying mechanisms to promote improvements in the quality of patient care.

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  • 49.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Visual functioning and quality of life among patients with diabetic macular edema2015Konferensbidrag (Refereegranskat)
    Abstract [en]

    Background

    One of the most common causes of vision impairment in patients with diabetes is diabetic macular edema (DME) and is regarded as the most feared late diabetic complication. In January 2011 a treatment for DME was approved, called anti-Vascular Endothelial Growth Factor treatment. The treatment involves an injection into the vitreous of the eye and places increasing demands on the patient because of more visits and a stressful treatment. Therefore it is of most importance to capturing patients’ thoughts and feelings, so called Patient reported Outcome (PRO).

    Aim

    To examine patient-reported outcome (PRO) in a selected group of Swedish patients with diabetes-related macula edema about to receive anti-vascular endothelial growth factor treatment for diabetic macular edema.

    Method

    Visual functioning was measured with National Eye Institute Visual Functioning Questionnaire 25 (NEI-VFQ-25), quality of life was measured with Short Form- 36 (SF-36). The initial eye examination included measurement of visual acuity with the ETDRS, and retinal thickness by OCT. In addition, medical variables were collected. The data collection was performed at baseline, after 4 months and one year. In this abstract we reported the result from the baseline.

    Result

    The participants were 30 men and 29 women (mean age, 68.5 years) and 92% of them had type 2 diabetes. With NEI VFQ-25, the participants showed the lowest score for the subscale of general health (mean 35.65 ± 22.04) and the highest for dependency (mean 93.48 ± 18.12). For SF-36, the participants gave the lowest score in the subscale of general health (mean 56.55 ± 22.14) and the highest for the subscale of role emotional (mean 88.73 ± 22.32). The mean ETDRS score in the eye planned for treatment was 63.9 (± 13.2) and the mean central retinal thickness was 396 (± 129).

    Conclusions: Patients diagnosed with diabetes macula edema about to receive anti-VEGF treatment reported low general health. Hence, it is of most importance to follow up patients’ thoughts and feelings (PRO) after the treatment is performed in order to promote improvements in the quality of patient care.

  • 50.
    Granström, Therese
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Leksell, Janeth
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Forsman, Henrietta
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Granstam, Elisabet
    Uppsala universitet.
    Visual functioning and quality of life among patients with macular edema: a quantitative study2015Konferensbidrag (Refereegranskat)
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