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  • 651. Johansson, Ann-Caroline
    et al.
    Axelsson, Malin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Berndtsson, Ina
    Brink, Eva
    Illness perceptions in relation to experiences of contemporary cancer care settings among colorectal cancer survivors and their partners2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 23581, article id 23581Article in journal (Refereed)
    Abstract [en]

    Illness is constituted by subjective experiences of symptoms and their psychosocial consequences. Illness perceptions concern people’s lay beliefs about understandings and interpretation of a disease and expectations as to disease outcome. Our knowledge about illness perceptions and coping in relation to the cancer care context among persons with colorectal cancer (CRC) and their partners is incomplete. The aim of the present study was to explore illness perceptions in relation to contemporary cancer care settings among CRC survivors and partners. The present research focused on illness rather than disease, implying that personal experiences are central to the methodology. The grounded theory method used is that presented by Kathy Charmaz. The present results explore illness perceptions in the early recovery phase after being diagnosed and treated for cancer in a contemporary cancer care setting. The core category outlook on the cancer diagnosis when quickly informed, treated, and discharged illustrates the illness perceptions of survivors and partners as well as the environment in which they were found. The cancer care environment is presented in the conceptual category experiencing contemporary cancer care settings. Receiving treatment quickly and without waiting was a positive experience for both partners and survivors; however partners experienced the information as massive and as causing concern. The period after discharge was being marked by uncertainty and loneliness, and partners tended to experience non-continuity in care as more problematic than the survivor did. The results showed different illness perceptions and a mismatch between illness perceptions among survivors and partners, presented in the conceptual category outlook on the cancer diagnosis. One illness perception, here presented among partners, focused on seeing the cancer diagnosis as a permanent life-changing event. The other illness perception, here presented among survivors, concentrated on leaving the cancer diagnosis behind and moving forward. The importance of illness perceptions among survivors, and the differences in illness perceptions between survivors and partners, should be recognized by healthcare professionals to achieve the goals of person-centered contemporary cancer care.

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  • 652.
    Andersson, Ann-Christine
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Perseius, Kent-Inge
    Elg, Mattias
    Two different strategies to facilitate involvment in healthcare improvements: a Swedish county council initiative2014In: Global Advances in Health and Medicine, ISSN 2164-957X, E-ISSN 2164-9561, Vol. 3, no 5, p. 22-28Article in journal (Refereed)
    Abstract [en]

    Background: From a management point of view, there are many different approaches from which to choose to engage staff members in initiatives to improve performance. Objective: The present study evaluated how two different types of improvement strategies facilitate and encourage involvement of different professional groups in health-care organizations. Methods/Design: Empirical data of two different types of strategies were collected within an improvement project in a County Council in Sweden. The data analysis was carried out through classifying the participants' profession, position, gender, and the organizational administration of which they were a part, in relation to their participation. Setting: An improvement project in a County Council in Sweden. Participants: Designed Improvement Processes consisted of n=105 teams and Intrapreneurship Projects of n=202 projects. Intervention: Two different types of improvement strategies, Designed Improvement Processes and Intrapreneurship Projects. Main Outcome Measures: How two different types of improvement strategies facilitate and encourage involvement of different professional groups in healthcare organizations. Results: Nurses were the largest group participating in both improvement initiatives. Physicians were also well represented, although they seemed to prefer the less structured Intrapreneurship Projects approach. Assistant nurses, being the second largest staff group, were poorly represented in both initiatives. This indicates that the benefits and support for one group may push another group aside. Conclusions: Managers need to give prerequisites and incentives for staff who do not participate in improvements to do so. Comparisons of different types of improvement initiatives are an underused research strategy that yields interesting and thoughtful results.

  • 653.
    Andersson, Ann-Christine
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Perseius, Kent-Inge
    Elg, Mattias
    Evaluating a Breakthrough Series Collaborative in a Swedish Health Care Context2014In: Journal of Nursing Care Quality, ISSN 1057-3631, E-ISSN 1550-5065, Vol. 29, no 2, p. E1-E10Article in journal (Refereed)
    Abstract [en]

    This study evaluated the use of the Breakthrough Series Collaborative methodology in a Swedish county council improvement program, comparing measurements at the beginning and after 6 months. A questionnaire was used, and improvement processes and outcomes were analyzed. The results showed an overall large engagement in improvements, although the methodology and facilitators were seen as only moderately supportive.

  • 654.
    Lindell, Lisbeth
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Omvårdnadshandledning: reflekterat erfarenhetsbaserat vetande2014Report (Other academic)
    Abstract [en]

    This report describes a systematic pedagogical process model for clinical supervision. The model is group­based and applicable both in theoretical and clinical training. This model is based on the group participants experiences in care work aimed at integrating practical and theoretical knowledge. The emotional part of the care process is referred as nurturing caregivers and to support and develop personal and empirical knowledge profession. The model starts from group participants self­perceived experience in care work. The method of instruction is equally applicable for professionals, professionals in the same profession or with different profession in healthcare. The model can further be used at moments of crisis or restruction­work at care facilities. The model can also be used in group supervision of patient/client groups based on different themes. The conversation method involves that you through questions systemati cally account for a self­perceived situation or problem, it can also be used as a communication technique in dealing with individual patients and families. The report also describes three program evaluations and some essay papers on clinical supervision from Vårdvetenskapen Hälsa och samhälle, Malmö university

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  • 655.
    Islamoska, Julli
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kliniska lärarpar: Malmömodellen för pedagogisk handledning i verksamhetsförlagd utbildning (VFU) för sjuksköterskestudenter2014Report (Other academic)
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  • 656.
    Rämgård, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Utvägen: ett salutogent samverkansprojekt: rapport 2: samverkan i Utvägen2014Report (Other academic)
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  • 657. Andersson, Maria
    et al.
    Bramhagen, Ann-Cathrine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Förekomst av förlossningsinduktion, indikationer och förlossningsutfall2014Report (Other academic)
    Abstract [en]

    Over the last twenty years, the National Board reports have shown an increase when it comes to launch, inducing childbirth. Statistics show that births started with induction has increased in Sweden from 8.1% in 1990 to 13.2% in 2007. For pregnancy more than 42 weeks of gestation or more, is the most frequent cause of inducing childbirth. This means an increased risk of complications and may result in cesarean uterus ruptures and or low Apgar Score for the child. The purpose of this report was to describe the incidence of labor induction, its indications and obstetric outcomes in women's clinic in Malmö. The report is based on retrospective medical record review. Data were processed in SPSS. The results show that induced births has increased, but no statistical difference over time could be shown. However, it turned out spontaneous birth that ended with vacuum extraction after induction was significantly elevated relative to spontaneous deliveries without induction. Induced women are at risk and require increased monitoring because of the risk of uterine rupture, over stimulation and the effect on the fetus. In several studies, it appears that induction leads to painful latensfaser and increased pain relief was needed. Midwives and doctors should be well aware that the indication for induction must be done to justify the increased risk for mother and child, choice of induction should be based on an overall assessment of the mother's and the child's condition and ability to cope with an induced labor. It should clearly state the cause of the induction, method and dosage of any medicine so that no doubt exists, either in the journal or on the drug list.

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  • 658.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ivarsson.Ekedahl, Ann-Britt
    Säker vård: patientsäkerhet ur sjuksköterskans perspektiv2014Conference paper (Other academic)
    Abstract [sv]

    BAKGRUND: En av grundprinciperna för all vårdverksamhet är att ingen patient ska komma till skada i vården och all vårdpersonal ska arbeta proaktivt med patientens säkerhet i fokus. Trots detta inträffar incidenter i den svenska sjukvården. Säker vård är en av sex kärnkompetenser som all vårdpersonal behöver kunskap om för att hälso- och sjukvården ska vara av god kvalitet. Implementeringen av Säker vård som ämne i sjuksköterskeprogrammet vid Malmö högskola inleddes våren 2009, och finns nu som en röd tråd i hela programmet. Ett konkret exempel är avvikelserapportering och anmälningsfall som återkommer på olika sätt under hela utbildningen. Utgångspunkten för pedagogiken är det livslånga lärandet och syftar till att stödja studenternas förmåga till bland annat kritiskt tänkande och reflektion. SYFTE: Syftet med projektet är att utvärdera och förbättra undervisning i ämnet Säker vård i sjuksköterskeprogrammet, såväl innehåll som pedagogik METOD: Sjuksköterskor som tagit sin examen vid Malmö högskola höstterminen 2009 eller senare har fått besvara en enkät med frågor om patientsäkerhetsaspekter med fokus på deras nuvarande kunskapsbehov och på undervisningen de fått under sin utbildning. En enkät skickades under våren 2013 hem till 475 sjuksköterskor. Av dessa besvarades och returnerades 245 enkäter dvs., en svarsfrekvens på 51.6 procent. De sjuksköterskor som svarat (206 kvinnor och 39 män) hade en medelålder på 30 år (range 22-53 år) och hade i medeltal arbetat som sjuksköterskor i 1.7 år. RESULTAT: Majoriteten av sjuksköterskorna som besvarat enkäten ansåg att undervisningen de fått under sin sjuksköterskeutbildning har medfört att de har med sig ett patientsäkerhets-perspektiv i sitt arbete som sjuksköterska. Omkring 70 procent av sjuksköterskorna ansåg att undervisningen bland annat har lett till att de kan identifiera risker i vården. Att de fått arbeta med avidentifierade patientfall och med avvikelsehantering under sin utbildning ansåg de ha varit värdefullt. Det som dock efterlystes var en tydligare koppling till riskanalyser i den verksamhetsförlagda utbildningen, framförallt avseende incidenter som inträffat där studenten gör sin praktik. Även mer tid för reflektion kring incidenter som har inträffat eller som kunnat inträffa önskades. KONKLUSION: Genom att få ta del av sjuksköterskors erfarenheter kan undervisningen anpassas så att dagens studenter kan en aktuell undervisning.

  • 659.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Jonazon, Gerd
    Virtuella patienter för lärande och examination2014Conference paper (Other academic)
    Abstract [sv]

    BAKGRUND: Under sjuksköterskeutbildningen ska omvårdnadsprocessen synliggöras och studenterna ska aktivt och kreativt delta i undervisningen för att utveckla sin professionella kompetens. Omvårdnadsprocessen är en problemlösnings- och beslutsmodell som används för att systematiskt identifiera problem, risker och resurser för att kunna planera och genomföra en för patienten individuellt anpassad omvårdnad. Enligt Strategi 2020 är intensionen att Malmö högskola ska ligga i framkant genom att använda informationsteknik och nya medier för att effektivisera det livslånga lärandet. Virtuella patientfall är interaktiva webbaserade patienter där datorn simulerar mötet mellan patient och vårdpersonal. Systemet syftar till att utveckla studenternas reflektiva förmåga utifrån ett helhetsperspektiv över patienters situation. Studenter ges därmed möjlighet att praktisera sina kunskaper i en virtuell miljö innan de har sin praktik i den kliniska verksamheten och där möter patienter i verkliga livet. SYFTE: Syftet med projektet är att med virtuella patientfall synliggöra omvårdnadsprocessen i somatiskt kontext samt förtydliga progressionen av omvårdnad under utbildningen. METOD: Virtuella patientfall kan användas som arbetsform för att träna specifika moment och som examinationsform på såväl grund som avancerad nivå inom vård och medicinutbildningar. Någon programvara för att använda de virtuella patientfallen behövs inte. Studenten loggar in på en webbsida kopplat till en databas på en server och hamnar i ett väntrum där det finns fotografier på patienter. Studenten väljer en av patienterna på skärmen och arbetar vidare med fallet utifrån kursens specifika uppgifter och lärandemål. Systemet ger studenten information om patienten men måste själv tolka den, svara på frågor och ge förslag på diagnos och åtgärder. Studenten ges också möjlighet att förklara sina ställningstaganden i en avslutande återkopplingsfas. Systemet är självrättande och studenten får feedback genom att få de rätta svaren. RESULTAT: En databas med patientfall inkluderande omvårdnadsprocessen i somatisk kontext baserad på programmet WebSP (Web Based Simulation of Patients) är under uppbyggnad vid Institutionen för vårdvetenskap. Det har varit en del tekniska problem med programvaran för att anpassa den utifrån omvårdnadsprocessen och den dokumentations-struktur som studenterna praktiserar under utbildningen idag. I form av ett projekt införs höstterninen 2014 webbaserade patientfall som läraktivitet i termin 6 på sjuksköterske-programmet. Patientfallen kommer att ersätta en skriftlig dokumentationsuppgift som varit tidskrävande för de kliniska lärarna att bedöma. Projektet kommer att utvärderas genom enkäter och fokusgruppintervjuer med studenterna. Ansikten är att virtuella patientfall framöver även delvis ska ersätta de läraktiviteter i omvårdnadsdokumentation som har fokus på omvårdnadsprocessen som sjuksköterskestudenterna idag utför i termin 1 och 2

  • 660.
    Bengtsson, Mariette
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Nationell klinisk slutexamination för sjuksköterskeexamen: verksamhetsintegrerat lärande2014Conference paper (Other academic)
    Abstract [sv]

    Syftet med Nationell klinisk slutexamination för sjuksköterskeexamen är att pröva om studenter i slutet av termin sex har uppnått den kliniska kompetens som krävs hos en nyexaminerad sjuksköterska. Examinationen avser att möta de förväntade studieresultat som framgår av mål för sjuksköterskeexamen enligt högskoleförordningen och högskolelagen samt från verksamhet där sjuksköterskorna ska arbete i. Deltagandet sker enligt avtal för att åstadkomma en nationell kvalitetskontroll med tydlig verksamhetsförankring av sjuksköterskans kliniska kompetens. I dag är 16 lärosäten anslutna till denna examination och ett lärosäte har en pågående försöksperiod. Från start år 2003, då i form av ett projekt, till idag har examinationen utvärderats och förändrats utifrån ett kvalitetssäkringsperspektiv. År 2007 inrättades en styrelse med representanter från anslutna lärosäte. Styrelsen ansvarar för kvalitetssäkring och utveckling av examinationen. Examinationen består av ett skriftligt prov och ett praktiskt prov som ska ses som en helhet. Det skriftliga provet konstrueras sedan år 2011 av en grupp bestående av erfarna lärare med klinisk förankring och styrelsemedlemmar. Provet är baserat på två patientfall som speglar realistiska vårdsituationer som en sjuksköterska kan stå inför. From hösten 2014 kommer det skriftliga provet att omfatta två delar, Delprov I och Delprov II. Delprov I kommer att omfatta 50 poäng (33 poäng för godkänt resultat) och baseras enbart på frågor kring patientfallen och Delprov II kommer att bestå av två frågor om läkemedelsberäkning som måste vara korrekt besvarade för godkänt resultat. Under det praktiska provet ska studenten under överseende av en sjuksköterska från verksamheten vårda en patient under tre timmar. Studenten bedöms utifrån fastställda kriterier. Därefter följer ett uppföljande samtal mellan student, sjuksköterska och lärare från lärosätet, där studenten utvecklar sitt teoretiska resonemang och får återkoppling på sina prestationer. Sedan våren 2013 har bedömningskriterierna och examensmålen förtydligats i det praktiska provet och det avslutande samtalet har fått en tydligare struktur. Examinationen upplevs av bedömningsansvariga sjuksköterskor i verksamheten och lärare på lärosätena vara en bra examinationsform för att säkerställa kvaliteten på utbildning, handledning och studentens kompetens. Hos studenterna ger examinationen innan genomförandet upphov till oro eftersom de ska bli observerade och bedömda. När examinationen väl är genomförd upplever studenterna att de fått bekräftelse på sin kunskap och förmåga att kunna arbeta som sjuksköterskor. Referenser Lilja Andersson P, Ahlner-Elmqvist M, Johansson UB, Larsson M, Ziegert K Nursing students' experiences of assessment by the Swedish National Clinical Final Examination. Nurse Education Today. 2012 Jan 5. http://dx.doi.org/10.1016/j.nedt.2011.12.004 Athlin E., Larsson M. & Söderhamn O. (2011) A model for a national clinical final examination in the Swedish bachelor programme in nursing. Journal of Nursing Management. 2011 20 Sept (1):90-101. doi: 10.1111/j.1365-2834.2011.01278.x Länk till hemsidan för Nationell klinisk slutexamination för sjuksköterskeexamen www.nkse.se

  • 661.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Dahlquist, Birgitta
    Carlson, Elisabeth
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Nursing students' perspective of their final clinical exam2014In: 33rd Annual International Nursing & Midwifery Research & Education Conference Programme, 2014Conference paper (Refereed)
    Abstract [en]

    Background: The nursing students’ professional role must be established before graduation, and therefore the majority of Swedish nursing students perform the National Clinical Final Examination (NCFE), a national theoretical and practical exam. Aim and objectives: The aim of this study was to investigate the students’ opinions and feelings for the forthcoming final practical part of the NCFE. Methods: The study is based on interviews with 18 nursing students in their final semester of their study programme. The interviews were analysed by content analysis. Analysis and Results: Three themes based on the interviews were identified, namely; Lack of emotional and practical control, Attainment of theoretical and practical knowledge, and Attainment of interpersonal skills. In their preparation, the students tried to balance fear with competence. The study showed that the students had more focused on the assessment itself, than on the aim of the exam, i.e. to demonstrate that the students had the skills to fill the role of a fully gratified nurse. Recommendations: By helping and supporting the students to develop their awareness of their own theoretical knowledge and practical skills, as well as their emotional and interpersonal skills by using different teaching methodologies, the students may handle the stressful nature of the national exam better and hopefully overcome their main concerns.

  • 662.
    Berhin, Ida
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Lundgren, My
    Theodoridis, Kyriakos
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Aktiv empati: sjuksköterskors strategier för att frammana empati i mötet med patienter som av sjuksköterskan upplevs vara svårbemötta2014In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 34, no 2/2014, p. 28-32Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to describe nurses´ strategies to bring out empathy when encountering patients who are felt difficult to empathize with. The study is empirical and based on qualitative semi-structured interviews with registered nurses at a surgical ward. The data material was analyzed using content analysis. The result of the study shows that nurses employ different types of deliberate strategies in order to secure an empathetic treatment of these patients. In the study, the strategies are summarized in four head categories: strategies focusing on the patient, to decide upon one's set of mind, strategies focusing on oneself and indirect factors.

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  • 663.
    Bengtsson, Mariette
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Elimination med fokus på mag-tarmkanalen2014In: Omvårdnadens grunder. Hälsa och ohälsa / [ed] Anna-Karin Edberg, Helle Wijk, Studentlitteratur AB, 2014, p. 527-551Chapter in book (Other academic)
    Abstract [sv]

    Elimination av avfallsprodukter i form av avföring är en av de mest grundläggande fysiologiska processerna i varje människas liv. Att råka ut för mag- och tarmbesvär är ofta dolda obehag som inte syns utanpå men är nog så besvärande för den som drabbas. Besvär från mag- och tarmkanalen kan vara kortvariga och av mindre allvarlig karaktär. De kan också orsakas av en sjukdom av kronisk karaktär som patienterna får leva med resten av sitt liv. Vården och omvårdnaden syftar till att patienter med mag- och tarmbesvär ska få den behandling och det stöd som de behöver för att kunna leva ett för dem bra liv. När mag- och tarmkanalen inte fungerar normalt uppkommer fysiska, psykiska och sociala problem för den drabbade. En kronisk sjukdom påverkar vardagen och det sociala livet på många sätt. Det kan ta tid för patient och närstående att lära sig hantera vardagen och hitta en hanterbar strategi. Sjuksköterskans viktigaste uppgift i mötet med dessa patienter är att bekräfta patienten och besvären, förmedla kunskap och stöd samt att göra patienten delaktig i behandlingen.

  • 664.
    Rämgård, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    The power of place in the context of pregnancy2014In: Geography and health: a Nordic outlook / [ed] Anders Schærström, Stig. H Jørgensen, Thomas Kistemann, Åke Sivertun, Universität Bonn, Institute for Hygiene and Public Health. Bonn, Germany , 2014, p. 47-59Chapter in book (Other academic)
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  • 665.
    Rämgård, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Spaces of Birth in Greenland2014In: Geography and health: a Nordic outlook / [ed] Anders Schærström, Stig. H Jørgensen, Thomas Kirsteman, Åke Sivertun, Universität Bonn, Institute for Hygiene and Public Health. Bonn, Germany , 2014, p. 95-101Chapter in book (Other academic)
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  • 666.
    Rämgård, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Geography of the elderly2014In: Geography and health: a Nordic outlook / [ed] Anders Schærström, Stig H Jørgensen, Thomas Kistemann, Åke Sivertun, Universität Bonn, Institute for Hygiene and Public Health. Bonn, Germany , 2014, p. 88-90Chapter in book (Other academic)
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  • 667. Monsen, Christina
    et al.
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Wictorsson, Catharina
    Acosta, Stefan
    Vacuum-assisted wound closure versus alginate for the treatment of deep perivascular wound infections in the groin after vascular surgery2014In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 59, no Jan 1, p. 145-151Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Vacuum-assisted wound closure (VAC) therapy may heal wounds faster than conventional dressings after surgical debridement of perivascular groin infections after vascular surgery. METHODS: Patients with deep infected wounds (Szilagyi grade III) were surgically revised and left open for secondary healing, then randomized to either VAC or alginate (Sorbalgon) therapy, between February 2007 and November 2011. To test the hypothesis, it was calculated that 42 patients needed to be included (90% power, 5% level of significance). It was decided to perform an interim analysis after inclusion of 20 patients. RESULTS: Among 66 patients undergoing groin revision, 20 patients were included in this study. Patients were randomized to VAC (n = 10) or alginate (n = 10). The two groups were comparable in patient and wound characteristics. Time to full skin epithelialization was significantly shorter in the VAC group (median, 57 days) compared with the alginate group (median, 104 days; P = .026). The number of positive wound cultures of bacteria and C-reactive protein values decreased equally in both groups between surgical revision and day 21. One femur amputation was performed in each group as a consequence of the groin infection, one patient died during the in-hospital stay in the alginate group, and none died in the VAC group. CONCLUSIONS: VAC achieves faster healing than alginate therapy after wound debridement for deep perivascular wound infections in the groin after vascular surgery. This finding does not allow further inclusion of patients from an ethical point of view, and this study was, therefore, stopped prematurely.

  • 668. Olsson, Cecilia
    et al.
    Ringnér, Anders
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Including systematic reviews in PhD programmes and candidatures in nursing: 'Hobson's choice'?2014In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 14, no 2, p. 102-105Article in journal (Refereed)
    Abstract [en]

    Nowadays, gathering and synthesising evidence, i.e. conducting systematic reviews, is considered an important part of any health service research endeavour. Reviewing the literature, however suggest that it is not yet common that PhD students/doctoral candidates publish systematic reviews or even include a high quality review of the literature as a part of their PhD programme or candidature. Implying that systematic reviewing skills might not be acquired by going through an education on a postgraduate level. Additionally, scholars debating systematic reviews 'to be or not to be' as a part of research training seem to be sparse, especially within the field of nursing. In this issue for debate, we would like to propose that the absence of systematic reviews' in this context might severely hamper the 'up and coming' researchers as well as the research conducted. We envisage that this lack can have a negative impact on international nursing practice, and therefore propose that systematic reviews should be considered, whenever appropriate, as a mandatory part of any PhD programme or candidature. We believe that abilities in systematic reviewing will be a sought after research skills in the near future. Including systematic reviews would promote i) refined, well-grounded adequate research questions, ii) PhDs with broad and elevated methodological skills, iii) an increased level of evidence based nursing praxis. However, to make this a reality, supervisors, PhD students, and candidates would need to understand the value of this kind of research activity. Finally, lobbying University faculty boards and grant providers that are not inclined to view literature reviews as 'proper' research or as an important part of health service research, needs to be put on the agenda.

  • 669. Bolejko, Anetta
    et al.
    Brodersen, John
    Zackrisson, Sophia
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hagell, Peter
    Psychometric properties of a Swedish version of the Consequences of Screening: Breast Cancer questionnaire2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 10, p. 2373-2388Article in journal (Refereed)
    Abstract [en]

    AIM: To evaluate the psychometric properties of a questionnaire addressing psychosocial consequences of false-positive mammographic screening. BACKGROUND: The Consequences of Screening--Breast Cancer and Lung Cancer questionnaires target psychosocial consequences of false-positive cancer screening. The Consequences of Screening--Breast Cancer questionnaire and ten items not considered lung cancer specific from the Lung Cancer questionnaire have been adapted for use in mammographic screening in Sweden, but remain psychometrically untested. DESIGN: Instrument development paper with psychometric cross-sectional and test-retest design. METHODS: Twelve scales of a Swedish questionnaire version were tested by the Rasch model and traditional psychometric methods. Women with false-positive (Group I, n = 640) and negative (Group II, n = 802) screening mammography responded to the study questionnaire and the Nottingham Health Profile during 2009-2011. RESULTS: Iterative analyses resulted in nine scales demonstrating Rasch model fit, but all scales exhibited poor targeting with relatively large floor effects. Corrected item-total correlations exceeded the recommended criterion. Score differences between Groups I and II and correlations with Nottingham Health Profile sections followed an expected pattern. Cronbach's α and test-retest reliability was acceptable for group-level assessments for ten and seven scales, respectively. CONCLUSIONS: Five scales (Sense of dejection, Anxiety, Behavioural, Sleep and Existential values) of the Swedish questionnaire version demonstrated the best psychometric properties. Other scales should be used more cautiously. Although filling an important gap, causes of concern were identified across scales. The questionnaire should therefore be considered for group-level assessments rather than for measurement of individual degrees of psychosocial consequences.

  • 670. Kisch, Annika
    et al.
    Bolmsjö, Ingrid
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Lenhoff, Stig
    Bengtsson, Mariette
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Having a sibling as donor: patients’ experiences immediately before allogeneic hematopoietic stem cell transplantation2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 4, p. 436-442Article in journal (Refereed)
    Abstract [en]

    Background Allogeneic haematopoietic stem cell transplantation (HSCT) offers a potential cure for a variety of diseases but is also associated with significant risks. With HSCT the donor is either a relative, most often a sibling, or an unrelated registry donor. Purpose The aim was to explore patients’ experiences, immediately before transplantation, regarding having a sibling as donor. Method Ten adult patients with sibling donors were interviewed before admission for HSCT. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. Results The main theme Being in no man’s land is a metaphor for the patients’ complex situation with its mixture of emotions and thoughts prior to transplantation. The three subthemes Trust in the sibling donor, Concern about others and Loss of control cover the various experiences. The patient’s experiences are influenced by their personal situation and the quality of the relationship with the sibling donor. While patients feel secure in having a sibling donor, they are dependent for their survival on the cell donation and feel responsible for the donor’s safety during donation. These emotions intensify the patients’ sense of dependency and loss of control. Conclusions In caring for HSCT patients the nurses should be aware of the complexity of the patients’ situation and keep in mind that having a sibling donor might imply extra pressure, including a sense of responsibility. Caring for both patients and sibling donors optimally is a challenge, which needs further improvement and exploration.

  • 671.
    Carlson, Elisabeth
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Nursing students' experiences of the clinical learning environment in nursing homes: A questionnaire study using the CLES+T evaluation scale2014In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 7, p. 1130-1134Article in journal (Refereed)
    Abstract [en]

    Background: One major challenge facing the health care systems worldwide is the growing demand for registered nurses able to provide qualified nursing care for a vulnerable population. Positive learning experiences during clinical practice influence not only learning outcomes, but also how students reason in relation to future career choices. Objectives: To investigate student nurses' experiences of the clinical learning environment during clinical practice in nursing homes, and to compare perceptions among student nurses with or without priorwork experience as health care assistants in elderly care. Design: A cross-sectional study was designed, utilising the Swedish version of the CLES + T evaluation scale. Methods: 260 student nurses (response rate 76%)who had completed a five week long clinical placement in nursing homes returned the questionnaire during the data collection period in 2011–2012. Data were analysed using descriptive statistics. Mann–Whitney U-test was used to examine differences in relation to students with or without prior experience of elderly care. Results: Overall, the clinical learning environment was evaluated in a predominantly positive way. The subdimension Supervisory relationship displayed the highest mean value, and the lowest score was calculated for the sub-dimension Leadership style of the ward manager. Statistical significant differences between sub-groups were displayed for four out of 34 items. Conclusion: The supervisory relationship had the greatest impact on how student nurses experienced the clinical learning environment in nursing homes. It is therefore, of utmost importance that collaborative activities, between educational and nursing home settings, supporting the work of preceptors are established and maintained.

  • 672. Nordanstig, Joakim
    et al.
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Karlsson, Jan
    Lundström, Mats
    Pettersson, Monica
    Morgan, Mark B.F.
    Vascular Quality of Life Questionnaire-6 facilitates health-related quality of life assessment in peripheral arterial disease2014In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 59, no 3, p. 700-707.e1Article in journal (Refereed)
    Abstract [en]

    Background Most commonly used outcome measures in peripheral arterial disease (PAD) provide scarce information about achieved patient benefit. Therefore, patient-reported outcome measures have become increasingly important as complementary outcome measures. The abundance of items in most health-related quality of life instruments makes everyday clinical use difficult. This study aimed to develop a short version of the 25-item Vascular Quality of Life Questionnaire (VascuQoL-25), a PAD-specific health-related quality of life instrument. Methods The study recruited 129 individuals with intermittent claudication and 71 with critical limb ischemia from two university hospitals. Participants were a mean age of 70 ± 9 years, and 57% were men. All patients completed the original VascuQoL when evaluated for treatment, and 127 also completed the questionnaire 6 months after a vascular procedure. The VascuQoL-25 was reduced based on cognitive interviews and psychometric testing. The short instrument, the VascuQoL-6, was tested using item-response theory, exploring structure, precision, item fit, and targeting. A subgroup of 21 individuals with intermittent claudication was also tested correlating the results of VascuQoL-6 to the actual walking capacity, as measured using global positioning system technology. Results On the basis of structured psychometric testing, the six most informative items were selected (VascuQoL-6) and tested vs the original VascuQoL-25. The correlation between VascuQoL-25 and VascuQoL-6 was r = 0.88 before intervention, r = 0.96 after intervention, and the difference was r = 0.91 (P < .001). The Cronbach α for the VascuQoL-6 was .85 before and .94 after intervention. Cognitive interviews indicated that the responders considered all six items to be relevant and comprehensible. Rasch analysis was used to reduce response options from seven (VascuQoL-25) to four (VascuQoL-6). VascuQol-6 was shown to have high precision and discriminative properties. Item fit was excellent, with both “infit” and “outfit” between 0.7 and 1.3 for all six items. The standardized response mean after intervention was 1.15, indicating good responsiveness to clinical change. VascuQoL-6 results correlated strongly (r = 0.72; P < .001) with the actual measured walking ability (n = 21). Conclusions VascuQoL-6 is a valid and responsive instrument for the assessment of health-related quality of life in PAD. The main advantage is the compact format that offers a possibility for routine use in busy clinical settings.

  • 673. Brorson, Hanna
    et al.
    Plymoth, Henrietta
    Örmon, Karin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bolmsjö, Ingrid
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Pain Relief at the End of Life: Nurses’ Experiences Regarding End-of-Life Pain Relief in Patients with Dementia2014In: Pain Management Nursing, ISSN 1524-9042, E-ISSN 1532-8635, Vol. 15, no 1, p. 315-323Article in journal (Refereed)
    Abstract [en]

    Patients with dementia receive suboptimal palliative care, and this patient group is at risk to have pain at the end of life. Because communicative impairments are common in this patient group, nurses play an important caregiver role in identifying, assessing, and relieving patients’ pain. This study aimed to describe nurses’ experiences regarding end-of-life pain relief in patients with dementia. This descriptive exploratory qualitative study was based on seven semistructured interviews. Burnard’s content analysis inspired the data analysis. Two main categories were identified: (1) nurses’ experience of difficulties concerning pain relief and (2) nurses’ experience of resources concerning pain relief. Nurses experienced difficulties, such as feeling of powerlessness because of difficulties in obtaining adequate prescriptions for analgesics, ethical dilemmas, feeling of inadequacy because analgesia did not have the desired effect, and a feeling of not being able to connect with the patient. Factors, including knowledge about the patient, professional experience, utilization of pain assessment tools, interpersonal relationships, and interprofessional cooperation, served as resources and enabled end-of-life pain relief. The results of this study highlight the complexity of pain relief in patients with dementia at the end of life from a nursing perspective. The inability of patients with dementia to verbally communicate their pain makes them a vulnerable patient group, dependent on their caregivers. Knowing the life story of the patient, professional experience, teamwork based on good communication, and use of a pain assessment tool were reported by the nurses to improve pain relief at the end of life for patients with dementia.

  • 674. Lindberg, Catharina
    et al.
    Fagerström, Cecilia
    Sivberg, Bengt
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Concept analysis: patient autonomy in a caring context2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 10, no 70, p. 2208-2221Article in journal (Refereed)
    Abstract [en]

    This paper is a report of an analysis of the concept of patient autonomy. Many problems regarding patient autonomy in healthcare contexts derive from the patient´s dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experince reveal a lack of consensus among nurses regarding the meaning of this ethical concept. This is a concept analysis with data sources: MedLine, CINAHL, The Cochrane Library and PsycINFO, searched 2005-June 2013 using the search blocks 'autonomy', 'patient', and 'nursing/caring'. A total of 41 articles were retrieved. The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Conclusion: Patient autonomy in a caring context does not need to be the same before, during and after a care episod. A tentative model has been constructed, thus extending the understanding of this critical concept in a caring context.

  • 675.
    Englander, Magnus
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Empathy training from a phenomenological perspective2014In: Journal of Phenomenological Psychology, ISSN 0047-2662, E-ISSN 1569-1624, Vol. 45, no 1, p. 5-26Article in journal (Refereed)
    Abstract [en]

    AbstractThe purpose of this article is to outline a phenomenological approach to empathy training developed over the past ten years in the context of higher education. The theoretical justification for this empathy training is founded in the phenomenological philosophical interpretation of the phenomenon of empathy, whereas the application of empathy as a skill is theoretically based upon entering the phenomenological attitude. The phenomenon of empathy is described as a unique intentionality as part of the self-other relation and contrasted to mainstreams views such as simulation theory. It is argued that the phenomenological attitude can open up for the possibility of empathy and interpersonal understanding to occur. The consecutive steps of the phenomenologically based empathy training are described as relating to theoretical and pedagogical issues as well as to student’s experiences.

  • 676. Bolejko, Anetta
    et al.
    Zackrisson, Sophia
    Hagell, Peter
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    A roller coaster of emotions and sense: coping with the perceived psychosocial consequences of a false-positive screening mammography2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 13-14, p. 2053-2062Article in journal (Refereed)
    Abstract [en]

    Aims and objectives To explore coping with the perceived psychosocial consequences of a false-positive screening mammography. Background Mammographic screening has been found effective to decrease breast cancer (BC) mortality, yet there are adverse effects. Psychosocial consequences of false-positive mammographic screening have mainly been investigated from a population-based perspective. A call for qualitative studies to further explore these consequences has thus been postulated. To date, qualitative studies have elucidated women's experiences following their recall breast examinations, but their coping with perceived psychosocial consequences of a false-positive screening mammography has not yet been explored. Design An explorative qualitative study. Methods Face-to-face interviews were held with a purposive heterogeneous sample of 13 Swedish-speaking women with a false-positive screening mammography. The transcripts were analysed by the use of an inductive content analysis. Results Coping with the perceived psychosocial consequences of a false-positive screening mammography implied a roller coaster of emotion and sense. Women described how they imagined the worst and were in a state of uncertainty feeling threatened by a fatal disease. Conversely, they felt protected, surrounded by their families and being professionally taken care of, which together with perceived sisterhood and self-empowerment evoked strength and hope. Being aware of family responsibility became a crucial matter. Experiencing false-positive screening raised thoughts of thankfulness and reappraisal of life, although an ounce of BC anxiety remained. Consequently, gained awareness about BC screening and values in life surfaced. Conclusions Experiencing a false-positive screening mammography triggers agonising experiences evoking a variety of coping strategies. Provision of screening raises the issue of responsibility for an impact on psychosocial well-being among healthy women.

  • 677.
    Sandström, Boel
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Svensson, Bengt
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    How do we know if this is the best?: mental health-care professionals' views on national guidelines for psychosocial interventions2014In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 23, no 3, p. 221-231Article in journal (Refereed)
    Abstract [en]

    ABSTRACT: National guidelines are released regularly, and professionals are expected to adopt and implement them. However, studies dealing with mental health-care professionals’ views about guidelines are sparse. The aim of the present study was to highlight mental health-care staff ’s views on the Swedish national guidelines for ‘psychosocial interventions for schizophrenia or schizophrenia-type symptoms’ and their implementation. The study took place in the southeast parts of Sweden, and data were collected through five group interviews consisting of 16 professionals working either in the county council or in the municipalities. The transcribed text was analysed by content analysis, revealing two categories. The first category ‘a challenge to the practice of care as known’ reflected that the release of guidelines could be perceived as a challenge to prevailing care and culture. The second category ‘anticipating change to come from above’ mirrored views on how staff expected the implementation process to flow from top to bottom. To facilitate working in accordance with guidelines, we suggest that future guidelines should be accompanied by an implementation plan, where the educational needs of frontline staff are taken into account. There is also a need for policy makers and managers to assume responsibility in supporting the implementation of evidence-based practice.

  • 678. Lukasse, Mirjam
    et al.
    Schroll, AnneMette
    Ryding, Elsa Lena
    Campbell, Jacquelyn
    Karro, Helle
    Kristjansdottir, Hildur
    Laanpere, Made
    Steingrimsdottir, Thora
    Tabor, Ann
    Temmerman, Marleen
    Van Parys, An-Sofie
    Wangel, Anne-Marie
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Prevalence of emotional, physical and sexual abuse among pregnant women in six European countries2014In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 93, no 7, p. 669-677Article in journal (Refereed)
    Abstract [en]

    Objectives The primary objective was to investigate the prevalence of a history of abuse among women attending routine antenatal care in six northern European countries. Second, we explored current suffering from reported abuse. Design A prospective cohort study. Setting Routine antenatal care in Belgium, Iceland, Denmark, Estonia, Norway, and Sweden between March 2008 and August 2010. Population A total of 7174 pregnant women. Methods A questionnaire including a validated instrument measuring emotional, physical and sexual abuse. Main outcome measure Proportion of women reporting emotional, physical and sexual abuse. Severe current suffering defined as a Visual Analogue Scale score of ≥6. Results An overall lifetime prevalence of any abuse was reported by 34.8% of the pregnant women. The ranges across the six countries of lifetime prevalence were 9.7–30.8% for physical abuse, 16.2–27.7% for emotional abuse, and 8.3–21.1% for sexual abuse. Few women reported current sexual abuse, 0.4% compared with 2.2% current physical abuse and 2.7% current emotional abuse. Current severe suffering was reported by 6.8% of the women who reported physical abuse, 9.8% of those who reported sexual abuse and 13.5% for emotional abuse. Conclusion A high proportion of pregnant women attending routine antenatal care report a history of abuse. About one in ten of them experiences severe current suffering from the reported abuse. In particular, these women might benefit from being identified in the antenatal care setting and being offered specialized care.

  • 679. Tuvesson, Hanna
    et al.
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    The challenge of giving written thesis feedback to nursing students2014In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 34, no 11, p. 1343-1345Article in journal (Other academic)
    Abstract [en]

    Providing effective written feedback on nursing student's assignments can be a challenging task for any assessor. Additionally, as the student groups tend to become larger, written feedback is likely to gain an overall more prominent position than verbal feedback. Lack of formal training or regular discussion in the teaching faculty about the skill set needed to provide written feedback could negatively affect the students' learning abilities. In this brief paper, we discuss written feedback practices, whilst using the Bachelor of Science in Nursing thesis as an example. Our aim is to highlight the importance of an informed understanding of the impact written feedback can have on students. Creating awareness about this can facilitate the development of more strategic and successful written feedback strategies. We end by offering examples of some relatively simple strategies for improving this practice.

  • 680. Hellström, Amanda
    et al.
    Hellström, Patrik
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Fagerström, Cecilia
    Association between sleep disturbances and leisure activities in the elderly: a comparison between men and women2014In: Sleep Disorders, ISSN 2090-3545, E-ISSN 2090-3553, Vol. 2014, article id 595208Article in journal (Refereed)
    Abstract [en]

    It has been suggested that physical or social activity is associated with fewer sleep disturbances among elderly people. Women report more sleep disturbances than men, which could indicate a variation in activity patterns between the genders. The aim of this study was to investigate associations between sleep disturbances and leisure activities in men and women (n=945) aged over 60 years in a Swedish population. Sleep disturbances were measured using eight dichotomous questionns and seventeen variables, covering a wide range of leisure activities. Few leisure activities were found to be associated with sleep disturbances and their importance decreased when the models were adjusted for confunders and gender interactions. After clustering the leisure activities and investigating individual activities, sociointellectual activities were shown to be significant for sleep. However, following adjustment for confounders and gender interactions, home maintenance was the only activity significant for sleep. Being a female increased the effect of homemaintenance. Besides those leisure activities, poor/fair self-rated Health (OR 7.50, CI: 4.27-11.81) and being a female (OR 4.86, CI: 2.75-8.61) were found to have the highest association with poor sleep. Leisure activities pursued by elderly people should focus on activities of sociointellectual nature, especially among women, to promote poor sleep.

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  • 681. Hägg, Miriam
    et al.
    Houston, Britta
    Elmståhl, Sölve
    Ekström, Henrik
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sleep quality, use of hypnotics and sleeping habits in different age-groups among older people2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 4, p. 842-851Article in journal (Refereed)
    Abstract [en]

    Background Sleep disturbances are common among older people (>65 years). Further, long-term use of sedative-hypnotics in older people is associated with morbidity and mortality. However, older people represent a large span of life years, and few studies have included the oldest-old above 85 years. Aim To investigate and compare sleep quality, use of hypnotics and sleeping habits in different age groups of the older population in the Scania region, Sweden and in relation to sociodemographic- and functional status. Design and participants A cross-sectional population-based study including 2931 people aged 60–93 years from five different municipalities in Scania was performed during 2001–2004. Method The sample was divided into age groups, young-old (60–72 years), old-old (78–84 years) and oldest-old (87–93) years. Data constitutes of sleep related questions, sociodemographic- and functional status from the study ‘Good Ageing in Skåne’. Descriptive statistics were used to describe sleep quality, hypnotics use and sleeping habits in relation to sociodemographic- and functional status. The aim was to investigate associations, not the magnitude of associations between variables. Results In all age groups, those who used hypnotics and were living alone had significantly poorer sleep quality and shortest sleeping time than nonhypnotic users and those who lived together. A significant increase of hypnotics and frequency of use was seen with increasing age. Frequency of napping increased significantly with degree of dependence in all age groups and with increasing age. Conclusions Insomnia is still a problem and hypnotic use has not improved sleep for a large number of older people. Hypnotics are effective as short-term treatment, however, nonpharmacological interventions and psychological and behavioural therapies should be considered for treating older people with chronic insomnia.

  • 682. Schei, Berit
    et al.
    Lukasse, Mirjam
    Ryding, Elsa Lena
    Campbell, Jacquelyn
    Karro, Helle
    Kristjansdottir, Hildur
    Laanpere, Made
    Schroll, Anne-Mette
    Tabor, Ann
    Temmerman, Marleen
    Van Parys, An-Sofie
    Wangel, Anne-Marie
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    A history of abuse and operative delivery: results from a European multi-country cohort study2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 1, article id e87579Article in journal (Refereed)
    Abstract [en]

    Objective The main aim of this study was to assess whether a history of abuse, reported during pregnancy, was associated with an operative delivery. Secondly, we assessed if the association varied according to the type of abuse and if the reported abuse had been experienced as a child or an adult. Design The Bidens study, a cohort study in six European countries (Belgium, Iceland, Denmark, Estonia, Norway, and Sweden) recruited 6724 pregnant women attending routine antenatal care. History of abuse was assessed through questionnaire and linked to obstetric information from hospital records. The main outcome measure was operative delivery as a dichotomous variable, and categorized as an elective caesarean section (CS), or an operative vaginal birth, or an emergency CS. Non-obstetrically indicated were CSs performed on request or for psychological reasons without another medical reason. Binary and multinomial regression analysis were used to assess the associations. Results Among 3308 primiparous women, sexual abuse as an adult (≥18 years) increased the risk of an elective CS, Adjusted Odds Ratio 2.12 (1.28–3.49), and the likelihood for a non-obstetrically indicated CS, OR 3.74 (1.24–11.24). Women expressing current suffering from the reported adult sexual abuse had the highest risk for an elective CS, AOR 4.07 (1.46–11.3). Neither physical abuse (in adulthood or childhood <18 years), nor sexual abuse in childhood increased the risk of any operative delivery among primiparous women. Among 3416 multiparous women, neither sexual, nor emotional abuse was significantly associated with any kind of operative delivery, while physical abuse had an increased AOR for emergency CS of 1.51 (1.05–2.19). Conclusion Sexual abuse as an adult increases the risk of an elective CS among women with no prior birth experience, in particular for non-obstetrical reasons. Among multiparous women, a history of physical abuse increases the risk of an emergency CS.

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  • 683.
    Sandström, Boel
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Svensson, Bengt
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Mapping attitudes and awareness with regard to national guidelines: an e-mail survey among decision makers.2014In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 22, no 7, p. 884-893Article in journal (Refereed)
    Abstract [en]

    Introduction The adoption of evidence-based guidelines within the mental health field has been slow. Changing inadequate practice is therefore a formidable challenge for mental health-care managers. Aim To explore decision-makers’ attitudes and awareness regarding the national guidelines for psychosocial interventions targeting people with schizophrenia. Method A questionnaire distributed by e-mail to 592 Swedish decision-makers was analysed using descriptive and comparative techniques. Results Significantly more of the top-level mental health-care managers than politicians stated that they knew about the national guidelines (i.e. their release and content) and they considered the guidelines to be a good source of support for planning and allocating resources. Conclusion If those responsible for allocating resources (i.e. politicians) are unaware of the dissemination of national guidelines or their content, and they do not perceive the national guidelines to be a good source of support for planning and allocating resources, this is likely to have a negative influence on the remit of nurse managers as well as nursing practice. Implications for nursing management Top-level mental health-care managers have a vital role to play in the implementation of national guidelines. However, our findings indicate that implementing national guidelines in practice could be virtually impossible without strategic government support. Keywords: attitude, electronic survey, evidence-based practice, guidelines, mental health

  • 684. Richards, David
    et al.
    Ross, Sarah
    Robbens, Sarah
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    The DiReCT Study: Improving recruitment into clinical trials: a mixed methods study investigating the ethical acceptability, feasibility and recruitment yield of the Cohort Multiple Randomised Controlled Trials design2014In: Trials, E-ISSN 1745-6215, no 15:398Article in journal (Refereed)
    Abstract [en]

    Background: The ‘cohort multiple Randomised Controlled Trial’ (cmRCT) design has been proposed as a potential solution to poor recruitment into clinical trials. The design randomly selects participants eligible for experimental treatments from a pre-enrolled cohort of patients, recruiting participants to multiple trials from a single cohort. Controls remain unaware of their participation in specific trials. Methods: We undertook a mixed methods study to determine the ethical acceptability, the proportion of patients in a routine service consenting to cohort participation, the proportion of these who would consent to being hypothetically randomly selected to receive new treatments, and the views of clinicians on the acceptability of the design. We submitted our cmRCT design for ethical review and recruited participants from people with anxiety and depression attending a community mental health service of twenty-one clinicians. We recorded the proportion of patients who were offered participation in the DiReCT study and the proportion that consented to researcher contact, medical record sharing, and who accepted to be randomly allocated to active treatment procedures in future hypothetical unspecified clinical trials. We used a thematic framework analysis to analyse clinician interviews. Results: We obtained a favourable ethical opinion from the UK Health Research Authority. Clinicians approached 131/752 (17%) potentially eligible participants for consent. Of these 131, 84 (64%) initially consented to be contacted by a researcher and all but one consented to being randomised into future trials. We confirmed consent for 71 (54%) of participants approached by clinicians, of whom 69 (53%) consented to being randomised into hypothetical future trials, 9% (69/752) of all potentially eligible patients. The interviewed clinicians described issues impacting on their ability to recruit participants in terms of clinical concerns for patient wellbeing, work pressure, their views of both general research and the specific DiReCT study, and how they viewed patients’ responses to being offered participation in the study. Conclusions: The cmRCT system offers the potential to improve the recruitment into clinical trials and is acceptable ethically and to many patients. Overcoming the multiple factors driving the difficulties clinicians experience in patient recruitment is likely to require the application of significant implementation science-informed efforts.

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  • 685. Backhausen, Mette G.
    et al.
    Ekstrand, Maria
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Tyden, Tanja
    Magnussen, Britta Kjeldberg
    Shawe, Jill
    Stern, Jenny
    Hegaard, Hanne K.
    Pregnancy planning and lifestyle prior to conception and during early pregnancy among Danish women2014In: European journal of contraception & reproductive health care, ISSN 1362-5187, E-ISSN 1473-0782, Vol. 19, no 1, p. 57-65Article in journal (Refereed)
    Abstract [en]

    Objective To investigate the extent to which Danish women attending antenatal care plan their pregnancies and to determine the association between pregnancy planning and the intake of folic acid, alcohol consumption and smoking habits prior to conception and before the 16th week of gestation. Methods A cross-sectional survey of 258 women. Main outcome measures: intake of folic acid, alcohol consumption and smoking. Pregnancy planning was assessed by the London Measure of Unplanned Pregnancy (LMUP) and the five graded Swedish Pregnancy Planning Scale. Results Most (77%) of the participants reported that their pregnancies were very or fairly well planned. Higher median LMUP scores were observed in women taking folic acid (p < 0.001), in those consuming less alcohol, and in women who stopped smoking prior to pregnancy (p = 0.043). However, 43% of the respondents with a high degree of pregnancy planning and 98% of those with a low degree of planning had not taken folic acid prior to pregnancy. Binge drinking during early pregnancy was reported by 20% of women with a high degree of planned pregnancy and 31% of those with a low degree (p = 0.1). Conclusion Pregnancy planning was associated with a healthier lifestyle but still many women could improve their lifestyle in connection to pregnancy. Their level of alcohol consumption is higher than that recommended for best pregnancy outcome.

  • 686. Andersson, E. K.
    et al.
    Strand, A. Sjostrom
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Conceptions of caring among a group of coronary care nurses2014In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 13, p. S62-S62Article in journal (Other academic)
    Abstract [en]

    Background: During the last decade fundamental changes have taken place at coronary care units (CCUs) with regard to medical treatment and advanced technology in order to improve care for patients with coronary heart disease. In the past, caring in a coronary care context was described in qualitative studies mostly from the patients’ point of view. Coronary care nurses (CCNs) are considered to play a crucial role in this care although research into nurses’ conceptions of caring in this area is still scarce. Extended knowledge from the CCNs’ perspective could be of help in developing and implementing new, nurse-led interventions in a coronary care context. Aim: This study aims to describe the conceptions of caring among a group of coronary care nurses. Methods: This is an interview study. Phenomenographic interviews with open-ended questions were conducted with 21 purposefully sampled CCNs from CCUs at two different county hospitals. The audio-taped interviews took place between March and May 2013 and the data consist of 365 double-spaced pages. The age of the CCNs ranged from 23 to 63 years, the length of experience working as a registered nurse ranged from 1 to 42 years and experience as a CCN ranged from 0.5 to 27 years. A phenomenographic analysis according to the steps described by åkerlind was used. The interviews were read several times in order to gain an overall impression of the data. The central elements of the CCNs’ responses that focus on ’what’ and ’how’ were identified, condensed and summarised as a preliminary means of understanding a phenomenon. Similar responses were carefully grouped or classified and a comparison of the categories was made in order to establish the borders between them. The descriptive categories were created on the basis of similarities and differences. An iterative process was used throughout the data analysis to check interpretation against the interviews that had been transcribed verbatim and the description categories. The description categories were used to develop an ‘outcome space’ that described the wholeness of the findings. Results: The analysis is ongoing. At the beginning of 2014 we expect to present preliminary results and answer questions about qualitatively different conceptions of caring found among a group of CCNs working in CCUs and how the different conceptions of these individuals can be understood.

  • 687.
    Sjöblom, Ingela
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Planerade hemförlossningar i Norden: kvinnors och barnmorskors perspektiv2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Home birth is common in an international perspective but in the West it is a rare occurrence. In the Nordic countries, Iceland and Denmark have the highest home birth rates with about two per cent, Norway and Sweden approximately one per thousand, and in Finland only a dozen women a year give birth to their children in the home. Background: Home birth is common in an international perspective but in the West it is a rare occurrence. In the Nordic countries, Iceland and Denmark have the highest home birth rates with about two per cent, Norway and Sweden approximately one per thousand, and in Finland only a dozen women a year give birth to their children in the home. Data collections and methods: Two interview studies (study I and V) and three questionnaire studies (study II, III and IV) were carried out. The interviews were analyzed with phenomenological-hermeneutical respectively phenomenological approach and the questionnaires with content analysis and descriptive statistical analysis, in study III as parts of the mixed method. Results: Women giving birth at home experience that they can give birth in their own terms with selected supporters around them in an environment where they feel safe (study I). They state that they are highly satisfied with their home birth midwives (study IV). The midwives described their work with assisting home birth as a lifestyle, with an opportunity to realize their full midwifery competence (study V). Women feel that they in a negative way are treated as irresponsible as they choose to give birth at home, and that this seems to strengthen their position to realize it (study II and III). Conclusion: The few women who choose to give home birth in Sweden are highly satisfied with their births experience. They have experienced that people around them, healthcare professionals as well as private individuals, were adverse to their choice and tried to make them change their minds. Women in the Nordic countries experienced that the midwife who assisted the home birth possessed good knowledge, medical as well as emotional and nurse care. Being a home birth midwife in the Nordic countries means to have chosen a lifestyle and a rewarding work, which allows her to use all her midwifery competencies to full extent.

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  • 688.
    Finnbogadóttir, Hafrún
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Exposure to domestic violence during pregnancy: impact on outcome, midwives’ awareness, women´sexperience and prevalence in the south of Sweden2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Objective: The overall aim of this thesis was to investigate pregnant women’shistory of violence and experiences of domestic violence during pregnancy andto explore the possible association between such violence and various outcomemeasures as well as background factors. A further aim was to elucidate midwives’awareness of domestic violence among pregnant women as well as women’sexperiences and management of domestic violence during pregnancy.Design/Setting/Population: Paper I utilised material derived from a populationbasedmulti-centre cohort study. A total of 2652 nulliparous women at nineobstetric departments in Denmark answered a self-administrated questionnaireat 37 weeks of gestation. Among the total sample, 37.1% (985) women met theprotocol criteria for labour dystocia. In Paper II an inductive qualitative methodwas used, based on focus group interviews with sixteen midwives working inantenatal care in southern Sweden who were divided into four focus groups. InPaper III a grounded theory approach was used to develop a theoretical modelof ten women’s experiences of intimate partner violence during pregnancy. PaperIV was a cross-sectional study including a cohort of 1939 pregnant women whoanswered a self-administered questionnaire at their first visit to seventeen ANCsin south-west Scania in Sweden.Results: In paper I, 35.4 % (n = 940) of the total cohort of women reportedhistory of violence, and among these, 2.5 % (n = 66) reported exposure toviolence during their first pregnancy. Further, 39.5% (n = 26) of those had neverbeen exposed to violence before. No associations were found between historyof violence or experienced violence during pregnancy and labour dystocia atterm. However, among those women consuming alcoholic beverages during latepregnancy, women exposed to violence had increased odds of labour dystocia(crude OR 1.49, CI: 1.07 – 2.07) compared to women who were unexposedto violence. In Paper II, an overarching category ‘Failing both mother and theunborn baby’ highlighted the vulnerability of the unborn baby and the needto provide protection for the unborn baby by means of adequate care to thepregnant woman. Also, the analysis yielded five categories: 1) ‘Knowledge about‘the different faces’ of violence’ 2) ‘Identified and visible vulnerable groups’, 3)‘Barriers towards asking the right questions’, 4) ‘Handling the delicate situation’and 5) ‘The crucial role of the midwife’. In Paper III, the analysis of the empiricaldata formed a theoretical model, and the core category, ‘Struggling to survivefor the sake of the unborn baby’, constituted the main concerns of women whowere exposed to IPV during pregnancy. The core category also demonstratedhow the survivors handled their situation. Three sub-core categories wereidentified that were properties of the core category; these were: ‘Trapped inthe situation’, ‘Exposed to mastery’ and ‘Degradation processes’. In Paper IV,‘history of violence’ was reported by 39.5% (n = 761) of the women. Prevalenceof experience of domestic violence during pregnancy, regardless of type or levelof abuse, was 1.0 % (n = 18), and prevalence of history of physical abuse byactual intimate partner was 2.2 % (n = 42). The strongest factor associated withdomestic violence during pregnancy was history of violence (p < 0.001). Thepresence of several symptoms of depression was associated with a 7-fold risk ofdomestic violence during pregnancy (OR 7.0; 95% CI: 1.9-26.3).Conclusions: Our findings indicated that nulliparous women who have ahistory of violence or experienced violence during pregnancy do not appearto have a higher risk of labour dystocia at term, according to the definitionof labour dystocia used in this study. Additional research on this topic wouldbe beneficial, including further evaluation of the criteria for labour dystocia(Paper I). Avoidance of questions concerning the experience of violence duringpregnancy may be regarded as failing not only the pregnant woman but also theunprotected and unborn baby. Still, certain hindrances must be overcome beforethe implementation of routine enquiry concerning pregnant women’s experiencesof violence (Paper II). The theoretical model “Struggling to survive for the sakeof the unborn baby” highlights survival as the pregnant women’s main concernand explains their strategies for dealing with experiences of violence duringpregnancy. The findings may provide a deeper understanding of this complexmatter for midwives and other health care professionals (Paper III). The reportedprevalence of domestic violence during pregnancy in southwest Scania in Swedenis low. Both history of violence and the presence of several depressive symptomsdetected in early pregnancy may indicate that the woman also is exposed todomestic violence during pregnancy (Paper IV).

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  • 689.
    Örmon, Karin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Experiences of abuse during the life course: disclosure and the care provided in a general psychiatric context2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Experiences of abuse are common among women in Sweden and being abused during childhood as well as adulthood has consequences for the lives of girls and women. One consequence of abuse is the impact on their mental health, which entails them seeking psychiatric care as a consequence of this. Being abused as a child has consequences during childhood as well as during adolescence and adulthood and there is a link between childhood abuse and mental ill health as an adult. Adults who have experienced abuse during their childhood have poorer mental health as adults and are overrepresented within the health care systems. Women who experience abuse as adults often describe consequences such as depression, posttraumatic stress disorder and anxiety. The psychiatric context is often described as being unhelpful when you have experience of abuse and women could be reluctant to disclose their experiences to staff for a variety of reasons. This thesis aims to identify experiences of abuse during childhood and adulthood among women who have experienced abuse and have mental ill health. The thesis also aims to explore women’s disclosure of abuse and experiences of the care provided in a general psychiatric context. The first study aimed to explore women’s disclosure of experiencing physical, emotional and/or sexual abuse to staff during their latest contact at a general psychiatric clinic. The study also aimed to explore whether the women had ever disclosed abuse to anyone at all. Seventy-seven women completed a questionnaire at the clinic and the results showed that the women often disclosed their experiences of abuse to others, but they had often chosen not to disclose their experiences during their latest contact with staff at the general psychiatric clinic. In the second study 10 women were interviewed regarding their experiences of physical, emotional and/or sexual abuse and its influence on their self-reported mental ill health. The overall theme evolving from the interviews were, “Being vulnerable and without protection in a frightful reality that limits one’s possibilities of living and being the person one wishes to be”. The categories that emerged were: ”Living in fear that persistently influences the substance of life”, “Living with the sense of being worthless”, “Living with a constant question about who you are” and “Living between hope and despair”. The third study aimed to elucidate how women subjected to physical, emotional and/or sexual abuse experience the care provided at a general psychiatric clinic after the disclosure of abuse. The overall theme capturing the essence of the nine interviews was visualized as ”Dependency as a reality containing a duality of suffering and trust”. The categories that emerged in the text were: “Being belittled”, “Being misinterpreted” and “Being cared for”. The fourth study aimed to investigate the life course of women within psychiatric care who had experienced abuse. The study also aimed to focus on the women’s resources, stressful events, experience of abuse, perpetrators, mental ill health and care and support throughout the life course. The subcategories that shaped the categories were presented within the life spans; childhood 0-12 years, adolescence 13-19 years and adulthood 20 years and above. The life charts revealed that adulthood was the period of life that had most frequent events of abuse. The women who had few experiences of abuse during childhood had also only a few noted events of mental ill health during that period of life. Emotional abuse was most frequent throughout the life course. Sexual abuse was the lesser noted abuse during childhood, but increased during adolescence and adulthood. The life charts also visualize that the women had seldom revealed the abuse during their childhood to others growing up and as adults the women often went to formal networks for support and care. The results of the thesis show that the general psychiatric care must improve their efforts to identify and support women who have experienced abuse. The women’s own stories regarding experiences of abuse during the life course must be recognized and integrated with traditional biomedical care.

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  • 690. Ohlen, Joakim
    et al.
    Ekman, Inger
    Zingmark, Karin
    Bolmsjö, Ingrid
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Benzein, Eva
    Conceptual development of "at-homeness'' despite illness and disease: A review2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 1, article id 23677Article, review/survey (Refereed)
    Abstract [en]

    Only one empirical study, the one by Zingmark, Norberg and Sandman published in 1995, explicitly focuses on at-homeness, the feeling of being metaphorically at-home, as a particular aspect of wellness. However, other studies reveal aspects of at-homeness, but if or how such aspects of at-homeness are related to each other is unclear. For this reason, the aim was to review Scandinavian nursing research related to at-homeness in the context of wellness-illness in severe and long-term conditions in order to take a step towards conceptual clarification of "at-homeness.'' The review included interpretive studies related to severe and long-term illness conducted in Sweden: 10 original articles and 5 doctoral theses. "At-homeness'' was found to be a contextually related meaning of wellness despite illness and disease embedded in the continuum of being metaphorically at-home and metaphorically homeless. This was characterized by three interrelated aspects and four processes: being safe through expanding-limiting experiences of illness and time, being connected through reunifying-detaching ways of relating, and being centred through recognition-non-recognition of oneself in the experience and others giving-withdrawing a place for oneself. This conceptualization is to be regarded as a step in conceptual clarification. Further empirical investigation and theoretical development of "at-homeness'' are needed. The conceptualization will be a step of plausible significance for the evaluation of interventions aimed at enhancing wellness for people with severe long-term illness, such as the frail elderly, and people with chronic illness or palliative care needs.

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  • 691. Richards, David A
    et al.
    Coulthard, Vania
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    The state of European nursing research: dead, alive, or chronically diseased? A systematic literature review2014In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 11, no 3, p. 147-55Article, review/survey (Refereed)
    Abstract [en]

    Background: Reviews of nursing research have suggested that most is descriptive; with no more than 15% providing strong evidence for practice. No studies have examined this from the perspective of nursing research conducted in Europe. Objective: The aim of this study was to review reports of European clinical nursing research in the top 20 nursing journals in 2010 to establish a baseline of nursing research activity in the year immediately prior to the launch of a European Science Foundation network to increase the proportion of intervention research in Europe. Methods: We identified eligible reports that were then data‐extracted by two independent reviewers. Disagreements were resolved through pair discussion and independent arbitration. We appraised and synthesized topics, methods, and the extent to which studies were programmatic. We synthesized data as proportions of study reports meeting our a priori categorization criteria. Results: We identified 1995 published reports and included 223 from 21 European countries, of which 193 (86.6%) reported studies of primary research only, 30 (13.5%) secondary research, and three (1.4%) a mix of primary and secondary. Methodological description was often poor, misleading, or even absent. One hundred (44.8%) articles reported observational studies, 87 (39.0%) qualitative studies. We found 26 (11.7%) articles reporting experimental studies, 10 (4.5%) of which were randomized controlled trials. We found 29 (13.0%) reports located within a larger program of research. Seventy‐six (34.1%) articles reported studies of nursing interventions. Linking Evidence to Action: European research in nursing reported in the leading nursing journals remains descriptive and poorly described. Only a third of research reports concerned nursing interventions, and a tiny proportion were part of a programmatic endeavor. Researchers in nursing must become better educated and skilled in developing, testing, evaluating, and reporting complex nursing interventions. Editors of nursing journals should insist on systematic reporting of research designs and methods in published articles.

  • 692.
    Kisch, Annika
    et al.
    Department of Haematology, Skåne University hospital, Lund, Sweden.
    Lenhoff, Stig
    Department of Haematology, Skåne University hospital, Lund, Sweden.
    Bengtsson, Mariette
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bolmsjö, Ingrid
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Potential adult sibling stem cell donors’ perceptions and opinions regarding an information and care model2013In: Bone Marrow Transplantation, ISSN 0268-3369, E-ISSN 1476-5365, Vol. 48, no S2, p. S471-S472, article id N1306Article in journal (Other academic)
    Abstract [en]

    Background: The first international recommendations and guidelines for the care of sibling stem cell donors were established in 2010 and have not yet been evaluated. However, a model for information and care of adult potential sibling stem cell donors (the IC model) developed and introduced at Skåne University Hospital, Lund, Sweden, in 2005 conforms closely to them. The IC model aims to protect the privacy of potential donors, support and respect their free choice, and identify quickly those unwilling or unable to donate and thus minimize delay in seeking alternative donors. All contacts with potential sibling donors are handled by the SCT (Stem Cell Transplantation) team. If the sibling is unwilling or unable to donate, HLA (Human Leukocyte Antigen) typing is not performed and the patient is told only that there is no possible donor among the siblings. To protect the sibling donor’s privacy, the physician and nurse assigned to the donor are never those responsible for the patient.

    Objectives: The main aim of the present study was to evaluate the IC model by surveying adult potential sibling stem cell donors’ perceptions and views regarding the provision of information, staff and relatives’ influence over decision making, and the care provision by health professionals around the time of the decision whether to undergo HLA typing.

    Methods: A questionnaire survey containing 30 questions was performed in 2010 gathering the perceptions and views on information provision; influences over decision making; and care provision under the IC model of 148 adult siblings informed about SCT donation and asked to undergo HLA typing since September 2005 at the hospital. The questionnaire responses were analysed using descriptive statistical methods.

    Results: The results suggest the IC model works well but highlights areas for improvement, such as in delivery of HLA typing results to non-matched siblings and a need to further prevent complicating influence from health professionals and relatives on the decision to undergo HLA typing.

    Conclusion: The majority of the siblings was satisfied with the information and care provided, and found the aspects of information, care provision and support important. The IC model could provide the groundwork for other SCT units seeking to implement handling of potential adult sibling stem cell donors according to the international recommendations and guidelines published after the IC model was developed and introduced.

  • 693.
    Annersten Gershater, Magdalena
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Forbes, Angus
    Identity and relationships are central to the construction of patient centred care2013In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 10, no 3, p. 78-78Article in journal (Other (popular science, discussion, etc.))
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  • 694.
    Annersten Gershater, Magdalena
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Forbes, Angus
    Are we failing vulnerable older people with diabetes in care homes?2013In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 10, no 1, p. 5-5Article in journal (Other (popular science, discussion, etc.))
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  • 695.
    Annersten Gershater, Magdalena
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Forbes, Angus
    The need to grow our own: research is a priority for diabetes nursing2013In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 10, no 2, p. 45-45Article in journal (Other (popular science, discussion, etc.))
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  • 696.
    Janzon, Ellis
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Health and Welfare Studies (HV).
    Bolmsjö, Ingrid
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Obesity in Somali migration women due to post migration dietary changes and decreasing self-esteem: a qualitative interview study on diet, knowledge ab out risk of heart disease, inactivity, body image and self-esteem2013In: Journal of research in obesity, ISSN 2333-3707, no 142971, article id 142971Article in journal (Refereed)
    Abstract [en]

    The last-decade incidence of myocardial infarction (MI) has diminished dramatically in most age groups but not in middle-aged women in Sweden. There has been a large influx of immigrants and it has been shown that immigrant wom en have a higher BMI and are less physically active than Swedish women. Thereby they have a higher risk for heart disease. The aim of the study was to examine post-migration diet ary changes, and knowledge about risks for heart diseases among Somali women. Furthermore, to examine the women’s perceptions of body image, self-esteem, and their knowledge about the positive effect of physical activity. The qualitative research method was used and eight Soma li women aged 40 years or more, who have lived in Sweden longer than ten years, were in terviewed with the help of a semi- structured questionnaire. The study revealed that S omali migrated women in Sweden had changed their diet and experienced weight increase. They reported low self-esteem and little motivation for physical activity. They understood t hat they had a higher risk for heart disease as compared to Swedish women and they had, in gener al, a preference for big body size. The women of this study are, in combination with other risk factors, at a high risk of myocardial infarction. They all revealed a general knowledge a bout the relationship between obesity and inactivity and enhanced risks for heart disease. Th ey had a preference for a larger female body image. They expressed low self-esteem, loneliness, and alienation from society. It is important to address the health issue among migrant Somali wo men in Sweden, but since this study had few informants, larger studies and more science is needed to further investigate the problem.

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  • 697. Sundström, Malin
    et al.
    Blomqvist, Kerstin
    Petersson, Pia
    Rämgård, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Varland, Linda
    Inte samma mall för alla: om vård och omsorgsplanering i samverkan2013Report (Other academic)
    Abstract [sv]

    Deltagarbaserad Utvärdering: Skl satsning på vårdplanering i samverkan i Norra Skåne. Erfarenheter ur närstående, personalen och patientens perspektiv

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  • 698.
    Annersten Gershater, Magdalena
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Pilhammar, Ewa
    Alm Roijer, Carin
    Prevention of foot ulcers in patients with diabetes in home nursing: a qualitative interview study2013In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 10, no 2, p. 52-57Article in journal (Refereed)
    Abstract [en]

    Summary Diabetes mellitus and foot ulcer increase the risk of amputation, and prevention of foot ulcers are therefore important. Patients with diabetes and other concomitant diseases are often cared for in a home nursing service and the registered nurses (RNs) have the opportunity to practise preventive care to avoid foot ulcers. How prevention of foot ulcer is performed in home nursing settings has not been previously described. The objective of this study was to explore RNs’ professional work with foot ulcer prevention in home nursing settings for patients with diabetes mellitus. Qualitative interviews were analysed, using manifest content analysis. The setting was four municipalities in Sweden (large and small cities, and rural areas). Fifteen RNs actively working in a home nursing service with more than two years’ experience were recruited. The participants were all women, had worked as RNs for 3–41 years (median 25), and in home nursing for 2–18 years (median 8). The results showed that the RNs work through leadership, coordination, education and evaluation. Health care assistants perform most of the nursing actions to prevent foot ulcers such as assessment of feet, off-loading, nutrition and hygiene. The RNs have medical and nursing responsibility but without the formal tools to execute this fully. The RNs’ formal education was some years back and they relied mostly on experience-based knowledge. It was concluded that patient assessment and nursing actions to prevent foot ulcers are mostly performed by health care assistants. The RNs need to be given formal responsibility in their role as leaders and educators, and need more education in pedagogy and leadership. Eur Diabetes Nursing 2013; 10(2): 52–57 Key words diabetes; diabetic foot ulcer; education; elderly; foot care; foot health; nursing; home care; pressure ulcer; prevention

  • 699.
    Sunnqvist, Charlotta
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Träskman-Bendz, Lil
    Westrin, Åsa
    Coping strategies used by suicide attempters and comparison groups2013In: Open Journal of Psychiatry, ISSN 2161-7325, E-ISSN 2161-7333, Vol. 3, p. 256-263Article in journal (Refereed)
    Abstract [en]

    A variety of factors have been identified as being risk factors for suicidal behaviour. One of them is the handling of stressful events. The aim of the present study was to investigate the coping-strategies used by suicide attempters and comparison groups. 37 pa- tients who had recently made a suicide attempt, 38 suicide attempters at follow up, 20 psychiatric follow up controls, and 19 healthy controls filled in the COPE. We found that suicide attempters at long term follow up and healthy controls used more adaptive problem solving strategies than patients who had re- cently made a suicide attempt, or psychiatric controls at follow up, who used more maladaptive coping strategies. Our findings suggest that suicide attempt- ers in a twelve year follow up are able to use coping strategies similarly to healthy controls by e.g. ap- proaching the stressor actively. Further examinations of the impact of long term professional care and treatment of suicide attempters on their coping strategies are necessary.

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  • 700.
    Idvall, Ewa
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Inledning2013In: Kvalitetsindikatorer inom omvårdnad / [ed] Ewa Idvall, Gothia Förlag AB, 2013, p. 7-9Chapter in book (Other academic)
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