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  • 701.
    Holst-Hansson, Annette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjövall, K.
    Idvall, Ewa
    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).
    The breath of life: womens' experiences of breathing adapted radiation therapy2013In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 17, no 3, p. 354-359Article in journal (Refereed)
    Abstract [en]

    Purpose To describe and analyze how women with breast cancer experience breathing adapted radiation therapy (BART) and to explore how women manage daily radiation therapy. Method Individual interviews were conducted with 20 women treated with BART for breast cancer concerning their perception of radiation therapy. The transcribed interviews were analyzed using qualitative content analysis. Results ‘The breath of life’ was the overall theme, as the women experienced the breathing as a way in which to influence their treatment and thus their survival. ‘Participating in one's treatment, for good or ill’, was the main category with four subcategories, ‘Knowing one has done something good’, ‘Getting an extra bonus – healthwise’, ‘The experience of being in control’ and ‘Being in a high-technology environment’. The breathing technique became the strategy by which they could manage their treatment and gave them a sense of participation which led to a feeling of being in control. The women also felt that breathing benefited their health both mentally and physically. The high-technology environment was experienced as both hopeful and frightening. Conclusion Survival or increasing the chances of survival, are of ultimate importance for a woman with breast cancer. BART requires commitment from the women, which was perceived as offering them an opportunity to participate in their own treatment, for their survival. Increasing the women's possibilities to participate in their treatment benefits their health and welfare during an otherwise turbulent time and allow the rehabilitation process to start during treatment.

  • 702.
    Stjernswärd, Sigrid
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Criminology (KR).
    Persson, Karin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Nielsen, René
    Tuninger, Eva
    Levander, Sten
    Malmö högskola, Faculty of Health and Society (HS), Department of Criminology (KR).
    A modified Drug Attitude Inventory used in long-term patients in sheltered housing2013In: European Neuropsychopharmacology, ISSN 0924-977X, E-ISSN 1873-7862, Vol. 23, no 10, p. 1296-1299Article in journal (Refereed)
    Abstract [en]

    The self-report Drug Attitude Inventory (DAI), in 30- and 10-item versions, provides unique information of clinical relevance for monitoring treatment adherence among people diagnosed with schizophrenia. The primary purpose of this paper was to evaluate the 10-item version among patients living in sheltered housing. Data were collected among 68 persons living in sheltered housing, most of them (82%) diagnosed with schizophrenia, 6% with non-organic psychoses, and 12% with other diagnoses. The dichotomic response format of the original DAI-10 was replaced by a 4-point Likert scale, in order to improve the resolution of the scale. Over 90% of the participants produced meaningful scores. A factor analysis suggested a 2-factor orthogonal structure: one highly homogenous factor (5 items) reflected wanted effects of the drug and displayed a bimodal distribution; one factor (3 items) reflected side effects. One item concerned the perceived control over one's drug treatment, which is a key clinical issue. One item was conceptually ambiguous and displayed no correlations with the other items. On the basis of the results we suggest cut-off scores which indicate the need for three kinds of adherence-improving interventions. Summing up, by dropping one item and using a Likert scale response format, the resulting instrument, DAI-9, appears to be an easy-to-use self-report instrument for monitoring drug attitudes and to identify needs for treatment adherence interventions among seriously ill patients.

  • 703. Mehica, Leila
    et al.
    Annersten Gershater, Magdalena
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Alm Roijer, Carin
    Diabetes and infected foot ulcer: a survey of patients' perceptions of care during the preoperative and postoperative periods2013In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 10, no 3, p. 91-95Article in journal (Refereed)
    Abstract [en]

    Diabetic foot ulcer is a serious threat to the extremities and to the individual's survival. The most common risk factors for amputation are deep infection, plantar ulcer and gangrene. The aim of this study was to measure inpatients' perception of health care quality, and to identify the health care needs of people with diabetes and infected foot ulcers during the preoperative and postoperative periods. The study design was empirical with a quantitative approach. The short form of the Quality of care from the Patient's Perspective (Mini QPP) was used. The results are described in four categories related to the Mini QPP model: medical technology; physical-technical conditions; identity-oriented approach; and socio-cultural atmosphere. The study participants (n=30) expressed a need for continuous information, a secure and comfortable physical environment, shared decision making, and better quality of pain management. More research about how to improve information, the environment, shared decision making, and pain control would be desirable.Eur Diabetes Nursing 2013; 10(3): 91–95

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  • 704. Andersson, Ewa K
    et al.
    Borglin, Gunilla
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjöström-Strand, Annika
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Standing alone when life takes an unexpected turn: being a midlife next of kin of a relative who has suffered a myocardial infarction2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 864-871Article in journal (Refereed)
    Abstract [en]

    Background Suffering a myocardial infarction (MI) is a life-threatening event that impacts not only on the individual concerned but also on the next of kin. However, there seems to be a paucity of naturalistic inquiries that focus specifically on midlife next of kin and their experience of being close to a relative who has suffered an MI. This study aims to elucidate the experience of being a midlife next of kin of a relative who has suffered a myocardial infarction. Method Nine women and four men in midlife participated in the focused interviews, which were conducted and analysed during 2010/2011 using Lindseths and Norbergs' description of the phenomenological hermeneutical method. Findings Four themes – Solely responsible, Lurking unease, Left out of the picture and Life on hold – formed the basis of the core theme Standing alone when life takes an unexpected turn. The core theme was interpreted as a central phenomenon encompassing the experience of being solely responsible for the well-being of their relative and the family, thus putting their own life on hold. The core theme also reflected the next of kin's experience of being left out of the picture when it came to the relative's care before and after the MI. Conclusion The next of kin's negative feelings of standing alone were further intensified by their experience of being left out of the picture by the healthcare professionals concerning their relative's care. As a cardiac nurse, it would seem essential to have knowledge about the experiences of next of kin in connection with a relative's MI event. Such knowledge can facilitate the planning and organisation of nursing care and at the same time address the next of kin's role in the recovery and rehabilitation process.

  • 705. Nilsson, Ulrica G.
    et al.
    Ivarsson, Bodil
    Alm-Roijer, Carin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Svedberg, Petra
    the SAMMI-study group,
    The desire for involvement in healthcare, anxiety and coping in patients and their partners after a myocardial infarction2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 5, p. 461-467Article in journal (Refereed)
    Abstract [en]

    Background: There is a lack of data about the information preferences of patients and their partners after a myocardial infarction. Aim: This paper explores anxiety, depression, coping and the desire to be actively involved in care in relation to age, gender and education level in myocardial infarction patients and partners. Methods: One hundred and twenty-eight patients and their partners answered the Swedish version of the Krantz Health Opinion Survey, the Hospital Anxiety and Depression Scale, and the Mastery Scale one year after the patient’s myocardial infarction. Results: More active roles in decision-making during care were desired by females, younger patients and partners, and patients and partners with higher education levels. Female partners reported more anxiety than male partners, and female patients reported more depression than male patients. No differences between groups were detected in coping; overall coping was rated high. Conclusions: Secondary prevention should consist of person-centred support to both the patients and their partners, since factors such as age, gender and education level can influence information preferences during patient care.

  • 706. Suhonen, Riitta
    et al.
    Schmidt, Lee
    Katajisto, Jouko
    Berg, Agneta
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kalafati, Maria
    Land, Lucy
    Lemonidou, Chryssoula
    Välimäki, Maritta
    Leino-Kilpi, Helena
    Cross-cultural validity of the individualised care scale: a rasch model analysis2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 5-6, p. 648-660Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: The aim of this study was to investigate, using Rasch model analysis, the measurement invariance of the item ratings of the Individualised Care Scale. Background: Evidence of reliability is needed in cross-cultural comparative studies. To be used in different cultures and languages, the items must function the same way. Design: A methodological and comparative design. Methods: Secondary analysis of data, gathered in 2005–2006 from a cross-cultural survey using the Individualised Care Scale from Finnish, Greek, Swedish and English predischarge hospitalised orthopaedic and trauma patients (n = 1093), was used. The Rasch model, which produces calibrations (item locations and rank) and item fit statistics, was computed using the Winstep program. Results: The rank of average Individualised Care Scale item calibrations (−2·26–1·52) followed a generally similar trend (Infit ≤ 1·3), but slight differences in the item rank by country were found and some item misfit was identified within the same items. There was some variation in the order and location of some Individualised Care Scale items for individual countries, but the overall pattern of item calibration was generally corresponding. Conclusions: The Rasch model provided information about the appropriateness, sensitivity and item function in different cultures providing more in-depth information about the psychometric properties of the Individualised Care Scale instrument. Comparison of the four versions of the Individualised Care Scale – patient revealed general correspondence in the item calibration patterns although slight differences in the rank order of the items were found. Some items showed also a slight misfit. Based on these results, the phrasing and targeting of some items should be considered. Relevance to clinical practice: The Individualised Care Scale – Patient version can be used in cross-cultural studies for the measurement of patients’ perceptions of individualised care. Information obtained with the use of the Individualised Care Scale in clinical nursing practice is important, and valid measures are needed in evaluating patients’ assessment of individualised care, one indicator of care quality.

  • 707. Andersson, Ewa K
    et al.
    Borglin, Gunilla
    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).
    The Experience of Younger Adults Following Myocardial Infarction2013In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 23, no 6, p. 762-772Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to elucidate the meaning of the experience of younger people (younger then 55 years) during their first year following a myocardial infarction. We analyzed 17 interviews using a phenomenological-hermeneutic method. The core theme and central phenomenon was the everyday fight to redress the balance in Life, which encompassed an existential, physical, and emotional battle to regain a foothold in Daily Life. The aftermath of a Life-threatening event involved a process of transition while at the same time creating a new meaning in Life. Lack of energy and its impact on the complex interplay of midlife combined with unreasonable demands from employers and Health care professionelas seemed to color the experince of the informants. The knowledge gained in this study can constitute a valuable contribution to overall quality Assurance in nursing care and the development of nursing interventions for the cardiac rehabilitation of younger patients.

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  • 708.
    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
    Sustainable outcomes of an improvement programme: do financial incentives matter?2013In: Total Quality Management and Business Excellence, ISSN 1478-3363, E-ISSN 1478-3371, Vol. 24, no 7-8, p. 959-969Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate whether an improvement programme can contribute to positive sustainable improvements in an organisation, and whether financial incentives are driving forces for improvements. The material was all projects (n¼232) that applied for funding in a county council improvement programme between 2007 and 2010. The projects were analysed as to whether they received funding (n¼98) or were rejected (n¼95). In addition, a categorisation of the projects’ intentions was analysed. Some projects were still ongoing, but 50 projects were implemented and sustained two or more years after being finalised. Implemented improvements were on different levels, from (micro-level) units up to the entire (macro-level) organisation. In addition, 27 rejected projects were finalised without funding. Eighteen of those 27 were sustainably implemented. This study indicates that there are incentives other than financial at work if an improvement programme contributes to sustainable improvements in the organisation. To encourage practice-based improvements is one way of incentivising the intention and effort to become and perform better.

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  • 709. Fåhraeus, Åsa
    et al.
    Bramhagen, Ann-Cathrine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Förekomst av lokala komplikationer efter kranskärlsintervention via artären i handleden2013Report (Other academic)
    Abstract [en]

    Cardiovascular disease is one of the West's most common diseases. Diagnosis and treatment of constricted coronary arteries can be performed with contrast imaging and percutaneous coronary intervention (PCI). Studies have shown that puncture through the radial artery reduces complications such as bleeding and decreased cardiac events compared with a punction of arteria femoralis. A follow-up regarding local complications of trans-radial procedure is important. The aim of this study was to retrospectively evaluate the incidence of local complications after trans-radial coronary intervention after discharge. A total of 139 patients were contacted by telephone after 2-4 months. Inquiry was made according to a questionnaire concerning local symptoms related to the area around the wrist for trans-radial coronary intervention and whether the pulsations in arteria radialis were palpable or not. In this study, 91.4% of patients had no local complications after trans-radial coronary intervention. All patients had palpable pulsations in arteria radialis, and one of them had a weak radial pulse which had to be verified by Doppler. Twelve patients (8.6%) reported local symptoms of any kind. Seven patients (5%) had various problems such as pain, numbness, swelling and hematoma from the hand. Two patients (1.4%) had symptoms of wrist and another two had symptoms from the forearm and one had pain in the shoulder. Eight patients (6%) reported different persistent symptoms. The conclusion is that a punction of arteria radialis in coronary intervention has benefits such as bleeding complications and preventing decreased cardiac death versus a punction of femoral which has been shown in several other studies. The results of this study showed that nearly 10 % experienced mild local complications, especially in the hand. Furthermore, since the patients reported increased well-being postoperatively trans-radial procedures should be first choice in coronary intervention.

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  • 710.
    Karlsson, Karin
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Vuckovic, Verica
    Peer learning: en pedagogisk modell för handledning av sjuksköterskestuderande under verksamhetsförlagd utbildning i Psykiatri Skåne, Malmö2013Report (Other academic)
    Abstract [sv]

    Institutionen för Vårdvetenskap, Hälsa och samhälle, har som utgångspunkt i sin pedagogiska grundsyn att främja det livslånga lärande (Willman & Carlson, 2012). Det innebär att undervisningen ska stödja studenternas förmåga till självständig kunskapsutveckling, kritisk tänkande, reflektion och problemlösningsförmåga. Peer Learning är en pedagogisk modell där fokus ligger på lärande och inte undervisning. Peer Learning kan tillämpas med studenterna såväl inom som mellan utbildningsnivåer. Metoden kan hjälpa och stödja studenterna genom att de lär av varandra samt genom att de lär ut till varandra. Kommunikation är en viktig förutsättning för framgångsrik Peer Learning där fokus är kritiskt tänkande och reflektion genom att studenterna får kontinuerlig feedback av såväl handledare som medstudent. Denna rapport redovisar implementeringen av Peer Learning inom Psykiatri Skåne, Malmö.

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  • 711.
    Rämgård, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Utvägen: ett salutogent samverkansprojekt finansierat av Finsam MittSkåne: Rapport 1: deltagarnas upplevelser2013Report (Other academic)
    Abstract [sv]

    En utvärderingsrapport om ett deltagarbaserat salutogent samverkansprojekt för långtidsarbetslösa med hälsoproblem. Rapporten visar att arbetsättet påverkat deltagarna positivt men påvisar också hur myndigheternas tidigare bemötande påverkat deltagarnas kognition.

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  • 712. Nylén, Sofie
    et al.
    Bahtsevani, Christel
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bramhagen, Ann-Cathrine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    PATIENTERS UPPLEVELSER OCH ERFARENHETER AV FÖRÄNDRAD LIVSSITUATION EFTER EN BEN ELLER NEDRE EXTREMITETS AMPUTATION2013Report (Other academic)
    Abstract [en]

    Aim. This literature study highlights patients with diabetes mellitus and / or peripheral vascular disease and their experiences of changes in life after a leg or lower extremity amputation. Background. Living with a chronic disease such as peripheral vascular disease and / or diabetes, can lead to strains and affect daily life, including pain, sleep difficulties, problems with ulcers and fear of amputation. Being amputated can lead to shock and grief postoperatively. The mental preparation preoperatively is important for how the patient's experience life postoperatively. Patients need support and encouragement from the nursing staff and relatives in order to increase well-being and for greater autonomy in the postoperative phase. Method. A systematic literature review, based on review and compilation of qualitative studies, was chosen in order to answer the research question. Three articles were found relevant to the purpose of the study, one study was found to be of high quality and two studies of medium quality. Two of the studies were conducted in Western and one in the Asian context. The authors used the SBU's manual in the selection process of literature. Results. After compilation of the three studies two overall third-level themes were identified: Suffering and to regain hope. Conclusion. There is scientific evidence that a leg or lower extremity amputation alters a patient’s situation in life. This may cause distress in different dimensions. In this study emotional, psychosocial and physical suffering were identified. There is also evidence that patients who has time can develop some acceptance and adjustment to their new situation. Support from family and friends are important for the motivation to fight and regain hope for the future. Similar experiences / experiences identified despite different cultural backgrounds.

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  • 713.
    Örmon, Karin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Tidsgeografi: en metod för att screena våldsutsatta kvinnor i en allmänpsykiatrisk kontext2013Conference paper (Other academic)
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  • 714.
    Bramhagen, Ann-Cathrine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Pain Management at Skåne University Hospital, Malmö/Lund, Sweden2013Conference paper (Other academic)
    Abstract [en]

    1. Nurses´ attitudes towards pain in children. Previous research has shown a lack of knowledge in pain treatment among nurses working with children. Children express pain different compared to adults and research has shown that nurses´ attitudes are important to pain assessment in children. The present study aimed to explore nurse’s attitudes towards pain in children. The study was conducted as a questionnaire study on nurses working with children at a pediatric ward at a university hospital in the south of Sweden. The questionnaire ”Views and knowledge about pain in children” was selected and translated into Swedish. A total of 357 surveys were handed out and 153 were answered, which provided a response frequency of 43 % of the total population. Data was analyzed descriptively and comparisons between groups were conducted The results showed that a majority of nurses don’t think that a child less than one month of age may be intubated without narcotics or pain medication but 22 % answered that they did not know. They also express the importance of total elimination of pain when treating post-operative and chronic pain. Some nurses´ believed that minor procedure can be carried out without pain medication. Advanced education and experience affect attitudes to some point. Place of work didn’t affect nurses attitudes towards pain in children. 2. Childrens´s pain from the children and parents perspective. Pain management is important for the child in many aspects and may lead to long term problems and affect quality of life for the child. Sweden is lacking optimal management of acute and chronic pain in children and adolescents. The aim of this study was to describe children´s and parent´s perception of pain in hospital be performing a prevalence study using a questionnaire containing seven questions. Totally 182 questionnaires were administrated and 146 were returned. The results showed that 68 % of children have experienced pain during hospital stay and rating scales concerning pain are not used in particularly high degree. "Did the staff ask you or your child about pain?" - 82 % ( 79/97) answered yes. Did you or your child during the last 24 hours had the possibility to assess pain with a scale e.g. VAS?" Only 23 % (22/97) have had the possibility. These results can provide increased knowledge of pain and pain assessment by health professionals, which may provide a basis for further discussion and increase quality of pain management for children in hospital.

  • 715. Noghi, Adina
    et al.
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Varför uppkommer brister i läkemedelshanteringen? En kunskapsöversikt om faktorer som negativt kan påverka sjuksköterskans iordningställande och administrering av läkemedel2013Report (Other academic)
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  • 716.
    Theodoridis, Kyriakos
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Omvårdnad som filosofisk aktivitet2013In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 33, no 2, p. 11-15Article in journal (Refereed)
    Abstract [sv]

    I denna artikel diskuteras tesen att omvårdnad kan beskrivas som en form av filosofisk aktivitet. Artikeln avser att belysa omvårdnadens filosofiska karaktär genom en analys av omvårdnad som yrkesverksamhet och som kunskapsdisciplin. I analysen framträder fyra attribut som kännetecknar omvårdnadens essens: etiskt ställningstagande, delaktighet i människors existentiella singulariteter, yrkeskompetensens komplexitet samt kravet på självkännedom. Sammantaget argumenteras att dessa fyra attribut konsoliderar omvårdnadens filosofiska dimension och ligger till grund för påståendet att omvårdnad (inom vissa kliniska regioner) kan beskrivas som en form av filosofisk aktivitet.

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  • 717. Gunningberg, Lena
    et al.
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Mäta för att mäta2013In: Ortopedisk vård och rehabilitering / [ed] Ami Hommel, Carina Bååth, Studentlitteratur AB, 2013, p. 377-385Chapter in book (Other academic)
  • 718. Nässtrom, L.
    et al.
    Jaarsma, T.
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Strömberg, A.
    Factors associated with heart failure patients' views of participation in care2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 1_suppl, article id P46Article in journal (Other academic)
    Abstract [en]

    Purpose: Participation of patients with chronic heart failure (CHF) in their care is important for improving outcomes. The aim of this study was to explore factors that were associated with patient views of the importance of involvement and participation in care. Methods: Baseline data from 100 CHF patients enrolled to home care in Sweden were used. A linear regression analysis, using enter method, was performed with three subscales (participation, information and needs) of a questionnaire measuring patient views of involvement in care, as the dependent variable. Socio-demographic (age, education, gender, home help service, co-habiting, smoking, alcohol) and clinical characteristics (NYHA-class, co-morbidities measured by Charlson Comorbidity Index), health (EuroQoL 5D), perceived control (Control Attitude Scale), and self-care behavior (European Self-Care Behavior Scale) were included to determine independent factors associated with participation. Results: Sixty-two percent were men, mean age 82 years, the majority (80%) was in NYHA-class III. Patients scored a mean level of 7.6 ± 2.0 (theoretical range 1-10) for the satisfaction of their participation in heart failure care. The regression analysis showed that patients view of the importance of participation was significantly associated with co-habiting (β = 0.25, t = 2.09 p = 0.04) and self-care behavior (β = -0.33, t = -3.44, p < 0.001). These variables explained 22% of the variance of importance of participation. The degree to which patients stated that they had received information about CHF and treatment was significantly related to gender (β = -0.23, t = -2.22, p = 0.03), self-care behavior (β = -0.42, t = -4.34, p < 0.001) and knowledge (β = 0.24, t = 2.25, p = 0.03). These variables explained 21% of the variance of information subscale. Meeting patients need regarding questions and respect was significantly associated with symptoms of depression (β = -0.25, t = -2.29, p = 0.02), self-care behavior (β = -0.37, t = -3.95, p < 0.001) and knowledge (β = 0.23, t = 2.25, p = 0.03). These variables explained 22% of the variance. Conclusion: Patient views of involvement, receiving information, ability to ask questions and being treated with respect were strongly associated with self-care behavior. Other factors influencing satisfaction with involvement and participation were higher level of knowledge, lower degree of depressive symptom, male gender and co-habiting. Interventions that focus on participation to improve self-care seem promising and need to be studied.

  • 719.
    Jakobsson, Jenny
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Fast-track kirurgi för den äldre populationen2013In: Omvårdnad på avancerad nivå: kärnkompetenser inom sjuksköterskans specialistområden / [ed] Anna-Karin Edberg, Anna Ehrenberg, Febe Friberg, Lars Wallin, Helle Wijk, Joakim Öhlén, Studentlitteratur AB, 2013Chapter in book (Other academic)
  • 720. Roth, Bodil
    et al.
    Bengtsson, Mariette
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ohlsson, Bodil
    Diarrhoea is not the only symptom that needs to be treated in patients with microscopic colitis2013In: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828, Vol. 24, no 6, p. 573-578Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Many patients with microscopic colitis (MC) also suffer from symptoms of irritable bowel syndrome (IBS), but the only treatment given is corticosteroids for the diarrhoea. The aim of this study was to examine how social factors, life style factors and drug treatment affect symptoms and well-being in patients suffering from MC. METHODS: Women, over the age of 73years, with biopsy-verified MC, at any Departments of Gastroenterology, Skåne, between 2002 and 2010 were invited. The questionnaires Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-being Index (PGWB) were sent by mail, along with questions about social and life style factors, and medical history. RESULTS: Of 240 invited, 158 patients (66%) were included (median age 63years, range 27-73years). Only 26% had never smoked. Smoking and concomitant IBS were associated with both impaired gastrointestinal symptoms (OR=3.96, 95% CI=1.47-10.66 and OR=4.40, 95% CI=2.09-9.26, respectively) and impaired psychological well-being (OR=2.77, 95% CI=1.04-7.34 and OR=3.82, 95% CI=1.83-7.99, respectively). Treatment with proton pump inhibitors (PPI) was associated with increased gastrointestinal symptoms (OR=3.44, 95% CI=1.45-8.16). Age, social factors, and corticosteroids had no effect on symptoms or well-being. Smoking was the only risk factor associated with IBS (OR=2.68, 95% CI=1.115-6.26). CONCLUSION: Smoking and IBS are associated with impaired gastrointestinal symptoms and psychological well-being in MC patients. PPI is associated with impaired gastrointestinal symptoms.

  • 721. Gustafsson, Markus
    et al.
    Kristensson, Jimmie
    Holst, Göran
    Willman, Ania
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bohman, Doris
    Case managers for older persons with multi-morbidity and their everyday work: a focused ethnography2013In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 13, article id 496Article in journal (Refereed)
    Abstract [en]

    Background: Modern-day health systems are complex, making it difficult to assure continuity of care for older persons with multi-morbidity. One way of intervening in a health system that is leading to fragmented care is by utilising Case Management (CM). CM aims to improve co-ordination of healthcare and social services. To better understand and advance the development of CM, there is a need for additional research that provides rich descriptions of CM in practice. This knowledge is important as there could be unknown mechanisms, contextual or interpersonal, that contribute to the success or failure of a CM intervention. Furthermore, the CM intervention in this study is conducted in the context of the Swedish health system, which prior to this intervention was unfamiliar with this kind of coordinative service. The aim of this study was to explore the everyday work undertaken by case managers within a CM intervention, with a focus on their experiences. Methods: The study design was qualitative and inductive, utilising a focused ethnographic approach. Data collection consisted of participant observations with field notes as well as a group interview and individual interviews with nine case managers, conducted in 2012/2013. The interviews were recorded, transcribed Verbatim and subjected to thematic analysis. Results: An overarching theme emerged from the data: Challenging current professional identity, with Three sub-themes. The sub-themes were 1) Adjusting to familiar work in an unfamiliar role; 2) Striving to improve the health system through a new role; 3) Trust is vital to advocacy. Conclusions: Findings from this study shed some light on the complexity of CM for older persons with multi-morbidity, as seen from the perspective of case managers. The findings illustrate how their everyday work as case managers represents a challenge to their current professional identity. These findings could help to understand and promote the development of CM models aimed at a population of older persons with complex health needs.

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  • 722.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjöberg, Klas
    Candamio, Martina
    Lerman, Annie
    Ohlsson, Bodil
    Anxiety in close relationship is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease2013In: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828, Vol. 24, no 3, p. 266-272Article in journal (Refereed)
    Abstract [en]

    Background Previous research has suggested an interaction between personality factors and inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS). We therefore aimed to elucidate differences in psychological and coping functioning between patients with IBD and IBS, and to assess the relationship of disease activity with these functions. Methods Seventy-four patients with IBD (mean age 43 ± 17 years, range 18–82 years) and 81 patients with IBS (mean age 37 ± 12 years, range 21–66 years) completed the questionnaires; Rosenberg Self-Esteem Scale, Toronto Alexithymia, Experiences in Close Relationships, and Sense of Coherence. Disease activity was evaluated either by the Harvey-Bradshaw index, the Simple Clinical Colitis Activity Index, or the Visual Analogue Scale for Irritable Bowel Syndrome. Results The study revealed that patients with IBS had higher degree of anxiety in close relationships than patients with IBD (p = 0.003), and lower self-esteem (p = 0.001). No other statistical differences between the whole groups IBS and IBD or between subgroups were seen. Conclusions The fact that patients with IBS seem to have higher levels of anxiety in relationships and lower self-esteem could influence the way the patient deal with the disease and how the communication with health care professionals works out. A higher awareness of the importance of past negative life events should be taken into consideration. Whether the disease or the personal traits are the primary event should be addressed in future research.

  • 723.
    Carlson, Elisabeth
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Precepting and symbolic interactionism: a theoretical look at preceptorship during clinical practice2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 2, p. 457-464Article in journal (Refereed)
    Abstract [en]

    Aim. To present a discussion of precepting through the use of symbolic interactionism as exemplified by findings from an ethnographic study. Background. It is a well-known fact that clinical practice, where students are supervised by precepting nurses, is an important part of nursing education. Several previous studies have stressed the vital role preceptors have for the development of student nurses’ clinical competence. Despite this, few of these findings are discussed from a theoretical standpoint to further explain and illustrate the complexity of preceptorship. Data sources. This article builds on findings from an ethnographic study undertaken between November 2006–May 2007 and again between March–September 2009. Full details of the empirical findings have been reported elsewhere. Discussion. Precepting can be understood as a trusting relationship between preceptor and student interacting and sharing nursing activities. The participants’ actions will influence and shape the meaning and understanding of these activities. Implications for nursing. Precepting is a complex and advanced role for nurses that they need to be properly prepared for. Thus, preceptor preparation needs to be organized in collaboration between healthcare organizations and universities. It is suggested that preceptor preparation programmes should focus on reflection, critical thinking and communication skills. Conclusion. Symbolic interactionism can serve as a potential theory that will expand the understanding of and give new perspectives of nursing practice. It would therefore be encouraging to see further testing of suitable theories to interpret empirical findings and create opportunities for practice improvement.

  • 724.
    Jakobsson, Jenny
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Nurses' perceptions of working according to standardized care plans: a questionnaire study2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 4, p. 945-952Article in journal (Refereed)
    Abstract [en]

    Aims The aim of this study was to investigate nurses′ perceptions of working according to standardized care plans (SCPs), regarding usability, documentation, quality of care and the implementation process. Background Administrative work is an extensive part of nursing practice which leads to decreased time for the near patient-related care. In addition, the number of very sick patients with short hospital stays has increased. This places new demands on healthcare teams to guarantee a high quality of care. For this reason development and use of standardized care plans has increased in Sweden during recent years. Method This was a cross-sectional survey and 116 registered nurses who had experience of working according SCPs answered a questionnaire with the option of providing written comments. Result The nurses reported that the use of SCPs facilitated their daily work, especially for new employees and worked well as a checklist ensuring the quality of care. The documentation was experienced as easy, less time consuming with less redundant information. The implementation process of SCPs was reported as satisfactory but a majority reported that they were not involved in the development of the SCP. However, even though 85.5% reported a positive attitude towards working according to an SCP, it was also sometimes experienced as inflexible. Conclusion The nurses had overall positive perceptions of working according to an SCP mainly in terms of usability, documentation and quality of care. The implementation process was not optimal and it was doubtful whether the SCP rendered any positive side effects.

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  • 725.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ohlsson, Bodil
    The brief Visual Analogue Scale for Irritable Bowel Syndrome questionnaire can be used to evaluate psychological well-being in patients with irritable bowel syndrome2013In: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828, Vol. 24, no 7, p. e82-e83Article in journal (Refereed)
    Abstract [en]

    Abstract Objective: The questionnaire Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) has been validated in measuring gastrointestinal symptoms and psychological well-being in patients with IBS. The aim of this study was to additional evaluate the items of VAS-IBS, and to examine correlations in the items measuring psychological well-being and intestinal symptoms´ influence on daily life to attachment in close relationships, self-esteem and coping. Methods: Eighty-one patients with IBS completed VAS-IBS with five VAS items for each gastrointestinal symptom, one item for the psychological well-being, and one item for the intestinal symptoms´ influence on daily life. They also completed the questionnaires Experiences in Close Relationships, the Rosenberg Self-Esteem Scale, and the Sense of Coherence. Correlations between the questionnaires and differences between subgroups were examined. Results: The rating of the item psychological well-being as poor well-being, correlated to a high degree of anxiety in close relationships (rs = -0.293, p = 0.008), low self-esteem (rs = 0.487, p = 0.000), and reduced coping (rs = 0.579, p = 0.000). Psychological well-being correlated to the intestinal symptoms´ influence on the patients´ daily life (rs = 0.515, p = 0.000). Conclusions. By this easy-to-use and brief VAS-IBS questionnaire, the health care professionals get a lot of information not only about physical symptoms, but also about the patient´s psychological well-being.

  • 726. Zarrouk, Moncef
    et al.
    Holst, Jan
    Malina, Martin
    Lindblad, Bengt
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rosvall, Maria
    Gottsäter, Anders
    The importance of socioeconomic factors for compliance and outcome at screening for abdominal aortic aneurysm in 65-year-old men2013In: Journal of Vascular Surgery, ISSN 0741-5214, E-ISSN 1097-6809, Vol. 58, no 1, p. 50-55Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate compliance with screening and prevalence of abdominal aortic aneurysm (AAA) in relation to background data regarding area-based socioeconomic status. Methods Our department annually invites 4300 65-year-old men from the city of Malmö and 15 neighboring municipalities to ultrasound AAA screening. In a cross-sectional cohort study, compliance and AAA prevalence among 8269 men were related to background socioeconomic data such as mean income, proportion of immigrants, percentage of subjects on welfare, smoking habits, and unemployment rate in the different municipalities. The 10 different administrative areas in Malmö were evaluated separately. Results Compliance with screening in the entire area was 6630/8269 (80.2%) but varied between 64.4% and 89.3% in different municipalities (P < .001). In univariate analysis, compliance increased with increasing mean income (r = 0.873; P < .001) but decreased with increasing proportion of immigrants (r = −0.685; P =.005) and subjects on welfare (r = −0.698; P = .004). Compliance in 10 different administrative parts of Malmö (P = .002) also increased with increasing mean income (r = 0.948; P < .001), and decreased with increasing proportion of immigrants (r = −0.650; P = .042) and increasing unemployment rate (r = −0.796; P = .006). Altogether, 117 (1.8%) AAAs were found, the prevalence differing between both different municipalities (P =.003) and the 10 different administrative parts of Malmö (P =.02). The prevalence of AAA in the 10 administrative parts of Malmö increased with increasing percentage of smokers (r = 0.784; P = .007), percentage of immigrants (r = 0.644; P = .044), and unemployment rate (r = 0.783; P =.007) but decreased with increasing mean income (r = −0.754; P = .012). Conclusions Compliance with ultrasound screening for AAA differed between different geographical areas. In areas with low socioeconomic status, compliance rates were lower, whereas AAA prevalence was higher. The identification of contextual factors associated with low compliance is important to be able to allow targeted actions to increase efficacy of ultrasound screening for AAA. Targeted actions to increase compliance in those areas are being scientifically investigated and implemented.

  • 727.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Persson, Jesper
    Sjölund, Kristina
    Ohlsson, Bodil
    Further validation of the visual analogue scale for irritable bowel syndrome after use in clinical practice2013In: Gastroenterology Nursing, ISSN 1042-895X, E-ISSN 1538-9766, Vol. 36, no 3, p. 188-198Article in journal (Refereed)
    Abstract [en]

    The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), a self-rating questionnaire, was designed to measure symptoms and the effect of treatment in patients suffering from irritable bowel syndrome. The aim of this descriptive correlational study was to conduct further psychometric validation after the VAS-IBS had been used in clinical practice, translate it into English, and compare the results with controls. Forty-nine patients with irritable bowel syndrome (median age = 38 years old [range, 18-69 years]) were compared with 90 healthy persons (median age = 44 years old [range, 21-77 years]) who served as controls. The patients with irritable bowel syndrome completed 3 questionnaires: the VAS-IBS, the Gastrointestinal Symptom Rating Scale, and the Perception of Change of Symptoms. Controls completed only the VAS-IBS. Results showed that the VAS-IBS is a valid questionnaire that measures the degree of change of symptoms and discriminates between patients who have irritable bowel syndrome from those who do not. It is important to compare the VAS-IBS among different cultural populations so we suggest that the English version of the VAS-IBS should now be used in English-speaking countries and be further tested for validity and reliability with English-speaking patients.

  • 728. Brunt, David
    et al.
    Rask, Mikael
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Validation of the Verbal and Social Interaction questionnaire: carers' focus in the carer–resident relationship in supported housing facilities for persons with psychiatric disabilities (VSI-SH)2013In: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, no 3, p. 279-285Article in journal (Refereed)
    Abstract [en]

    A questionnaire to measure the verbal and social interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities has been developed. It is an adaptation of a questionnaire originally used in a forensic psychiatric setting. The aim of the present study was thus to investigate the construct validity and the reliability of this new version of the Verbal and Social Interactions questionnaire for use in supported housing facilities (VSI-SH). Two hundred and twenty-three carers from municipal and privately run housing facilities completed the questionnaire. A factor analysis was performed, which resulted in six factors. The number of items was reduced from the original 47 to 30 in order to minimize factorial complexity and multiple loadings. The reliability was tested with Cronbach's alpha and good internal consistency for the questionnaire and five of the six factors was found. The resulting six factors and the items were compared to the conceptual model and four of the six factors corresponded well with the categories in this original theoretical model. The questionnaire can be a useful contribution to the study of interactions between carers and residents in supported housing facilities for persons with psychiatric disabilities.

  • 729.
    Carlson, Elisabeth
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Time, trust and reflection: three aspects of precepting in clinical nursing education2013In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 13, no 4, p. 237-238Article in journal (Other academic)
  • 730. Bolejko, Anetta
    et al.
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Zackrisson, Sophia
    Brodersen, John
    Hagell, Peter
    Adaptation to Swedish and further development of the 'Consequences of Screening - Breast Cancer' questionnaire: a multimethod study2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 475-486Article in journal (Refereed)
    Abstract [en]

    Experiencing a false-positive screening mammography can cause considerable psychosocial distress. The Consequences of Screening - Breast Cancer questionnaire (COS-BC parts 1 and 2), recently developed in Denmark, is the only condition-specific questionnaire for measuring short- and long-term psychosocial consequences of false-positive mammographic screening. Additional studies are needed to further test the COS-BC before use across cultures. Furthermore, studies have suggested that the consequences of false-positive screening results are partly common across cancer screening settings, although this hypothesis remains largely untested. This study (i) assesses content validity of a Swedish version of the COS-BC, (ii) tests whether items expressing long-term consequences of false-positive lung cancer screening results are relevant in a breast cancer screening context and (iii) explores the usefulness of taking results from Rasch analyses of the source version as an aid in questionnaire translation and adaptation.Following dual-panel translation, content validity was assessed through qualitative interviews with representatives of the target population and the content validity index (CVI). Item locations and Rasch model fit of the source questionnaires were considered in the translation and assessment process.The COS-BC items were generally found relevant and provided coverage of the target construct. Content validity was supported also for nine of 10 lung cancer screening items. Scale CVI values were ≥0.81. Previous Rasch data were useful in facilitating translation and assessing item content validity. The resulting Swedish version of the COS-BC parts 1 and 2 consists of 34 and 23 items, respectively. This study illustrates the value of methodological triangulation and use of data from previous Rasch analyses in questionnaire translation and adaptation. We found support for the hypothesis that consequences of false-positive screening are common across cancer screening settings. Psychometric properties of the Swedish COS-BC remain to be established.

  • 731.
    Ekstrand, Maria
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Tydén, Tanja
    Darj, Elisabeth
    Larsson, Margareta
    Twelve-month follow-up of advance provision of emergency contraception among teenage girls in Sweden: a randomized controlled trial2013In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 118, no 4, p. 271-275Article in journal (Refereed)
    Abstract [en]

    Objective. The objective of this study was to evaluate the effect of an intervention with advance provision of emergency contraceptive pills (ECP), condoms, and extended information to a targeted group of teenage girls, compared with a control group, 12 months after intervention. Material and methods. A randomized controlled trial among 420 girls, 15–19 years old, requesting emergency contraception at a youth clinic in Sweden was carried out. Data were collected by a questionnaire at the initial visit and structured telephone interviews 12 months after enrolment. Differences between the intervention group and the control group regarding ECP use, time interval from unprotected intercourse to ECP intake, contraceptive use, and sexual risk-taking were analysed. Results. One year after the intervention 62% of the girls could be reached for follow-up. The girls in the intervention group reported a shorter time interval (mean 15.3 hours) from unprotected intercourse to ECP intake compared to the control group (mean 25.8 hours) (p = 0.019), without any evidence of decreased use of contraceptives or increased sexual risk-taking. Conclusion. Even up to 12 months following the intervention, advance provision of ECP at one single occasion, to a specific target group of adolescent girls, shortens the time interval from unprotected intercourse to pill intake, without jeopardizing contraceptive use or increasing sexual risk-taking. Considering the clinical relevance of these results, we suggest that advance provision of ECP could be implemented as a routine preventive measure for this target group.

  • 732. Hammar, Oskar
    et al.
    Roth, Bodil
    Bengtsson, Mariette
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Mandl, Thomas
    Ohlsson, Bodil
    Autoantibodies and gastrointestinal symptoms in infertile women in relation to in vitro fertilization2013In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 13, article id 201Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Prior reports suggest a link between gonadotropin-releasing hormone (GnRH) and gastrointestinal function. The aim of the study was to prospectively investigate women subjected to in vitro fertilization (IVF) using the GnRH analog buserelin, taking into account gastrointestinal symptoms and antibody development against buserelin, GnRH, luteinizing hormone (LH), and their receptors. METHODS: Gastrointestinal symptoms were registered by the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) before and after IVF treatment, and five years later. Health-related quality of life was evaluated by the 36-item Short-Form questionnaire (SF-36). ELISA was used for antibody analyses before and after treatment. Data were compared with women from the general population. RESULTS: In total, 124 patients were investigated before and after IVF, and 62 were re-evaluated after five years. Buserelin treatment led to significant impairment of constipation (p = 0.004), nausea and vomiting (p = 0.035), psychological well-being (p = 0.000), and the intestinal symptoms' influence on daily life (p = 0.027). At 5-year follow-up, abdominal pain was worsened (p = 0.041), but psychological well-being was improved (p = 0.036), compared to prior treatment, and 15% had an observable deterioration in gastrointestinal symptoms. None developed severe dysmotility. Patients had higher prevalence of IgG antibodies against LH (p = 0.001) and its receptor (p = 0.016), and IgM antibodies against the GnRH receptor (p = 0.001) prior treatment compared with controls, but no antibody development was observed after IVF. CONCLUSION: Patients experience gastrointestinal symptoms during buserelin treatment, and abdominal pain is still increased after five years, but buserelin does not increase antibody formation against GnRH, LH or their receptors.

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  • 733.
    Kisch, Annika
    et al.
    Malmö högskola, Faculty of Health and Society (HS). 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 8, p. 1133-1137Article in journal (Refereed)
    Abstract [en]

    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 the 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. To evaluate the IC model a questionnaire survey in 2010 gathered 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 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. Thus improved, the IC model could provide the groundwork for other SCT units seeking to implement the recommendations and guidelines.

  • 734.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Stenberg, Marie
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Utvärdering av studentaktivt lärande i verksamhetsförlagd utbildning: peer learning och patientfokuserad handledning2013In: Högre Utbildning, E-ISSN 2000-7558, Vol. 3, no 1, p. 53-56Article in journal (Other academic)
    Abstract [sv]

    Vården står idag inför en rad utmaningar inte minst ekonomiskt och en allt större del av befolkningen är 80 år eller äldre. Behovet av hälso- och sjukvårdspersonal kommer därmed att vara fortsatt högt och samverkan mellan olika professioner och organisationer behöver stärkas. Det betyder att det är nödvändigt att implementera pedagogiska modeller som främjar samarbete och personcentrerad vård redan tidigt i utbildningarna. I sjuksköterskeprogrammet vid Malmö Högskola är flera modeller för studentaktivt lärande implementerade i den verksamhetsförlagda utbildningen (VFU). Den första modellen, peer learning, är en handledningsmodell som bygger på strategier där studenterna lär från och av varandra. Den andra modellen är patientfokuserad handledning vilken ger studenten möjlighet att följa patienters väg genom vården. Syftet med de pedagogiska modellerna är att studenterna ska kunna skapa djupare vårdrelationer och förberedas inför den kommande yrkesrollen genom att träna reflektion, kritiskt tänkande och samarbete. Vi planerar just nu ett större forskningsprojekt för att mer genomgripande utvärdera såväl peer learning som patientfokuserad handledning där även patienters upplevelse av att vårdas i en studentaktiv modell ska inkluderas.

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  • 735.
    Andersson, Ann-Christine
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Elg, Mattias
    Perseius, Kent-Inge
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Evaluating a questionnaire to measure improvement initiatives in Swedish healthcare2013In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 13, no 48Article in journal (Refereed)
    Abstract [en]

    Background: Quality improvement initiatives have expanded recently within the healthcare sector. Studies have shown that less than 40% of these initiatives are successful, indicating the need for an instrument that can measure the progress and results of quality improvement initiatives and answer questions about how quality initiatives are conducted. The aim of the present study was to develop and test an instrument to measure improvement process and outcome in Swedish healthcare. Methods: A questionnaire, founded on the Minnesota Innovation Survey (MIS), was developed in several steps. Items were merged and answer alternatives were revised. Employees participating in a county council improvement program received the web-based questionnaire. Data was analysed by descriptive statistics and correlation analysis. The questionnaire psychometric properties were investigated and an exploratory factor analysis was conducted. Results: The Swedish Improvement Measurement Questionnaire consists of 27 items. The Improvement Effectiveness Outcome dimension consists of three items and has a Cronbach’s alpha coefficient of 0.67. The Internal Improvement Processes dimension consists of eight sub-dimensions with a total of 24 items. Cronbach’s alpha coefficient for the complete dimension was 0.72. Three significant item correlations were found. A large involvement in the improvement initiative was shown and the majority of the respondents were satisfied with their work. Conclusions: The psychometric property tests suggest initial support for the questionnaire to study and evaluate quality improvement initiatives in Swedish healthcare settings. The overall satisfaction with the quality improvement initiative correlates positively to the awareness of individual responsibilities.

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  • 736.
    Andersson, Ann-Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Managers' views and experiences of a large-scale county council improvement program: limitations and opportunities2013In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 22, no 2, p. 152-160Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and evaluate managers’ views of a large-scale improvement program, including their experiences and opinions about improvement initiatives and drivers for change. The study is based on a survey used in 2 nationwide mappings of improvement initiatives and developmental trends in Swedish health care. The participants were all managers in a county council in Sweden. Data were analyzed descriptively, and statements were ranked in order of preferences. A majority of the respondents stated that they had worked with improvements since the county council improvement program started. The managers sometimes found it difficult to find data and measurements that supported the improvements, yet a majority considered that it was worth the effort and that the improvement work yielded results. The top-ranked driving forces were ideas from personnel and problems in the daily work. Staff satisfaction was ranked highest of the improvement potentials, but issues about patients’ experiences of their care and patient safety came second and third. The managers stated that no or only a few patients had been involved in their improvement initiatives. Large-scale county council improvement initiatives can illuminate quality problems and lead to increased interest in improvement initiatives in the health care sector.

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  • 737.
    Annersten Gershater, Magdalena
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Forbes, Angus
    Sharing innovations to maximise patient benefit2012In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 9, no 3, p. 69-69Article in journal (Other (popular science, discussion, etc.))
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  • 738.
    Wennick, Anne
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Huus, Karina
    What it is like being a sibling of a child newly diagnosed with type 1 diabetes: an interview study2012In: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 9, no 3, p. 88-92Article in journal (Refereed)
    Abstract [en]

    Although previous studies have stressed that having a brother or sister with a chronic condition may affect the healthy sibling, few have specifically focused on healthy siblings of children with type 1 diabetes. Hence, this study aimed to illuminate what it is like to be a brother or sister of a child newly diagnosed with type 1 diabetes. Individual interviews were conducted with seven siblings aged 10–17 years(median=12)from six different families. Each interview was analysed using content analysis. Three different categories emerged – Living differently, Being concerned and Participating in caring for the affected child – indicating that, for the healthy sibling, the illness entails a transformed everyday life including worry about the affected child and the need to help in the home. In conclusion, the paediatric health care service may need to develop new strategies to meet the siblings’ desired level of knowledge in educational team sessions related to diabetes. As the sibling relationship is probably the longest one that an affected child will experience in her/his lifetime, it is worth investing in it to promote this long-term support resource. Eur Diabetes Nursing 2012; 9(3): 88–92

  • 739.
    Örmon, Karin
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sunnqvist, Charlotta
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bahtsevani, Christel
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Torstensson Levander, Marie
    Malmö högskola, Faculty of Health and Society (HS), Department of Criminology (KR).
    The life-time experience of abuse and suicidal behavior among abused women in a general psychiatric context2012Conference paper (Other academic)
    Abstract [en]

    INTRODUCTION AND AIMS: Research concerning domestic violence and intimate partner violence reports life time prevalence of abuse and associations between suicidal behaviors among female psychiatric patients. The aim of the study was to describe abused women’s experiences of emotional, physical, sexual abuse and suicidal behavior experienced by women in general psychiatric care. METHODS: Women attending general psychiatric in-and outpatient care were asked to participate, using the NorVold abuse questionnaire, and seventy seven abused women contributed. RESULTS: Thoughts of suicide were significantly more common among women subjected to severe emotional abuse (n= 35, 71%), compared to women not subjected (n=14, 29%).Women suffering from mild emotional abuse register higher frequency of thoughts of suicide (n=39, 80%) compared to women with no experience (n=10, 20%). Suicide attempts were significantly higher among women experiencing severe emotional abuse (n=14, 82%) compared to women with no experience (n=3, 18%). Women who endured severe physical abuse made suicide attempt significantly more often (n=14, 74%) than women with no experience (n=5, 26%). Acts of self-deliberate harm were significantly higher among women experiencing mild emotional abuse (n=24, 86%) compared to the women with no experience (n=4, 14%). CONCLUSIONS: Results indicate that women with suicidal behavior could be victims of mild and severe emotional abuse and severe physical abuse. Even when suffering from the abuse, the women rarely confide to personnel.

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  • 740.
    Rämgård, Margareta
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Petersson, Pia
    Blomqvist, Kerstin
    Att vårda i blindo - en forskningsrapport om professioners samverkan i närsjukvården2012Report (Other academic)
    Abstract [sv]

    Projektet berör långsiktig vårdplanering i samverkan (VOPS) mellan olika professioner i vårdkedjan. Projektet är upplagt som ett utvecklingsarbete och ett forskningsprojekt. I projektet deltar de kommunala vårdteamen, primärvårdsläkare samt överläkare på sjukhuset i fokusgrupper där de presenterar olika case. Dessa har som uppgift att forma ett gemensamt VOPS-dokument som kan följa personen i primär- och sjukhusvård såväl som i det egna hemmet. Forskarna följer processen i grupperna och resultatet påvisar att en god vårdplanering i det egna hemmet förutsätter en vårdplanering i grupp där flera professioner deltar tillsammans med vårdtagare och närstående. Genom gruppens dialog och reflektion i en mer grupporienterad vårdplanering så överbryggas olika synsätt mellan professionerna vilket resulterar i en personcentrerad vård som tar hänsyn till vårdtagarens egna preferenser och önskningar.

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  • 741.
    Dychawy Rosner, Irena
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Shleev, Sergey
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Wennick, Anne
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bahtsevani, Christel
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Triad handledning: en handledningsmodell för introduktion av empiriska koncept i sjuksköterskeutbildningen2012Book (Other academic)
    Abstract [en]

    This study was aimed to create a practical supervision model, in which three levels of academic work are weaved together: undergraduate studies, PhD stidies and research programs. The research methods used in development of the supervision model include literature studies, seminars connected to the subject and abductive reasoning. This work resulted in development of a multipart model called TRIAD SUPERVISION. This TRIAD model of supervising is meant to be used at bachelor-level in nursing education where the supervision may become a didactically conducted process of learning. It is concluded that the TRIAD way of crating learning environment may be a smooth introduction to empiric concepts of students.

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  • 742. Näsström, Lena L
    et al.
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Strömberg, Anna
    Patients Descriptions of Participation in Structured Heart Failure Home Care2012In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 11, no suppl 1, p. S72-S72, article id P199Article in journal (Other academic)
    Abstract [en]

    Background: A growing number of patients with heart failure (HF) will need lifelong care and one option is to provide advanced HF care in the patient’s home. A Euro - pean integrated home care model has been developed and tested in the Netherlands and Sweden. The model pro - vides structured home care with the goal that patients will experience participation, safety and have knowledge about their disease and treatment. The aim of this study was to examine how HF patients, who receive a structured home care, describe participation in the care. Method: Swedish HF patients receiving structured home care at four different settings were included in the study. Strategic sampling was used to reach a variation regard - ing severity of HF, different needs of home-care, age and gender. A total of 19 open ended interviews have been con - ducted. The interviews were analyzed with qualitative con - tent analysis, where categories were developed inductively. Results: In the preliminary findings 5 categories with asso - ciated subcategories emerged on how patients with HF described participation in structured home care. To expe - rience room for communication including having room for dialogue and receiving care-related information was described as important for participation. To have accessi - bility to care through planned home visits or patient initi - ated visits facilitated participation. The patients described participation by engaging in self care and to collaborate with the home care team. To have trust in the home care team with confidence for competence and have continu - ity to meet individual needs was of importance. To have options to make decisions was expressed as a will to make decisions or to entrust decisions to the caregiver, but some - times patients opportunity to choose was restricted due to different aspects and impeded participation. Conclusion/significance of the study: The findings describe different aspects of participation among patients with HF who receive structured home care. Home visits facilitated communication between the patient and care - giver and enables participation. Getting information was an important condition for participation that often was met during home visits. Good accessibility to care increased feeling of participation as well as to meet caregivers of whom they trust. Own desire to make choices vary depend - ing on what choice it regards and also between different individuals. However, several patients expressed a complex situation with several health care contacts, where the opportunity for participation was limited.

  • 743. Allvin, Renée
    et al.
    Kling, Anna-Maria
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Svensson, Elisabeth
    Patient Reported Outcome Measures (PROMs) after total hip- and knee replacement surgery evaluated by the Postoperative Recovery Profile questionnaire (PRP): improving clinical quality and person-centeredness2012In: The International Journal of Person Centered Medicine, ISSN 2043-7730, E-ISSN 2043-7749, Vol. 2, no 3, p. 368-376Article in journal (Refereed)
    Abstract [en]

    Rationale and aims: The importance of evaluating postoperative recovery with consideration to the patient’s perspective has been emphasized. The aim of this study was to demonstrate how the recovery-specific Postoperative Recovery Profile (PRP) questionnaire can be used to evaluate patient-reported outcome measures (PROMs) after hip- and knee replacement in the enhancement of clinical quality and the person-centeredness of clinical services. Method: Patients undergoing primary total knee- and hip replacement were eligible for this longitudinal follow-up study. The participants completed the PRP questionnaire on repeated occasions. In this paper, data from Day 3 and Month 1 after discharge were used. The change in recovery, between the two measurement occasions, on item-, dimensional- and global levels, both for each patient and for the group, were evaluated. Results: A total number of 75 patients were included. One month after discharge the median PRP score was 13 (partly recovered) out of 19. Recovery changes towards lower levels of problems/difficulties were shown in both item-, dimensional- and global levels of recovery month 1 after discharge, as compared with Day 3. The group of patients was homogenous in change. Conclusions: We demonstrated that the PRP questionnaire can be used to evaluate postoperative recovery after hip- and knee replacement surgery on item-, dimensional- and global levels. Data from each recovery level can be useful for quality development and in informing increases in the person-centeredness of clinical services. The global population scores can be used to evaluate treatment effect on a group of patients. It can also be used to define endpoints in follow-up studies.

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  • 744. Bååth, Carina
    et al.
    Wilde-Larsson, Bodil
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hall-Lord, Marie-Louise
    Assessments of patients’ pain, nutrition and skin in clinical practice: Registered and enrolled nurses’ perceptions2012In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 16, no 1, p. 3-12Article in journal (Refereed)
    Abstract [en]

    Aim The aim of the study was to describe registered and enrolled nurses’ perceptions of how they assess patients’ pain, nutrition and skin. Introduction Planning for pain, nutrition and skin care management is an essential part of nursing. In Sweden, it is common that registered and enrolled nurses work together in the care of patients. Method Interviews with nine registered and nine enrolled nurses were analyzed using qualitative content analysis. Results One theme; blurring boundaries between registered and enrolled nurses regarding pain, nutrition and skin suit assessments was identified. The manifest content of interviews is described in four categories: nurse–patient interaction, using oneself as a tool, collaborating with colleagues and listening to patients’ next of kin. Conclusion The analysis showed a blurring of boundaries between RNs and ENs regarding pain, nutrition and skin suit assessments. How they perform their assessments conforms to a large extent. However, even if the activities are the same, the education levels of RNs and ENs are different and therefore the assessment of the patients might be different in clinical practice. Taking the results into account it is important that RNs and ENs collaborate regarding assessment of the patients’ pain, nutrition and skin suit.

  • 745. Nilsson, Ulrica
    et al.
    Svedberg, Petra
    Fridlund, Bengt
    Alm-Roijer, Carin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Thylén, Ingela
    SAMMI-study group,
    Sex knoxledge i males and females recovering from a myocardial infarction: a brief communication2012In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 21, no 4, p. 486-494Article in journal (Refereed)
    Abstract [en]

    The purpose of this article was to explore sexual knowledge in persons who had suffered from myocardial infarction (MI). Seventy-six Swedish persons completed the "Sex after MI Knowledge Test" questionnaire. Overall, 53% of the men and 45% of the women scored maximum in the test. In a comparison between sexes, the men scored significantly more often a correct answer compared to the women for two out of the 25 items. The levels of correct answers were less then 50% for 14 out of the 25 items in both sexes. In conclusion we found that people who had suffered MI had poor levels of knowledge about sex and that there were some differences concerning lesser knowledge among the females in comparison to males. In regard to application, using a validated instrument facilitates an interactive communication between the patient and health care professionals, and opens up for a tailored education in line with the patient's and his or her partner's needs.

  • 746.
    Sjöblom, Ingela
    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).
    Lindgren, Helena
    Changing attitudes – Women’s experiences of negative reactions to their decision for home birth: A population-based study2012In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, no 1, p. 55-56Article in journal (Refereed)
    Abstract [en]

    Being confronted with negative attitudes influences the self-concept of pregnant women. Few women in Sweden give birth at home, and Sweden does not have national home birth guidelines. This study describes women’s experiences concerning reactions to their decision to give birth at home. One in five women experienced negative attitudes to a high extent from health care staff during the study period (1992–2005). Fewer women reported this during the latter part of the period compared to the earlier part. The change in attitudes may be related to the introduction in 2002 of guidelines for planned home births in Stockholm County Council.

  • 747.
    Finnbogadóttir, Hafrún
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Dykes, Anna-Karin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Midwives' awareness and experiences regarding domestic violence among pregnant women in southern Sweden2012In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 2, p. 181-189Article in journal (Refereed)
    Abstract [en]

    Objective to explore midwives' awareness of and clinical experience regarding domestic violence among pregnant women in southern Sweden. Design an inductive qualitative design, using focus groups interviews. Setting midwives with experience of working in antenatal care (ANC) units connected to two university hospitals in southern Sweden. Participants 16 midwives recruited by network sampling and purposive sampling, divided into four focus groups of three to five individuals. Findings five categories emerged: ‘Knowledge about ‘the different faces’ of violence’, perpetrator and survivor behaviour, and violence-related consequences. ‘Identified and visible vulnerable groups’, ‘at risk’ groups for exposure to domestic violence during pregnancy, e.g. immigrants and substance users. ‘Barriers towards asking the right questions’, the midwife herself could be an obstacle, lack of knowledge among midwives as to how to handle disclosure of violence, fear of the perpetrator and presence of the partner at visits to the midwife. ‘Handling the delicate situation’, e.g. the potential conflict between the midwife's professional obligation to protect the pregnant woman and the unborn baby who is exposed to domestic violence and the survivor's wish to avoid interference. ‘The crucial role of the midwife’, insufficient or non-existent support for the midwife, lack of guidelines and/or written plans of action in situations when domestic violence is disclosed. The above five categories were subsumed under the overarching category ‘Failing both mother and the unborn baby’ which highlights the vulnerability of the unborn baby and the need to provide protection for the unborn baby by means of adequate care to the pregnant woman. Key conclusions and implication for practice avoidance of questions concerning the experience of violence during pregnancy may be regarded as a failing not only to the pregnant woman but also to the unprotected and unborn baby. Nevertheless, certain hindrances must be overcome before the implementation of routine enquiry concerning violence during pregnancy. It is important to develop guidelines and a plan of action for all health-care personnel at antenatal clinics as well as to provide continuous education and professional support for midwives in southern Sweden.

  • 748.
    Wangel, Anne-Marie
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Schei, Berit
    Ryding, Elsa Lena
    Östman, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Health and Welfare Studies (HV).
    Mental health status in pregnancy among native and non-native Swedish speaking women: a Bidens study2012In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, no 12, p. 1395-1401Article in journal (Refereed)
    Abstract [en]

    Objectives. To describe mental health status in native and non-native Swedish-speaking pregnant women and explore risk factors of depression and of posttraumatic stress symptoms. Design and setting. A cross-sectional questionnaire study was conducted at midwife-based antenatal clinics in Southern, Sweden. Sample. A non-selected group of women in mid-pregnancy participated. Methods. Participants completed a questionnaire including background characteristics, social support, life events, mental health variables and the short Edinburgh Depression Scale. Main outcome measures. Depressive symptoms during last week and posttraumatic stress symptoms during past year. Results. Out of 1003 women, 21.4% reported another language than Swedish as their mother tongue and were defined as non-native. These women were more likely to be younger, have fewer years of education, potential financial problems, and lack of social support. More non-native speakers self-reported depressive, posttraumatic stress, anxiety and, psychosomatic symptoms, and fewer had had consultations with a psychiatrist or psychologist. Of all women 13.8% had depressive symptoms defined by Edinburgh Depression Scale as 7 or above. Non-native status was associated with statistically increased risks of depressive symptoms and having ≥ 1 posttraumatic stress symptom compared to native speaking women. Multivariate modeling including all selected factors resulted in adjusted OR for depressive symptoms of 1.75 (95% CI: 1.11-2.76) and of 1.56 (95% CI: 1.10-2.34) for posttraumatic stress symptoms in non-native Swedish speakers. Conclusion. Non-native Swedish-speaking women had a more unfavorable mental health status than native speakers. In spite of this, non-native speaking women had sought less mental health care.

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  • 749.
    Sunnqvist, Charlotta
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Persson, Ulla
    Westrin, Åsa
    Träskman-Bendz, Lil
    Lenntorp, Bo
    Grasping the dynamics of suicidal behaviour: combining time-geographic life charting and COPE ratings2012In: Journal of Psychiatric Mental Health Nursing, Vol. 20, no 4, p. 336-344Article in journal (Refereed)
    Abstract [en]

    A primary aim of suicide research is to gain a profound knowledge of the suicidal individual so preventive strategy can be formulated. •  Time-geographic life charting used in combination with the pattern of coping strategies may be helpful when assessing risk of suicidal behaviour. •  It can also be a therapeutic intervention to look back and to reflect coping styles. ABSTRACT: The aim of this study is to explore whether a time-geographic life charting, combined with a survey of a person's coping capacities over time, elucidates the pathway to suicidal behaviour, and therefore could be useful in suicide prevention. Twenty-three patients were recruited shortly after a suicide attempt. A time-geographic life charting and COPE inventory ratings were used separately and in combination. According to COPE ratings, the participants could be divided into three groups using different coping strategies: (1) adaptive, (2) maladaptive, and (3) both adaptive and maladaptive coping. Within these subgroups, three different pathways to suicidal behaviour were described and illustrated. We conclude that time-geographic life charting used in combination with the pattern of coping strategies may be helpful when assessing risk of suicidal behaviour, because this approach strengthens the comprehensive picture of the patient's life situation.

  • 750.
    Isma, Gabriella E
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Health and Welfare Studies (HV).
    Bramhagen, Ann-Cathrine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ahlström, Gerd
    Östman, Margareta
    Malmö högskola, Faculty of Health and Society (HS), Department of Health and Welfare Studies (HV).
    Dykes, Anna-Karin
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Swedish Child Health Care nurses conceptions of overweight in children: a qualitative study2012In: BMC Family Practice, E-ISSN 1471-2296, Vol. 13, no 57Article in journal (Refereed)
    Abstract [en]

    Abstract Background: Registered Sick Children’s Nurses and District Nurses employed at Child Health Care centres are in a position to help prevent childhood overweight and obesity. Prevention of this challenging public health threat could be improved through having a better understanding of how this group of nurses perceives childhood obesity. The aim of this study was to elucidate the conceptions of childhood overweight, including obesity, among nurses working in Child Health Care. Method: A qualitative study using a phenomenographic approach, based on open-ended interviews with 18 Child Health Care nurses (CHC-nurses) strategically selected from 17 Child Health Care Centres in the southern part of Sweden. Results: Four categories of description emerged from the data: Perception of childhood overweight changes, Overweight in younger children a neglected concern, Overweight a delicate issue and Importance of family lifestyle. The participating CHC-nurses conceived overweight in children, primarily obesity in children to be an extensive and serious problem which affects children, families and the surrounding society. Overweight in children was further perceived as a consequence of their parent’s lifestyle and their awareness of the problem, which was considered by the CHC-nurses as a sensitive and a provoking issue. It was also perceived that overweight in children is not taken seriously during the pre-school period and that concerns regarding overweight in younger children were mainly about the appearance and not the health of the child. The CHC-nurses perceived that the proportion of overweight children has increased, which Swedish society and the CHC-nurses have adapted to. This adaptation makes it difficult for CHC-nurses to define those children who are overweight. Conclusion: CHC-nurses provide a comprehensive and complex picture of childhood overweight, which includes several difficulties dealing with this issue. Attention to CHC-nurse’s conceptions of overweight in children is important since it can affect the parent-nurse relationship and thereby the nurse’s, as well as the parent’s efforts to influence the children’s weight. It is suggested that CHC- nurses should work with person centered counseling and empowerment concerning parent to child relations in cases involving overweight. Keywords: Child, Conceptions, Nurses, Overweight, Perceptions, Primary health care, Qualitative research

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