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  • 1. Acosta, Stefan
    et al.
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Forsberg, Anna
    Nilsson, Johan
    Ingemansson, Richard
    Gottsäter, Anders
    Engaging patients and caregivers in establishing research priorities for aortic dissection2019In: SAGE Open Medicine, E-ISSN 2050-3121, Vol. 7, p. 1-7Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to establish the top 10 research uncertainties in aortic dissection together with the patient organization Aortic Dissection Association Scandinavia using the James Lind Alliance concept. Methods: A pilot survey aiming to identify uncertainties sent to 12 patients was found to have high content validity (scale content validity index = 0.91). An online version of the survey was thereafter sent to 30 patients in Aortic Dissection Association Scandinavia and 45 caregivers in the field of aortic dissection. Research uncertainties of aortic dissection were gathered, collated and processed. Results: Together with research priorities retrieved from five different current guidelines, 94 uncertainties were expressed. A shortlist of 24 uncertainties remained after processing for the final workshop. After the priority-setting process, using facilitated group format technique, the ranked final top 10 research uncertainties included diagnostic tests for aortic dissection; patient information and care continuity; quality of life; endovascular and medical treatment; surgical complications; rehabilitation; psychological consequences; self-care; and how to improve prognosis. Conclusion: These ranked top 10 important research priorities may be used to justify specific research in aortic dissection and to inform healthcare research funding decisions.

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  • 2.
    Axelsson, Malin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bahtsevani, Christel
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Neziraj, Merita
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Persson, Karin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    A registry study of oral health problems and preventive interventions among older persons receiving municipal healthcare - PROSENIOR2023In: Nursing Open, E-ISSN 2054-1058, Vol. 10, no 2, p. 525-534Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to identify planned and completed preventive interventions among older persons with oral health problems receiving municipal health care. A further aim was to determine the correspondence between oral health problems and planned preventive interventions among older persons with oral health problems receiving municipal health care. Design: Cross-sectional register study. Methods: Oral health data from the Swedish national quality registry, Senior Alert, were extracted for 4,024 older persons (>= 65 years) receiving municipal health care in a county in Southern Sweden. Data were statistically analysed. Results: A large majority of older persons (97.4%) with assessed oral health problems had at least one planned preventive intervention, and approximately three quarters of the planned interventions were completed. There seemed to be a mismatch between type of oral health problems and preventive interventions as not all older persons had a planned preventive intervention related to their specific oral health problem.

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  • 3.
    Axelsson, Malin
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Gudmundsson, Petri
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Skane Univ Hosp, Vasc Ctr, Dept Cardiothorac & Vasc Surg, Malmo, Sweden..
    Jakobsson, Jenny
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Translation and validation of the Swedish version of the IPECC-SET 9 item version2022In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 36, no 6, p. 900-907Article in journal (Refereed)
    Abstract [en]

    Interprofessional Education (IPE) is essential to prepare future health-care professionals for collaborative practice, but IPE requires evaluation. One psychometrically sound instrument is the Interprofessional Education Collaborative Competence Self-Efficacy Tool consisting of nine items (IPECC-SET 9). This tool does not, to date, exist in a Swedish version. Therefore, the aim of this study was to translate and validate the Swedish version of the IPECC-SET 9. The English version was translated into Swedish and tested among 159 students in the 3-year Bachelor Programs in Nursing and in Biomedical Laboratory Science. The psychometric analysis was guided by a Rasch model, which showed that the items functioned well together, confirming unidimensionality, and that the person misfit was also lower than the set criterion. The separation index was 2.98, and the Rasch-equivalent Cronbach-alpha measure was estimated to .92, supporting internal consistency. No systematic differences on item level in IPECC-SET 9 further supported fairness in testing. The Swedish IPECC-SET 9 demonstrates sound psychometric properties and has the potential to be used as a measure of self-efficacy for competence in interprofessional collaborative practice among health profession students. However, the IPECC-SET 9 is recommended to be further tested in larger samples representing the entirety of health-care teams.

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  • 4.
    Backlund, Anja
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Holmbeck, Olga
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Cardio-Thoracic and Vascular Surgery, Skane University hospital, Malmö, Sweden.
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    A registry study of nursing assessments, interventions and evaluations according to nutrition for persons living in municipal residential care homes2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 3, p. 341-350Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to explore planned nursing interventions and evaluations of such interventions, in older people at risk for malnutrition living in municipal residential care homes. Designs: A registry study. Methods: The study was conducted using data from the Swedish national quality registry Senior Alert. Data on all persons assessed and registered in Senior Alert living in municipal residential care homes in a mid‐sized town between January and December 2014 were subjected to statistical analysis. Results: In total, 677 nutritional risk assessments were performed among the participants (N = 587), who were between 65‐109 years. A larger proportion of women were estimated as being at risk for malnutrition compared with men. The three most common prescribed nursing interventions were nutritional treatment, dietary support and weight control; however, interventions were not prescribed for all participants at risk for malnutrition. Lesser than 50% of the interventions were evaluated, with dietary support, pharmaceutical review and weight control the three most likely to be evaluated. Further, planned interventions for participants at risk of malnutrition were implemented more often for men than for women.

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  • 5.
    Bengtsson, Mariette
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    Införande av portfoliometodik för professionell utveckling mot yrkesrollen som sjuksköterska2011Report (Other academic)
    Abstract [sv]

    Författarna Mariette Bengtsson och Christine Wann-Hansson fick år 2007 i uppdrag av dåvarande enhetschef Marianne Ahlner-Elmqvist Omvårdnad, Hälsa och samhälle, Malmö högskola och chefssjuksköterska Else-Maj Rosenlöf Universitetssjukhuset MAS, Malmö att undersöka möjligheterna att införa portfoliometodik i sjuksköterskeutbildningen på Malmö högskola och skapa en modell för detta. Syftet var att säkra progressionen och kvalitén i utbildningen och då framförallt i den verksamhetsförlagda utbildningen (VFU). Även om styrdokument och andra verktyg fanns behövde studentens kunskapsutveckling under den 3-åriga utbildningen ytterliggare synliggöras och konkretiseras. Arbetet med att skapa en portfolio anpassad för sjuksköterskeprogrammet på Malmö högskola har gjorts i fyra faser utifrån Sand-ströms och Ekholms (1984) utvecklingsmodell; Förberedande fas, Accepterande fas, Tillämpad fas och Spridningsfas. De tre första faserna genomfördes 2007-2009 (Bengtsson & Wann-Hansson, 2008) och den fjärde fasen genomfördes 2010. Implementeringen under 2010 fokuserades på hur VFU i termin 2 och 6 kunde kopplas till portfoliometodiken. Rapporten beskriver arbetsprocessen och de aktiviteter i VFU som kopplats till portfolion. Projektet i sin helhet kommer att utvärderas efter höstterminen 2012 och under hela processen följas upp kontinuerligt och ytterligare utvecklas.

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  • 6.
    Bengtsson, Mariette
    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).
    Portfolio - ett verktyg för lärandeprocessen under erksamhetsförlagd utbildning i sjuksköterskeprogrammet?2010Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Under den verksamhetsförlagda utbildningen (VFU) i sjuksköterskeprogrammet används ofta reflektion som ett sätt att träna studenten i att vara en reflekterande praktiker dvs. en sjuksköterska som kan binda samman teori och praktik. Det är dock inte en självklarhet att kunna reflektera utan det är snarare en förmåga som måste utvecklas. Dessutom varierar såväl omfattning som vilka modeller som används för reflektion och oftast sker ingen form av dokumentation av de reflektioner som gjorts. En portfolio är egentligen en samling av alster men kan också fungera som ett redskap för att förtydliga progression i lärandeprocessen och löpa som en ”röd tråd” genom utbildningen. Att använda sig av portfoliometodiken skulle kunna vara ett sätt att följa studenternas lärandeprocess och ge möjlighet till att arbeta mer strukturerat med skriftlig reflektion. Syfte: Denna studie avser att utifrån studenters, handledares och lärares perspektiv beskriva hur reflektion används i lärandeprocessen under VFU i sjuksköterskeprogrammet samt deras inställning till att arbeta med reflektion kopplat till portfolios. Metod: Studien har en kvalitativ design där 5 fokusgruppsintervjuer har genomförts med studenter (7 st), handledare (2 st), kliniska lärare (3) och universitetsadjunkter (3). Intervjuerna har transkriberats ordagrant och kommer att analyseras med hjälp av innehållsanalys Resultat: Den första preliminära analysen visar på betydelsen av reflektion för både studenter, handledare och lärare. Det framkom också att det finns olika former av reflektion såsom (1) här och nu, (2) avslutande, sammanfattande, eller (3) en speciell reflektionsstund ex då ett speciellt tema tas upp. Det fanns till övervägande del en positiv inställning till portfoliometodiken som sågs som ett tänkbart pedagogiskt verktyg för reflektion i VFU. Portfolion ansågs också möjliggöra en visualisering av lärandeprocessen för alla parter. Det fanns dock även en del farhågor i grupperna såsom att arbetet med portfolion inte fick bli en belastning och att det var bra om portfolion utgick från de befintliga dokument som används idag. Likaså upplevdes det som viktigt att reflektionerna som var kopplade till portfolion gavs en tyngd, kändes betydelsefulla och efterfrågades av handledare och lärare. Det fanns annars en risk att ingen skulle bry sig om att använda den och skriva i den och det hela skulle rinna ut i sanden. Sammanfattningsvis gav dock alla grupper uttryck för att användande av reflektion kopplat till portfolio kändes mer modernt och att det kändes angeläget att något sådant infördes i VFU:n.

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  • 7.
    Bengtsson, Mariette
    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).
    Portfolio för professionell utveckling mot yrkesrollen;2010Conference paper (Other academic)
    Abstract [sv]

    En portfolio är inte bara en samling alster utan är också en lär-, kommunikationsoch utvärderingsstrategi för att spegla studentens utveckling under utbildningstiden för att säkerställa att lärandemålen uppfylls. Portfoliouppgifter baserade på kursplanens lärandemål skall underlätta för studenten att nå målen med aktuell kurs och utbildning (Biggs & Tang, 1998; Ellmin & Ellmin, 2003). Intentionen med portfoliometodiken är att skapa ett helhetsperspektiv över studentens utveckling och ska vara ett hjälpmedel för både läraren och studenten att på ett strukturerat sätt dokumentera, kommunicera och skapa forum som främjar ett optimalt lärande. Studenten skall se sin utveckling och lärandeprocess under hela utbildningen och inte bara i en enstaka kurs. När utbildningen är klar har studenten en portfolio som visar på den egna utvecklingen och kompetensen som färdig sjuksköterska. Portfoliometodiken ska stimulera till ökat ansvarstagande och genom att formulera egna mål kan studenten öka medvetenheten hos sig själv och belysa de områden som behöver utvecklas (Gannon et al, 2001). Studenter har under sin utbildning behov av olika former av stöd och portfoliometodiken kan möjliggöra att studenten får det stöd som behövs genom att studenten belyser sina speciella behov. I utvecklings- och bedömningssamtalen vars summativa och reflekterande dokumentation kan ingå i portfolion, skall studenten vara en aktiv samtalspartner och genom att leda samtalet får studenten också ett större ansvar för sitt eget lärande (Ellmin & Ellmin, 2003; Van Tartwijk & Driessen, 2009). Portfoliometodiken stimulerar också till reflektion då studenten tittar tillbaka på och analyserar sina tidigare genomförda uppgifter och upplevelser från såväl teoretiska som praktiska moment (Van Tartwijk & Driessen, 2009). På sjuksköterskeutbildningen på Malmö högskolan finns metodiken till viss del implementerad sedan vårterminen 2010. Implementeringen fokuserades initialt på hur portfoliometodiken ska användas i den verksamhetsförlagda utbildningen (VFU) men finns nu även i andra kurser. Denna process har varit komplicerad men utmanande då flera hundra handledare men också många lärare varje termin blir involverade i denna pedagogik (FoU-rapport 2, 2011, http://hdl.handle.net/2043/11938).

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  • 8.
    Bengtsson, Mariette
    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).
    Gebru, Kerstin
    Falk, Solvig
    Dejin-Karlsson, Elisabeth
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjöblom, Ingela
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Utveckling och samstämmighet avseende bedömningskriterier i de vetenskapliga metodkurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola2008Conference paper (Other academic)
    Abstract [sv]

    BAKGRUND Idag sker den vetenskapliga metodskolningen i huvudämnet omvårdnad i kurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola. Studenter har visat i utvärderingar att det inte fanns någon kontinuitet och progression mellan de vetenskapliga metodkurserna på sjuksköterskeprogrammet, vilket också uppmärksammats av undervisarna. Enligt förvaltningslagen är det en myndighetsutövning gentemot en enskild person när en examinator sätter ett betyg. Därför måste betygssättning hanteras rättsäkert och konsekvent vilket kräver väl förankrade betygskriterier (Ekecrantz, 2007). För att säkra kvalitet och kontinuitet mellan kurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola och för att EU-anpassa betygsgraderingen enligt ECTS-skalan (ECTS USERS`GUIDE) behövdes nya bedömningskriterier baserade på nya lärandemål enligt Bologna processen utarbetas. För att successivt öka kunskapsstegringen mellan de vetenskapliga metodkurserna har i ett tidigare projekt nya lärandemål enligt Bologna modellen för respektive kurs utarbetats. SYFTE Syftet med projektet är att identifiera och formulera bedömningskriterier baserade på en successiv kunskapsstegring inom forskningsområdet omvårdnad både avseende metod och ett kritiskt förhållningssätt. GENOMFÖRANDE Arbetet påbörjades i augusti 2007 och projektgruppen består av sex undervisande och examinerande lärare i de berörda kurserna. Litteratur i ämnet studerades och gruppen samlade in information om hur andra universitet och högskolor tillämpat ECTS-skalan. Arbetsgrupper för respektive kurs bildades som utarbetade förslag för bedömningskriterier A till F för respektive kurs. Därefter strålade arbetsgrupperna samman för att gemensamt fastställa samstämmighet samt progression mellan kurserna. Gruppen har också diskuterat examinationsformer, undervisningsmetoder, litteratur och begreppsdefinitioner relaterade till betygskriterier. Arbetet har också lett till att lärandemålen för respektive kurs har fått korrigeras och anpassat för att kunna vara utvärderingsbara. För att få studenternas synpunkter kommer de utarbetade förslagen att presenteras för studenter i respektive kurs för att få deras syn på bedömningskriterierna. Studenter i kurs 4 och 8/9 kommer under läsåret 08/09 att få vara delaktiga i utvecklingsprocessen av bedömningskriterierna. Implementering av resultatet kan tidigast ske VT09 och kommer därefter att utvärderas. Betygskriterierna kan ses i bilaga 1-5. DISKUSSION Dessa kriterier skall vara ett stöd för betygsättning av examensarbete såväl som seminarier och enskilda uppgifter dock utan att minska examinatorns ansvar för bedömningen. Bedömningskriterierna bör också ge utrymme för examinatorns egen bedömning (Boij m.fl., 2007). Betygskriterierna skall fungera som ett stöd för examinatorn så väl som för studenten, som kan inspireras att sträva efter ett högre betyg. Eftersom ECTS-graderingen är målrelaterad så finns det inget krav på att en viss del av studenterna skall få ett visst betyg. Det är dock viktigt att kraven för E skall vara likvärdiga med betyget GODKÄND. Det finns både fördelar och nackdelar med betyg i många grader. Enligt Ekecrantz (2007) ger det större precision och rättvisa samt en bättre feedback till studenterna på deras prestationer. Ekecrantz menar dock att många grader kan leda till ökad stress för studenten och ge en ökad arbetsbelastning för läraren samt att examinationsformerna kan försämras. Arbetsgruppen håller inte riktigt med om detta. Visserligen kan examinationsformerna behöva förändras men det behöver nödvändigtvis inte leda till en försämring. En intressant aspekt som Boij m.fl. (2007) tar upp i sin rapport från Kungliga Tekniska Högskolan är att bedömning av t.ex. examensarbete kan göras utifrån flera perspektiv såsom process, vetenskapligt innehåll och prestation för att examinatorn skall kunna skaffa ett bra underlag för att sätta betyg. Studentinflytande är viktigt och det är en utmaning att få studenterna delaktiga i processen, vilket inte har varit så lätt inom alla verksamheter (Åkesson 2006).

  • 9.
    Berlin Hallrup, Leena
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Service managers' experiences of how the participation of people with intellectual disabilities can be promoted in Swedish group homes2019In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 32, no 2, p. 427-434Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People with intellectual disabilities in staffed group homes often need lifelong support and dependency on others. Thereby, special demands are placed on staff and service managers to ensure opportunities for participation in everyday life. This study aims to explore how service managers promote participation in Swedish group homes for adults with intellectual disabilities. METHOD: A qualitative research design involving individual interviews with 14 service managers was used to gain an understanding of how the participation of adults with intellectual disabilities can be promoted in Swedish group homes. RESULTS: The results comprise two main themes; Creating preconditions for participation and Barriers for promotion of participation. CONCLUSIONS: Service managers experienced that promoting service user participation in group homes was an important part of their responsibility. The findings indicate that structural strategies such as coaching, supervision and reflection are important and should be further developed.

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

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

  • 11. Bolejko, Anetta
    et al.
    Hagell, Peter
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Zackrisson, Sophia
    Prevalence, Long-term Development, and Predictors of Psychosocial Consequences of False-Positive Mammography among Women Attending Population-Based Screening2015In: Cancer Epidemiology, Biomarkers and Prevention, ISSN 1055-9965, E-ISSN 1538-7755, Vol. 24, no 9, p. 1388-1397Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cancer screening aims to detect cancer at an asymptomatic stage, although side effects from screening also occur. We investigated the prevalence, longitudinal development, and predictors of psychosocial consequences of false-positive breast cancer screening. METHODS: Three hundred ninety-nine women with false-positive screening mammography responded to the Consequences of Screening-Breast Cancer (COS-BC) questionnaire immediately after a negative diagnosis (free from breast cancer) following recall examination(s) (baseline), and 6 and 12 months later. Age-matched controls (n = 499) with a negative mammogram responded to the COS-BC at the same occasions. Five COS-BC scales (Sense of dejection, Anxiety, Behavioral, Sleep, and Existential values) were used as outcome measures. RESULTS: Women with false-positive mammography had consistently higher prevalence of all five consequences compared with controls (P < 0.001). The prevalences decreased between baseline and 6 months (P < 0.001) but were stable between 6 and 12 months (P ≥ 0.136). Early recall profoundly predicted long-term consequences for all five outcomes (OR, 3.05-10.31), along with dissatisfaction with information at recall (OR, 2.28-2.56), being foreign-born (OR, 2.35-3.71), and lack of social support (OR, 1.13-1.25). CONCLUSION: This 1-year longitudinal study shows that women experience psychosocial consequences of false-positive screening mammography. Early recall should be performed cautiously, and provision of information as well as social support may reduce psychosocial consequences. IMPACT: Although delivery of population-based screening reduces breast cancer mortality, it also raises the issue of its impact on the psychosocial well-being of healthy women. Our findings identify predictors that can be targeted in future efforts to reduce the side effects of mammographic screening.

  • 12. 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.

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

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

  • 14.
    Bratt, Annika
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Allvin, Renee
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Modifying a generic postoperative recovery profile instrument to an instrument specifically targeting coronary artery bypass grafting2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 3, p. 475-486Article in journal (Refereed)
    Abstract [en]

    Patients may suffer from a wide range of postoperative symptoms after coronary artery bypass grafting. In-depth knowledge of the recovery process is a prerequisite for nursing interventions. However, we found no specific instrument covering the entire range and duration of postoperative symptoms related to this procedure. We therefore modified and extended the 19 items, generic Postoperative Recovery Profile questionnaire for the specific evaluation of the recovery after coronary artery bypass grafting. We here report on the development process of the new questionnaire. Procedure-specific symptoms were identified by a literature review and by experts. The content validity was assessed by healthcare professionals (n = 15), inpatients (n = 12) and outpatients (n = 4). A test run was done with inpatients (n = 10), which was followed by a test-retest reliability evaluation with inpatients (n = 24). We identified 15 new symptoms in the literature review and six in the content validity assessment. Only three of the 35 items had an acceptable content validity index, but all 35 items in the test run were reported by at least two patients. The questionnaire took 4-9 minutes to complete and was considered easy to use. The final instrument used in the reliability test included 22 new items, and 25 of the 35 items were satisfactory stable. To conclude, we developed a 35 items, procedure-specific questionnaire that was easy to use and may aid systematic assessment of the recovery after coronary artery bypass grafting.

  • 15.
    Carlson, Elisabeth
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Pilhammar Andersson, Ewa
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    "This is nursing": nursing roles as mediated by precepting nurses during clinical practice2010In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 30, no 8, p. 763-767Article in journal (Refereed)
    Abstract [en]

    In nursing education, it has been argued that professional socialization is facilitated by clinical experiences where students work together with precepting nurses. However, few studies found have focused on how nurses think and act as preceptors, hence providing a base for professional socialization to occur. Therefore; this study aimed to describe how preceptors mediated nursing as a profession to undergraduate nursing students during clinical practice. This was an ethnographic study guided by symbolic interactionism. A purposeful sampling of 13 precepting nurses was observed during the field work period. In addition, 16 staff nurses, purposively selected, and experienced in precepting, participated in focus group interviews. All text from field notes and interviews were read as a whole and analyzed following the ethnographic approach. Findings illustrated how nursing was mediated as the medical-technical, the administrative, and the caring role. Preceptors aimed for professionalism in their students by teaching the students to reflect on what they can do independently as nurses. Preceptors strived to verbalise their practical knowledge to make theory explicit and contextualize to student nurses. This knowledge can guide implementation of preceptor programmes focusing on the meaning and implications of professionalism.

  • 16.
    Carlson, Elisabeth
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Pilhammar Andersson, Ewa
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    Time to precept: supportive and limiting conditions for precepting nurses2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 2, no 66, p. 432-441Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study describing conditions for precepting in a Swedish clinical context from the perspective of precepting nurses. BACKGROUND: Clinical practice is a complex part of nursing education, and registered nurses who are acting as preceptors for nursing students face a number of challenges that need to be addressed during the precepting process. METHOD: An ethnographic approach guided by symbolic interactionism was used. Data were collected by participant observation and focus group interviews over a ten-month period in 2006-2007. Participants were selected by purposive sampling of 13 staff nurses who were preceptors during the field work period. In addition, 16 staff nurses, experienced in precepting, were purposively selected for four focus groups. FINDINGS: Precepting was found to be a complex function for nurses, influenced by conditions that could be both supportive and limiting in nature. Three themes described these conditions: organization, comprising clinical responsibilities and routines; collaboration, focusing on professional relations and interactions; and the personal perspective, comprising preceptors' experiences, need for feed back and notions of benefits. Time as a limiting condition reappeared through all categories. CONCLUSION: It is important to raise the issue of time and its impact on the precepting process. Precepting needs to be further discussed in terms of an integrated nursing competence prioritized by all stakeholders involved in clinical practice. Therefore; efforts should be made to plan nurses' clinical work so that allocated time for precepting can be facilitated.

  • 17.
    Carlson, Elisabeth
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Pilhammar, Ewa
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    The team builder: the role of nurses facilitating interprofessional student teams at a Swedish clinical training ward2011In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 11, no 5, p. 309-313Article in journal (Refereed)
    Abstract [en]

    Interprofessional education (IPE) is an educational strategy attracting increased interest as a method to train future health care professionals. One example of IPE is the clinical training ward, where students from different health care professions practice together. At these wards the students work in teams with the support of facilitators. The professional composition of the team of facilitators usually corresponds to that of the students. However, previous studies have revealed that nurse facilitators are often in the majority, responsible for student nurses’ profession specific facilitation as well as interprofessional team orientated facilitation. The objective of this study was to describe how nurses act when facilitating interprofessional student teams at a clinical training ward. The research design was ethnography and data were collected through participant observations and interviews. The analysis revealed the four strategies used when facilitating teams of interprofessional students to enhance collaborative work and professional understanding. The nurse facilitator as a team builder is a new and exciting role for nurses taking on the responsibility of facilitating interprofessional student teams. Future research needs to explore how facilitating nurses balance profession specific and team oriented facilitating within the environment of an interprofessional learning context.

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  • 18.
    Carlson, Elisabeth
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    Pilhammar, Ewa
    Teaching during clinical practice: Strategies and Techniques used by Preceptors in Nursing Education2009In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 29, no 5, p. 521-526Article in journal (Refereed)
    Abstract [en]

    The preceptor is a nurse who teaches and supports the student and is seen as pivotal to student learning within the clinical setting. Earlier studies have shown that preceptors’ pedagogical competence is significant for facilitating learning during clinical practice. However, studies describing pedagogical competence, especially in terms of teaching strategies, seem to be scarce. The aim of this study was to describe which strategies and techniques preceptors use to teach undergraduate nursing students during clinical practice. The study had an ethnographic approach; methods used were participant observations and focus group interviews with nurses who were experienced in precepting undergraduate nursing students.Findings illustrated how preceptors used different strategies and techniques in a continuous process of adjusting, performing and evaluating precepting. Increased knowledge on how the preceptors actually teach student nurses during clinical practice will help facilitate educational programmes for preceptors,which will enhance their pedagogical skills and competences.

  • 19. Carlsson, Ingela
    et al.
    Edberg, Anna-Karin
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    Hand-injured Patients' Experiences of Cold Sensitivity and the Consequences and Adaptation for Daily Life: A Qualitative Study2009In: Journal of Hand Therapy, ISSN 0894-1130, E-ISSN 1545-004X, Vol. 23, no 1, p. 53-62Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Qualitative descriptive. INTRODUCTION: Cold sensitivity is a common and persistent complaint after hand injuries. PURPOSE OF THE STUDY: To explore the experiences of severe cold sensitivity, its consequences for daily life, and the strategies for enduring and enabling occupation. METHODS: Fifteen hand-injured patients with abnormal cold sensitivity were interviewed. The transcribed text was analyzed using manifest and latent content analysis. Experiences of triggering factors, symptoms, and relieving strategies were described. RESULTS: The consequences and adaptation in daily life entailed a change in life roles, a struggle to maintain self-image and changed occupational performance and/or occupational patterns. CONCLUSIONS: Our findings highlight the importance of a holistic approach, including a screening of patients' occupational roles and patterns as well as psychosocial needs, to obtain the information needed to support patients with severe cold sensitivity to achieve a sense of control and self-mastery. LEVEL OF EVIDENCE: not applicable.

  • 20. Ericsson, Anna
    et al.
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Malmö University, Malmö Institute for Studies of Migration, Diversity and Welfare (MIM).
    Ching, Shirley Siu-Yin
    Molassiotis, Alex
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Partners' experiences of living with men who have screening-detected abdominal aortic aneurysms: A qualitative descriptive study2020In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 19-20, p. 3711-3720Article in journal (Refereed)
    Abstract [en]

    AIM: To describe partners' experiences of living with men with a screening-detected abdominal aortic aneurysm (AAA).

    BACKGROUND: Diagnosis of a chronic life-threatening disease affects the patients' as well as their partners' lives in different aspects. AAA, with rupture as the major consequence, is a life-threatening disease that can affect the whole family. Screening programmes for AAA have been introduced in several countries to reduce the mortality rate. Although the awareness of having an AAA influences the individuals' quality of life and well-being, it is still unclear how it affects their partners.

    DESIGN: Qualitative descriptive design.

    METHODS: . The data were analysed using qualitative content analysis. The study conforms to the COREQ checklist.

    RESULTS: Three categories were identified: (a) experiencing the unexpected; (b) being reminded of fragility; and (c) balancing a changing relationship. The partners had a positive attitude towards the screening process and were pleased that their husbands were under surveillance. Nevertheless, at the same time, the diagnosis caused worries and questions. The AAA diagnosis was constantly in the minds of the partners, which sometimes affected and limited daily activities. Furthermore, ambivalent feelings towards surgical treatment were described. The partners tried to support their men and encouraged them to achieve a healthy lifestyle.

    CONCLUSION: The partners' well-being and daily lives were impacted by the awareness of the screening-detected AAA. Different degrees of worry were the most common reaction and were pervasive in all three categories.

    RELEVANCE FOR CLINICAL PRACTICE: The result highlights the need to review routines or develop new strategies to include the partners in the process of screening and offer supplementary support and information.

  • 21.
    Ericsson, Anna
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Holst, Jan
    Gottsäter, Anders
    Zarrouk, Moncef
    Kumlien, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Psychosocial consequences in men taking part in a national screening program for abdominal aortic aneurysm2017In: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 35, no 4, p. 211-220Article in journal (Refereed)
    Abstract [en]

    Screening for abdominal aortic aneurysm (AAA) has proven to reduce AAA-related mortality, but how the knowledge of having an untreated AAA affects health and daily life requires further clarification. The aim was to investigate the psychosocial consequences and sense of coherence (SOC) in 65-year-old men diagnosed with AAA and participating in a national screening program during a 6-month follow-up compared with men with no AAA. The single-center cohort study included 52 men with AAA and 118 men without AAA. A questionnaire including the Short Form 36 Health Survey, Hospital Anxiety and Depression Scale, SOC, questions concerning stress, and questions related to AAAwere answered at baseline and after 6 months. Men with AAA reported more problems with physical functioning, pain, and general health than men with a normal aorta at baseline. After 6 months, men with AAA still reported more problems with physical functioning and stress in relation to disease than men with normal aortic diameter. No differences were observed between groups in SOC, anxiety, and depression. A significantly higher satisfaction with information from the physician and desire to learn about the AAA diagnosis was reported at baseline compared with that at follow-up. Having knowledge about the AAA diagnosis may moderately impact physical health and perceived stress, and in combination with the increased prevalence of other cardiovascular diseases, may lead to impaired perceived health for men diagnosed with AAA.

  • 22. Ericsson, Anna
    et al.
    Hult, Camilla
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Patients' Experiences During Carotid Endarterectomy Performed Under Local Anesthesia2018In: Journal of Perianesthesia Nursing, ISSN 1089-9472, E-ISSN 1532-8473, Vol. 33, no 6, p. 946-955Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe patients' experiences undergoing a carotid endarterectomy (CEA) under local anesthesia. Design: Explorative qualitative design. Methods: Semistructured interviews with 15 participants who had undergone CEA under local anesthesia, analyzed by content analysis. Findings: Undergoing CEA under local anesthesia entails enduring stress with no possibility of withdrawal. Patients' lack of understanding of local anesthesia and experiencing pain and discomfort caused feelings of stress. The surgery resulted in a loss of control; patients had to surrender their autonomy to someone else. The nurse anesthetist was the link to the world outside the operating room (OR), and that nurse conveyed feelings of safety and security during the surgery. Conclusions: Patients' experiences ranged from being pleased with the surgical procedure and local anesthesia to vowing never to undergo such a procedure again. It is important to focus on the patients' experiences and feelings when choosing a method of anesthesia.

  • 23. Ericsson, Anna
    et al.
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Ching, Shirley
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Molassiotis, Alex
    Impact on Quality of Life of Men with Screening-Detected Abdominal Aortic Aneurysms Attending Regular Follow ups: A Narrative Literature Review2019In: European Journal of Vascular and Endovascular Surgery, ISSN 1078-5884, E-ISSN 1532-2165, Vol. 57, no 4, p. 589-596Article, review/survey (Refereed)
    Abstract [en]

    Objective: This study aimed to review, summarise, and assess the available evidence regarding the impact on the quality of life (QoL) of men undergoing screening for abdominal aortic aneurysm (AAA) and attending regular follow ups. Methods: PubMed, MEDLINE, CINAHL, and PsycINFO were used for searching. The search was performed from April to July 2016, with an update in February-March 2018. The quality of the studies was appraised with respective checklists from the Critical Appraisal Skills Programme. A narrative synthesis of the included studies was performed. The analysis included studies evaluating QoL in relation to one or more of the following concepts: physical function, psychological impact and social life in men undergoing AAA screening, but excluded studies evaluating QoL in AAA patients diagnosed outside a screening program. Results: The initial results from the search were 128 articles. Duplicates were removed, titles and abstracts were screened, and 22 full text articles were collected. Based on the inclusion criteria, 11 quantitative studies were included. Inferior quality of life among men with detected AAA was identified compared to those without the diagnosis and the general population in the included studies. The self-perceived health decreased over time for the participants with AAA. Assessments after surgery showed that the participants returned to similar health as before the screening. A wide variety of factors regarding the methodologies, designs, measurements, sample sizes, and the time for the assessment were noted in the included studies. Conclusion: Quality of life is an important outcome for AAA screening and studies have been conducted in an attempt to address the imbalance between benefits and harm. However, it is still difficult to draw clear conclusions, possibly due to the heterogeneity of the original studies. Nevertheless, it is important to identify men with an AAA who develop conditions influencing their health and QoL in order to understand their care needs to further support them and improve their situation.

  • 24.
    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).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Prevalence and incidence of domestic violence during pregnancy and associated risk factors: a longitudinal cohort study in the south of Sweden2016In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 16, article id 228Article in journal (Refereed)
    Abstract [en]

    Abstract Background: Domestic violence during pregnancy is not only a severe public health issue that jeopardizes maternal and foetal health but also violates human rights. The aim was to explore the prevalence and incidence of domestic violence among pregnant women, in the southwestern region of Scania in Sweden, and their experience of a history of violence. In addition, to explore the association between domestic violence during pregnancy and possible risk factors. Methods: This is a longitudinal cohort-study including pregnant women ≥18 years of age, registered at antenatal care when pregnant. A cohort of 1939 pregnant women answered Questionnaire I (QI) in gestational week 13 (mean 12.8 week, SD 5.11). Response rate of Questionnaire II (QII) in gestation week 34 (mean 33.9 week, SD 2.2) was 78.8 % (n = 1527). Statistical analysis was descriptive statistics, logistic regression and multiple regression with Odds ratios (OR) and 95 % confidence intervals (95 % CI). Results: Both QI and QII were completed by 77.8 % (n = 1509) of the women and 44.3 % (n = 668) reported a lifetime experience of abuse irrespective of type, severity or perpetrator. Also, 5.1 % (n = 77) reported some experience of abuse past year. Prevalence of domestic violence during pregnancy was 2.0 % (n = 29) and the incidence was 7.3 new cases per 1000 women. The strongest risk factor for domestic violence, during early and late pregnancy, was history of violence whereby all women who disclosed exposure had also reported history of violence (p < 0.001). To be single/living apart gave 8.4 times more risk associated with domestic violence during pregnancy (AOR 8.4; 95 % CI: 2.2–32.6). Having several symptoms of depression and lack of sleep gave 3.8 times more risk respectively (AOR 3.8; 95 % CI: 1.1–13.6) and (AOR 3.8; 95 % CI 1.1–12.9). Conclusions: Pregnant women with a history of violence as well as being single/living apart and/or having several symptoms of depression during pregnancy should be alerts for clinical working midwives and obstetricians. Further, this is important knowledge for health care providers to develop or upgrade guidelines and plans of action for pregnant women exposed to violence. Keywords: Domestic violence, Pregnancy, Prevalence, Incidence, Risk factors

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  • 25.
    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).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Prevalence of domestic violence during pregnancy and related risk factors: a cross-sectional study in southern Sweden2014In: BMC Women's Health, E-ISSN 1472-6874, Vol. 14, no 63, article id 63Article in journal (Refereed)
    Abstract [en]

    Background: Domestic violence during pregnancy is a serious public health issue which threatens maternal and foetal health outcomes. The aim of the study was to explore prevalence of domestic violence among pregnant women in southern Sweden (Scania) and to explore associations with background factors, as symptoms of depression and sense of coherence. Methods: This study has a cross-sectional design and is the first part of a longitudinal, cohort study. Inclusion criteria were women ≥ 18 years, registered at antenatal care when pregnant and who understand and write Swedish or English. Questionnaires were collected prospectively at seventeen antenatal care receptions situated in the two cities and six smaller municipalities in Scania. Statistical analyses were done using descriptive statistics, chi-square tests, bivariate logistic regression and multiple regression with Odds ratios (OR) and 95% confidence intervals (95% CI). Results: Study sample included 1939 women. History of violence was reported by 39.5% (n =761) women. Significant differences were obtained between the groups with or without history of violence regarding being single/living apart, unemployment, financial distress, smoking/snuffing, unintended pregnancy as well as history of miscarriage/legalised abortion (p < 0.001). Experience of domestic violence during pregnancy regardless of type or level of abuse was 1.0% (n = 18); history of physical abuse by actual intimate partner was 2.2% (n = 42). History of violence was the strongest risk factor associated with domestic violence during pregnancy, where all women (n = 18) exposed reported history of violence (p < 0.001). Several symptoms of depression (adjusted for low socio-economic status, miscarriage/abortion, single/living apart, lack of sleep, unemployment, age and parity) were associated with a 7.0 fold risk of domestic violence during pregnancy (OR 7.0; 95% CI: 1.9-26.3). Conclusions: The reported prevalence of domestic violence during pregnancy in southwest Sweden is low. However, a considerable proportion of women reported history of living in a violent relationship. Both history of violence and the presence of several depressive symptoms detected in early pregnancy may indicate that the woman also is exposed to domestic violence during pregnancy. Increased attention to this vulnerable group of women is needed to improve maternal and child health.

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  • 26.
    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).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Struggling to survive for the sake of the unborn baby: a grounded theory model of exposure to intimate partner violence during pregnancy2014In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 28, no 14, article id 293Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Intimate partner violence (IPV) during pregnancy is a serious matter which threatens maternal and fetal health. The aim of this study was to develop a grounded theoretical model of women's experience of IPV during pregnancy and how they handle their situation. METHOD: Ten interviews with women who had experience of being exposed to IPV during pregnancy were analyzed using the grounded theory approach. RESULTS: The core category 'Struggling to survive for the sake of the unborn baby' emerged as the main concern of women who are exposed to IPV during pregnancy. The core category also demonstrates how the survivors handle their situation. Also, three sub-core categories emerged, 'Trapped in the situation' demonstrates how the pregnant women feel when trapped in the relationship and cannot find their way out. 'Exposed to mastery' demonstrates the destructive togetherness whereby the perpetrator's behavior jeopardizes the safety of the woman and the unborn child. 'Degradation process' demonstrates the survivor's experience of gradual degradation as a result of the relationship with the perpetrator. All are properties of the core category and part of the theoretical model. CONCLUSION: The theoretical model "Struggling to survive for the sake of the unborn baby" highlights survival as the pregnant women's main concern and explains their strategies for dealing with experiences of violence during pregnancy. The findings may provide a deeper understanding of this complex matter for midwives and other health care providers. Further, the theoretical model can provide a basis for the development and implementation of prevention and intervention programs that meet the individual woman's needs.

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  • 27.
    Franz, Anna
    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).
    Patients' experiences of living with varicose veins and management of the disease in daily life2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 5-6, p. 733-741Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: The aim was to describe the experience of living with varicose veins classified according CEAP (clinical class, aetiology, anatomy, pathophysiology) as C4 (eczema or thrombophlebitis) and management of the disease in daily life. BACKGROUND: Primary chronic venous insufficiencies with varicose veins are a relatively common condition among both men and women. Several studies have shown that quality of life improved after treatment of varicose veins compared to before treatment. This suggests that patients with a milder form of varicose veins such as C4 experience a negative influence on their quality of life before treatment. DESIGN: This is an explorative qualitative study with a phenomenological approach. METHOD: A purposive sample was used, and 12 in-depth interviews were conducted with persons having superficial venous insufficiency classified C4. A descriptive phenomenological analysis was performed. RESULTS: The essence of the phenomenon of living with varicose veins classified C4 and management of the disease in daily life meant adapting to a life with varicose veins and relieve discomfort from legs with an unfavourable appearance. Coping with discomfort involved dealing with the disease emotionally and finding strategies that helped to relieve symptoms; however, living with 'repulsive' legs was seen as embarrassing, and many found the need to hide their condition. CONCLUSION: Patients with varicose veins classified C4 had notable symptoms of the disease that affected daily living. This in turn required the use of different coping strategies to manage symptoms, and significant adjustments related to activities and social life were made. RELEVANCE TO CLINICAL PRACTICE: It seems desirable that patients with varicose veins receive treatment at an earlier stage of the disease and are familiar with the tools and solutions available to alleviate symptoms and avoid a negative impact on daily life

  • 28. Herlin, Caroline
    et al.
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    The experience of being 30-45 years of age and depending on haemodialysis treatment: a phenomenological study2010In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 693-699Article in journal (Refereed)
    Abstract [en]

    The experience of being 30-45 years of age and depending on haemodialysis treatment: a phenomenological study The aim of this study was to describe how haemodialysis (HD) patients, between 30 and 45 years of age, experience their dependence on HD treatment. Nine patients undergoing HD treatment were interviewed. The transcribed texts were analysed according to Giorgi's four basic principles. Being between 30 and 45 years of age and needing HD treatment meant experiencing a total lack of freedom, which was illuminated through the sub-themes: a sense of fear, dependency on caregivers, time lost in dialysis, feelings of loneliness and the stress of being on the waiting list for a new kidney. The participants felt that being dependent on HD treatment was 'not a real life' and that they were experiencing a double life of sorts: the life of dialysis versus their ordinary life outside treatment. The dependency on HD treatment was also expressed as a feeling that life 'stood still.' The results also indicate that the participants expected to encounter competent healthcare professionals, and they emphasised the importance of providing support for younger HD patients by focusing on their ability to cope with their life situation.

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

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

  • 30.
    Jakobsson, Jenny
    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).
    Kumlien, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Patient characteristics and surgery-related factors associated with patient-reported recovery at 1 and 6 months after colorectal cancer surgery2017In: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 26, no 6, article id e12715Article in journal (Refereed)
    Abstract [en]

    Predictors for postoperative recovery after colorectal cancer surgery are usually investigated in relation to length of stay (LoS), readmission, or 30-day morbidity. This study describes patient characteristics and surgery-related factors associated with patient-reported recovery 1 and 6 months after surgery. In total, 153 consecutively included patients who were recovering from colorectal cancer surgery reported their level of recovery using the Postoperative Recovery Profile. Multiple logistic regression analysis was used to calculate associations with recovery, defined as good or poor, divided into five recovery dimensions: physical symptoms, physical functions, psychological, social and activity. Better preoperative health predicted good recovery regarding three dimensions 1 month after surgery. Regarding all dimensions 1 month after surgery, poor recovery was predicted by a poor recovery on the day of discharge within corresponding dimensions. Higher age was associated with good recovery 6 months after surgery, while chemotherapy showed negative associations. Overall, a majority of factors had a negative impact on recovery, but without any obvious relation to one specific dimension or point in time. Those factors were: high Body Mass Index, comorbidity, abdominoperineal resection, loop ileostomy, colostomy and LoS. This study illustrates the complexity of postoperative recovery and a need for individualised follow-up strategies.

  • 31.
    Jakobsson, Jenny
    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).
    Kumlien, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    The lived experience of recovery during the first 6 months after colorectal cancer surgery2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4498-4505Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the lived experience of recovery during the first 6 months after colorectal cancer surgery. BACKGROUND: Colorectal cancer is the third most common cancer diagnosis worldwide. Early discharge places demands on healthcare professionals to prepare patients for their return home and to provide them with appropriate support throughout the recovery process. This requires knowledge of what it is like to recover from colorectal cancer surgery. DESIGN: A qualitative phenomenological design was used to describe the structure of recovery after colorectal cancer surgery. METHODS: Ten patients recovering from colorectal cancer surgery were interviewed at one month and six months after surgery. The descriptive phenomenological method by Giorgi was used throughout the study. RESULTS: Postoperative recovery was described as a progressive process. This process was accompanied by experiences of physical powerlessness, difficulties with food intake, altered bowel function and dependency on others. The experiences were most intense at the beginning of the recovery but disappeared as time went by and normality in life returned. CONCLUSION: While recovering from colorectal cancer surgery, patients experience obstacles that impede their ability to live life as normal. Six months after surgery, those experiences disappear or become adjusted to being part of normal life. RELEVANCE TO CLINICAL PRACTICE: Patients should be provided with information about the expected postoperative recovery before discharge from hospital. The need for professional support appears to be most frequently needed in early recovery, but it should be considered on an individual basis.

  • 32.
    Jakobsson, Jenny
    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).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    General health and state anxiety in patients recovering from colorectal cancer surgery2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 2, p. 328-338Article in journal (Refereed)
    Abstract [en]

    AIM: To describe and compare general health and state anxiety before surgery and up to 6 months after surgery in patients with colorectal cancer undergoing elective rectal resection, abdominoperineal resection or colonic resection in an enhanced recovery context. BACKGROUND: Little is known about patient-reported health and anxiety after colorectal cancer surgery in an enhanced recovery context. DESIGN: A prospective cohort study. METHODS: Data were collected from October 2011-February 2013. The questionnaires - EuroQol 5-Dimensions 3-Levels and State-Trait Anxiety Inventory - were answered before surgery, at discharge and 1 and 6 months after surgery. Data were analysed using inferential statistics to describe differences between groups of patients (Kruskal-Wallis test) and between assessments within groups (Friedman's anova). RESULTS: Patients (N = 105), divided into three groups based on surgical procedure, showed a high health index and a low state anxiety in all assessments without differences between the groups. Patients considered for abdominoperineal resection rated their pre-operative health as significantly higher than patients after rectal and colonic resections did. Within groups, patients recovering from abdominoperineal resection and rectal resection deteriorated significantly in health index 1 month after surgery. However, after 6 months they had improved again. After colonic resection, patients improved significantly in self-rated health and anxiety 1 month after surgery with no further discernible improvement after 6 months. CONCLUSION: The study showed that patients generally had a high level of health and a low level of anxiety throughout the study period. Only a few differences occurred between assessments within groups.

  • 33.
    Jakobsson, Jenny
    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).
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Patient-reported recovery after enhanced colorectal cancer surgery: a longitudinal six-month follow-up study2014In: International Journal of Colorectal Disease, ISSN 0179-1958, E-ISSN 1432-1262, Vol. 29, no 8, p. 989-998Article in journal (Refereed)
    Abstract [en]

    Purpose: The concept of enhanced recovery after surgery (ERAS) is a modern regime of care, and numerous studies have proved its beneficial impact on recovery after colorectal surgery. However, little is known about patients’ continuing recovery after discharge. Therefore, the purpose of this study was to describe patient-reported recovery after colorectal cancer surgery in the context of ERAS from the day of discharge until one month and six months after surgery. Method: Assessments were made at discharge, at one month, and at six months after surgery using the questionnaire Postoperative Recovery Profile (PRP). In all, 119 patients recovering from abdominoperineal resection, rectal resection, or colonic resection completed all three assessments. Results: The global score of recovery showed that no patient experienced being fully recovered at discharge. After rectal resection, patients frequently reported being not at all recovered. One month after surgery, patients recovering from colonic resection reported significant improvements regarding 11 of 17 questionnaire items, whereas abdominoperineal resection patients reported no significant improvements regarding any item. Instead, significantly higher levels of problems were reported in the items fatigue, muscle weakness, and feeling down. Rectal resection patients reported significant improvements between one and six months after surgery regarding 7 of 19 items. However, the item gastrointestinal function distinguished, as patients reported significant deterioration towards higher levels of problems six months after surgery. Conclusion: This study elucidates the difference between groups of colorectal patients and the diverse patterns of their recovery, implying different needs in terms of prolonged support after discharge.

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  • 34.
    Jakobsson, Jenny
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden.
    Everyday challenges following hospital discharge. A multi-method study identifying and describing areas of concern for patients during the first month after colorectal cancer surgery2023In: Nursing Open, E-ISSN 2054-1058, Vol. 10, no 4, p. 2172-2181Article in journal (Refereed)
    Abstract [en]

    AIM: Identify and describe areas of concern focusing on day-to-day variations during the first month after surgery for patients recovering from colorectal cancer surgery.

    DESIGN: A multi-method design was applied using diaries and interviews.

    METHOD: Data was collected using semi-structured diaries kept 1 month after surgery by seven patients recovering from colorectal cancer surgery. Also, face-to-face interviews were conducted 1 month after surgery. Data from the diaries constituted a framework for the following directed content analysis of interviews.

    FINDINGS: Low levels of pain were experienced but caused reduced mobility and tiredness. Practical matters in daily living were restricted, while social life could be hampered by a frequent need to defecate. Appetite and consequently the ability to eat and drink was the most prominent concern, due to changes in taste and ability to tolerate food. Worries were mainly related to changes in bowel movements. No Patient or Public Contribution.

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  • 35.
    Jakobsson, Jenny
    et al.
    Malmö högskola, Faculty of Health and Society (HS).
    Perlqvist, Agnetha
    Wann-Hansson, Christine
    Malmö högskola, Faculty of Health and Society (HS).
    Searching for Evidence Regarding Using Preoperative Disinfection Showers to Prevent Surgical Site Infections: A Systematic Review2011In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X, E-ISSN 1741-6787, Vol. 8, no 3, p. 143-152Article, review/survey (Other academic)
    Abstract [en]

    Background: Postoperative surgical site infections (SSI) are the third most common health care associated infection. Even though several studies have pointed out the benefits of disinfection showers prior to surgery in order to reduce SSI, it remains unclear how to optimize this disinfection procedure. Aim: To find evidence for how many times preoperative disinfection showers should be performed in order to reduce bacterial colonies and minimize the risk of SSI. Method: A comprehensive literature search of multiple databases published during 1986-2008, supplemented by a manual search of the references in all relevant articles. Protocols were used in quality assessment and the data synthesis is descriptive in a narrative form. Results: The 10 studies included had different designs, interventions, and samples, which makes it difficult to compare them. Moreover, the quality of the reviewed studies varied and only four had a high level of evidence. Therefore, the results failed to give an unambiguous answer about the optimal number of preoperative showers, so only assumptions can be made. It is quite obvious, however, that preoperative disinfection showers with chlorhexidine gluconate (CHG) are effective from a microbiological point of view since eight of the reviewed studies showed a sharply reduced skin flora after using CHG. Conclusions: Currently, clear evidence for how many times preoperative disinfection showers should be performed to minimize the risk of SSI is missing. This highlights the need for further research that focuses on the number of preoperative disinfection showers in relation to SSI, in order to obtain optimal effect. Until then, it would be wise to follow previously made recommendation of three to five preoperative showers. Moreover, in order to have the intended effect of preoperative disinfection, it is important that health care professionals have the knowledge to guide patients with information and clear instructions about disinfection shower procedures.

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  • 36.
    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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  • 37.
    Kumlien, Christine
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Skane Univ Hosp, Dept Cardiothorac & Vasc Surg, Malmo, Sweden..
    Acosta, Stefan
    Skane Univ Hosp, Dept Cardiothorac & Vasc Surg, Malmo, Sweden.;Lund Univ, Dept Clin Sci, Malmo, Sweden..
    Björklund, Sebastian
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University, Biofilms Research Center for Biointerfaces.
    Lavant, Eva
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University, Biofilms Research Center for Biointerfaces.
    Lazer, Victoria
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Engblom, Johan
    Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV). Malmö University, Biofilms Research Center for Biointerfaces.
    Ruzgas, Tautgirdas
    Malmö University, Biofilms Research Center for Biointerfaces. Malmö University, Faculty of Health and Society (HS), Department of Biomedical Science (BMV).
    Gershater, Magdalena
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Research priorities to prevent and treat diabetic foot ulcers-A digital James Lind Alliance Priority Setting Partnership2022In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 39, no 11, article id e14947Article in journal (Refereed)
    Abstract [en]

    Aim To establish outcomes of a priority setting partnership between participants with diabetes mellitus and clinicians to identify the top 10 research priorities for preventing and treating diabetic foot ulcers (DFUs). Methods Due to the COVID-19 pandemic, the James Lind Alliance Priority Setting Partnership process was adapted into a digital format which involved a pilot survey to identify understandable uncertainties with high relevance for participants tested by calculating the content validity index; a main survey answered by 53 participants living with diabetes and 49 clinicians; and a final digital workshop to process and prioritise the final top 10 research priorities. Results The content validity index was satisfactory for 20 out of 25 uncertainties followed by minor changes and one additional uncertainty. After we processed the 26 uncertainties from the main survey and seven current guidelines, a list of 28 research uncertainties remained for review and discussion in the digital workshop. The final top 10 research priorities included the organisation of diabetes care; screening of diabetes, impaired blood circulation, neuropathy, and skin properties; vascular surgical treatment; importance of self-care; help from significant others; pressure relief; and prevention of infection. Conclusion The top 10 research priorities for preventing and treating DFUs represent consensus areas from persons living with diabetes and clinicians to guide future research. These research priorities can justify and inform strategic allocation of research funding. The digitalisation of James Lind Alliance methodology was feasible.

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  • 38.
    Kumlien, Christine
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Axelsson, Malin
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Hellman, Peter
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Neziraj, Merita
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Andersson, Magdalena
    Malmö Stad.
    PROSENIOR-prevention av fall, trycksår, undernäring och dålig munhälsa hos äldre personer i samverkan med personal, äldre personer och Senior Alert2021In: Ä : en tidning för Riksföreningen sjuksköterskan inom äldrevård : geriatriker, dietister inom geriatrik samt alla professioner runt den äldre patienten, ISSN 2001-1164Article in journal (Other (popular science, discussion, etc.))
  • 39.
    Kumlien, Christine
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bish, Melanie
    Chan, Engle A
    Rew, Lynn
    Chan, P S
    Leung, Doris
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Psychometric properties of a modified cultural awareness scale for use in higher education within the health and social care fields2020In: BMC Medical Education, E-ISSN 1472-6920, Vol. 20, no 1, article id 406Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Cultural awareness and cultural competence have become important skills in higher education as populations continue to grow in diversity around the world. However, currently, there are few instruments designed to assess student awareness of the aspects of culture, and the existing instruments need further development and testing for use with different target populations. Therefore, the aim of this study was to test the psychometric properties of a modified version of the Cultural Awareness Scale (CAS) for use in higher education within the health and social care fields.

    METHODS: A modified version of the CAS was developed, which was tested psychometrically using cross-sectional data. In total, 191 undergraduate students from different health and social care undergraduate programs in Sweden and Hong Kong responded to a call to test the modified instrument.

    RESULTS: The results showed that the modified CAS is a four-factor measure of cultural awareness and possesses satisfactory internal consistency. Results also support the use of the modified CAS as a generic tool to measure cultural awareness among students in higher education within the health and social care fields.

    CONCLUSION: The modified CAS showed satisfactory psychometric properties and can be recommended as a generic tool to measure cultural awareness among students in higher education within the health and social care fields. However, further psychometric testing on the effectiveness of the modified CAS as a tool to evaluate the efficacy of cultural awareness interventions is required.

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  • 40.
    Kumlien, Christine
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Miller, Michael
    Fagerström, Cecilia
    Hagell, Peter
    Evaluation of Self-management Program Outcomes: Adaptation and Testing of a Swedish Version of the Health Education Impact Questionnaire (heiQ).2018In: Journal of Applied Measurement, ISSN 1529-7713, Vol. 19, no 3, p. 303-319Article in journal (Refereed)
    Abstract [en]

    Self-management programs require a range of indicators to evaluate their outcomes. The Health Education Impact Questionnaire (heiQ) was developed to meet this need. The heiQ contains 40 items with 4 response categories, representing eight scales. We developed a Swedish version of the heiQ that was tested by cognitive interviews (n = 15) and psychometrically (n = 177) using classical test theory (CTT) and Rasch measurement theory (RMT). The Swedish heiQ was easily understood by interviewees and met CTT criteria, with supported scaling assumptions (corrected item-total correlations, 0.37) and reliability (ordinal alpha 0.78). General support was demonstrated for the measurement properties of the eight heiQ scales by acceptable RMT fit. However, there were signs of malfunctioning response categories for four items in two scales, and of suboptimal item coverage of the measurement continua. The Swedish heiQ appears comparable to other available language versions. Further efforts may be needed to optimize response categories and measurement precision.

  • 41.
    Kumlien, Christine
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Nordanstig, Joakim
    Lundström, Mats
    Pettersson, Monica
    Validity and test retest reliability of the vascular quality of life Questionnaire-6: a short form of a disease-specific health-related quality of life instrument forpatients with peripheral arterial disease2017In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 15, no 187Article in journal (Refereed)
    Abstract [en]

    Background: Many existing patient-reported outcome measures are extensive regarding both patient burden and administration, and in terms of analysing and reporting results. The VascuQoL-6 (VQ6) – a short version of the original Vascular Quality of Life Questionnaire (VascuQoL), a disease-specific instrument for peripheral arterial disease – was recently developed. However, the VQ6 has not yet been empirical tested with regard to content validity, construct validity and test retest reliability. Our aim was, therefore, to explore both the validity and the reliability of the VQ-6 in a target population with established peripheral arterial disease. Methods: Two hundred patients treated at two vascular centres were consecutively recruited for the survey. Administered questionnaires included VQ6 and the Short Form Health Survey-36 (SF-36). Out of the 200 patients, 150 also received a second VQ6 questionnaire for a test-retest assessment. Further, a purposive sample of 22 patients consented to participate in cognitive interviews. All included patients suffer from peripheral arterial disease. The questionnaire data was tested by both Rasch analysis and traditional psychometric methods, while the cognitive interviews were analysed descriptively. Results: The validity and reliability of the VQ6, as tested in a target population without the surrounding 19 items from the original VascuQoL, was high, in general, and a good fit to the Rasch model was observed. Further, an excellent internal consistency and significant correlations between comparable dimensions in SF-36 were demonstrated. In the test-retest analysis, the percentage agreement was somewhat poor (<70%) in the six items. However, no systematic disagreements between the two assessments were seen in any of the six items, and the test-retest assessment for the VQ6 sum score showed an acceptable intraclass correlation coefficient (0.86). Finally, all items in the VQ6 were considered as both understandable and relevant by the interviewed patients. Conclusions: The VQ6 has acceptable to good psychometric properties with regard to data quality, scale assumptions, targeting, validity and reliability. Further, VQ6 seems to be easy to use and comprehend within the target population of patients with PAD.

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  • 42.
    Kumlien, Christine
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rystedt, Jenny
    Omvårdnad & kirurgi2016Collection (editor) (Other academic)
  • 43.
    Kumlien, Christine
    et al.
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rystedt, Jenny
    Postoperativa komplikationer2016In: Omvårdnad och kirurgi / [ed] Christine Kumlien, Jenny Rystedt, Studentlitteratur AB, 2016, p. 221-238Chapter in book (Other academic)
  • 44.
    Lampridou, Smaragda
    et al.
    Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK.
    Saghdaoui, Layla Bolton
    Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK.
    Bicknell, Colin
    Vascular Surgery Department, Imperial College Healthcare NHS Trust, London, UK; Faculty of Medicine, Department of Surgery & Cancer, Imperial College London, London, UK.
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, 214 28 Malmö, Sweden.
    Lear, Rachael
    NIHR Imperial Biomedical Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK.
    Health Related Quality of Life Following Intervention for Thoracoabdominal Aortic Aneurysm: a Systematic Review and Narrative Synthesis2024In: Annals of Vascular Surgery, ISSN 0890-5096, E-ISSN 1615-5947, Vol. 101, p. 105-119, article id S0890-5096(23)00860-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Thoracoabdominal aortic aneurysms (TAAA) pose significant risks of morbidity and mortality. Considering the evolving techniques for TAAA intervention and the growing interest in quality of life (QoL) outcomes for decision-making, we aimed to evaluate the impact of patient and perioperative characteristics on short-, medium-, and long-term post-operative QoL in TAAA repair patients.

    METHODS: A systematic search was conducted in CINAHL, APA PsycINFO, EMBASE, Medline and Cochrane to identify primary research studies evaluating QoL post TAAA surgery, published in English or Swedish between 01 January 2012 and 26 September 2022. A narrative synthesis was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence was assessed using the Critical Appraisal Skills Programme and Joanna Briggs Institute checklists.

    RESULTS: Eight studies of low or moderate quality with 455 patients were included. Preoperative QoL in TAAA patients was lower compared to the general population. While there is an initial short-term improvement in post-operative QoL, patients fail to reach baseline levels even after seven years, with physical activity and functioning domains being particularly affected. Experiencing post-operative complications, including paraplegia and cardiovascular events, negatively impacts post-operative QoL. Patients with uncomplicated postoperative status had improved QoL. Prolonged hospital stay negatively affects physical functioning.

    CONCLUSIONS: Individuals with TAAA are likely to have lower baseline QoL compared to the general population. Following TAAA repair, post-operative QoL may remain lower than baseline levels, persisting over the long-term. Comorbidities, post-operative complications, and hospitalisation duration appear to exert adverse effects on post-operative QoL.

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  • 45.
    Larsson, Helena
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
    Blomqvist, Kerstin
    Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
    Edberg, Anna-Karin
    Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden;Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö, Sweden.
    Swedish family care advisors’ views on existential loneliness and existential support to informal caregivers of older people: A cross-sectional national survey2022In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 42, no 2, p. 93-100Article in journal (Refereed)
    Abstract [en]

    The number of older people needing care is increasing, and care is often provided by informal caregivers. The mission of family care advisors (FCAs) is to provide them with support; however, whether and how support in existential matters such as existential loneliness is provided is unclear. Therefore, the aim of this study was to describe FCAs’ views on existential loneliness, and existential support provided to relatives who act as informal caregivers to older people. A national survey was distributed to 349 FCAs in Sweden, response rate n = 120 (36%). The STROBE checklist was followed when presenting the study. Existential loneliness was viewed as thoughts about life and meaning (78%). Existential support was provided by dialogues (87%), visits (75%) and support groups (73%); 45% of FCAs stated that they had time to provide existential support and 27% reported having knowledge of how to encounter existential loneliness. FCAs provide existential support, but often lack experience, knowledge and time. Time and knowledge are important prerequisites for acknowledging existential needs. 

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  • 46.
    Larsson, Helena
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Blomqvist, Kerstin
    Spouses' existential loneliness when caring for a frail partner late in life: a hermeneutical approach2020In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 15, no 1, article id 1734166Article in journal (Refereed)
    Abstract [en]

    Purpose: Spouses are in a vulnerable situation when caring for a frail partner late in life. Exploring their existential loneliness can be a way to understand more about their existential needs. Method: A hermeneutic approach was used. Multistage focus group interviews were conducted with two groups consisting of five spouses, respectively, who met three times each. To work with the text, an approach was adapted where quotations are converted into poems in a linguistic manner. Results: Existential loneliness can be understood as the following: 1) being in a transition from us to merely me, 2) being forced to make decisions and feeling excluded, 3) navigating in an unfamiliar situation and questioning oneself, and 4) longing for togetherness but lacking the energy to encounter other people. The main interpretation is that existential loneliness emerges when one is in moments of inner struggle, when one is forced to make impossible choices, when one is approaching and is in limit situations, and when one is experiencing the endless loss of the other. Conclusion: For health care professionals to achieve a holistic picture, person-centeredness can be a way to make the spouses' existential needs visible and to provide support based on their needs.

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  • 47. Leung, Doris
    et al.
    Carlson, Elisabeth
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kwong, Enid EY
    Idvall, Ewa
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö högskola, Faculty of Health and Society (HS), Department of Care Science (VV).
    Exploring research cultures through internationalization at home for doctoral students in Hong Kong and Sweden2017In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 19, no 4, p. 525-531Article in journal (Refereed)
    Abstract [en]

    Cultural skills are fundamental to developing global academic scholars. Internationalization at home can facilitate the acquisition of these skills without students having to go abroad. However, research on the effect of internationalization of higher education is scarce, despite apparent benefits to incorporating cultural sensitivity in research. Further, little is known about the role information and communication technology plays. In this pilot study, we describe the experience of doctoral students with an internationalization‐at‐home program, and its impact on developing an understanding about different research cultures. Eight doctoral nursing students from Sweden and Hong Kong participated in five webinars as “critical friends”. The study followed a descriptive, qualitative design. The results demonstrated that students observed cultural differences in others' research training programs. However, while cultural differences reinforced friendship among local peers, they challenged engagement with critical friends. Challenges led to the perception of one another not as critical friends but as “distant” friends. We discuss the possible reasons for these outcomes, and emphasize a need to nurture connectivity and common goals. This would prepare students to identify, translate, and recognize cultural differences to help develop knowledge of diverse research cultures.

  • 48.
    Leung, Doris Y
    et al.
    The Hong Kong Polytechnic University.
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Bish, Melanie
    La Trobe University, Australia.
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Chan, Pui Sze
    The Hong Kong Polytechnic University.
    Chan, E Angela
    The Hong Kong Polytechnic University.
    Using internationalization-at-home activities to enhance the cultural awareness of health and social science research students: A mixed-method study2021In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 100, article id 104851Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Despite healthcare scholars valuing diversity, current cultural awareness training does not address mechanisms that drive societal patterns, that generates cultural insensitivity and reinforces stereotypes of minority groups. The influence of culture on thinking is an important issue because of potential ethnocentric biases on the design, data collection, analysis, and dissemination of research.

    OBJECTIVES: Using internationalization-at-home activities to explore the mechanisms that enhance the development of cultural awareness in postgraduate health and social science research students.

    DESIGN AND METHODS: A pragmatic critical realist study, qualitatively dominant, using mixed-methods to integrate and analyze qualitative and quantitative data. Data were collected pre- and post-internationalization-at-home activities. Qualitative data were collected from online discussion forums and focus groups, and quantitative data were collected from a pre-test and post-test measure of cultural awareness.

    SETTING AND PARTICIPANTS: Eighteen research students in postgraduate health and social science programs from three universities (Australia, Hong Kong, and Sweden) participated in five formal internationalization-at-home webinars and informal international group activities.

    RESULTS: Participants reported four mechanisms counteracting structures (i.e., ethnocentric biases) toward the emergence of cultural awareness: 1. awareness of cultural issues motivating people toward achieving a common goal; 2. reflexivity within psychological safety; 3. deliberations that challenge the veracity of individual assumptions; 4. courage coupled with curiosity. When some or all the mechanisms occurred, properties of enhanced cultural awareness emerged, as confirmed by the quantitative data.

    CONCLUSIONS: Cultural awareness training should emphasize social relations to allow cultural safety to develop for postgraduate health and social science research students. Without skills revealing unconsciously held ethical values, this study argues that postgraduate health and social science students may inadvertently reconstitute and reinforce in their research the discrimination of underserved groups.

  • 49.
    Lie Ken Jie, Christopher
    et al.
    School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland.
    Finn, Yvonne F
    School of Medicine, College of Medicine, Nursing and Health Sciences, National University of Ireland, Galway, Galway, Ireland.
    Bish, Melanie
    La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
    Carlson, Elisabeth
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV). Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, Malmö.
    Chan, E Angela
    School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Leung, Doris Y L
    School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Mechanisms Driving Postgraduate Health and Social Science Students' Cultural Competence: An Integrated Systematic Review2022In: Academic Medicine, ISSN 1040-2446, E-ISSN 1938-808X, Vol. 97, no 11, p. 1707-1721Article, review/survey (Refereed)
    Abstract [en]

    PURPOSE: The COVID-19 pandemic revealed a global urgency to address health care provision disparities, which have largely been influenced by systematic racism in federal and state policies. The World Health Organization recommends educational institutions train clinicians in cultural competence (CC); however, the mechanisms and interacting social structures that influence individuals to achieve CC have received little attention. This review investigates how postgraduate health and social science education approaches CC and how it accomplishes (or not) its goals.

    METHOD: The authors used critical realism and Whittemore and Knafl's methods to conduct a systematic integrated review. Seven databases (MEDLINE, CINAHL, PsycINFO, Scopus, PubMed, Web of Science, and ERIC) were searched from 2000 to 2020 for original research studies. Inclusion criteria were: the use of the term "cultural competence" and/or any one of Campinha-Bacote's 5 CC factors, being about postgraduate health and/or social science students, and being about a postgraduate curriculum or a component of it. Thematic analysis was used to reveal the mechanisms and interacting social structures underlying CC.

    RESULTS: Thirty-two studies were included and 2 approaches to CC (themes) were identified. The first theme was professionalized pedagogy, which had 2 subthemes: othering and labeling. The second theme was becoming culturally competent, which had 2 subthemes: a safe CC teaching environment and social interactions that cultivate reflexivity.

    CONCLUSIONS: CC conceptualizations in postgraduate health and social science education tend to view cultural differences as a problem and CC skills as a way to mitigate differences to enhance patient care. However, this generates a focus on the other, rather than a focus on the self. Future research should explore the extent to which insight, cognitive flexibility, and reflexivity, taught in safe teaching environments, are associated with increasing students' cultural safety, cultural humility, and CC.

  • 50.
    Lindsjö, Cecilia
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Sjögren Forss, Katarina
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kumlien, Christine
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Kottorp, Anders
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Rämgård, Margareta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Migrant women's engagement in health-promotive activities through a women's health collaboration2023In: Frontiers In Public Health, ISSN 2296-2565, Vol. 11, article id 1106972Article in journal (Refereed)
    Abstract [en]

    Introduction: Social determinants of health impact health, and migrants are exposed to an inequitable distribution of resources that may impact their health negatively, leading to health inequality and social injustice. Migrant women are difficult to engage in health-promotional activities because of language barriers, socioeconomic circumstances, and other social determinants. Based on the framework of Paulo Freire, a community health promotion program was established in a community-academic partnership with a community-based participatory research approach.

    Aim: The aim of this study was to describe how a collaborative women's health initiative contributed to migrant women's engagement in health promotion activities.

    Materials and methods: This study was part of a larger program, carried out in a disadvantaged city area in Sweden. It had a qualitative design with a participatory approach, following up on actions taken to promote health. Health-promotional activities were developed in collaboration with a women's health group, facilitated by a lay health promoter. The study population was formed by 17 mainly Middle Eastern migrant women. Data was collected using the story-dialog method and the material was analyzed using thematic analysis.

    Result: Three important contributors to engagement in health promotion were identified at an early stage of the analysis process, namely, the group forming a social network, the local facilitator from the community, and the use of social places close to home. Later in the analysis process, a connection was made between these contributors and the rationale behind their importance, that is, how they motivated and supported the women and how the dialog was conducted. This therefore became the designated themes and were connected to all contributors, forming three main themes and nine sub-themes.

    Conclusion: The key implication was that the women made use of their health knowledge and put it into practice. Thus, a progression from functional health literacy to a level of critical health literacy may be said to have occurred.

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