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  • 1.
    Adermark, Louise
    et al.
    Dept of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Dept of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Galanti, Maria Rosaria
    Dept of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Centre of Epidemiology and Community Medicine, Stockholm, Sweden.
    Ryk, Charlotta
    Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU), Stockholm, Sweden.
    Gilljam, Hans
    Dept of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
    Hedman, Linnea
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Dept of Public Health and Clinical Medicine, Division Sustainable health, The OLIN Unit, Umeå University, Umeå, Sweden.
    Prospective association between use of electronic cigarettes and use of conventional cigarettes: a systematic review and meta-analysis2021In: ERJ Open Research, E-ISSN 2312-0541, Vol. 7, no 3, p. 00976-2020Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this systematic review and meta-analysis was to assess the association between e-cigarette use and subsequent initiation or recurrence of cigarette smoking.Data sources A systematic literature search was finalised on 11 November 2019 using PubMed (including MEDLINE), EMBASE, Cochrane Library, Scopus, PubMed Health, NICE Evidence Search, PROSPERO, CRD and PsycInfo.Study selection Studies were included if meeting the following criteria: reporting empirical results; longitudinal observational design with a minimum of 3 months of follow-up; including general population samples; allowing for the comparison between users and nonusers of e-cigarettes. Studies rated as having high risk of bias were excluded. Studies were independently assessed by at least two authors. The procedures described by PRISMA were followed, and the quality of evidence was rated using GRADE.Data synthesis 30 longitudinal studies from 22 different cohorts assessing e-cigarette use among nonsmokers or never-smokers at baseline, and subsequent use of cigarette smoking at follow-up, were included in this review. A random-effects meta-analysis based on 89 076 participants showed a pooled unadjusted odds ratio (OR) of cigarette smoking among baseline nonsmoker e-cigarette users compared with nonusers of 4.68 (CI 3.64–6.02), while the adjusted OR was 3.37 (CI 2.68–4.24). These results were consistent irrespective of whether the outcome was measured as ever-smoking or as past 30-day smoking. The evidence was graded as moderate.Conclusions Use of e-cigarettes may predict the initiation or recurrence of cigarette smoking.

  • 2.
    Alerby, Eva
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Education, Language, and Teaching.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    ‘The pine tree, my good friend’: The other as more-than-human2021In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 22, no 4, article id e12366Article in journal (Refereed)
  • 3.
    Almevall, Albin Dahlin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Healthcare, Region Norrbotten, Luleå, Sweden.
    Wennberg, Patrik
    Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
    Zingmark, Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Öhlin, Jerry
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Söderberg, Stefan
    Department of Public Health and Clinical Medicine, Medicine, Umeå University, Umeå, Sweden.
    Olofsson, Birgitta
    Department of Nursing, Umeå University, Umeå, Sweden; Department of Surgical and Perioperative Science Orthopaedics, Umeå University, Umeå, Sweden.
    Nordmark, Sofi
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Niklasson, Johan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden.
    Associations between everyday physical activity and morale in older adults2022In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 48, p. 37-42Article in journal (Refereed)
    Abstract [en]

    Studies that objectively investigate patterns of everyday physical activity in relation to well-being and that use measures specific to older adults are scarce. This study aimed to explore objectively measured everyday physical activity and sedentary behavior in relation to a morale measure specifically constructed for older adults. A total of 77 persons (42 women, 35 men) aged 80 years or older (84.3 ± 3.8) wore an accelerometer device for at least 5 days. Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS scores were significantly positively associated with number of steps, time spent stepping, and time spent stepping at >75 steps per minute. Sedentary behavior did not associate with PGCMS. Promoting PA in the form of walking at any intensity–or even spending time in an upright position—and in any quantity may be important for morale, or vice versa, or the influence may be bidirectional.

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  • 4.
    Almevall, Albin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Development, Region Norrbotten, Luleå, Sweden.
    Nordmark, Sofi
    Department of Development, Region Norrbotten, Luleå, Sweden.
    Niklasson, Johan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden.
    Zingmark, Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Experiences of home as an aspect of well-being in people over 80 years: A mixed method study2022In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 78, no 1, p. 252-263Article in journal (Refereed)
    Abstract [en]

    Aims To (1) describe experiences of home from a well-being perspective, (2) describe participant characteristics and well-being measures in relation to housing type (3) and how the aforementioned aspects may affect well-being in very old persons. Design Cross-sectional, convergent parallel-results mixed method design with semi-structured interviews analysed by qualitative content analysis, in relation to descriptive statistics and specific well-being outcome measures related to home. Methods A total of 50 persons 80 years or older living in ordinary housing were interviewed (July 2017 to November 2018) about home in relation to well-being, along with collection of participant characteristics and well-being measures related to home. Results Participants described how home had become increasingly important as it provided autonomy and acted as a social and occupational hub. However, autonomy was not unconditional, and home could also be perceived as a place of inactive solitude. Results were interpreted as relating to being in the margins of home and had a major impact on well-being. Housing type seemed of importance with higher measures of well-being for participants in single-living housing compared with those living in apartment. Conclusion Home is increasingly central to well-being in old age; however, very old persons also have to relate to being physically and mentally in the margins of being able to remain in the home. These aspects of home potentially have a major impact on well-being. Impact As very old persons living in ordinary housing will constitute a larger segment of society in coming years, aspects of home can potentially have a considerable impact on well-being for this age-group. This study describes aspects of home that contribute to, or has adverse impact on well-being. These aspects need thorough consideration in policy-making and planning of health care that can affect experiences of home.

  • 5.
    Almevall, Ariel
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Health in later life: A nursing perspective2024Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The ongoing demographic shift towards an older population calls for a corresponding shift to a proactive approach, aiming for health and well-being in old age. This dissertation addresses the need for increased knowledge about health in the context of aging at home. It explores the roles of relationships, home, health, and well-being while examining the various factors influencing health. The disseration also explores how key stakeholders in home care organizations percive a good life for older persons. From a nursing perspective, the disseration explores pathways of change and experiences related to health, guided by the caritative caring theory, which underscores health as wholeness and holiness. By thoroughly examining self-rated health, relationships, and the experiences of older persons receiving home support, along with key stakeholders' perceptions, the dissertation aims to provide valuable insights for nursing practices and the promotion of health in later life.

    This dissertation aims to explore health in later life, specifically concentrating on widowed women living alone with extensive home care needs. This exploration encompasses both the perspective of older widows and that of key stakeholders. For a comprehensive understanding health, the disseration also study self-rated health among older persons over a 20-year period, exploring its associations to health and well-being factors, including survival. Additionally, the dissertation explores the shared relationship between older women and nurses.

    This dissertation comprises one quantitative and three qualitative studies, all centred around older persons aged 80 years and older. Paper I is a quantitative, longitudinal study investigating changes in Self-Rated Health (SRH) across the aging spectrum. The study included 1595 participants initially (aged 59-79) and 541 participants at follow-up (age 80-96). Most participants rated their health as "Quite good" (54.5%) at baseline. Over the study period, 42.6% had stable SRH, 40.6% had declined, and 16.8% had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p<0.05). Paper II is a qualitative study about the concept of a good life for single-living older women with extensive care needs. This involved individual interviews with 11 participants aged 82-95, analysed through reflexive thematic analysis. Paper III is a qualitative description of key stakeholders' perceptions regarding a good life for the oldest old persons living at home with extensive care needs. The study utilized qualitative focus groups with 28 participants aged 31-69 (1 man, 27 women), analysed through qualitative content analysis. Paper IV is a qualitative study that aim to explore the meaning of relationship between older women and registered nurses in home care. The research employed qualitative methods, including focus groups and individual interviews, with 11 older women (aged 82-95) and 5 registered nurses (aged 35-47), analysed using qualitative content analysis. 

    In conclusion, health in later life is not merely about avoiding a decline in health; rather, it involves integrating existing aspects into an ever-changing situation. However, challenges such as living alone, experiencing depressive symptoms, and coping with illness and/or functional disability can pose threats, risking overall health and survival. In contrast, for those living with disabilities and illnesses with extensive care needs, the significance of daily life becomes paramount. Simultaneously, the relationship between older women and registered nurse emerges as a recurring connection with the potential not only to enhance daily life but also to serve as a consistent and supportive presence in the home.

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  • 6.
    Almevall, Ariel
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Almevall, Albin Dahlin
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Öhlin, Jerry
    Department of Public Health and Clinical Medicine, Sustainable Health, Umeå University, Umeå, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Zingmark, Karin
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Niklasson, Johan
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Sunderby Research Unit, Umeå University, Umeå, Sweden.
    Nordström, Peter
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Rosendahl, Erik
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.
    Söderberg, Stefan
    Department of Public Health and Clinical Medicine, Section of Medicine Umeå University, Umeå, Sweden.
    Olofsson, Birgitta
    Department of Nursing, Department of Diagnostics and Intervention, Orthopedics, Umeå University, Umeå, Sweden.
    Self-rated health in old age, related factors and survival: A 20-Year longitudinal study within the Silver-MONICA cohort2024In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 122, article id 105392Article in journal (Refereed)
    Abstract [en]

    Introduction: Self-rated health (SRH) offers insights into the evolving health demographics of an ageing population.

    Aim: To assess change in SRH from old age to very old age and their associations with health and well-being factors, and to investigate the association between SRH and survival.

    Methods: All participants in the MONICA 1999 re-examination born before 1940 (n = 1595) were included in the Silver-MONICA baseline cohort. The Silver-MONICA follow-up started in 2016 included participants in the Silver-MONICA baseline cohort aged 80 years or older. Data on SRH was available for 1561 participants at baseline with 446 of them also participating in the follow-up. The follow-up examination included a wide variety of measurements and tests.

    Findings: Most participants rated their health as "Quite good" (54.5 %) at baseline. Over the study period, 42.6 % had stable SRH, 40.6 % had declined, and 16.8 % had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p < 0.05).

    Conclusion: This study demonstrates associations between changes in SRH and a multitude of health- and wellbeing-related factors, as well as a relation between survival and SRH, accentuating their relevance within the ageing population.

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  • 7.
    Almevall, Ariel
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Juuso, Päivi
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Melander, Catharina
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Zingmark, Karin
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Exploring the meaning of a good life for older widows with extensive need of care: a qualitative in-home interview study2024In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 19, no 1, article id 2322757Article in journal (Refereed)
    Abstract [en]

    Introduction: Studies of older women’s life transitions is rare but gains relevance as the aging population, with older women as the majority, expands.

    Purpose: To explore the meaning of a good life for older widows with extensive home care needs.

    Materials and methods: Semi-structured interviews were carried out with eleven women, aged 80 and over (82–95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5–6 hours, mean 3). Data were analysed by reflexive thematic analysis.

    Results: The theme “This Day in My Home, the frame of my life” reflects the women’s experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely.

    Conclusion: A day at home may seem static, yet it mirrors life’s dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.

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  • 8.
    Almevall, Ariel
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Juuso, Päivi
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Zingmark, Karin
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Nilsson, Carina
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Perceptions of a good life for the oldest old living at home2022In: International Journal of Ageing and Later Life, E-ISSN 1652-8670, Vol. 16, no 1, p. 25-48Article in journal (Refereed)
    Abstract [en]

    An increasing number of people are growing older and living longer in their homes. This study aims to describe key stakeholders’ (politicians, managers, and professionals) perceptions of a good life for single-living oldest old persons living at home with extensive needs for support. Inter­views with stakeholders were analysed with content analysis. The analy­sis resulted in the theme: An incongruence between intentions and actions in promoting a good life for the oldest old. Our findings show a gap between intentions and actions, which caused feelings of powerlessness in the key stakeholders. To promote a good life for the oldest old persons, a congruence is needed between individual awareness and the prerequisite of promoting a good life. Developing methods that identify and bridge gaps between intentions and actions could support the abilities of organ­isations to promote a good life for the oldest old persons with extensive needs for support.

  • 9.
    Almqvist, Daniel
    et al.
    Department of Surgery, Piteå Hospital, Lasarettsvägen 14, 94150 Piteå, Sweden.
    Norberg, David
    Department of Surgery, Skellefteå lasarett, Lasarettsvägen 29, 93141 Skellefteå, Sweden.
    Larsson, Fanny
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Gustafsson, Silje Rysst
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Strategies for a safe interhospital transfer with an intubated patient or where readiness for intubation is needed: A critical incidents study2023In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 74, article id 103330Article in journal (Refereed)
    Abstract [en]

    Introduction: The number of interhospital transports with intubated patients or where intubation readiness is required is increasing in Sweden and globally. Specialist nurses are often responsible for these transports, which involve numerous risks for critically ill patients.

    Aim: The aim of this study was to describe nurse anaesthetists’ and intensive care nurses’ strategies for safe interhospital transports with intubated patients or where intubation readiness is required.

    Method: A qualitative study was conducted using the critical incident technique. During March and April 2020, 12 semi-structured interviews were conducted with nurse anaesthetists and intensive care nurses. Data were analysed according to the critical incident technique, and a total of 197 critical incidents were identified. The analysis revealed five final strategies for safe interhospital transport.

    Results: Participants described the importance of ensuring clear and adequate information transfers between caregivers to obtain vital patient information that enables the nurse in charge to identify risks and problems in advance and create an action plan. Stabilising and optimising the patient's condition before departure and preparing drugs and equipment were other strategies described by the participants, as well as requesting assistance or support if questions or complications arose during transport.

    Conclusion: Transports with intubated patients or where intubation readiness is required are complex and require systematic patient-safety work to ensure that strategies for increasing patient safety and decreasing risks are visible to the nurses in charge, that they are applied, and that they are, indeed, effective.

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  • 10.
    Andersson, Maria
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Swedish Red Cross University College, Huddinge, Sweden.
    Fredholm, Angelica
    County Council Värmland, Karlstad, Sweden; Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Health Science, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Moral Distress, Health and Intention to Leave: Critical Care Nurses’ Perceptions During COVID-19 Pandemic2023In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 9Article in journal (Refereed)
    Abstract [en]

    Introduction: Moral distress increases the risk that critical care nurses will lose the ability to provide quality nursing care.

    Aims: To describe person-related conditions and perceptions of moral distress, health and intention to leave among critical care nurses in intensive care units, and to examine the relationship between person-related conditions, moral distress, health and intention to leave.

    Method: Cross-sectional, with 220 critical care nurses in 15 Swedish ICUs, and data gathered via a self-reported questionnaire.

    Results: Highest moral distress scores were reported in futile care and poor teamwork and 21% reported entertaining an intention to leave. Self-reported health was lower than before the COVID-19 pandemic and 4.1% reported pronounced exhaustion disorder. Self-reported health, reduced capacity to tolerate demands under time pressure, emotional instability or irritability, physical weakness, or being more easily fatigued and with decreased well-being were factors that had a relationship with futile care. Sleeping problems and intention to leave had a relationship with poor teamwork.

    Conclusions: Different strategies are needed to reduce moral distress and the leadership is crucial for managing crises such as the COVID-19 pandemic.

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  • 11.
    Andersson, Maria
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Critical care nurses’ experiences of working during the first phase of the COVID-19 pandemic –Applying the Person-centred Practice Framework2022In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 69, article id 103179Article in journal (Refereed)
    Abstract [en]

    Aim:

    The aim of the study was to deductively study person-centred care, based on critical care nurses’ experiences during the first phase of the covid-19 pandemic.

    Design:

    The study used a qualitative design.

    Method:

    Data collection was conducted as individual interviews and was analysed with qualitative content analysis with a deductive approach.

    Participants:

    Six critical care nurses working in a special covid-19 intensive care unit during the first phase of the pandemic participated.

    Findings:

    The findings are presented within the four domains of person-centred practice: the prerequisites, the care environment, person-centred processes and person-centred outcomes. While the ambition and knowledge about how to work in accordance with person-centred practice were high, there were several obstacles to perform it.

    Conclusion:

    We need to prepare ahead of time so that nurses have optimal organisational prerequisites to be able to work in accordance with person-centred practice, also during pandemics and other crisis, which means to be able to give nursing care in accordance with the ill person’s needs and resources.

  • 12.
    Andersson, Maria
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Critical care nurses’ perception of moral distress in intensive care during the COVID-19 pandemic – A pilot study2022In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 72, article id 103279Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe critical care nurses’ perception of moral distress during the second year of the COVID-19 pandemic.

    Design/Methods: A cross-sectional study involving a questionnaire was conducted. Participants responded to the Italian version of the Moral Distress Scale-Revised, which consists of 14 items divided in dimensions Futile care (three items), Ethical misconduct (five items), Deceptive communication (three items) and Poor teamwork (three items). For each item, participants were also invited to write about their experiences and participants’ intention to leave a position now was measured by a dichotomous question. The data were analysed with descriptive statistics and qualitative content analysis. The study followed the checklist (CHERRIES) for reporting results of internet surveys.

    Setting: Critical care nurses (n = 71) working in Swedish adult intensive care units.

    Results: Critical care nurses experienced the intensity of moral distress as the highest when no one decided to withdraw ventilator support to a hopelessly ill person (Futile care), and when they had to assist another physician or nurse who provided incompetent care (Poor teamwork). Thirty-nine percent of critical care nurses were considering leaving their current position because of moral distress.

    Conclusions: During the COVID-19 pandemic, critical care nurses, due to their education and experience of intensive care nursing, assume tremendous responsibility for critically ill patients. Throughout, communication within the intensive care team seems to have a bearing on the degree of moral distress. Improvements in communication and teamwork are needed to reduce moral distress among critical care nurses.

  • 13.
    Andersson, Maria
    et al.
    Swedish Red Cross University College, SE-141 21 Huddinge, Sweden.
    Nordin, Anna
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden.
    Fredholm, Angelica
    Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden; Centre for Clinical Research, County Council of Värmland, Karlstad, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    The four domains of the person-centred practice framework from the perspective of critical care nurses in intensive care units during a pandemic2023In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 78, article id 103449Article in journal (Refereed)
  • 14.
    Asplund, Maria
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Microtechnology and Nanoscience, Chalmers University of Technology, Gothenburg, Sweden.
    Accessing the brain with soft deployable electrocorticography arrays2023In: Science Robotics, E-ISSN 2470-9476, Vol. 8, no 78, article id eadg2785Article, review/survey (Refereed)
  • 15.
    Backman, Helena
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Umeå university, Public Health and Clinical Medicine, section for Sustainable Health/the OLIN unit.
    Lindmark, Sofia Winsa
    Umeå University, Public Health and Clinical Medicine, section for Sustainable Health/the OLIN unit, Luleå, Sweden.
    Hedman, Linnea
    Umeå University, Public Health and Clinical Medicine, section for Medicine/the OLIN unit, Luleå, Sweden.
    Warm, Katja
    Umeå University, Public Health and Clinical Medicine, section for Medicine/the OLIN unit, Kalmar, Sweden.
    Myrberg, Tomi
    Umeå University, Department of Surgical and Perioperative Sciences, Anaesthesiology and Intensive Care Medicine, Umeå, Sweden.
    Stridsman, Caroline
    Umeå University, Public Health and Clinical Medicine, section for Medicine/the OLIN unit, Luleå, Sweden.
    Kankaanranta, Hannu
    Department of Respiratory Medicine, Seinäjoki Central Hospital, Faculty of Medicine and Health Technology, University of Tampere; Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Lindberg, Anne
    Umeå University, Public Health and Clinical Medicine, section for Medicine/the OLIN unit, Umeå, Sweden.
    Lundbäck, Bo
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Rönmark, Eva
    Umeå University, Public Health and Clinical Medicine, section for Medicine/the OLIN unit, Luleå, Sweden.
    Obesity and inflammatory markers in adult-onset asthma2021In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 58, no 65, article id OA4215Article in journal (Other academic)
  • 16.
    Bashir, M.
    et al.
    Gothenburg University, Gothenburg, Sweden.
    Basna, R.
    Krefting research centre, University of Gothenburg, Gothenburg, Sweden.
    Hedman, Linnea
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Backman, H.
    Department of public health and clinical medicine, section of sustainable health/ the OLIN unit, Umeå University, Umeå, Sweden.
    Ekerljung, L.
    Krefting research centre, University of Gothenburg, Gothenburg, Sweden.
    Wennergren, G.
    Department of Paediatrics, University of Gothenburg, Queen Silvia Children's Hospital, Gothenburg, Sweden.
    Lindberg, A.
    Department of Public Health and Clinical Medicine, Section of Medicine/the OLIN unit, Umeå University, Umeå, Sweden.
    Kankaanranta, H.
    Krefting research centre, University of Gothenburg, Gothenburg, Sweden; Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Tampere University Respiratory Research Group, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
    Rönmark, E.
    Department of public health and clinical medicine, section of sustainable health/ the OLIN unit, Umeå University, Umeå, Sweden.
    Nwaru, B. I.
    Krefting research centre, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Interactive effect of socioeconomic status and smoking on the risk of allergic and nonallergic asthma among certain occupation groups – Results from two Swedish large adult populations: A Nordic Epilung study2023In: Special Issue: Abstracts from the European Academy of Allergy and Clinical Immunology Hybrid Congress, 1‐3 July 2022, John Wiley & Sons, 2023, Vol. 78, p. 220-220, article id 001190Conference paper (Other academic)
  • 17.
    Bashir, Muwada Bashir Awad
    et al.
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden.
    Basna, Rani
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden.
    Zhang, Guo-Qiang
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden.
    Backman, Helena
    Section of Sustainable Health/the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Lindberg, Anne
    Section of Medicine/the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Ekerljung, Linda
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden.
    Axelsson, Malin
    Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Hedman, Linnea
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Vanfleteren, Lowie
    COPD Center, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.
    Lundbäck, Bo
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden.
    Rönmark, Eva
    Section of Sustainable Health/the OLIN Unit, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Nwaru, Bright I.
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, SE-405 30, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
    Computational phenotyping of obstructive airway diseases: protocol for a systematic review2022In: Systematic Reviews, E-ISSN 2046-4053, Vol. 11, no 1, article id 216Article, review/survey (Refereed)
    Abstract [en]

    Background: Over the last decade, computational sciences have contributed immensely to characterization of phenotypes of airway diseases, but it is difficult to compare derived phenotypes across studies, perhaps as a result of the different decisions that fed into these phenotyping exercises. We aim to perform a systematic review of studies using computational approaches to phenotype obstructive airway diseases in children and adults.

    Methods and analysis: We will search PubMed, Embase, Scopus, Web of Science, and Google Scholar for papers published between 2010 and 2020. Conferences proceedings, reference list of included papers, and experts will form additional sources of literature. We will include observational epidemiological studies that used a computational approach to derive phenotypes of chronic airway diseases, whether in a general population or in a clinical setting. Two reviewers will independently screen the retrieved studies for eligibility, extract relevant data, and perform quality appraisal of included studies. A third reviewer will arbitrate any disagreements in these processes. Quality appraisal of the studies will be undertaken using the Effective Public Health Practice Project quality assessment tool. We will use summary tables to describe the included studies. We will narratively synthesize the generated evidence, providing critical assessment of the populations, variables, and computational approaches used in deriving the phenotypes across studies

    Conclusion: As progress continues to be made in the area of computational phenotyping of chronic obstructive airway diseases, this systematic review, the first on this topic, will provide the state of the art on the field and highlight important perspectives for future works.

    Ethics and dissemination: No ethical approval is needed for this work is based only on the published literature and does not involve collection of any primary or human data.

  • 18.
    Beck, Simon
    et al.
    Dalarna University, Sweden.
    Lundblad, Lina
    Dalarna University, Sweden.
    Göras, Camilla
    Dalarna University, Sweden.
    Eneslätt, Malin
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Implementing advance care planning in North Sweden healthcare settings – a study of professionals’ experiences2023In: Abstractkatalog Norrskenskonferensen 2023, Region Jämtland Härjedalen , 2023, p. 71-Conference paper (Refereed)
  • 19.
    Beck, Simon
    et al.
    School of Health and Welfare, Dalarna University, Falun, Sweden.
    Lundblad, Lina
    School of Health and Welfare, Dalarna University, Falun, Sweden.
    Göras, Camilla
    School of Health and Welfare, Dalarna University, Falun, Sweden.
    Eneslätt, Malin
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Implementing advance care planning in Swedish healthcare settings–a qualitative study of professionals’ experiences2023In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 1, p. 23-32Article in journal (Refereed)
    Abstract [en]

    Background: Advance care planning (ACP) is a process involving conversations about values and preferences regarding future care at the end-of-life. ACP has led to positive outcomes, both in relation to quality of life and with increased use of palliative care, less life-sustaining treatment and fewer hospital admissions. Sweden has yet to embrace the practice systematically, but scattered initiatives exist.

    Aim: To study implementation of a routine for ACP in NH settings in Sweden by exploring healthcare professionals’ experiences of engaging in ACP following this implementation.

    Methods: The study followed a qualitative inductive design with convenience and snowball sampling. Semi-structured group and individual interviews with registered healthcare professionals were analysed using qualitative content analysis.

    Findings: Organisational support for sustainable ACP implementation was found to be essential. This included sufficient training, facilitation, collaboration and uniform work routines across providers and professionals. Engaging in ACP conversations following the implemented routine was found to be a process of preparing, being, talking, deciding and sharing.

    Conclusions: Successful implementation of ACP in NHs requires a carefully planned implementation strategy. ACP in NHs tend to be medically focused at the expense of residents’ psychosocial care-planning needs. Widespread uptake of ACP in Sweden could be useful in the national effort to adopt more person-centred care in Swedish healthcare.

    KEY POINTS While advance care planning has been implemented in many other countries, Sweden lacks a national strategy on advance care planning and Swedish healthcare settings have yet to systematically implement this practice. • This study is the first to report on professionals’ experiences of engaging in sustainable advance care planning, following top-down implementation of the practice in one Swedish region. • Successful implementation of advance care planning in nursing homes requires a system-level approach, and shortcomings of the implementation process are highlighted.

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  • 20.
    Bermúdez Barón, Nicolás
    et al.
    Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, Section of Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
    Stridsman, Caroline
    Department of Public Health and Clinical Medicine, Section of Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
    Andersson, Martin
    Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
    Hedman, Linnea
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
    Vikjord, Sigrid Anna
    HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
    Kankaanranta, Hannu
    Department of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland; Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
    Lundbäck, Bo
    Department of Public Health and Clinical Medicine, Section of Medicine, The OLIN Unit, Umeå University, Umeå, Sweden; Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, University of Gothenburg Institute of Medicine, Göteborg, Sweden.
    Rönmark, Eva
    Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
    Backman, Helena
    Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN Unit, Umeå University, Umeå, Sweden.
    Among respiratory symptoms, wheeze associates most strongly with impaired lung function in adults with asthma: a long-term prospective cohort study2021In: BMJ Open Respiratory Research, E-ISSN 2052-4439, Vol. 8, no 1, article id e000981Article in journal (Refereed)
    Abstract [en]

    Background Asthma is a common disease and a major public health concern. Respiratory symptoms are related to its prognosis, which in turn associates with lung function. Still this association on a long-term basis is not entirely understood.

    Aim To study the association of the type and number of respiratory symptoms with FEV1 and FEV1 decline in women and men with asthma.

    Method A population-based cohort of adults with asthma was examined at study entry between 1986 and 2001 and at follow-up between 2012 and 2014, and n=977 had valid measurements of FEV1 on both occasions. Data regarding respiratory symptoms at study entry (recurrent wheeze, dyspnoea, longstanding cough and productive cough) were analysed in relation to FEV1 and annual decline in FEV1, both unadjusted and adjusted for other potentially associated factors by linear regression.

    Results For both sexes recurrent wheeze and dyspnoea were associated with lower FEV1 at study entry and follow-up, while productive cough was associated with lower FEV1 only at follow-up. No associations were found between the type of symptoms and annual decline in FEV1. In adjusted analyses, the association between recurrent wheeze and lower FEV1 both at study entry and follow-up remained significant among women. Also, the association between a higher number of symptoms with lower FEV1 both at study entry and follow-up were present for both sexes and remained after adjustment.

    Conclusions Particularly recurrent wheeze and a higher number of respiratory symptoms may predict lower lung function also in the long run among women and men with asthma.

  • 21.
    Bianchi, Michele
    et al.
    Center for Translational Neurophysiology of Speech and Communication, Fondazione Istituto Italiano di Tecnologia, via Fossato di Mortara 17, Ferrara, 44121 Italy.
    De Salvo, Anna
    Center for Translational Neurophysiology of Speech and Communication, Fondazione Istituto Italiano di Tecnologia, via Fossato di Mortara 17, Ferrara, 44121 Italy; Sezione di Fisiologia Università di Ferrara via Fossato di Mortara 17 Ferrara 44121 Italy.
    Asplund, Maria
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Microsystems Engineering‐IMTEK, University of Freiburg, Freiburg, 79110 Germany; BrainLinks‐BrainTools Center, University of Freiburg, Freiburg, 79110 Germany.
    Carli, Stefano
    Center for Translational Neurophysiology of Speech and Communication, Fondazione Istituto Italiano di Tecnologia, via Fossato di Mortara 17, Ferrara, 44121 Italy.
    Di Lauro, Michele
    Center for Translational Neurophysiology of Speech and Communication, Fondazione Istituto Italiano di Tecnologia, via Fossato di Mortara 17, Ferrara, 44121 Italy.
    Schulze‐Bonhage, Andreas
    BrainLinks‐BrainTools Center, University of Freiburg, Freiburg, 79110 Germany; Epilepsy Center, Faculty of Medicine, University of Freiburg, Freiburg, 79110 Germany.
    Stieglitz, Thomas
    Department of Microsystems Engineering‐IMTEK, University of Freiburg, Freiburg, 79110 Germany; BrainLinks‐BrainTools Center, University of Freiburg, Freiburg, 79110 Germany.
    Fadiga, Luciano
    Center for Translational Neurophysiology of Speech and Communication, Fondazione Istituto Italiano di Tecnologia, via Fossato di Mortara 17, Ferrara, 44121 Italy; Sezione di Fisiologia, Università di Ferrara, via Fossato di Mortara 17, Ferrara, 44121 Italy.
    Biscarini, Fabio
    Center for Translational Neurophysiology of Speech and Communication, Fondazione Istituto Italiano di Tecnologia, via Fossato di Mortara 17, Ferrara, 44121 Italy; Life Science Department, Università di Modena e Reggio Emilia, Via Campi 103, Modena, 41125 Italy.
    Poly(3,4‐ethylenedioxythiophene)‐Based Neural Interfaces for Recording and Stimulation: Fundamental Aspects and In Vivo Applications2022In: Advanced Science, E-ISSN 2198-3844, Vol. 9, no 12, article id 2104701Article, review/survey (Refereed)
    Abstract [en]

    Next‐generation neural interfaces for bidirectional communication with the central nervous system aim to achieve the intimate integration with the neural tissue with minimal neuroinflammatory response, high spatio‐temporal resolution, very high sensitivity, and readout stability. The design and manufacturing of devices for low power/low noise neural recording and safe and energy‐efficient stimulation that are, at the same time, conformable to the brain, with matched mechanical properties and biocompatibility, is a convergence area of research where neuroscientists, materials scientists, and nanotechnologists operate synergically. The biotic–abiotic neural interface, however, remains a formidable challenge that prompts for new materials platforms and innovation in device layouts. Conductive polymers (CP) are attractive materials to be interfaced with the neural tissue and to be used as sensing/stimulating electrodes because of their mixed ionic‐electronic conductivity, their low contact impedance, high charge storage capacitance, chemical versatility, and biocompatibility. This manuscript reviews the state‐of‐the‐art of poly(3,4‐ethylenedioxythiophene)‐based neural interfaces for extracellular recording and stimulation, focusing on those technological approaches that are successfully demonstrated in vivo. The aim is to highlight the most reliable and ready‐for‐clinical‐use solutions, in terms of materials technology and recording performance, other than spot major limitations and identify future trends in this field.

  • 22.
    Booth, Frederick
    et al.
    Department of Accounting, Finance & Economics, Belfast, United Kingdom.
    Potts, Courtney
    School of Psychology, Ulster University, Coleraine, United Kingdom.
    Bond, Raymond
    School of Computing, Ulster University, Belfast, United Kingdom.
    Mulvenna, Maurice
    School of Computing, Ulster University, Belfast, United Kingdom.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Dhanapala, Indika
    Nimbus Research Centre, Munster Technological University, Cork, Ireland.
    Vakaloudis, Alex
    Nimbus Research Centre, Munster Technological University, Cork, Ireland.
    Cahill, Brian
    Nimbus Research Centre, Munster Technological University, Cork, Ireland.
    Kuosmanen, Lauri
    Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
    Ennis, Edel
    School of Psychology, Ulster University, Coleraine, United Kingdom.
    A Mental Health and Well-Being Chatbot: User Event Log Analysis2023In: JMIR mhealth and uhealth, E-ISSN 2291-5222, Vol. 11, article id e43052Article in journal (Refereed)
    Abstract [en]

    Background: Conversational user interfaces, or chatbots, are becoming more popular in the realm of digital health and well-being. While many studies focus on measuring the cause or effect of a digital intervention on people’s health and well-being (outcomes), there is a need to understand how users really engage and use a digital intervention in the real world.

    Objective: In this study, we examine the user logs of a mental well-being chatbot called ChatPal, which is based on the concept of positive psychology. The aim of this research is to analyze the log data from the chatbot to provide insight into usage patterns, the different types of users using clustering, and associations between the usage of the app’s features.

    Methods: Log data from ChatPal was analyzed to explore usage. A number of user characteristics including user tenure, unique days, mood logs recorded, conversations accessed, and total number of interactions were used with k-means clustering to identify user archetypes. Association rule mining was used to explore links between conversations.

    Results: ChatPal log data revealed 579 individuals older than 18 years used the app with most users being female (n=387, 67%). User interactions peaked around breakfast, lunchtime, and early evening. Clustering revealed 3 groups including “abandoning users” (n=473), “sporadic users” (n=93), and “frequent transient users” (n=13). Each cluster had distinct usage characteristics, and the features were significantly different (P<.001) across each group. While all conversations within the chatbot were accessed at least once by users, the “treat yourself like a friend” conversation was the most popular, which was accessed by 29% (n=168) of users. However, only 11.7% (n=68) of users repeated this exercise more than once. Analysis of transitions between conversations revealed strong links between “treat yourself like a friend,” “soothing touch,” and “thoughts diary” among others. Association rule mining confirmed these 3 conversations as having the strongest linkages and suggested other associations between the co-use of chatbot features.

    Conclusions: This study has provided insight into the types of people using the ChatPal chatbot, patterns of use, and associations between the usage of the app’s features, which can be used to further develop the app by considering the features most accessed by users.

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  • 23.
    Boyd, Kyle
    et al.
    Ulster University, School of Art, Belfast, UK.
    Potts, Courtney
    Ulster University, School of Computing, Belfast, UK.
    Bond, Raymond
    Ulster University, School of Computing Belfast, UK.
    Mulvenna, Maurice D
    Ulster University, School of Computing Belfast, UK.
    Broderick, Thomas
    Munster Technological University, Department of Sport, Leisure and Childhood Studies, Cork, Ireland.
    Burns, Con
    Munster Technological University, Department of Sport, Leisure and Childhood Studies, Cork, Ireland.
    Bickerdike, Andrea
    Munster Technological University, Department of Sport, Leisure and Childhood Studies, Cork, Ireland.
    McTear, Michael F
    Ulster University, School of Computing Belfast, UK.
    Kostenius, Catrine
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Vakaloudis, Alex
    Munster Technological University, Nimbus Research Centre, Cork, Ireland.
    Dhanapala, Indika
    Munster Technological University, Nimbus Research Centre, Cork, Ireland.
    Ennis, Edel
    Ulster University School of Psychology Coleraine, UK.
    Booth, Frederick
    Ulster University, School of Computing Belfast, UK.
    Usability testing and trust analysis of a mental health and wellbeing chatbot2022In: Proceedings of the 33rd European Conference on Cognitive Ergonomics (ECCE 2022): Evaluating the Reality–Virtuality Continuum / [ed] Achim Ebert; Thomas Lachmann, Association for Computing Machinery , 2022, article id 18Conference paper (Refereed)
    Abstract [en]

    Mental health chatbots are particularly useful for those who are isolated and may have difficulty attending services or for those who are reluctant to speak to a professional. In this study, the usability and trust of a chatbot known as ’ChatPal’ has been assessed. ChatPal has been developed by an interdisciplinary team encompassing health service providers, local authorities, charities and universities to promote positive mental wellbeing among individuals in rural areas across Europe. This study employed a usability test protocol to recruit representative users to complete a set of tasks using the ChatPal chatbot. Usability issues were assessed along with trust and users’ satisfaction on the System Usability Scale and the Chatbot Usability Questionnaire. The study shows the usability issues and trust with a mental health chatbot and highlights recommendations for improvement.

  • 24.
    Bromfalk, Åsa
    et al.
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
    Hultin, Magnus
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
    Myrberg, Tomi
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sunderbyn), Umeå University, Umeå, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Walldén, Jakob
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sundsvall), Umeå University, Umeå, Sweden.
    Postoperative recovery in preschool‐aged children: A secondary analysis of a randomized controlled trial comparing premedication with midazolam, clonidine, and dexmedetomidine2023In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 33, no 11, p. 962-972Article in journal (Refereed)
    Abstract [en]

    Background

    Preoperative anxiety in pediatric patients can worsen postoperative outcomes and delay discharge. Drugs aimed at reducing preoperative anxiety and facilitating postoperative recovery are available; however, their effects on postoperative recovery from propofol-remifentanil anesthesia have not been studied in preschool-aged children. Thus, we aimed to investigate the effects of three sedative premedications on postoperative recovery from total intravenous anesthesia in children aged 2–6 years.

    Methods

    In this prespecified secondary analysis of a double-blinded randomized trial, 90 children scheduled for ear, nose, and throat surgery were randomized (1:1:1) to receive sedative premedication: oral midazolam 0.5 mg/kg, oral clonidine 4 μg/kg, or intranasal dexmedetomidine 2 μg/kg. Using validated instruments, outcome measures including time for readiness to discharge from the postoperative care unit, postoperative sedation, emergence delirium, anxiety, pain, and nausea/vomiting were measured.

    Results

    After excluding eight children due to drug refusal or deviation from the protocol, 82 children were included in this study. No differences were found between the groups in terms of median time [interquartile range] to readiness for discharge (midazolam, 90 min [48]; clonidine, 80 min [46]; dexmedetomidine 100.5 min [42]). Compared to the midazolam group, logistic regression with a mixed model and repeated measures approach found no differences in sedation, less emergence delirium, and less pain in the dexmedetomidine group, and less anxiety in both clonidine and dexmedetomidine groups.

    Conclusions

    No statistical difference was observed in the postoperative recovery times between the premedication regimens. Compared with midazolam, dexmedetomidine was favorable in reducing both emergence delirium and pain in the postoperative care unit, and both clonidine and dexmedetomidine reduced anxiety in the postoperative care unit. Our results indicated that premedication with α2-agonists had a better recovery profile than short-acting benzodiazepines; although the overall recovery time in the postoperative care unit was not affected.

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  • 25.
    Bromfalk, Åsa
    et al.
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sunderbyn), Umeå University, Umeå, Sweden.
    Myrberg, Tomi
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sunderbyn), Umeå University, Umeå, Sweden.
    Walldén, Jakob
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine (Sundsvall), Umeå University, Umeå, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Hultin, Magnus
    Department of Surgical and Perioperative Sciences, Anesthesiology and Intensive Care Medicine, Umeå University, Umeå, Sweden.
    Preoperative anxiety in preschool children: A randomized clinical trial comparing midazolam, clonidine, and dexmedetomidine2021In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 31, no 11, p. 1225-1233Article in journal (Refereed)
    Abstract [en]

    Introduction: Anxiety in pediatric patients may challenge perioperative anesthesiology management and worsen postoperative outcomes. Sedative drugs aimed to reducing anxiety are available with different pharmacologic profiles, and there is no consensus on their effect or the best option for preschool children. In this study, we aimed to compare the effect of three different premedications on anxiety before anesthesia induction in preschool children aged 2−6 years scheduled for elective surgery. The secondary outcomes comprised distress during peripheral catheter (PVC) insertion, compliance at anesthesia induction, and level of sedation.

    Patients and methods: In this double-blinded randomized clinical trial, we enrolled 90 participants aged 2−6 years, who were scheduled for elective ear-, nose-and-throat surgery. The participants were randomly assigned to three groups: those who were administered 0.5 mg/kg oral midazolam, 4 µg/kg oral clonidine, or 2 µg/kg intranasal dexmedetomidine. Anxiety, distress during PVC insertion, compliance with mask during preoxygenation, and sedation were measured using the modified Yale Preoperative Anxiety Scale, Behavioral Distress Scale, Induction Compliance Checklist, and Ramsay Sedation Scale, respectively.

    Results: Six children who refused premedication were excluded, leaving 84 enrolled patients. At baseline, all groups had similar levels of preoperative anxiety and distress. During anesthesia preparation, anxiety was increased in the children who received clonidine and dexmedetomidine; however, it remained unaltered in the midazolam group. There were no differences in distress during PVC insertion or compliance at induction between the groups. The children in the clonidine and dexmedetomidine groups developed higher levels of sedation than those in the midazolam group.

    Conclusions: In preschool children, midazolam resulted in a more effective anxiolysis and less sedation compared to clonidine and dexmedetomidine.

  • 26.
    Bäckström, Josefin
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Department of Medical Sciences, Psychiatry, Uppsala University, SE-751 85 Uppsala, Sweden.
    Pöder, Ulrika
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, SE-751 22 Uppsala, Sweden.
    Karlsson, Ann-Christin
    Department of Public Health and Caring Sciences, Caring Sciences, Uppsala University, SE-751 22 Uppsala, Sweden.
    I Was Merely a Brick in the Game: A Qualitative Study on Registered Nurses’ Reasons for Quitting Their Jobs in Hospitals2024In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, article id 6662802Article in journal (Refereed)
    Abstract [en]

    The aim was to explore why registered nurses (RNs) in Sweden choose to quit their jobs in hospitals, also in relation to experienced patient safety. Previous research has shown that nurse turnover, especially in hospital settings, is a serious challenge for society and health care globally. Insufficient staffing of RNs is linked to poorer patient outcomes and a general patient safety at risk. It is, therefore, important to continually explore how nurses describe their reasons for quitting their jobs. The study was conducted using a qualitative descriptive design, based on 11 semistructured interviews with RNs. The analysis generated four categories describing the results: Feeling that the profession is not valued; Psychological and physical symptoms related to work; An insufficient and unsupportive organization; and Unsatisfying leadership and teamwork. Specifically, the RNs participating in this study described a range of reasons for quitting, where the feeling of not being valued and treated as a respected and autonomous profession was a common thread throughout the results. RNs experienced that, overall, the insufficient work conditions, also resulting in lower patient safety, ultimately led to their decision to quit. The findings highlight the crucial need for employers to develop working conditions for RNs, to make sure that the profession is valued according to professional standards and provide the potential for autonomous nursing practice. To reduce nurse turnover, and instead attract and retain nurses, leadership and management in nursing need to be adjusted to meet the demands of a modern academic profession.

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  • 27.
    Bäckström, Josefin
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Uppsala university, Sweden.
    Salberg, Johanna
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Uppsala university, Sweden.
    Närstående i psykiatrisk vård2024In: Vårdande vid psykisk ohälsa: på avancerad nivå / [ed] Lena Wiklund Gustin, Studentlitteratur AB, 2024, p. 375-398Chapter in book (Other academic)
  • 28.
    Bäckström, Josefin
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Søndergård, Susanne Friis
    Lovisenberg University College, Oslo, Norway; Aarhus University, Faculty of Health, Aarhus, Denmark.
    Hopia, Hanna
    School of Health and Social Studies, JAMK, University of Applied Sciences, Finland.
    Urban, Reet
    Department of Nursing and Midwifery, Tartu Health Care College, Estonia.
    Assessment and Evaluation Methods in APN Education2024In: Navigating the Future: Advanced Practice Nursing Educational Tools for Success, Nordic/Baltic Advanced Practice Nursing Educators Nordplus network , 2024, p. 39-50Chapter in book (Other academic)
    Abstract [en]

    Assessing nursing skills, whether in the first term of a bachelor’s programme or the final term of an APN programme, is, from our experience, a topic frequently discussed among colleagues. This collaborative discussion occurs irrespective of whether the assessment or evaluation targets more solitary theoretical course activities or theoretical knowledge manifested as clinical skills. In all courses – and in broader perspective educational programmes – it is pivotal that teachers and educators, together with students, ensure that learning activities allow students to achieve the expected learning outcomes. All components, from the curriculum to course content and activities, intended outcomes, and evaluation and assessment methods and tools, should be aligned.

    Since these are fundamentally based on theoretical knowledge, it is seldom meaningful or purposeful to differentiate between theoretical and clinical nursing skills in clinical skill evaluation and assessments. Hence, assessing clinical skills will also always include theoretical knowledge and reasoning.

    This chapter will comprehensively summarise formative and summative evaluation and assessment tools and guidelines relevant to APN education, highlighting best practices for evaluating educational outcomes and competencies which are essential in Advanced Practice Nursing. Numerous methods and tools in this chapter may apply to education at both bachelor’s and master’s level and to other healthcare professions. In this chapter, we emphasise that assessment and evaluation are closely related concepts, where formative methods are related to an evaluation approach, and summative methods are related to an assessment approach. By the end of this chapter, educators and students will feel well-informed and prepared to implement these tools and guidelines in their educational practices.

  • 29.
    Bäckström, Marice
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Leijon-Sundqvist, Katarina
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Lundvall, Liselott
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Department of Radiology, Linköping University Hospital, Linköping, Sweden; Department of Radiology, Västerviks Hospital, Västervik, Sweden.
    Jonsson, K.
    Department of Nursing, Umeå University, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    On the edge of decision-making in trauma care: A focus group study on radiographers’ experiences of interprofessional collaboration2023In: Radiography, ISSN 1078-8174, E-ISSN 1532-2831, Vol. 29, no 6, p. 1123-1129Article in journal (Refereed)
    Abstract [en]

    Introduction: The temporary trauma teams in trauma alerts consist of a diverse group of unique professionals requiring interprofessional collaboration and coordination to achieve efficient, high-quality care. The uncertain situation and complex care environment impose high demands on team dynamics such as individual attitudes and team behaviours. Within interprofessional teams, interaction and coordination reflect the collective success of collaboration and the achievement of goals. Interactions with radiographers have increased in trauma teams given computed tomography&apos;s prominent role in providing crucial knowledge for decision-making in trauma care. This study aimed to explore radiographers&apos; experiences of interprofessional collaboration during trauma alerts.

    Method: The study was designed with focus group methodology, including 17 radiographers participating in five focus groups, analysed with an inductive focus group analysis.

    Results: An overarching theme, “On the edge of decision-making”, emerged along with three sub-themes: “Feeling included requires acknowledgement”, “Exclusion precludes shared knowledge”, and “Experience and mutual awareness facilitate team interaction”.

    Conclusions: Interprofessional collaboration from the radiographer&apos;s perspective within trauma teams requires a sense of inclusion and the ability to interact with the team. Exclusion from vital decision-making obstructs radiographers&apos; comprehension of situations and thereby the interdependence in interprofessional collaboration. Implications for practice: Common platforms are needed for knowledge sharing and team practices, including radiographers’ areas of responsibility and relational coordination to foster interprofessional relationships. Through these means interdependence through awareness and shared knowledge can be facilitated on trauma teams.

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  • 30.
    Böhler, Christian
    et al.
    Department of Microsystems Engineering (IMTEK), University of Freiburg, 79110, Freiburg, Germany; BrainLinks-BrainTools Center, University of Freiburg, 79110, Freiburg, Germany.
    Vomero, Maria
    Department of Microsystems Engineering (IMTEK), University of Freiburg, 79110, Freiburg, Germany; BrainLinks-BrainTools Center, University of Freiburg, 79110, Freiburg, Germany.
    Soula, Marisol
    Neuroscience Institute, Langone Medical Center, New York University, New York, 10016, USA.
    Vöröslakos, Mihály
    Neuroscience Institute, Langone Medical Center, New York University, New York, 10016, USA.
    Porto Cruz, Maria
    Department of Microsystems Engineering (IMTEK), University of Freiburg, 79110, Freiburg, Germany; BrainLinks-BrainTools Center, University of Freiburg, 79110, Freiburg, Germany.
    Liljemalm, Rickard
    Department of Microsystems Engineering (IMTEK), University of Freiburg, 79110, Freiburg, Germany.
    Buzsaki, György
    Neuroscience Institute, Langone Medical Center, New York University, New York, 10016, USA; Department of Physiology and Neuroscience, Langone Medical Center, New York University, New York, 10016, USA; Department of Neurology, Langone Medical Center, New York University, New York, 10016, USA.
    Stieglitz, Thomas
    Department of Microsystems Engineering (IMTEK), University of Freiburg, 79110, Freiburg, Germany; BrainLinks-BrainTools Center, University of Freiburg, 79110, Freiburg, Germany; Bernstein Center Freiburg, University of Freiburg, 79110, Freiburg, Germany.
    Asplund, Maria
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Microsystems Engineering (IMTEK), University of Freiburg, 79110, Freiburg, Germany; BrainLinks-BrainTools Center, University of Freiburg, 79110, Freiburg, Germany; Department of Microtechnology and Nanoscience, Chalmers University of Technology, Gothenburg, SE-41296, Sweden; Freiburg Institute for Advanced Studies (FRIAS), University of Freiburg, 79110, Freiburg, Germany.
    Multilayer Arrays for Neurotechnology Applications (MANTA): Chronically Stable Thin-Film Intracortical Implants2023In: Advanced Science, E-ISSN 2198-3844, Vol. 10, no 14, article id 2207576Article in journal (Refereed)
    Abstract [en]

    Flexible implantable neurointerfaces show great promise in addressing one of the major challenges of implantable neurotechnology, namely the loss of signal connected to unfavorable probe tissue interaction. The authors here show how multilayer polyimide probes allow high-density intracortical recordings to be combined with a reliable long-term stable tissue interface, thereby progressing toward chronic stability of implantable neurotechnology. The probes could record 10–60 single units over 5 months with a consistent peak-to-peak voltage at dimensions that ensure robust handling and insulation longevity. Probes that remain in intimate contact with the signaling tissue over months to years are a game changer for neuroscience and, importantly, open up for broader clinical translation of systems relying on neurotechnology to interface the human brain.

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  • 31.
    Choudhury, Saptamita Paul
    et al.
    School of Biotechnology, Kalinga Institute of Industrial Technology, Bhubaneswar, Odisha, 751024, India.
    Bano, Sarika
    Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, 110007, India.
    Sen, Srijon
    Indian Institute of Technology-Kharagpur, Kharagpur, 721302, India.
    Suchal, Kapil
    Department of Pharmacy, Panipat Institute of Engineering and Technology, Panipat, India.
    Kumar, Saroj
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Deparment of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India.
    Nikolajeff, Fredrik
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Dey, Sanjay Kumar
    Dr. B.R. Ambedkar Center for Biomedical Research, University of Delhi, Delhi, 110007, India.
    Sharma, Vaibhav
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Altered neural cell junctions and ion-channels leading to disrupted neuron communication in Parkinson’s disease2022In: npj Parkinson's Disease, E-ISSN 2373-8057, Vol. 8, no 1, article id 66Article, review/survey (Refereed)
    Abstract [en]

    Parkinson’s disease (PD) is a neurological disorder that affects the movement of the human body. It is primarily characterized by reduced dopamine levels in the brain. The causative agent of PD is still unclear but it is generally accepted that α-synuclein has a central role to play. It is also known that gap-junctions and associated connexins are complicated structures that play critical roles in nervous system signaling and associated misfunctioning. Thus, our current article emphasizes how, alongside α-synuclein, ion-channels, gap-junctions, and related connexins, all play vital roles in influencing multiple metabolic activities of the brain during PD. It also highlights that ion-channel and gap-junction disruptions, which are primarily mediated by their structural-functional changes and alterations, have a role in PD. Furthermore, we discussed available drugs and advanced therapeutic interventions that target Parkinson’s pathogenesis. In conclusion, it warrants creating better treatments for PD patients. Although, dopaminergic replenishment therapy is useful in treating neurological problems, such therapies are, however, unable to control the degeneration that underpins the disease, thereby declining their overall efficacy. This creates an additional challenge and an untapped scope for neurologists to adopt treatments for PD by targeting the ion-channels and gap-junctions, which is well-reviewed in the present article.

  • 32.
    Dahlin Almevall, Albin
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Healthy Ageing and Well-Being in Old Age2023Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In the decades to come, Sweden will be facing an unprecedented increase in the proportion of inhabitants aged 80 years or older. This age group is characterised by large heterogeneity; however ageing also poses challenges for health and well-being. These challenges apply not only to the individual, but also to the health care systems. Care of this older age group employs much of the nursing resources, affecting society as a whole. Healthy ageing can and should, therefore, be promoted in the decades prior to reaching old age, and once having reached old age, well-being should be a continued focus of health care and society. In this way older adults can continue perceiving good health and well-being. The overall aim of this thesis was to explore and describe areas of importance to healthy ageing and well-being in old age. 

    Predictors of healthy ageing were prospectively studied as part of the northern Sweden Silver-MONICA project, from baseline in 1999 (n=1595) to follow-up 20 years later (n=541). For the healthy ageing outcome, a composite outcome comprised of measures of cognition (MMSE), 2.4 metre walking speed, personal independence in everyday life (Katz P-ADL) and depression (GDS15) was constructed. To study perceptions of general well-being in old age, a subsample (n=52) age > 80 was analysed as a cross-section using mixed method with open-ended interviews and the PGCMS well-being measure. A similar approach was used (n=50) to investigate specific aspects of well-being in relation to home. To study the relationship between well-being and objectively measure everyday physical activity, an accelerometer was worn 24 hours per day for at least 5 consecutive days (n=77) and analysed for associations with the PGCMS and its subscales.  

    The five top ranking predictors determined by the healthy ageing index, comprising the total baseline cohort including those who passed away before possible follow-up were smoking status, NT-proBNP, waist circumference, leisure time physical activity level and HbA1c. For those who participated in the Silver-MONICA follow-up, the top five ranking predictors as determined by the healthy ageing index were leisure time physical activity, HbA1c, BMI, waist circumference and high sensitivity Troponin I. In interviews of general well-being, six areas were described that related to social context, health, physical activity, home, engagement and freedom. In regression analysis independence in activities of everyday living along with age were significantly associated with well-being. Acceptance was key for handling consequences of ageing that impacted well-being. Home was perceived as a central aspect of well-being; however, participants described being in the margins of home. Morale was higher among persons living in single-dwelling housing compared to those living in apartments. In activity measures, well-being was associated with the number of steps, time spent stepping and time spent stepping at >75 steps/minute.

    In conclusion, the combination of qualitative, quantitative and mixed methodology utilised in this thesis to study healthy ageing allowed for the possibility to nuance conclusions and to describe the subject from different points of view. Based on the findings, this thesis suggests that physical ability in old age is the basis for being able to engage in and experience the important factors of well-being described above. However, support from others, often family, can compensate for the lack of physical ability. The support is positive to well-being as long as it does not create feelings of being a burden. As consequences of ageing affect the areas most crucial to well-being, it seems that the extent and way these changed conditions are accepted has an important role in the maintaining of well-being in old age.

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  • 33.
    Deliens, Luc
    et al.
    Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium.
    Scheerrens, Anne-Lore
    Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium; Ghent University, Health Promotion Unit, Ghent, Belgium.
    Matthys, Marjolein
    Vrije Universiteit Brussel (VUB) & Ghent University, End-of-life Care Research Group, Brussels, Belgium; Ghent University, Health Promotion Unit, Ghent, Belgium.
    Eneslätt, Malin
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet.
    Using a health promotion approach in palliative care research2022In: 7th Public Health Palliative Care International Conference. Democratizing caring, dying and grieving: participation, action, understanding and evaluation, Sage Publications, 2022, article id 208Conference paper (Refereed)
    Abstract [en]

    Background: Growing evidence shows that using a health promotion approach in palliative care can also have a positive impact on health outcomes in patients, their families and communities. A health promotion approach focuses on factors such as empowerment, attitude and self-efficacy that stimulate health and wellbeing and on enabling individuals to have control of these factors and to make healthy choices even when confronted with life-threatening illness.

    Objectives: To improve knowledge and skills to use a health promotion approach in palliative care research by 1) sharing experiences (challenges; facilitators, barriers) with the use of a health promotion approach in palliative care research and providing inspiring practices and 2) discussing the (potential) impact for people confronted with serious illness, communities, health care services and policy. This workshop will also schedule time for any questions or other ideas related to using a health promotion approach in palliative care research.

    Workshop format: The speakers will shortly (10’) and interactively present their work and experience with using a health promotion approach in palliative care research. Following these presentations, ideas for using a health promotion approach in future palliative care research will be discussed. For example: how to apply principles and practices of health promotion; how to co-create and design studies with the target group and other potential end-users in palliative care research? These discussions will be held in small groups i.e. one group will include both people having experience and having no experience. Afterwards, time will be scheduled for presenting the ideas back to the group.

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  • 34.
    Derblom, Katharina
    et al.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Molin, Jenny
    Department of Nursing, Umeå University, Umeå, Sweden; Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden.
    Gabrielsson, Sebastian
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Lindgren, Britt-Marie
    Department of Nursing, Umeå University, Umeå, Sweden.
    ‘Acknowledge me as a capable person’: How people with mental ill health describe their experiences with general emergency care staff – A qualitative interview study2021In: International Journal of Mental Health Nursing, ISSN 1445-8330, E-ISSN 1447-0349, Vol. 30, no 6, p. 1539-1549Article in journal (Refereed)
    Abstract [en]

    People with mental ill health attend general emergency care more often than others for physical and psychiatric care needs. Staff in general emergency care report they lack knowledge and strategies to meet with and care for people with mental ill health. This study aimed to describe how people with mental ill health experience encounters with staff in general emergency care. We conducted individual semi-structured interviews with 11 people with mental ill health about their experiences in general emergency care and subjected the interview data to qualitative content analysis. Our results show the importance to people with mental ill health of being acknowledged as capable persons, and how this relates to their experiences of being recognized, ignored, or dismissed by staff in general emergency care. Even small, ordinary aspects of staff/patient interactions can have major impacts on a person’s recovery and well-being. The study is reported according to the consolidated criteria for reporting qualitative research (COREQ) guidelines.

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  • 35.
    Derblom, Katharina
    et al.
    Department of Nursing, Umeå University, Umeå, Sweden.
    Molin, Jenny
    Department of Nursing, Umeå University, Umeå, Sweden; Department of Clinical Sciences, Division of Psychiatry, Umeå University, Umeå, Sweden.
    Gabrielsson, Sebastian
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Lindgren, Britt-Marie
    Department of Nursing, Umeå University, Umeå, Sweden.
    Nursing Staff’s Experiences of Caring for People with Mental Ill-Health in General Emergency Departments: A Qualitative Descriptive Study2022In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 43, no 12, p. 1145-1154Article in journal (Refereed)
    Abstract [en]

    While people with mental ill-health report unsatisfying experiences and poor treatment in general emergency departments, nursing staff report a lack of adequate knowledge and training. This study describes nursing staff’s experiences caring for people with mental ill-health in general emergency departments. A qualitative descriptive design was used and 14 interviews were subjected to qualitative content analysis. Results show that nursing staff are dealing with uncertainty and competing priorities when caring for people with mental ill-health. Nursing staff must both take and be given the opportunity to maintain and develop confidence and independence and need support in promoting mental health recovery.

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  • 36.
    Dupont, Charlèss
    et al.
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), 1090, Brussel, Belgium.
    Smets, Tinne
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), 1090, Brussel, Belgium.
    Monnet, Fanny
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), 1090, Brussel, Belgium.
    Eneslätt, Malin
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Marie Cederschiöld University College, Stockholm, Sweden.
    Tishelman, Carol
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Center for health care economics, informatics and health care research (CHIS). Stockholm Health Care Services (SLSO), Region Stockholm, Stockholm, Sweden.
    Van den Block, Lieve
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), 1090, Brussel, Belgium.
    The cultural adaptation of the go wish card game for use in Flanders, Belgium: a public health tool to identify and discuss end-of-life preferences2022In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 2110Article in journal (Refereed)
    Abstract [en]

    Background

    Public health tools like the Go Wish card game from the US, have been found useful to support people in reflecting on their end-of-life preferences, but a cultural adaptation is essential for their success. In the present study, we explore the necessary cultural adaptations to the Go Wish cards by applying an extensive, systematic, and community-engaging negotiating procedure to facilitate the use of the cards in the general population of Flanders, Belgium.

    Methods

    We used an iterative cultural adaptation process with repeated discussions with various community organizations and representatives of minority and religious groups. After that, the cards were evaluated by 12 healthcare professionals in relation to: linguistic equivalence to the original version, applicability, comprehensibility, and relevance per card. Additional testing with potential users preceded final adjustments.

    Results

    We found that stakeholders were keen to engage throughout the process of cultural adaptation and we were able to make a range of cultural adaptations for the use of the cards in Flanders. All original statements were rephrased from passive to more active statements. Sixteen out of 36 cards were adjusted to make them more culturally appropriate for use in Flanders, e.g., “to meet with clergy or a chaplain” to “having a spiritual counselor as support.” Three new cards were added: two with statements appropriate to the Belgian patient rights and euthanasia legislation and one extra Wild Card. Potential users (n = 33) felt that the cards supported conversations about end-of-life preferences.

    Conclusion

    By making community engagement a cornerstone of our adaption process, we developed a card set that potential end-users considered a supportive public health tool for reflecting and discussing end-of-life values and preferences. The described process is particularly valuable for culturally adapt interventions, especially given that community engagement in adapting interventions is essential to creating grounded interventions.

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  • 37.
    Dupont, Charlèss
    et al.
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.
    Smets, Tinne
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.
    Monnet, Fanny
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.
    Eneslätt, Malin
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Tishelman, Carol
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Marie Cederschiöld University College, Stockholm, Sweden.
    Van den Block, Lieve
    VUB-UGhent End-of-life Care Research Group, Vrije Universiteit Brussel (VUB), Brussel, Belgium.
    The cultural adaptation of the GoWish cards for use in Flanders, Belgium: a game to identify and discuss end-of-life preferences2022In: 7th Public Health Palliative Care International Conference. Democratizing caring, dying and grieving: participation, action, understanding and evaluation, Sage Publications, 2022, article id 93Conference paper (Refereed)
    Abstract [en]

    Background: Games like the GoWish cards, from the US, have been found useful to support people in reflecting about their end-of-life preferences. Because card games like GoWish are culturally sensitive, we aimed to perform a systematic cultural adaptation of the cards for use in Flanders, Belgium involving multiple stakeholders.

    Methods: We used an iterative cultural adaptation process with repeated discussions with various community organizations and representatives of minority and religious groups. Next, the cards were evaluated in relation to: linguistic equivalence to original version, applicability, comprehensibility, and relevance per card. Based on the evaluation for each item the content validity index (I-CVI) was calculated with >0,78 as minimum required score. The translated version was tested with potential users. Their feedback and items with a I-CVI of <0,78 were used for final adjustments.

    Results: After translation, the organizations and representatives of minorities and religions made cultural adaptations to nine cards (e.g. “accomplishments” was changed to “memories” since this was deemed more appropriate in our culture). Because of the legal context in Belgium, two cards were added: “a self-chosen end of life” and “being able to record my choices”. The modified version was reviewed by 12 healthcare workers. 28/38 cards had an I-CVI score >0.78 on all four items. Potential users (n = 33) felt that the cards supported conversations about end-of-life preferences. Based on the ten cards with a I-CVI <0.78 and feedback from potential users, the wording of four cards was reformulated.

    Conclusion: Using a systematic process of cultural adaptation involving multiple stakeholders, we were able to identify detailed adjustments needed to achieve cultural adaptations appropriate for use of the cards in Flanders. The strength of the adaptation process lies in the multiple perspectives using different methods throughout the process.

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  • 38.
    Ejderlöf, Jennifer
    et al.
    Intensive Care Unit, Gällivare Hospital, Gällivare, Sweden.
    Engström, Åsa
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    The Helicopter Transports of Patients Critically ill with COVID-192022In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 8, p. 1-10Article in journal (Refereed)
    Abstract [en]

    Objective

    The aim of our study was to describe specialist nurses’ experiences with the helicopter transport of patients critically ill with COVID-19.

    Method

    Our study followed a descriptive qualitative design anchored in the naturalistic paradigm and was based on qualitative content analysis. The study followed the consolidated criteria for reporting qualitative research.

    Results

    Six semi-structured interviews were conducted with specialist nurses who have cared for patients critically ill with COVID-19 during helicopter transport. The analysis of the interviews resulted in three themes—designing new routines before transport, working under new conditions and post-transport and reflections—with 11 categories. The goal of the intensive care transport of patients with COVID-19 was twofold: to prevent the spread of infection by using personal protective equipment and to prevent the contamination of the helicopter.

    Conclusion

    For the nurses, working in personal protective equipment created a feeling of distance from patients that compromised patient–nurse intimacy. Our results suggest that ensuring the sufficiency of equipment required in the event of major accidents and pandemics is critical.

  • 39.
    Ekblom‐Bak, Elin
    et al.
    Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden.
    Börjesson, Mats
    Center for Health and Performance, Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Sweden; Dept MGA, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg Sweden.
    Bergman, Frida
    Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
    Bergström, Göran
    Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg; Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Dahlin-Almevall, Albin
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Drake, Isabel
    Department of Clinical Sciences in Malmö Lund University, Malmö, Sweden.
    Engström, Gunnar
    Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
    Engvall, Jan E
    CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Department of Clinical Physiology, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Gummesson, Anders
    Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg; Clinical Genetics and Genomics, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Hagström, Emil
    Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
    Hjelmgren, Ola
    Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg; Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Jernberg, Tomas
    Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Johansson, Peter J
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden.
    Lind, Lars
    Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden.
    Mannila, Maria
    Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
    Nyberg, André
    Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Persson, Margaretha
    Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
    Reitan, Christian
    Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Rosengren, Annika
    Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg; Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Rådholm, Karin
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Schmidt, Caroline
    Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg.
    Sköld, Magnus C
    Department of Respiratory Medicine and Allergy, Karolinska University Hospital Solna, Stockholm, Sweden; Respiratory Medicine Unit, Department of Medicine Solna and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
    Sonestedt, Emily
    Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
    Sundström, Johan
    Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala University Hospital, Uppsala, Sweden; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
    Swahn, Eva
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Cardiology, Linköping University, Linköping, Sweden.
    Öhlin, Jerry
    Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Östgren, Carl Johan
    Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
    Ekblom, Örjan
    Department of Physical Activity and Health The Swedish School of Sport and Health Sciences Stockholm Sweden.
    Accelerometer derived physical activity patterns in 27.890 middle‐aged adults: The SCAPIS cohort study2022In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 32, no 5, p. 866-880Article in journal (Refereed)
    Abstract [en]

    The present study aims to describe accelerometer-assessed physical activity (PA) patterns and fulfillment of PA recommendations in a large sample of middle-aged men and women, and to study differences between subgroups of socio-demographic, socio-economic, and lifestyle-related variables. A total of 27 890 (92.5% of total participants, 52% women, aged 50–64 years) middle-aged men and women with at least four days of valid hip-worn accelerometer data (Actigraph GT3X+, wGT3X+ and wGT3X-BT) from the Swedish CArdioPulmonary bioImage Study, SCAPIS, were included. In total, 54.5% of daily wear time was spent sedentary, 39.1% in low, 5.4% in moderate, and only 0.1% in vigorous PA. Male sex, higher education, low financial strain, born in Sweden, and sedentary/light working situation were related to higher sedentary time, but also higher levels of vigorous PA. High BMI and having multiple chronic diseases associated strongly with higher sedentary time and less time in all three PA intensities. All-year physically active commuters had an overall more active PA pattern. The proportion fulfilling current PA recommendations varied substantially (1.4% to 92.2%) depending on data handling procedures and definition used. Twenty-eight percent was defined as having an “at-risk” behavior, which included both high sedentary time and low vigorous PA. In this large population-based sample, a majority of time was spent sedentary and only a fraction in vigorous PA, with clinically important variations between subgroups. This study provides important reference material and emphasizes the importance of a comprehensive assessment of all aspects of the individual PA pattern in future research and clinical practice.

  • 40.
    Eman, Erika
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Nevander, Sara
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Upplevelsen av stress hos sjuksköterskor inom primärvården under Covid-19 pandemin2021Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Att arbeta som sjuksköterska anses som ett riskabelt och stressfyllt yrke vilket kan påverka både den fysiska och den psykiska hälsan. Stress har sedan länge drabbat personer som arbetar inom hälso- och sjukvård. Covid-19 pandemin har medfört en arbetssituation för sjuksköterskor som kan vara ett hot mot deras hälsa. Syfte: Att beskriva upplevelsen av stress hos sjuksköterskor inom primärvård under Covid-19 pandemin. Metod: Kvalitativ metod med induktiv ansats. Datainsamlingen genomfördes i form av individuella semistrukturerade intervjuer och dataanalysen utfördes med kvalitativ innehållsanalys. Resultat: Studien resulterade i fem slutkategorier; Att möta patienters oro och tvingas prioritera; Oro över att smitta andra; Ovisshet om att bli omplacerad samt Psykosociala arbetsmiljöns betydelse för att hantera stress. Slutsats: Det är viktigt att det bedrivs en fungerande och patientsäker hälso- och sjukvård men den bör också bedrivas så att sjuksköterskorna får en god arbetsmiljö och kan bevara sin hälsa. Det behövs kraftansträngningar och insatser från arbetsgivaren för att bevara sjuksköterskors hälsa och att en säker vård kan bedrivas.

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  • 41.
    Eneslätt, Malin
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Karolinska Institutet, Sverige.
    Implementing advance care planning in Swedish healthcare settings – a qualitative study of professionals’ experiences2023Conference paper (Other academic)
  • 42.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Ayoub, Maria
    Högskolan Dalarna, Sverige.
    Udo, Camilla
    Högskolan Dalarna, Sverige.
    Kreicbergs, Ulrika
    Marie Cederschiöld högskola, Stockholm, Sverige.
    Lövgren, Malin
    Marie Cederschiöld högskola, Stockholm, Sverige.
    Stödprogrammet Family Talk Intervention: Mål och innehåll i samtal med familjer inom barncancervård2023Conference paper (Other academic)
  • 43.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Karolinska Institutet, Dept of Learning, Informatics, Management and Ethics, Stockholm, Sweden.
    Helgesson, G.
    Karolinska Institutet, Dept of Learning, Informatics, Management and Ethics, Stockholm, Sweden.
    Tishelman, C.
    Karolinska Institutet, Dept of Learning, Informatics, Management and Ethics, Stockholm, Sweden; SLSO, Stockholm Health Services, Stockholm, Sweden; University of Southampton, Southampton, United Kingdom.
    Dissemination, Use and Impact of a Community-based, Conversational Advance Care Planning Intervention: Ripple Effects of the Swedish DöBra cards2021In: Palliative Medicine: A Multiprofessional Journal, ISSN 0269-2163, E-ISSN 1477-030X, Vol. 35, no 1_suppl, article id J-27Article in journal (Other academic)
    Abstract [en]

    Background: There is growing interest in community-based advance care planning (ACP) interventions, but few studies investigate the societal impact of such initiatives. A Swedish adaptation of the GoWish cards, the DöBra cards, were used as a tool in the SweACP participatory action research project with older people in the community, without imminent End-of-Life (EoL) care needs. Due to popular demand, the DöBra cards were later made available to the general public as a social innovation.

    Aim: To explore how the publicly available DöBra cards have been disseminated and used without researchers’ engagement, to provide a basis for understanding their impact in a wider community setting.

    Methods: Using a Ripple Effects Mapping approach, we followed three chains of dissemination of the DöBra cards originating in a patient organization, a national interest organization for older people, and in a health care organization. Data were collected through interviews with 20 participants and analyzed with directed content analysis.

    Results: A variety of strategies for use were noted, as the DöBra cards were adapted to fit needs in different personal, professional, and organizational settings. The cards were found to act as both a means to raise awareness about EoL issues in different contexts, as well as an end in themselves, e.g. by facilitating ACP conversations for people with serious disease. Resistance, from various instances, to use or promotion of the DöBra cards was however also found. Impact included personal development as well as strengthened personal and professional relationships, with potential to affect EoL care provision.

    Conclusions: The broad dissemination of the DöBra cards in a variety of contexts beyond those controlled by researchers, has led to capacity building in dealing with EoL issues in the community, as the topic of dying and death has been brought to agendas in new contexts.

  • 44.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Department of Health Care Sciences, Marie Cederschiöld University College, Stockholm, Sweden.
    Helgesson, Gert
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Tishelman, Carol
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services (SLSO), Stockholm county council (SLL), Stockholm, Sweden.
    Dissemination, Use and Impact of a Community-based Advance Care Planning Intervention: Ripple Effects of the Swedish DöBra cards2022In: 7th Public Health Palliative Care International Conference. Democratizing caring, dying and grieving: participation, action, understanding and evaluation, Sage Publications, 2022, article id 224Conference paper (Refereed)
    Abstract [en]

    Background: There is growing interest in community-based advance care planning (ACP) interventions, but few studies investigate the societal impact of such initiatives. A Swedish adaptation of the GoWish cards, the DöBra cards, were used as a tool in the SweACP participatory action research project with older people in the community, without imminent End-of-Life (EoL) care needs. Due to popular demand, the DöBra cards were later made available to the general public as a social innovation.

    Aim: To explore how the publicly available DöBra cards have been disseminated and used without researchers’ engagement, to provide a basis for understanding their impact in a wider community setting.

    Methods: Using a Ripple Effects Mapping approach, we followed three chains of dissemination of the DöBra cards originating from a patient organization, a national interest organization for older people, and a health care organization. Data were collected through interviews with 20 participants and analyzed with directed content analysis.

    Results: A variety of strategies for use were noted, as the DöBra cards were adapted to fit needs in different personal, professional, and organizational settings. The cards were found to act as both a means to raise awareness about EoL issues in different contexts, as well as an end in themselves, e.g. by facilitating ACP conversations for people with serious disease. However, in some instances, resistance to use or promotion of the DöBra cards was also described. Impact included personal development as well as strengthened personal and professional relationships, with potential to affect EoL care provision.

    Conclusions: The primarily positive perspectives and broad dissemination of the DöBra cards in a variety of contexts beyond those controlled by researchers, has led to capacity building in dealing with EoL issues in the community, as the topic of dying and death has been brought to agendas in new contexts.

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  • 45.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden.
    Helgesson, Gert
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Tishelman, Carol
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services (SLSO), Region Stockholm, Stockholm, Sweden; School of Health Sciences, University of Southampton, Southampton, UK.
    Dissemination, use, and impact of a community-based, conversational advance care planning intervention: ripple effects of the Swedish DöBra cards2021In: Palliative Care and Social Practice, ISSN 2632-3524, Vol. 15, article id 26323524211032983Article in journal (Refereed)
    Abstract [en]

    Introduction & Aim: Despite increasing interest in community-based advance care planning interventions, few studies investigate the societal impact of such initiatives. The DöBra cards, a Swedish adaptation of the GoWish cards, were first used for advance care planning conversations in a participatory action research project and later, due to popular demand, made available for purchase by the general public. We explore how the DöBra cards were disseminated and used publicly, to understand their impact in the community.

    Methods: We used Ripple Effects Mapping to follow three dissemination ripples, based on interviews with 20 participants, analyzed with directed content analysis.

    Findings: Key factors influencing dissemination of the DöBra cards included ‘champions’ with a mandate within their context or organization, policy documents including use of the cards, media coverage, and presentations of the cards in various settings. The DöBra cards were adapted for use individually and in groups in different private, professional, and organizational settings. Perceived benefits of the cards included acting as an icebreaker in initiating end-of-life conversations and having preformulated statements to reflect upon. Other positive experiences included discussions on different interpretations of card statements, thus opening new perspectives regarding end-of-life. The DöBra cards functioned both as means to raise end-of-life issues in different contexts, and as an end in themselves, for example, by facilitating advance care planning conversations for those with serious disease. Impact also included personal development and strengthening of private and professional relationships, with potential to affect end-of-life care.

    Conclusion: The broad dissemination of the DöBra cards influenced capacity-building in dealing with end-of-life issues in communities, as the topic of dying and death was brought to agendas in new contexts.

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    fulltext
  • 46.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Helgesson, Gert
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden.
    Tishelman, Carol
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden; Stockholm Health Care Services (SLSO), Region Stockholm, Stockholm, Sweden; University of Southampton, School of Health Sciences, Southampton, UK.
    Same, same, but different? A longitudinal, mixed-methods study of stability in values and preferences for future end-of-life care among community-dwelling, older adults2021In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 20, article id 148Article in journal (Refereed)
    Abstract [en]

    Background

    End-of-life preferences may change over time, e.g. due to illness progression or life events. Research on stability of end-of-life preferences has largely focused on life-sustaining treatments in seriously ill patients or medical decision-making based on hypothetical illness scenarios and possible treatment options. Few studies focus on community-dwellers in natural settings. The aim of this study was thus to explore if and how community-dwelling, older adults’ prioritizations and reasoning about values and preferences for future end-of-life care change over time.

    Methods

    Using a mixed-methods design, we explored stability of end-of-life preferences in older community-dwelling adults without imminent end-of-life care needs. At two timepoints (T1 and T2), 5.5–12 months apart, 52 individuals discussed what would be important to them at the end-of-life, through open conversations and while using DöBra cards, a Swedish version of GoWish cards. Participants ranked their most important card statements from 1 to 10. Stability in card rankings, i.e. a card recurring in the top-10 ranking at T2 regardless of position, was explored using descriptive statistics and non-parametric analyses. Participants’ reasoning about card choices were explored with longitudinal qualitative analysis.

    Results

    Stability between T1 and T2 in the top-10 priorities ranged from 20 to 80%, median 60%. Stability in cards rankings could not be explained by changes in participants’ health status, extent of card use (no/little/frequent use) between interviews, or days between T1 and T2, nor was it related to demographic variables. Qualitative analysis showed that consistent reasoning was not always paired with consistency in card choices and changed card choices were not always related to changes in reasoning.

    Conclusions

    Longitudinal exploration combining DöBra card rankings with underlying reasoning about end-of-life preferences over time furthers knowledge on the dynamics between values and preferences in end-of-life decision-making. Individuals’ end-of-life preferences in form of card choices were relatively stable over time albeit with large variation between different individuals. However, the values and underlying reasoning that participants used to motivate their choices appeared more stable than ranking of card choices. We thus conclude that concurrent conversation-based exploration is a more comprehensive indicator of end-of-life values and preferences over time than ranking of cards alone.

  • 47.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology. Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Helgesson, Gert
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Tishelman, Carol
    Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
    Same, Same But Different? Changes in Community-Dwelling, Older Adults’ End-of-Life Preferences Over Time2021Conference paper (Refereed)
  • 48.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Jobe, Ingela
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Melander, Catharina
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.
    Using Innovative Means To Educate Nursing Students At A North Sweden University About End-Of-Life2023In: Abstractkatalog Norrskenskonferensen 2023, 2023, p. 56-Conference paper (Refereed)
  • 49.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Learning and Technology, Nursing and Medical Technology.
    Johansson, Therese
    Cicely Saunders Institute, King’s College London, United Kingdom; Karolinska Institutet and Stockholm Health Care Services, Sweden.
    Stoor, Krister
    Várdduo - Centre for Sámi Research, Dept. of Language Studies/Sámi dutkan, Umeå University, Sweden.
    Tishelman, Carol
    Karolinska Institutet, Stockholm, Sweden; Region Stockholm, Stockholm, Sweden; End-of-Life Research Group, Vrije University, Brussels, Belgium.
    The DöBra cards: A tool to support death literacy?2023In: Culture, Spirituality and Religious Literacy in Healthcare: Nordic Perspectives / [ed] Daniel Enstedt; Lisen Dellenborg, Taylor & Francis, 2023, p. 163-179Chapter in book (Refereed)
  • 50.
    Eneslätt, Malin
    et al.
    Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology. Karolinska Institutet, Sverige.
    Kleijberg, Max
    Karolinska Institutet, Sverige.
    Presentation av abstrakt från DöBra-projektet: Att engagera allmänheten i frågor om döende, död och sorg2022In: Konferensbok: Palliativ vård - det gäller livet, Västra Götalandsregionen , 2022, p. 12-13Conference paper (Other academic)
1234 1 - 50 of 176
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