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  • 301.
    Heikkilä, Fanny
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Larsson, Agnes
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Ofrivilligt barnlösa kvinnors upplevelser av infertilitet: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Möjligheten att få barn kan av många tas för givet. I nutid rankas infertilitet som den femte allvarligaste funktionsnedsättningen hos kvinnor under 60 år. Syftet med litteraturstudien var att beskriva ofrivilligt barnlösa kvinnors upplevelser av infertilitet. En kvalitativ innehållsanalys med manifest ansats tillämpades i analysen där tio vetenskapliga studier granskades och resulterade i fem kategorier; Att känna sig ofullständig som kvinna när kroppen sviker, Att känna sig utanför, Att känna skuld till sin partner men komma närmare varandra emotionellt, Att pendla mellan hopp och förtvivlan vid behandling, Att försöka acceptera och föreställa sig en meningsfull framtid utan barn. Resultatet visade att infertiliteten och den ofrivilliga barnlösheten påverkade kvinnornas liv och självbild negativt. Kvinnorna var i behov av information och stöd för att hantera sin livssituation. I mötet med ofrivilligt barnlösa kvinnor som lider av infertilitet bör sjuksköterskor tillämpa ett personcentrerat förhållningssätt och arbeta för att stärka kvinnornas känsla av sammanhang och främja till upplevelsen av hälsa och välbefinnande.

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  • 302.
    Heikkilä, Ida
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Olsson, Sofia
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Upplevelsen av att vara anhörig till en person med demenssjukdom som bor på vård- och omsorgsboende - En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Varje år drabbas ett stort antal människor av demenssjukdom och det förväntas öka i framtiden, vilket kommer leda till ett ökat behov av vårdinsatser. På grund av att personer med demenssjukdom kräver mycket omvårdnad leder det till att anhöriga får ta ett stort ansvar, vilket vid försämring i sjukdomen ofta leder till att personen med demenssjukdom behöver flytta in på boende. Syftet med studien var att beskriva upplevelsen av att vara anhörig till en person med demenssjukdom som bor på vård-och omsorgsboende. En systematisk litteratursökning utfördes där 14 artiklar som svarade på syftet analyserades med kvalitativ manifest innehållsanalys med induktiv ansats vilket resulterade i fem kategorier: Skuldkänslor och sorg efter närståendes flytt; en bra relation med personalen; god kommunikation och information; en stimulerande omgivning på boendet samt förändrad relation efter närståendes flytt. Resultatet diskuteradesutifrån hur anhöriga kan få stöd med och att sjuksköterskan behöver upprätta en god relation med anhöriga där stöd och information är av vikt. Slutsatsen visar vikten av att sjuksköterskor prioriterar och planerar sitt arbete på ett sätt som ger förutsättningar för en god kommunikation med anhöriga och att det är viktigt att involvera både patienten och anhöriga, samt att kunskap om anhörigas upplevelser ger möjlighet för sjuksköterskan att se deras främsta behov

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  • 303.
    Hemmingsson, Eva-Stina
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Gustafsson, Maria
    Department of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University, Umeå, Sweden.
    Isaksson, Ulf
    Department of Nursing, Umeå University, Umeå, Sweden. Arctic Research Centre at Umeå University, Umeå, Sweden.
    Karlsson, Stig
    Department of Nursing, Umeå University, Umeå, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Sandman, Per-Olof
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Department of Nursing, Umeå University, Umeå, Sweden. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Lövheim, Hugo
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Prevalence of pain and pharmacological pain treatment among old people in nursing homes in 2007 and 20132018In: European Journal of Clinical Pharmacology, ISSN 0031-6970, E-ISSN 1432-1041, Vol. 74, no 4, p. 483-488Article in journal (Refereed)
    Abstract [en]

    Purpose

    Many elderly people living in nursing homes experience pain and take analgesic medication. The aim of this study was to analyze the prevalence of pain and pharmacological pain treatment among people living in nursing homes in Sweden, in two large, comparable, samples from 2007 to 2013.

    Methods

    Cross-sectional surveys were performed in 2007 and 2013, including all residents in nursing homes in the county of Västerbotten, Sweden. A total of 4933 residents (2814 and 2119 respectively) with a mean age of 84.6 and 85.0 years participated. Of these, 71.1 and 72.4% respectively were cognitively impaired. The survey was completed by the staff members who knew the residents best.

    Results

    The prescription of opioids became significantly more common while the use of tramadol decreased significantly. The staff reported that 63.4% in 2007 and 62.3% in 2013 had experienced pain. Of those in pain, 20.2% in 2007 and 16.8% in 2013 received no treatment and 73.4 and 75.0% respectively of those with pain, but no pharmacological treatment, were incorrectly described by the staff as being treated for pain.

    Conclusions

    There has been a change in the pharmacological analgesic treatment between 2007 and 2013 with less prescribing of tramadol and a greater proportion taking opioids. Nevertheless, undertreatment of pain still occurs and in many cases, staff members believed that the residents were prescribed analgesic treatment when this was not the case.

  • 304.
    Henningsson, Pauline
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Öhman, Petra
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Påverkan på dagligt liv i en familj när en nära anhörig drabbas av demens i tidig ålder: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Demens är en vanlig sjukdom i samhället. När en person drabbas av kronisk sjukdom

    påverkas hela familjen. Syftet med denna litteraturstudie var att sammanställa kunskap om

    hur dagligt liv i en familj påverkas när en nära anhörig drabbas av demens i tidig ålder.

    Studien utfördes i form av en integrerad litteraturöversikt. 11 vetenskapliga studier valdes ut

    och ingick i analysen som resulterade i 12 kategorier. Resultatet visade att det dagliga livet

    påverkades genom att ovissheten ökade i familjen, sjukdomen medförde ekonomiska

    konsekvenser, och det skedde rollförändringar. Till följd av sjukdomen skedde en ökning av

    konflikter i familjen, relationer förändrades och familjen stigmatiserades. Det fanns en stor

    emotionell påverkan på familjemedlemmarna, och levnadssituationen påverkade hälsan

    negativt. För att hantera situationen använde familjemedlemmarna olika coping-strategier. De

    efterfrågade utbildning, stöd, samt god vård och omsorg om personen med demens i tidig

    ålder. Sjuksköterskan kan stödja närstående och möta deras behov genom interventioner i

    form av utbildning, stöd i olika former, och personcentrerad vård.

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  • 305.
    Henriksson, Frida
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Palmcrantz, Emma
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sexualitet inom palliativ vård: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sexualitet i vården är ett relativt outforskat ämne, speciellt inom palliativ vård. I alla vårdsammanhang är det viktigt att patienter ses som individer och samtliga av deras behov ska mötas. Bland dessa behov glöms ofta sexualiteten bort, särskilt hos personer i behov av palliativ vård. Detta arbete är därför mycket viktigt att utföra. Syftet med denna litteraturstudie var att sammanställa kunskap om palliativ vård med fokus på sexualitet, ur detta syfte kom sedan tre frågeområden; Patienters syn på sexualitet, Vårdpersonals syn på sexualitet och Påverkan på relationen mellan partners. Litteratursökning utfördes i databaserna PubMed och CINAHL och resulterade i tio artiklar med olika metodologiska ansatser som användes i analysen. Analysen resulterade i tio kategorier, den fortsatta sexualiteten, begränsningar, viljan att ämnet tas upp, attityder, att prata om sexualiteten, ansvarsfråga, kunskap, kommunikation, begränsningar och förluster samt behov av stöd. Det som främst framkom i resultatet var brist på kunskap hos vårdpersonal, att sexualitet är ett känsligt och svårt ämne för både personal och patient samt att par inom palliativ vård upplever det svårt att få vara ensamma. Resultatet diskuterades utifrån litteratur om värdighet. Interventioner som sågs kunna hjälpa sjuksköterskor att ta upp ämnet sexualitet var Ex-PLISSIT samt rutiner. De slutsatser som kan dras av arbetet är att sjuksköterskor behöver mer kunskap om sexualitet, att rutiner för hur ämnet ska tas upp bör finnas. Möjlighet för par att vara nära varandra och möjlighet till avskildhet ska ges. En sjuksköterska ska alltid se patienten som hel individ med dennes autonomi och värdighet.

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  • 306.
    Hermansson, Lovisa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Marklund, Ida
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Anestesisjuksköterskors uppfattning av patientsäkerhetskultur på opererande enheter.2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Anestesisjuksköterskan har ett stort ansvar för att tillse att patienten får en säker vård under operationen. Patientsäkerhet definieras av Socialstyrelsen (2014; 2017) som skydd mot vårdskada. Ledningen ska tillsammans med de anställda arbeta för en säker vård. Anestesisjuksköterskan ska kunna identifiera och kompensera för riskfyllda situationer och problem vid anestesin. Syftet var att beskriva anestesisjuksköterskors uppfattning av patientsäkerhetskultur på opererande enheter. En kvantitativ deskriptiv enkätundersökning genomfördes under våren 2018 på tre utvalda opererande enheter inkluderande alla tillsvidareanställda anestesisjuksköterskor. Enkäten som användes är utformad av Sveriges Kommuner och Landsting (2013) och validerad. Resultatet visar att anestesisjuksköterskorna generellt skattade patientsäkerhetskulturen som god, oberoende av hur lång arbetslivserfarenhet de hade. De frågor där anestesisjuksköterskorna skattade högst var; `teamet samarbetar bra för att ge patienterna den bästa vården´ och `när det är mycket arbete som måste utföras snabbt, arbetar vi tillsammans som ett team för att få arbetet avklarat´. En av de frågor som skattades lägst av anestesisjuksköterskorna var; `vi har tillräckligt med bemanning för att klara arbetsbelastningen´. Det positiva resultatet kan ha sin grund i att anestesisjuksköterskor har en specialistutbildning vilket innebär en hög kompetens och en medvetenhet om hur viktigt det är att vården är säker för patienten. En bidragande faktor till att anestesisjuksköterskor skattade patientsäkerheten som god kan vara att studien inkluderade opererande enheter på mindre och mellanstora sjukhus.

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  • 307.
    Hertzberg, Annika
    et al.
    Karolinska institutet, Department of Neurotec.
    Ekman, Sirkka-Liisa
    Karolinska institutet, Department of Neurotec.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    'Relatives are a resource, but...': registered nurses' views and experiences of relatives of residents in nursing homes2003In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 12, no 3, p. 431-41Article in journal (Refereed)
    Abstract [en]

    Registered Nurses (RNs) working in nursing homes in Sweden have obligations towards the residents' relatives, besides the care of residents. Relatives' involvement and satisfaction with the care partly depend on their contacts and communication with the staff. This study aimed to explore and describe RNs' views and experiences of relatives of residents who live in nursing homes. Open interviews were conducted with 19 RNs at three nursing homes. The verbatim-transcribed interviews were subjected to qualitative content analysis. Relatives were seen as a resource (with some restrictions) and nice, although demanding. The RNs saw relatives as part of their work--a part that could be time-consuming and had low priority. Interviewees noticed a difference between young and old relatives, and between female and male relatives. A large proportion of accounts could be related to issues about communication and interpersonal relationships with relatives. Building a trusting relationship with relatives may result in them being involved in residents' care and thus giving the nurses time rather than consuming time.

  • 308.
    Hertzberg, Annika
    et al.
    Röda korsets högskola.
    Ekman, Sirkka-Liisa
    Blekinge Tekniska Högskola, sektionen för hälsa.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Staff activities and behaviour are the source of many feelings: relatives' interactions and relationships with staff in nursing homes2001In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 3, p. 380-388Article in journal (Refereed)
    Abstract [en]

    Family members do not give up their involvement in the life of their older relatives when they move to an institution. Relatives feel that it is they who take the initiative to establish a working relationship with the staff at the nursing home. Relatives want more spontaneous information from staff, particularly about residents' daily lives, and there is a need for relatives to have opportunities to talk with staff under relaxed conditions. Staff behaviour and activities towards residents and relatives are a source of many feelings for relatives. Relatives' understandings of the challenges faced by staff are not communicated to staff, nor are positive or negative experiences explicitly passed on to staff.

  • 309.
    Hildingsson, Ingegerd
    et al.
    Härnösands sjukhus, Härnösand, Sweden.
    Häggström, Terttu
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Boden University College of Health Science, Boden, Sweden.
    Midwives' lived experiences of being supportive to prospective mothers/parents during pregnancy1999In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 15, no 2, p. 82-91Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To elucidate midwives' narrated experiences of being supportive to prospective mothers or parents during pregnancy.

    DESIGN: Phenomenological hermeneutic analysis of transcribed text from seven tape-recorded interviews.

    SETTING: Midwifery clinics in five health centres in the context of Swedish primary health care.

    PARTICIPANTS: Seven midwives working in antenatal care.

    FINDINGS: The interpretation of the text showed that through perception and intuition the midwives seemed to become aware that some women needed increased support. The situations of these prospective mothers were often characterised by difficult social problems or fears. The prospective fathers were mostly absent in the narratives. The midwives acted on both a personal and a professional level with ethical perspectives in mind, when they were advocating their clients' rights to receive proper care. The comprehensive understanding of the interpretation revealed that the midwife sometimes perceived herself as being metaphorically 'The Good Mother'.

    KEY CONCLUSIONS: Having the role of 'The Good Mother' could be understood as a way for the midwife to establish a fruitful relationship with prospective mothers/parents.

    IMPLICATIONS FOR PRACTICE: The findings provide a basis for reflection on the mothering and supportive function of midwives when providing antenatal care.

  • 310.
    Holmdahl, Solveig
    et al.
    Norrbotten County Council, Luleå.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Imoni, RoseMarie
    Norrbotten County Council, Luleå.
    Parenteral nutrition in home-based palliative care: Swedish district nurses experiences2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 1, p. 89-96Article in journal (Refereed)
    Abstract [en]

    AimThe aim of this study was to describe the experiences of district nurses in caring for patients with home-parenteral nutrition (HPN) in palliative care.MethodA qualitative approach was adopted using thematic content analysis of semi-structured interviews. Twelve district nurses working with primary health care in Sweden participated in the study that was conducted during 2011.FindingsThe analysis resulted in one overarching theme: The agony of terminating hope and three categories: all focus is on the infusion, alone without support, confidence in the relationship. HPN seemed to have a symbolic meaning when patients and family members connected the infusion with hope and life. District nurses expressed that they felt alone with the responsibility for the HPN due to the lack of a structured plan. Difficult discussions around termination of the infusion seemed to be connected to a feeling of agony of terminating hope among the district nurses. All district nurses expressed a need for support in their work, and factors like experience and the development of a good relationship with the patient and the family, could decrease the agony.ConclusionThe draw up of a plan when starting HPN, could be a support for the district nurse and make the aim, follow-up and future termination clearer. The establishment of a plan could make the work easier and reduce the feeling of agony of terminating hope among the district nurses.

  • 311.
    Holmlund, Fanny
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Niskanen, Anna
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Stöd till barn vars förälder är döende eller har avlidit: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Barn är en utsatt grupp där ålder och mognad påverkar möjligheten att förstå och hantera svåra situationer. Varje dag förlorar cirka 8 barn en förälder i Sverige, vilket ställer stora krav på vårdpersonalens kunskap om barnets behov av stöd. Syftet med denna integrerade litteraturstudie var att sammanställa kunskap för att sjuksköterskor ska kunna ge stöd till barn vars förälder förväntas dö eller har avlidit i slutenvården. Utifrån syftet formulerades två frågeställningar som handlade om vilka interventioner som kan stödja barn vars förälder är döende eller har avlidit samt vilket behov av ny kunskap om hur stöd ges till barn vars förälder är döende eller har avlidit. Studien genomfördes som en litteraturstudie, där den systematiska litteratursökningen resulterade i 22 artiklar, 15 kvalitativa och 7 kvantitativa. Resultatet visar att barnet behöver tid för att bygga upp en relation till vårdpersonal. Barnet har många känslor som kan behöva komma till uttryck i samband med en förälders bortgång. Därmed är det är viktigt att tillgodose barnets välbefinnande på kort och lång sikt, vilket underlättas genom ett bra bemötande och delaktighet i vården. Resultatet visar även att vårdpersonalens kunskaper om att bemöta och samtala med barn i sorg är begränsad. Bristande stöd och obearbetade känslor i samband med förälderns bortgång kan orsaka påföljder i barnets liv framledes. Denna litteraturstudie belyser barnets behov av stöd i samband med vård föräldern samt den bristande kunskap vårdpersonal har vad gäller vilket stöd som kan ges till barn vars förälder är döende eller har avlidit.

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  • 312.
    Holmlund, Ida
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Severin, Anna
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Att inte göra något mer och samtidigt göra allt...: Intensivvårdssjuksköterskors upplevelse av att vårda patienter i livets slutskede2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Vården på en intensivvårdsavdelning är ofta både aggressiv och intensiv, men ändå överlever inte alla patienter. Cirka 3,9 % av alla som avled i Sverige under 2017 gjorde det på en intensivvårdsavdelning. Det är därför av betydelse att beskriva hur en intensivvårdssjuksköterska, i en högteknologisk miljö skapad för att rädda liv, egentligen upplever att vårda en patient i livets slutskede? Syfte: Syftet var att beskriva intensivvårdssjuksköterskors upplevelser av att vårda patienter i livets slutskede på en intensivvårdsavdelning. Metod: En intervjustudie med ändamålsenligt urval och kvalitativ innehållsanalys genomfördes. Resultat: Resultatet bildade fem kategorier; att vilja inkludera och värna om anhöriga, att vilja skapa en lugn miljö som främjar en fridfull död, att vilja ge en värdig omvårdnad och själv behöva stöd, att vilja möjliggöra ett värdigt avslut, att behöva mer kunskap. Slutsats: Det framkom flera exempel på både svåra och fina situationer som intensivvårdssjuksköterskorna upplevde i samband med vård i livets slutskede, både rörande anhöriga, miljö och omvårdnad. Studien visar att det saknas fortbildning och rutiner inom området, vilket författarna önskar kunna stimulera till genom att påvisa att det finns ett behov. Även fler studier behövs inom området.

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  • 313.
    Holmström, Julia
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Persson, Anja
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Kvinnors upplevelser av sexuell hälsa i samband med bröstcancer: En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Den vanligaste cancerformen för kvinnor är bröstcancer. Att bli diagnostiserad ochbehandlad innebär fysiskt trauma men även psykisk påfrestning. Sexuell hälsa är viktigtför välbefinnande och livskvalité. Syftet med denna litteraturstudie var därför attbeskriva kvinnors upplevelser av sexuell hälsa i samband med bröstcancer. I studiensanalys ingick 13 vetenskapliga artiklar som analyserades med kvalitativ manifestinnehållsanalys. Analysen resulterade i sex kategorier; minskad lust och upphetsning,svårigheter och smärta vid samlag, en förlust av sin tidigare kropp, känslan att förlorafemininiteten och självförtroendet, bröstcancerns påverkan på relationer och strategieroch hantering av sexualiteten. I resultatet framkom att kvinnor påverkades på mångasätt av bröstcancern och behandlingen, både psykiskt och fysiskt. Problematik somuppstod var bland annat smärta vid samlag, minskad sexuell lust, förändrad kroppsbild,minskad vaginal lubrikation, förlust av femininitet samt förändrad relation till sinpartner men även sig själv. Det ansågs viktigt med stöd från omgivningen ochsjukvårdspersonal. Dock framkom det att sjukvårdspersonal inte kunde stötta kvinnornaeller ge tillräcklig information. Genom att tillämpa PLISSIT-modellen kansjukvårdspersonal stötta kvinnor med sexuellt relaterade problem bättre.

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  • 314.
    Hopper, Louise
    et al.
    Dublin City University (DCU), Dublin, Ireland.
    Karakostas, Anastasios
    Centre for Research and Technology Hellas (CERTH), Thessaloniki, Greece.
    König, Alexandra
    Intelligent Assistive Technology and Systems Lab (IATSL), Toronto Rehabilitation Institute, University of Toronto, Toronto, ON, Canada.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Kompatsiaris, Ioannis
    Centre for Research and Technology Hellas (CERTH), Thessaloniki, Greece.
    The personal and societal impact of the den´mentia ambient care (Dem@care) multi-sensor remot-monitoring demential care system2016In: Alzheimer's & Dementia: Journal of the Alzheimer's Association, ISSN 1552-5260, E-ISSN 1552-5279, Vol. 12, no 7 Suppl., p. P149-Article in journal (Refereed)
  • 315.
    Hortlund, Emma
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Vesterberg, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Personers upplevelse av stigmatisering vid lungcancer – en litteraturstudie: People’s experience of stigma in lung cancer – a literature study2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Lungcancer är den femte vanligaste cancerformen i Sverige och ca 90 procent av all lungcancer orsakas av tobaksrökning. Förutom besvärande symtom och dålig prognos får de som drabbas även utstå stigmatisering från omgivningen till följd av det starka sambandet mellan rökning och lungcancer. Syftet med denna studie var att beskriva personers upplevelse av stigmatisering vid lungcancer. Analysen genomfördes med kvalitativ manifest innehållsanalys med induktiv ansats och baserades på 10 vetenskapliga artiklar med kvalitativt innehåll. Analysen resulterade i tre slutkategorier: att känna sig stämplad, orättvist behandlad och bemött med fördomar; att nära relationer påverkas; att drabbas av en sjukdom som anses vara självorsakad. Resultatet visade att lungcancer är en högt stigmatiserad sjukdom och personer som lever med diagnosen får utstå stigmatisering från alla delar av samhället. Detta leder ofta till känslor av skam och skuld som i sin tur påverkar viljan att söka vård. Slutsatsen är att lungcancerbör uppmärksammas genom bättre information, utbildning, offentligt stöd och bidrag i syfte att minska den stigmatisering som omger sjukdomen. Det är också viktigt att främja god kommunikation mellan vårdpersonal och desom drabbats av lungcancer för att kunna motivera till rökstopp och följsamhet till behandling.

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  • 316.
    Hultdin, Ida
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nilsson, Erika
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Närståendes upplevelser när en anhörig suiciderar och tiden därefter: En analys av narrativ2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Varje år suiciderar 800 000personer världen över. I Sverige 2016 avled 1 129 personer till följd av suicid. Efter ett suicid är det ett stort antal närstående som lämnas kvar. Ett suicid kan av närstående upplevas traumatiskt och leda till en stor sorg och ett enormt lidande. Syftet med denna litteraturstudie var att beskriva närståendes upplevelser av att en anhörig suicideraroch tiden därefter. Studiens resultat bygger på en kvalitativ innehållsanalys med manifest ansats där narrativ i en bok har analyserats. Detta resulterade i tre kategorier: Att nås av beskedet och söka förklaringar; Att klandra sig själv och känna skuld; Att det är viktigt att få dela sin sorg med andra och få stöd. Närstående har ett behov av stöd och tröst, både professionellt samt från vänner och familj. Sjuksköterskan kan hjälpa dessa personer genom att lyssna och identifiera deras styrkor och behov, på så vis kan närstående erbjudas rätt hjälp och stöd.

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  • 317.
    Häggström, Terttu
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Finska krigsbarns livsberättelser: att leva med uppbrott och rotlöshet2003Collection (editor) (Other (popular science, discussion, etc.))
  • 318.
    Häggström, Terttu
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Life story perspective on caring in different cultural context2004In: Workgroup of European nurse researchers. Biennial conference (12 : Lisboa : 2004), WENR , 2004, p. 25-Conference paper (Other academic)
  • 319.
    Häggström, Terttu
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Life-story perspective on caring within cultural contexts: experiences of severe illness and of caring2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    People are afflicted by severe illnesses and adversities in life and they practice care privately and professionally in different cultural contexts from the view of their own life-story perspective. Five studies with a qualitative approach were linked together with the overall aim of disclosing the experience of severe illness and caring with a life-story perspective in different cultural contexts. Audio-recorded, transcribed narrative and reflective interviews were analysed with a phenomenological hermeneutic approach. Data were from 34 people living with a stroke in Sweden and Vietnam, five Vietnamese relatives and 29 professional carers caring for people with a stroke in Vietnam, with dementia in Sweden and girls living on the streets in East Africa. In this study, living with a stroke meant living with a sudden, adverse event that had interrupted the past of the life story from continuing in a similar fashion in the future. Apparently, some interviewees had not integrated the stroke event with their narrative identity and their life stories. They seemed to be confused about what had happened to them. The sensed feelings of living with a stroke in the study from Sweden were conveyed with the use of a metaphoric language. Living with a stroke in Vietnam meant feeling as a weakened thread in the family net. Caring professionally in this context meant collective narrative identity with a view of being assistants, advisers and supporters of a ‘family network’. Carers identified as good at achieving an understanding of people with dementia used maternal thinking emanating from personal experience together with knowledge about each resident’s life stories and the course of the disease. These carers used affect attunement and personal talents. The carers tuned into a resident’s affective state, noticed signs, put these into sentences and stories that corresponded with the narrative identity and the life story of the resident in the caring situation. Professional carers working among girls living on the streets in East Africa felt that they became committed to caring and had motherly feelings when they met with the girls. Caring for these girls meant fighting against the grip of street life, but also experience of satisfaction and hope. It meant experiencing powerlessness and frustration, and the carers felt squeezed between integrated values and the perceived demands from the girls in their meeting with them, whilst conveying visions to the girls of a better future. Inspired by Ricoeur’s philosophy on language and personal identity, the findings from the five papers indicate that a life-story perspective can serve as a framework for bringing human experience in various cultural contexts and different ages into comprehensible language. This perspective should be useful in professional nursing when caring for people who encounter adversities in life as an afflicted person or relative. It is suggested that a life-story perspective can serve as a framework for professional nursing care that aims at a good quality of care.

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  • 320.
    Häggström, Terttu
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Jansson, Lilian
    Umeå University, Department of Nursing.
    Norberg, Astrid
    Umeå University, Department of Nursing.
    Skilled carers' ways of understanding people with Alzheimer's disease1998In: Scholarly Inquiry for Nursing Practice, ISSN 0889-7182, Vol. 12, no 3, p. 239-68Article in journal (Refereed)
    Abstract [en]

    Five carers in a group dwelling for people with dementia were observed and interviewed concerning their interactions with five residents with Alzheimer's disease. The tape-recorded and transcribed data were analyzed as text. The carers' personal ways of achieving understanding were defined as: affect attunement; affect attunement and completing a puzzle through explanatory connections of observation, knowledge about the residents' life histories and behavior at the group dwelling; and affect attunement within the context of caring as an intrinsic end. Personal experience from childhood and motherhood, knowledge about the residents' life history and the nature of the disease, and personal talent seemed to form these carers' ways of achieving understanding

  • 321.
    Häggström, Terttu
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Guiding for re-direction of life-stories: narrated experience of female professionals working among girls living on the streets in East Africa2004In: Workgroup of European nurse researchers. Biennial conference (12 : Lisboa : 2004), WENR , 2004, p. 83-Conference paper (Other academic)
  • 322.
    Hörnlund, Anny
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Westling, Emelie
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Transpersoners upplevelser av bemötande inom hälso- och sjukvård2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Det finns ett heteronormativt synsätt i samhället vilket påverkar transpersoner som faller utanför denna norm, både i samhället och inom vården. Transpersoner utsätts för stigmatisering och självmordsstatistiken för dessa personer är hög. Syftet med denna studie var att beskriva transpersoners upplevelser av bemötandet inom hälso- och sjukvården. Metod: En litteraturöversikt genomfördes där 16 kvalitativa studier analyserades med kvalitativ innehållsanalys. Resultatet visade att det finns en stor kunskapsbrist hos hälso- och sjukvårdspersonal om transpersoner och transfrågor. Transpersoner möts av heteronormativa antaganden och stereotyper samt utsätts för diskriminering och stigmatisering inom vården. Slutsats: Det krävs mer kunskap om transpersoner och de problem som dessa personer stöter på inom vården för att de ska kunna få en likvärdig vård och inte utsättas för diskriminering eller bemötande som upplevs kränkande. Det behövs även mer utbildning inom ämnet för hälso- och sjukvårdspersonal samt redan i utbildningen för sjuksköterskor.

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  • 323.
    Iggbom, Maria
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Åström, Klara
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Anestesisjuksköterskors strategier vid omvårdnad av patienter med rädsla och oro inför att genomgå generell anestesi2020Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Personer som upplever rädsla och oro inför att genomgå generell anestesi är vanligt förekommande. Preoperativ rädsla och oro kan ha en negativ inverkan på patientens perioperativa process, både psykiskt och fysiskt. Det krävs utarbetade strategier och riktlinjer för hantering av rädsla och oro men forskning och dokumentation om strategier vid omvårdnad av patienter med rädsla och oro är sparsam.

    Syfte: Syftet med studien var att identifiera anestesisjuksköterskans strategier vid omvårdnad av patienter med rädsla och oro inför att genomgå generell anestesi.

    Design: Studien har genomförts med en kvalitativ och deskriptiv ansats.

    Metod: Data samlades in genom femton semistrukturerade individuella intervjuer. Data analyserades med kritisk incident teknik (CIT). CIT är en metod som används för att analysera beteenden eller handlingar i särskilda situationer som är avgörande för ett visst resultat. Dessa beteenden eller handlingar kallas för kritiska incidenter och analyseras i syfte att förbättra praktiska ageranden och lösa praktiska problem.

    Resultat: Sex viktiga strategier vid omvårdnad av patienter med rädsla och oro inför att genomgå generell anestesi identifierades. Dessa strategier var att beskriva förloppet och att samtala med patienten om dennes oro, att vara inkännande och anpassa vården, att balansera delaktighet och vägledning, att uppträda lugnt, planera och skapa en lugn miljö, att skapa en lättsam stämning och att sätta infart och ge läkemedel vid behov.

    Slutsats: Detta resultat kan bidra till att utveckla, öka och sprida kunskapen om strategier som kan användas vid omvårdnad av patienter med rädsla och oro inför att genomgå generell anestesi, vilket ökar möjligheten till att skapa en så god upplevelse som möjligt för patienten.

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  • 324.
    Iranmanesh, Sedigheh
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Caring for dying and meeting death: the views of Iranian and Swedish nurses and student nurses2009Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Nurses play a principal role in the caring for dying persons and their families. Increasing diversity and globalisation demand culturally sensitive and competent health personnel who have scientifically based knowledge about the universal phenomenon of death and dying. A mixed method of research was conducted to describe student nurses' and nurses' views of caring for dying people in the cultural contexts of Iran and Sweden. In the first part, a quantitative method with two questionnaires (FATCOD and DAP-R) was used to examine the student nurses' and registered nurses' attitudes towards death and caring for dying persons in Iran. In the second part, a phenomenological hermeneutic approach was used to illuminate the meaning of nurses' experiences with the caring for dying persons in the cultural contexts of Iran and Sweden. According to the results (I, II), student nurses' and nurses' attitudes towards caring for dying people were influenced by their attitudes towards death, education, previous experience with death, and previous experience of caring for a dying relative. Iranian nurses were unlikely to talk about death with dying persons and their families. The findings of the qualitative part indicate that professional care for dying people is a lifelong learning process that takes place in a sociocultural context (III, IV). The Iranian and Swedish registered nurses' experiences showed similarities that crossed cultures. The existential context for their care was almost identical. The nurses met people and their families at the end of their lives. Being invited to share the understanding of this unique experience raised an ethical demand to care within close relationships. It called for a personal and professional response in all aspects. Swedish nurses preserved patients' dignity by meeting personal caring needs according to each person's preferences as well as providing each person with appropriate information. Iranian nurses were also concerned about each person's dignity, although they were not allowed to inform persons and family members about a person's real condition. They believed that such information could hasten the patient's death. Swedish nurses regularly used teamwork. Team reflective practices were important in the support of their professional development. The study revealed that Iranian nurses lacked collaboration between nurses and other professionals, including social workers. The results suggest that student nurses and nurses should be offered the opportunity to reflect on their experiences, feelings, actions, and reactions to death, as well as caring for dying people and their families. This could be accomplished at work or in professionally guided individual or group sessions. Such supervision could transform their personal experiences into positive and constructive learning. Recognition of the common foundation behind different cultures, religions, and nurses' own caring behaviours could support the universal phenomenon of care as a human mode of being, in order to be able to provide culturally sensitive and competent and supportive care to patients with various cultural backgrounds. General educational programmes and programmes dealing with end of life care must focus on to the fact that patients' and family members are unique beings with unique backgrounds and preferences. Specific training programmes should aim at increasing an understanding among professional carers about what shape patients' world views in order to support their dignity and well-being at the end of life.

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  • 325. Iranmanesh, Sedigheh
    et al.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    A caring relationship with persons who have cancer2009In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 65, no 6, p. 1300-1308Article in journal (Refereed)
    Abstract [en]

    Aim. This paper is a report of a study conducted to elucidate the meaning of a caring relationship with people with cancer.Background. A caring relationship becomes the most important focus of caregiving when treatment of the body has reached the limits where cure is no longer expected. Caring as perceived by people with cancer involves nurses having professional attitudes and skills in order to provide good care, including emotional and practical support.Methods. A phenomenological hermeneutic approach influenced by Ricoeur was used. Eight nurses working in an oncology unit in Iran were interviewed in 2007 about their experiences of caring relationships with people who have cancer.Findings. The findings were interpreted as getting involved in a mutual/demanding close relationship. Closeness demanded nurses to be present, to listen to patients, and to be compassionate. Closeness was also mutual and characterized both caregiving and receiving new insights into values in the nurses' own lives. The close relationship was at times frustrating when they were faced with situations that they could not handle and were out of their control.Conclusion. Closeness is an important foundation for caring, and acquires a special dimension in the care of people with cancer and their relatives. It derives from the personal and professional experiences of nurses in their own life stories. Nursing education should include a reflective approach in order to develop caring skills in oncology nursing that are not merely attuned to medical care.

  • 326.
    Iranmanesh, Sedigheh
    et al.
    Razi Faculty of Nursing and Midwifery, Kerman Medical University, Kerman, Iran.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Häggström, Terttu
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Caring for dying people: Attitudes among Iranian and Swedish nursing students2010In: Indian Journal of Palliative Care, ISSN 0973-1075, E-ISSN 1998-3735, Vol. 16, no 3, p. 147-153Article in journal (Refereed)
    Abstract [en]

    Aim: To compare the attitudes of Iranian and Swedish nursing students toward caring for dying persons. Materials and Methods: Their attitudes were measured with the Frommelt′s Attitude Toward Caring of the Dying and the Death Attitude Profile Revised. Results: The results indicated that the participating Iranian students were more afraid of death and less likely to give care to dying persons than the Swedish participants. Conclusion: It is suggested that theoretical education should be individualized and culturally sensitive in order to positively influence the students′ attitudes, and promote professional development.

  • 327. Iranmanesh, Sedigheh
    et al.
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Häggström, Terttu
    Caring for dying and meeting death: experiences of Iranian and Swedish nurses2010In: Indian Journal of Palliative Care, ISSN 0973-1075, E-ISSN 1998-3735, Vol. 16, no 2, p. 90-96Article in journal (Refereed)
    Abstract [en]

    Objective: Our world is rapidly becoming a global community, which creates a need to further understand the universal phenomena of death and professional caring for dying persons This study thus was conducted to describe the meaning of nurses' experiences of caring for dying people in the cultural contexts of Iran and Sweden. Materials and Methods: Using a phenomenological approach, phenomenon of caring for dying people was studied.Eight registered nurses who were working in oncology units in Tehran, Iran and eight registered nurses working in hospital and home care in North part of Sweden were interviewed. The interviews were analyzed using the principles of phenomenological hermeneutics. Results: The findings were formulated based on two themes included: (1) "Sharing space and time to be lost", and (2) "Caring is a learning process Conclusions: The results showed that being with dying people raise an ethical demand that calls for personal and professional response, regardless of sex, culture or context The physical and organizational context must be supportive and enable nurses to stand up to the demands of close relationships Specific units and teamwork across various personnel seem to be a solution that is missing in Iran.

  • 328.
    Iranmanesh, Sedigheh
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Dargahi, Helen
    Valiasr Hospital, Tehran University of Medical Science.
    Abbaszadeh, Abbas
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Attitudes of Iranian nurses toward caring for dying patients2008In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 6, no 4, p. 363-369Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the attitudes of Iranian nurses toward caring for dying patients.Methods: Nurses' attitudes toward death and caring for dying patients were examined by using two types of questionnaires: the Death Attitude Profile-Revised (DAP-R) and Frommelt's Attitude towards Caring for Dying Patients (FATCOD), both with a demographic survey.Results: The results showed that most respondents are likely to view death as a natural part of life and also as a gateway to the afterlife. The majority reported that they are likely to provide care and emotional support for the people who are dying and their families, but they were unlikely to talk with them or even educate them about death. They had a tendency not to accept patients and their families as the authoritative decision makers or involve families in patient care. Nurses' personal views on death, as well as personal experiences, affected their attitudes toward care of the dying.Significance of results: Lack of education and experience, as well as cultural and professional limitations, may have contributed to the negative attitude toward some aspects of the care for people who are dying among the nurses surveyed. Creating a reflective narrative environment in which nurses can express their own feelings about death and dying seems to be a potentially effective approach to identify the factors influencing their interaction with the dying. Continuing education may be required for Iranian palliative care nurses in order to improve the patients quality of care at the end of life.

  • 329.
    Iranmanesh, Sedigheh
    et al.
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Ghazanfari, Zahra
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Häggström, Terttu
    Narvik University College, 8505 Narvik, Norway.
    Professional development: Iranian and Swedish nurses' experiences of caring for dying people2011In: Journal of Palliative Care, ISSN 0825-8597, Vol. 27, no 3, p. 202-209Article in journal (Refereed)
    Abstract [en]

    Our world is rapidly becoming a global community. This creates a need for us to further understand the universal phenomena of death and professional care for dying persons. A transcultural study was undertaken using a phenomenological approach to illuminate the meaning of nurses' experiences of professional development in the contexts of Iran and Sweden. Eight registered nurses working in oncology units in Tehran, Iran, and eight working in the context of a hospital and private homes in northern Sweden were interviewed. The interviews were analyzed using the principles of phenomenological hermeneutics inspired by Paul Ricoeur. A naive reading guided a structural analysis, which yielded four main themes: coping with existential, organizational, and cultural contexts; sharing knowledge, experiences, and responsibilities; using embodied knowledge; and developing personal competence. The interpreted comprehensive understanding revealed that the meaning of professional development is that it actualizes other-oriented values and self-oriented values. Caring professionally for dying people was a learning process that could help nurses to develop their personal and professional lives when they were supported by teamwork, reflective practice, and counselling.

  • 330. Iranmanesh, Sedigheh
    et al.
    Häggström, Terttu
    Axelsson, Karin
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Swedish nurses' experiences of caring for dying people: a holistic approach2009In: Holistic Nursing Practice, ISSN 0887-9311, E-ISSN 1550-5138, Vol. 23, no 4, p. 243-52Article in journal (Refereed)
    Abstract [en]

    Most people need to be cared for at the end of their lives by professionals. This study aimed to elucidate the meaning of nurses' experiences of caring for dying persons at home and in a special unit in a hospital. Four registered nurses working in private homes and 4 registered nurses working in a specific unit in a hospital setting were interviewed. The study was planned and carried out with a phenomenological hermeneutic approach. A naive reading guided a structural analysis, which resulted in 3 main themes: meeting patients and family members as unique persons, learning in a challenging environment, and gaining personal strength. The interpreted comprehensive understanding conveyed a meaning that caring for families with a member awaiting the end of life created a situation where the presence of an inevitable death demanded nurses to create close relationships with each unique person involved.

  • 331.
    Iranmanesh, Sedigheh
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Sävenstedt, Stefan
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Abbaszadeh, Abbas
    Kerman University of Medical Sciences, Faculty of Nursing and Midwifery.
    Student nurses' attitudes towards death and dying in south-east Iran2008In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 14, no 5, p. 214-219Article in journal (Refereed)
    Abstract [en]

    In this study, the attitudes of student nurses from Kerman and Bam in Iran towards death and caring for dying patients were compared. Two types of questionnaire were used: the DAP-R (Death Attitude Profile Revised) and FATCOD (Frommelt Attitude Towards Caring for Dying patients). The Bam student nurses, who had more experience of death due to the Bam earthquake in December 2003, were found to be less afraid of death and also less likely to give care to people at the end of life compared to their counterparts in Kerman. In both groups, those who were educated about death and dying had more positive attitudes towards caring for people who are dying than non-educated participants. The study suggests that adding palliative care education, accompanied by a reflective narrative approach, to the nursing curriculum is necessary to improve quality of care at the end of life.

  • 332.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josefsson, Staffan
    Neurotec Department, Division of Occupational Therapy, Karolinska Institute, Huddinge.
    Lexell, Jan
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    To regain participation in occupations through human encounters: narratives from women with spinal cord injury2007In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 29, no 22, p. 1679-1688Article in journal (Refereed)
    Abstract [en]

    Purpose. To gain an understanding of how women with spinal cord injury (SCI) experienced human encounters in occupations and how these influenced their participation. Method. The data were collected through two or three in-depth interviews with 13 women (age 25 - 61 years) with SCI. Data analysis was carried out by using a paradigmatic analysis of narrative data, followed by an interpretation based on a narrative theory. Results. The results showed a complexity where the women's experiences and acting in human encounters changed over time. In these human encounters the women struggled with conflicts, supported other persons that were insecure and revaluated their apprehension about persons in their social network. These multidimensional human encounters thereby enabled them to regain participation in occupations. Conclusions. This shows that human encounters are important for persons with disabilities so they can restructure their occupational identity and their needs for participation in occupations. The study also showed that the use of narratives as a tool within rehabilitation could lead to an increased understanding of the subjective changes that occur over time for a person with a disability

  • 333.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Karolinska institute, Neurobiology Care Sciences and Society, Division of Occupational Therapy.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences, Medical Science.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Men's experiences of giving and taking social support after their wife's spinal cord injury2008In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 15, no 4, p. 236-246Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to gain an understanding of how men living with women with spinal cord injury (SCI) experienced and acted when they were giving and taking social support to and from their wives and other persons in their social network. Another aim was to give some possible explanations of the complex process of change that they went through. Data were collected through in-depth interviews with four men and field notes. To describe the men's subjective experiences and the process of change, a narrative approach inspired by Polkinghorne was used. The analyses resulted in one story that included the four men's experiences and action. The story showed that when the men went through a process of change, they used and needed both emotional and practical support to handle their new life situation. Furthermore, the men's experiences and action against social support changed over time. This indicated that, through narratives from spouses, professionals within rehabilitation could understand the process of change they went through after their partner's sudden injury, and support them to find strategies to handle their changed life situation. To give some possible explanations for the men's experiences and action during the process of change, the findings are discussed in relation to theories concerning adaptation and coping

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  • 334.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Josephsson, Staffan
    Karolinska institutet, Sektionen för arbetsterapi.
    Lexell, Jan
    Luleå University of Technology, Department of Health Sciences.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    To regain participation in occupations through human encounters: narratives from women with spinal cord injury2008Conference paper (Other academic)
  • 335.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehabilitation.
    Lexell, Jan
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Social support provides motivation and ability to participate in occupation2007In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 27, no 1, p. 23-30Article in journal (Refereed)
    Abstract [en]

    In this study, a qualitative perspective of how 13 women (aged 25 to 61 years) with spinal cord injury perceive the importance of social support for their participation in occupation is presented. The data were collected through repeated in-depth interviews and field notes, and the analysis used a grounded theory approach. The women needed both emotional and practical support, which was important in a time perspective and motivated them to participate in occupation. The women needed to receive support soon after the injury, but after a period of time they needed to give and receive support in a reciprocal fashion. Social support is therefore an effective rehabilitation strategy that can motivate people with disabilities to participate in meaningful occupation. The importance of social support for a person's motivation and ability to participate in occupation expands our knowledge of the relationship between individuals, their social environment, and occupation.

  • 336.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Social support provides motivation and ability to participate in occupation2008Conference paper (Other academic)
  • 337.
    Isaksson, Gunilla
    et al.
    Luleå University of Technology, Department of Health Sciences, Health and Rehab.
    Skär, Lisa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lexell, Jan
    Women's perception of changes in the social network after a spinal cord injury2005In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 27, no 17, p. 1013-1021Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To describe how women with a spinal cord injury (SCI) perceived changes in the social network, and how these changes affected their ability to participate in occupation. METHOD: Thirteen women, aged 25 to 61 years, with a SCI were interviewed twice. The interviews focused on their ability to participate in occupation, their relations with individuals within the social network, and changes in the social network following the SCI. The analysis was carried out using qualitative content analysis. RESULTS: The women described an emotional need for social support after the SCI to participate in occupation. This was a new experience that required time to adapt to. The women also described a need for practical social support from the social network members to manage meaningful occupation. After the SCI, the women had developed new habits through close cooperation with members in the social network. The women felt that they had become more responsible for the development of their relations. Many relations had improved after the SCI, while some had decreased. The women had also developed new relations with other persons with disabilities. CONCLUSIONS: The women perceived substantial changes in the social network following the SCI, which in several ways affected their ability to participate in occupation. To adapt to their new life situation, the women gradually developed different strategies. The results point out the need to identify persons in the social network that women with SCI develop relations with, and integrate them in the rehabilitation process.

  • 338.
    Isaksson, Kerstin
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Wallgren, Amanda
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Faktorer som påverkar livskvaliteten efter akut sjukdom eller skada: En litteraturöversikt2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att ha drabbats av akut sjukdom eller skada kan leda till livsomställningar och förändrad kropp vilket kan påverka livskvaliteten. De drabbade återvänder inte alltid till tidigare hälsostatus och livskvalitet oavsett hur länge det gått sedan sjukdom eller skada inträffat. Syftet med studien var att beskriva faktorer som påverkar livskvaliteten efter akut sjukdom eller skada. Studien genomfördes som en systematisk integrerad litteraturöversikt där aktuell forskning söktes i tre databaser samt genom manuell sökning. Sjutton vetenskapliga artiklar med kvalitativ och kvantitativ ansats analyserades. Analysen resulterade i tre områden: Mentala faktorer; Fysiska faktorer och Sociala faktorer. Resultatet visade att depression, ångest, låg livslust och frustration var mentala faktorer som påverkade livskvaliteten efter akut sjukdom eller skada. Nedsatt fysisk förmåga, ålder, förändrad kropp samt kvarvarande komplikationer var fysiska faktorer som framkom att påverka livskvaliteten. Sociala faktorer som framkom var att det sociala livet förändrades, socialt stöd, isolering, rollförändringar, familjerelaterade problem samt begränsningar i vardagen, hobbys och nöjen. Slutsatsen var att sjuksköterskor i ett tidigt skede behöver fånga upp de personer som är i behov av stöd och hjälp för att förbättra personers livskvalitet på långsikt efter akut sjukdom eller skada. 

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  • 339.
    Isaksson, Loella
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Skog, Clara
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Telemedicin som stöd för egenvård vid diabetes typ 2: en systematisk litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Typ 2 diabetes mellitus (T2DM) är den vanligaste formen av diabetes. Denna form ökar kraftigt i hela världen och debuterar i allt tidigare ålder. Egenvård är den kanske mest betydande delen i behandlingen. Främst handlar egenvården om att ändra på sina levnadsvanor för att hålla blodsockernivån på en hälsosam nivå. Dessa förändringar i livsstil och levnadsvanor ställer krav på patienten, och kan av vissa upplevas svåra att genomföra. För att kunna ge patienter ett bra stöd är det viktigt att sjuksköterskan har kunskaper om hjälpmedel som främjar egenvården. Telemedicin är ett sådant hjälpmedel. Syftet med denna studie var att undersöka hur telemedicin kan stödja patienter med T2DM i deras egenvård. Studien genomfördes som en systematisk litteraturstudie. I analysen ingick tretton vetenskapliga artiklar av kvalitativ och kvantitativ design. Resultatet visade att telemedicinska lösningar var ett bra hjälpmedel för egenvården vid diabetes. Det gav bättre kliniska värden, positiva livsstilsförändringar, stärkte patienternas empowerment och var kostnadseffektivt. Bristande kunskap, motivation och engagemang var faktorer som hindrade användandet. Slutsatsen blev att sjuksköterskan behöver känna till och kunna informera om de resurser som finns att tillgå. Med ökad kunskap om sjukdomen ökar patientens känsla av kontroll, samt känsla av trygghet i egenvården. Den ökade kunskapen leder i sin tur till att patienten lär sig se vilka livsstilsförändringar som främjar behandlingen och motiverar därigenom patienten att utföra sin egenvård. 

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  • 340.
    Isaksson, Sanna
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Stenbom, Evelina
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Nyexaminerade sjuksköterskors upplevelser av sitt första år som legitimerad sjuksköterska: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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  • 341.
    Jaako, Lisa
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Juuso, Sara
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Kvinnors upplevelser av att leva med vestibulit2018Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Vestibulit anses vara den vanligaste orsaken till smärta vid samlag och drabbar uppskattningsvis 2-5% av kvinnor i 20-30 årsåldern. Det är ett smärttillstånd i underlivet med en inte helt klarlagd etiologi vilket gör att kunskapen samt förståelsen är låg kring ämnet. Syftet med denna litteraturstudie var att beskriva kvinnors upplevelser av att leva med vestibulit. Metoden som användes var en kvalitativ innehållsanalys, detta för att fånga kvinnornas upplevelser, utifrån de fyra frågeställningarna: Hur upplevs den psykiska hälsan när man lever med vestibulit? Hur upplevs sexualiteten när man lever med vestibulit?  Hur upplevs relationer av att leva med vestibulit? Hur upplevs vardagslivet av att leva med vestibulit? Den kvalitativa innehållsanalysen är baserad på fyra bloggar och fem intervjuer av kvinnor som lever med vestibulit. Analysen är utförd systematiskt enligt Bengtsson (2016) genom ett flertal steg som dekontextualisering, rekontextualisering, kondensering, kategorisering och kompilering. Analysen resulterade i elva slutkategorier: att känna sig nedstämd, att känna hopp och hopplöshet, att få ett förändrat självförtroende, att vara i behov av stöd, att uppleva smärta vid samlag, att få en förändrad sexlust, att vilja vara sexuellt aktiv, att erfara hur relationer förändras, att känna sig otillräcklig, att se smärtan som en central del i vardagen och att smärtan utgör ett hinder i vardagen. Resultatet visade att dessa kvinnor påverkas psykiskt, sexuellt, relationsmässigt och i sitt vardagsliv av att leva med vestibulit. Det resulterade i att avstå från en mängd aktiviteter och påverkade kvinnorna och deras livsstil, relationer, sociala kontakter och välbefinnande. Resultatet från denna litteraturstudie kan användas som ett hjälpmedel för sjuksköterskor till att öka förståelsen för hur det är att leva med vestibulit. Det finns ett ökat behov av omvårdnadsforskning inom ämnet för att kunna bedriva en bättre individanpassad vård där man identifierar och tillgodoser dessa kvinnors behov.

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  • 342.
    Jacobsson, Lars
    et al.
    Luleå University of Technology, Department of Health Sciences.
    Westerberg, Mats
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Innovation and Design.
    Söderberg, Siv
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lexell, Jan
    Functioning and disability 6-15 years after traumatic brain injuries in northern Sweden2009In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 120, no 6, p. 389-395Article in journal (Refereed)
    Abstract [en]

    Objectives - To assess long-term functioning and disability after traumatic brain injury (TBI). Material and methods - Individuals (n = 88) in Norrbotten, northern Sweden, who had been transferred for neurosurgical care were assessed with internationally established TBI outcome measures 6-15 years post-injury. Results - There was an improvement in overall outcome from discharge from inpatient rehabilitation to follow-up. Many individuals had a high degree of motor and cognitive functioning, which enabled them to live independently in their own home without assistance, but there remained a disability related to community reintegration and social participation. This affected their productivity and to some degree their marital stability. The remaining disability and reduced productivity were related to the age at injury and the injury severity. Conclusions Our data showed that individuals with a TBI can achieve and maintain a high degree of functioning many years after the injury. Increasing age and a greater injury severity contributed to their long-term disability.

  • 343.
    Jansson, Anna Berg
    et al.
    Luleå University of Technology, Department of Business Administration, Technology and Social Sciences, Human Work Science.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Working Together: Swedish Critical Care Nurses' Experiences of Temporary staffing within Swedish health care: a Qualitative Study2017In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 41, p. 3-10Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aim of this study is to describe critical care nurses (CCN’s) experiences of working with or as temporary agency staff.

    Research methodology

    This explorative qualitative study is based on interviews with five agency CCNs and five regular CCNs, a total of ten interviews, focusing on the interviewees’ experiences of daily work and temporary agency staffing. The interviews were analysed manually and thematically following an inductive approach.

    Findings

    Four themes that illustrate both similarities and differences between regular and temporary agency CCNs emerged: “working close to patients versus being responsible for everything”, “teamwork versus independence”, “both groups needed” and “opportunities and challenges”.

    Conclusion

    The study findings illustrate the complexity of the working situation for agency and regular staff in terms of the organisation and management of the temporary agency nurses and the opportunities and challenges faced by both groups.

  • 344.
    Jansson, Molly
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Andersson, Frida
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    En kvinnas upplevelse av att leva med bipolär sjukdom2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Bipolär sjukdom är en psykiatrisk diagnos som påverkar känslolivet. Det som karaktäriserar sjukdomen är ett pendlande mellan depression och hypomani/mani som är en eufori utöver det vanliga. Vårdpersonalen har en viktig roll i mötet med patientgruppen, de bör ge stöd och skapa interventioner då dessa patienter har högre suicidrisk än den resterande befolkningen. Syfte: Syftet med denna studie var att beskriva en kvinnas upplevelse av att leva med bipolär sjukdom. Metod: En manifest kvalitativ innehållsanalys med en narrativ ansats av en självbiografi. Resultat: Sex kategorier presenteras: att pendla mellan olika verkligheter, att ångesten kan komma när som helst och var som helst, att behöva behandla den kroniska sjukdomen varje dag, att inte vilja utsätta andra för sitt dåliga mående, att det ständigt pågår ett krig i huvudet samt att vilja leva och att inte vilja leva. Diskussion: Vårdpersonal och närstående har betydelse för patientens välmående i stödjandet av patienten, de bör vara öppensinnade och därmed inte döma eller förminska patientens egna upplevelser. Slutsats: Sjuksköterskor bör se patientgruppen utifrån ett holistiskt perspektiv då sjukdomen handlar om mycket mer än bara depressioner och manier.

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  • 345.
    Jansson, Sven-Arne
    et al.
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
    Axelsson, Malin
    Department of Care Sciences, Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Hedman, Linnea
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
    Leander, Mai
    Department of Medical Sciences, Respiratory Medicine and Allergology, Uppsala University, Uppsala, Sweden.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Rönmark, Eva
    Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, The OLIN Unit, Umeå University, Umeå, Sweden.
    Subjects with well-controlled asthma have similar health-related quality of life as subjects without asthma2016In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 120, p. 64-69Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The burden of asthma and rhinitis on health-related quality of life (HRQL) among adults has been assessed mainly in studies of patients seeking health-care, while population-based studies are relatively scarce. The objective of this study was to investigate HRQL among subjects with asthma and rhinitis derived from a random population sample and to identify factors related to impairment of HRQL.

    METHODS:

    A randomly selected cohort was invited to participate in a postal questionnaire survey. Of those who responded, a stratified sample of 1016 subjects was invited to clinical examinations and interviews, and 737 subjects in ages 21-86 years participated. Of these, 646 completed HRQL questions. HRQL was assessed with the generic SF-36 Health Survey.

    RESULTS:

    The physical score was lower among subjects with asthma vs. subjects without asthma (p < 0.001). No significant difference was found in the mental score. Subjects with well-controlled asthma had higher physical score compared to subjects with partly and un-controlled asthma (p = 0.002). Actually, subjects with well-controlled asthma had similar physical HRQL as subjects without asthma. Asthmatics who were current smokers had lower physical score compared to those who were non-smokers (p = 0.021). No significant differences in physical or mental scores were found between subjects with and without rhinitis. Subjects with both asthma and rhinitis had lower physical score compared to subjects without these conditions (p < 0.001), but subjects with asthma alone had even worse physical score.

    CONCLUSIONS:

    The physical score was significantly lower in asthmatics compared to subjects without asthma. Importantly, non-smoking and well-controlled asthmatics have similar HRQL compared to subjects without asthma. Thus, subjects with asthma should be supported to achieve and maintain good asthma control and if they smoke, be offered smoking cessation as means to improve their HRQL.

  • 346.
    Jansson, Sven-Arne
    et al.
    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.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
    Axelsson, Malin
    Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Kriit, Hedi Katre
    Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
    Lundbäck, Bo
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, 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.
    Life-years lost due to asthma2019In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 54, no Suppl. 63, article id PA5063Article in journal (Other academic)
  • 347.
    Jansson, Sven-Arne
    et al.
    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 Sciences, Nursing and Medical technology. Department of Public Health and Clinical Medicine, Section of Sustainable Health, The OLIN unit, Umeå University.
    Stridsman, Caroline
    Luleå University of Technology, Department of Health Sciences, Nursing Care. Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
    Axelsson, Malin
    Department of Care Science, Faculty of Health and Science, Malmö University, Malmö, Sweden.
    Lindberg, Anne
    Department of Public Health and Clinical Medicine, Division of Medicine, Umeå University, Umeå, Sweden.
    Lundbäck, Bo
    Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, 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.
    Life-years lost due to asthma and COPD2020In: European Respiratory Journal, ISSN 0903-1936, E-ISSN 1399-3003, Vol. 56, no Suppl 64, article id 1400Article in journal (Other academic)
    Abstract [en]

    Background: Quality-adjusted life-years (QALYs) is commonly used in health-economic evaluations. QALY-weights combine health status and time into one measure.

    Aims: To investigate the association between multimorbidity and QALY-weights among adults with asthma and COPD.

    Methods: Within the OLIN-studies in northern Sweden, a random sample was invited to a postal questionnaire survey. A random sample of 1016 responders was invited to clinical examinations and interviews in 2009 (737 participated, ages 21-86 years), of which 605 completed the health-related quality of life (HRQL) questionnaire SF-36. QALY-weights were derived from the SF-36 data using the SF-6D tool via the standard gamble method. The SF-6D scores are equivalent to QALY-weights with low values representing poor health and the score one representing perfect health.

    Results: Of the 605 participants, 74 had current asthma, 81 had COPD (FEV1/FVC<0.7), 66 had heart disease, 30 had diabetes, 30 had rheumatic disease, and 160 had hypertension. There was an association between an increasing number of morbid conditions and lower QALY-weights (p<0.001). The mean QALY-weight tended to be lower among subjects with asthma compared to COPD, 0.77 and 0.81, respectively (p=0.078). Subjects with COPD and two or more non-respiratory conditions had significantly lower QALY-weights compared to subjects with COPD alone (0.75 vs.0.83, p=0.016). No significant difference in QALY-weights was found among asthmatics with versus without other non-respiratory conditions.

    Conclusions: Subjects with asthma tended to have lower QALY-weights compared to subjects with COPD. Having two or more non-respiratory conditions affected the QALY-weight negatively among subjects with COPD but not among subjects with asthma.

  • 348.
    Jemander, Joel
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Ripoll Bergqvist, Lina
    Anestesidjup och anestesiduration hos elektiva ortopediska patienter som upplevt påverkan på kognitiv funktion postoperativt2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Abstrakt

    Bakgrund: Forskning visar att generell anestesi kan bidra till kognitiv dysfunktion postoperativt. En alltför djup anestesi och/eller en lång duration av anestesi är två faktorer som kan inverka på kognitionen med besvär såsom minnesproblem och koncentrationssvårigheter. Anestesisjuksköterskans roll är att individanpassa anestesin för att inte orsaka för djup anestesi och därmed har det blivit alltmer vanligt att monitorera anestesidjupet för att minska på onödigt lidande för patienten. Syfte: Syftet är att kartlägga anestesidjup och anestesiduration  hos patienter med självskattad  kognitiv svikt efter elektiv ortopedisk operation. Metod: För att kartlägga detta valdes en retrospektiv observationsstudie med tvärsnittsdesign med insamlad data från kvalitetsregister. Resultat: Av 920 patienter var det 116 patienter som uppgav kognitiv dysfunktion dag 1 postoperativt och upp till över 16 dagar postoperativt med  ett genomsnittsvärde på 37,7 i entropy och 104,4 minuter i anestesiduration. Slutsats: Desto längre duration av anestesin och ju djupare anestesi desto mer kognitiv påverkan postoperativt. Anestesidjupsmonitorering bör användas mer frekvent och önskvärt är att bedöma kognition preoperativt med ett mätinstrument för att kunna se om skillnad finns postoperativt.

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  • 349.
    Jobe, Ingela
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Birgitta
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Knowledge and views about coordinated individual planning from the perspective of active older adults2019In: Clinical Journal of Nursing Care and Practice, ISSN 2639-9911, Vol. 3, p. 17-26Article in journal (Refereed)
    Abstract [en]

    Background Today’s older adults are often well informed and want to participate in decision-making processes. The coordinated individual planning process offers them active involvement in deciding and owning how their care will be managed.

    Aim

    The aim of the study was to explore active older adults’ knowledge and views regarding coordinated individual planning.

    MethodsThe study has an exploratory inductive approach. Five focus-group discussions were conducted with 40 participants from different organizations and associations. A qualitative interpretive description framework was used, and the analysis resulted in four unique themes.

    ResultsThe four themes resulting from the analysis are collaboration and continuity, participation and involvement in decision, individual need for support, and access to information and service. Collaboration between different levels of the healthcare system and between professionals is crucial. Older adults wanted to be participating actors in their healthcare. They worried about the lack of continuity and thought that services were not responsive or did not meet individuals’ needs.

    ConclusionsOlder adults want their views and preferences to be taken into consideration, and they want to be actively engaged in the decision-making process regarding their care.

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  • 350.
    Jobe, Ingela
    et al.
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Lindberg, Birgitta
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Engström, Åsa
    Luleå University of Technology, Department of Health Sciences, Nursing Care.
    Perceptions of healthcare services and preference of factors related to care planning among active older persons2019Conference paper (Refereed)
    Abstract [en]

    Introduction

    The care-planning process offers people active involvement in deciding, agreeing and owning how their care will be managed. It is intended to be a process of collaboration supported by the principles of person-centredness, partnership and empowerment. According to Swedish legislation, coordinated individual planning must occur for patients transferring to another level of care or when an individual, living in their own home, has the need of efforts from different welfare actors. Awareness of older peoples’ preferences regarding different factors related to the care-planning process may generate knowledge that can facilitate bridging the gaps between care recipients’ preferences and caregivers’ decisions during the care-planning process. The aim of the study was to explore active older persons’ perceptions of healthcare services and preferences of factors related to care planning.

    Methods

    A qualitative interpretive description framework was chosen for the study. Five focus-group were conducted with 40 members, aged between 70 to 88 years, from six different organizations and associations. Participants represent the growing older population in society that remains active for many years after retirement. The general principles of interpretative descriptions were used in the analysis.

    Results

    The results showed that the participants thought that many organizational changes that had been made had not improved healthcare services. The participants wanted more flexibility regarding decisions and the possibility to change them. Personal freedom and making choices independently were momentous. They worried about the lack of continuity and perceived that no one assumed overall responsibility. Overall, participants cared more about the quality of the interactions with personnel than about how services were organized. The majority of participants were not aware of the development of a coordinated individual plan. A new service of being able to access the coordinated individual plan on the Internet is offered. A majority of the participants did not have Internet access; they saw themselves as the generation between the old and new systems. They did not resist the new technology but stressed the importance of not excluding anyone.

    Discussions

    Older persons want their views and preferences to be taken into consideration, and they want to be actively engaged in the decision-making process and make decisions themselves. Older people’s lives have become more individualized with the rest of society, and this requires healthcare service solutions that are more tailored and include different options.

    Conclusions

    Older persons’ want to be active partners in healthcare and social services and they value a personal relation with the professional actor, easy access and well-coordinated and more personalized and flexible services. They value their independency and want to stay active as long as possible.

    Lessons learned

    Older persons value their independency and want to remain active and maintain functioning. Views of older people must be considered on different levels, from planning healthcare and social services to individualized care-planning processes.

    Limitations

    It is important to remember that older people are not a homogeneous group. The participants in this study are active in society and chose to participate. Majority of the participants had no previous experiences of the coordinated individual planning however, they can still have other experiences of healthcare and social services that influence their preferences, and made them participate in the study. Their views do not necessarily correspond with older persons’ views in general.

    Suggestions for future research

    More knowledge is needed about how individuals and their relatives experiences the Coordinated individual planning process.

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