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  • 1.
    Ahlander, Britt-Marie
    et al.
    Ryhov County Hospital.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Engvall, Jan
    Linköping University.
    Maret, Eva
    Karolinska Univ Hosp ; Karolinska Institutet.
    Ericsson, Elisabeth
    Örebro university.
    Development and validation of a questionnaire evaluating patient anxiety during Magnetic Resonance Imaging: the Magnetic Resonance Imaging-Anxiety Questionnaire (MRI-AQ)2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 6, p. 1368-1380Article in journal (Refereed)
    Abstract [en]

    Aim. To develop and validate a new instrument measuring patient anxiety during Magnetic Resonance Imaging examinations, Magnetic Resonance Imaging-Anxiety Questionnaire. Background. Questionnaires measuring patients' anxiety during Magnetic Resonance Imaging examinations have been the same as used in a wide range of conditions. To learn about patients' experience during examination and to evaluate interventions, a specific questionnaire measuring patient anxiety during Magnetic Resonance Imaging is needed. Design. Psychometric cross-sectional study with test-retest design. Methods. A new questionnaire, Magnetic Resonance Imaging-Anxiety Questionnaire, was designed from patient expressions of anxiety in Magnetic Resonance Imaging-scanners. The sample was recruited between October 2012-October 2014. Factor structure was evaluated with exploratory factor analysis and internal consistency with Cronbach's alpha. Criterion-related validity, known-group validity and test-retest was calculated. Results. Patients referred for Magnetic Resonance Imaging of either the spine or the heart, were invited to participate. The development and validation of Magnetic Resonance Imaging-Anxiety Questionnaire resulted in 15 items consisting of two factors. Cronbach's alpha was found to be high. Magnetic Resonance Imaging-Anxiety Questionnaire correlated higher with instruments measuring anxiety than with depression scales. Known-group validity demonstrated a higher level of anxiety for patients undergoing Magnetic Resonance Imaging scan of the heart than for those examining the spine. Test-retest reliability demonstrated acceptable level for the scale. Conclusion. Magnetic Resonance Imaging-Anxiety Questionnaire bridges a gap among existing questionnaires, making it a simple and useful tool for measuring patient anxiety during Magnetic Resonance Imaging examinations.

  • 2.
    Aho, Anna-Carin
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Hultsjö, Sally
    Cty Hosp, Jönköping.
    Hjelm, Katarina
    Linköping University.
    Health perceptions of young adults living with recessive limb-girdle muscular dystrophy2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 8, p. 1915-1925Article in journal (Refereed)
    Abstract [en]

    AimThe aim of this study was to describe health perceptions related to sense of coherence among young adults living with recessive limb-girdle muscular dystrophy. BackgroundLimb-girdle muscular dystrophy refers to a group of progressive muscular disorders that may manifest in physical disability. The focus in health care is to optimize health, which requires knowledge about the content of health as described by the individual. DesignA descriptive study design with qualitative and quantitative data were used. MethodInterviews were conducted between June 2012-November 2013 with 14 participants aged 20-30years. The participants also answered the 13-item sense of coherence questionnaire. Qualitative data were analysed with content analysis and related to self-rated sense of coherence. FindingsHealth was viewed as intertwined physical and mental well-being. As the disease progressed, well-being was perceived to be influenced not only by physical impairment and mental strain caused by the disease but also by external factors, such as accessibility to support and attitudes in society. Factors perceived to promote health were having a balanced lifestyle, social relations and meaningful daily activities. Self-rated sense of coherence varied. The median score was 56 (range 37-77). Those who scored 56 described to a greater extent satisfaction regarding support received, daily pursuits and social life compared with those who scored <56. ConclusionCare should be person-centred. Caregivers, with their knowledge, should strive to assess how the person comprehends, manages and finds meaning in daily life. Through dialogue, not only physical, psychological and social needs but also health-promoting solutions can be highlighted.

  • 3.
    Berglund, Annika
    et al.
    Södersjukhuset Hospital Stockholm ; Karolinska Institutet.
    Heikkilä, Kristiina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bohm, Katarina
    Södersjukhuset Hospital Stockholm.
    Schenck-Gustafsson, Karin
    Karolinska Institutet.
    von Euler, Mia
    Södersjukhuset Hospital Stockholm ; Karolinska Institutet.
    Factors facilitating or hampering nurses identification of stroke in emergency calls2015In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 71, no 11, p. 2609-2621Article in journal (Refereed)
    Abstract [en]

    Aims. To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position.

    Background. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke.

    Design. A qualitative study using interpretive phenomenology.

    Methods. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position.

    Findings. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own.

    Conclusion. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke.

  • 4.
    Blomqvist, Kerstin
    University of Kalmar, School of Human Sciences.
    Older persons in persistent pain: nursing and paramedical staff perceptions and pain management.2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 41, no 6, p. 571-584Article in journal (Refereed)
  • 5.
    Blomqvist, Kerstin
    et al.
    University of Kalmar, School of Human Sciences.
    Edberg, Anna-Karin
    Living with persistent pain: experiences of older people receiving home help2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 40, no 3, p. 297-306Article in journal (Refereed)
  • 6.
    Boman, Erika
    et al.
    Åland Univ Appl Sci, Finland;Univ Coll Southeast Norway, Norway.
    Lundman, Berit
    Umeå University.
    Nygren, Bjoern
    Umeå University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University.
    Fischer, Regina Santamaki
    Umeå University;Åbo Akad Univ, Finland.
    Inner strength and its relationship to health threats in ageing: A cross-sectional study among community-dwelling older women2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2720-2729Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the relationship between inner strength and health threats among community-dwelling older women. Background: Inner strength is described as a resource that promotes experiences of health, despite adversities. Inner strength and its dimensions (i.e. connectedness, creativity, firmness and flexibility) can be assessed using the Inner Strength Scale (ISS). Exploring attributes of weaker inner strength may yield valuable information about areas to focus on in enhancing a person's inner strength and may ultimately lead to the perception of better health. Design: Cross-sectional questionnaire survey. Methods: The study is based on responses from 1270 community-dwelling older women aged 65 years and older; these were collected in the year 2010 and describe the situation that still exists today for older women. The questionnaire included the ISS, background characteristics and explanatory variables known to be health threats in ageing. Data were analysed using descriptive and inferential statistics. Results: Poorer mental health was related to weaker inner strength in total and in all the dimensions. Symptoms of depressive disorders and feeling lonely were related to three of the dimensions, except firmness and creativity respectively. Furthermore, poor physical health was associated with the dimensions firmness and flexibility. Other health threats were significantly related to only one of the dimensions, or not associated at all. Conclusion: Mental ill health has overall the strongest association with weaker inner strength. Longitudinal studies are recommended to confirm the results. However, the ISS does not only estimate inner strength but can also be a tool for discovering where (i.e. dimension) interventions may be most profitable.

  • 7.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Reminiscence and problem-based method as an intervention to prevent depressive symptoms in elderly2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, p. 67-68Article in journal (Other academic)
  • 8.
    Ekstedt, Mirjam
    et al.
    Karolinska Institutet.
    Fagerberg, Ingegerd
    Mälardalen University ; Karolinska Institutet.
    Lived experiences of the time preceding burnout2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 49, no 1, p. 59-67Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reports a study to illuminate the complex interaction between person and their life world during the burnout development period.

    BACKGROUND: Burnout is a construct describing the psychological state resulting from ineffective strategies for coping with enduring stress in both client and non-client work. Role conflict and role ambiguity, or long-term stress and frustration caused by strain in daily life, promote or exacerbate burnout, indicating that the person's entire life world is involved. There is still a lack of description of lived experiences of the time preceding manifest burnout.

    METHOD: Data were collected from interviews with eight people suffering from burnout and analysed using a phenomenological method.

    FINDINGS: The essential meaning of the phenomenon of burnout is understood as being trapped with stimulating challenges as a self-nourishing drive on one side and with responsibilities and demands on the other. This essence can be illuminated by its eight constituents: inner incentive, feeling responsible, threatened self-image, cutting off, bodily manifestations, psychological manifestations, fatigue and reaching the bottom line.

    CONCLUSIONS: The lived experiences of the time preceding manifest burnout are an ambiguous struggle. Cutting off is understood as a mean to shelter the threatened self-image in a state of vulnerability and weakened strength. Accordingly, a better understanding of how to reach behind the defence of 'cutting off' and thus help to open up for consolation and self-acceptance is an essential skill for nurses, health care professionals and others encountering the burnout sufferers. Furthermore this study illuminates early signs of burnout and an important issue is how to strengthen the individuals' ability to shelter their need for recovery and restitution.

  • 9.
    Eriksson, Kerstin
    et al.
    Jönköping University;Ryhov County Hospital.
    Wikström, Lotta
    Jönköping University;Ryhov County Hospital.
    Fridlund, Bengt
    Jönköping University.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University;Kalmar County Hospital.
    Broström, Anders
    Jönköping University;University Hospital Linköping.
    Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery: A quantitative study with repeated measures2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2664-2675Article in journal (Refereed)
    Abstract [en]

    Aim: To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery. Background: Previous research has indicated that average self-rated pain reflects patients' ability to recover the same day. However, there is a knowledge gap about the feasibility of using average pain ratings to predict patients' physical recovery for the next day. Design: Descriptive, quantitative repeated measures. Methods: General and orthopaedic inpatients (n = 479) completed a questionnaire (October 2012-January 2015) about pain and recovery. Average pain intensity at rest and during activity was based on the Numeric Rating Scale and divided into three levels (0-3, 4-6, 7-10). Three out of five dimensions from the tool "Postoperative Recovery Profile" were used. Because few suffered severe pain, general and orthopaedic patients were analysed together. Results: Binary logistic regression analysis showed that average pain intensity postoperative day 1 significantly predicted the impact on recovery day 2, except nausea, gastrointestinal function and bladder function when pain at rest and also nausea, appetite changes, and bladder function when pain during activity. High pain ratings (NRS 7-10) demonstrated to be a better predictor for recovery compared with moderate ratings (NRS 4-6), day 2, as it significantly predicted more items in recovery. Conclusion: Pain intensity reflected general and orthopaedic patients' physical recovery postoperative day 1 and predicted recovery for day 2. By monitoring patients' pain and impact on recovery, patients' need for support becomes visible which is valuable during hospital stays.

  • 10.
    Eriksson, Kerstin
    et al.
    Jönköping University, Sweden;Ryhov County Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Broström, Anders
    Jönköping University, Sweden;University Hospital, Linkoping, Sweden.
    Wikström, Lotta
    Jönköping University, ;Ryhov County Hospital, Sweden.
    Nausea intensity as a reflector of early physical recovery after surgery2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 5, p. 989-999Article in journal (Refereed)
    Abstract [en]

    Aim To compare different levels of self-rated average nausea intensity with early physical recovery and determine if nausea can reflect recovery in patients undergoing general or orthopaedic surgery. Background Nausea has been found to influence postoperative physical recovery. Despite the incidence of nausea in postoperative care, there is a knowledge gap about the possibility of using average nausea intensity to reflect recovery, motivating further investigation. Design An observational design with repeated measures. Methods General and orthopaedic patients answered a questionnaire (October 2012-January 2015) about nausea and impact on recovery on postoperative days 1 (N = 479) and 2 (N = 441). Questions about average nausea intensity at rest and during activity were answered based on the Numeric Rating Scale (NRS) (0-10). Impact on recovery was evaluated using three dimensions from the postoperative recovery profile tool. Results About one-fifth of the patients reported nausea intensity as moderate to severe on days 1 and 2. Nausea intensity was associated with eight of nine aspects of recovery on postoperative day 1. Nausea intensity on day 1 also reflected four of nine aspects of recovery on day 2. About reflecting physical recovery, the association was strongest between nausea intensity and appetite changes. Conclusions As postoperative nausea is common, regular assessments by healthcare professionals are needed. Assessment of nausea is of importance since it reflects physical recovery. This also shows the importance of treating nausea without delay. Using the NRS to measure nausea intensity is a simple method that is easy to use in clinic.

  • 11.
    Erlingsson, Christen
    et al.
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Mitsu, Ono
    Hiroshima University, Japan.
    Sasaki, Akiko
    Tokyo Medical and Dental University, Japan.
    Saveman, Britt-Inger
    Umeå University.
    An international collaborative study comparing Swedish and Japanese nurses’ reactions to elder abuse.2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 1, p. 56-68Article in journal (Refereed)
    Abstract [en]

    Aim. This paper reports an analysis of aggregated data from two national studies on Swedish community-based nurses’ and Japanese Public Health Nurses’ responses to hypothetical elder abuse cases.

    Background. Elder abuse is an under-researched area despite being globally recognized as a serious and escalating problem. Yet research, adding needed sociocultural perspectives to current knowledge has been limited.

    Methods. Eighty-one community-based nurses in Sweden and 124 Public Health Nurses in Japan responded to a questionnaire based on three hypothetical elder abuse cases. Swedish and Japanese results (data collection 2006–2007) were combined and the aggregated data were analysed using manifest and qualitative content analyses.

    Results. Nurses’ response patterns in the aggregated data were similar across all three hypothetical cases and within themes Awareness, Assessment and Intervention. However, there were also noteworthy differences between Swedish and Japanese responses, e.g. Swedish responses were generally practical, action oriented and involved increased levels of suspicion and personal intervention to achieve increased control; whereas Japanese responses concerned better understanding that involved the family members and their situation, focusing on interventions grounded in collaboration.

    Conclusion. Despite cultural differences, responses of Swedish and Japanese nurses were very similar which points to a global ‘humanness’ of the problem of, and nurses’ responses to, elder abuse. Results endorse the value of international collaborations that give information and inspiration to nursing colleagues across cultural boundaries. Results also give hope that global tools for elder abuse assessment and intervention can be developed.

  • 12.
    Ewertzon, Mats
    et al.
    Ersta Sköndal Bräcke University College, Sweden.
    Alvariza, Anette
    Ersta Sköndal Bräcke University College, Sweden;Dalen Hospital, Sweden.
    Winnberg, Elisabeth
    Ersta Sköndal Bräcke University College, Sweden.
    Leksell, Janeth
    Dalarna University, Sweden;Uppsala University, Sweden.
    Andershed, Birgitta
    Norwegian Univ Sci & Technol, Norway.
    Goliath, Ida
    Karolinska Institutet, Sweden;Ersta Hospital, Sweden.
    Momeni, Pardis
    Ersta Sköndal Bräcke University College, Sweden.
    Kneck, Åsa
    Ersta Sköndal Bräcke University College, Sweden.
    Skott, Maria
    Karolinska Institutet, Sweden;Stockholm County Hospital, Sweden.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Linköping University, Sweden;Kalmar County Hospital, Sweden.
    Adaptation and evaluation of the Family Involvement and Alienation Questionnaire for use in the care of older people, psychiatric care, palliative care and diabetes care2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 8, p. 1839-1850Article in journal (Refereed)
    Abstract [en]

    AimTo adapt the Family Involvement and Alienation Questionnaire (FIAQ) for use in the care of older people, psychiatric care, palliative care and diabetes care and to evaluate its validity and reliability. BackgroundInvolvement in the professional care has proven to be important for family members. However, they have described feelings of alienation in relation to how they experienced the professionals' approach. To explore this issue, a broad instrument that can be used in different care contexts is needed. DesignA psychometric evaluation study, with a cross-sectional design. MethodThe content validity of the FIAQ was evaluated during 2014 by cognitive interviews with 15 family members to adults in different care contexts. Psychometric evaluation was then conducted (2015-2016). A sample of 325 family members participated, 103 of whom in a test-retest evaluation. Both parametric and non-parametric methods were used. ResultsThe content validity revealed that the questionnaire was generally understood and considered to be relevant and retrievable by family members in the contexts of the care of older people, psychiatric care, palliative care and diabetes care. Furthermore, the FIAQ (Revised), demonstrated satisfactory psychometric properties in terms of data quality, homogeneity, unidimensionality (factor structure), internal consistency and test-retest reliability. ConclusionThe study provides evidence that the FIAQ (Revised) is reliable and valid for use in further research and in quality assessment in the contexts of the care of older people, psychiatric care, palliative care and diabetes care.

  • 13. Gustafsson, Birgitta Åkesdotter
    et al.
    Ponzer, Sari
    Heikkilä, Kristiina
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Ekman, Sirkka-Liisa
    The lived body and the perioperative period in replacement surgery: older people´s experiences2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 1, p. 20-28Article in journal (Refereed)
    Abstract [sv]

    Aim. This paper is a report of a study to explore older people´s expereinces of their lived bodies during the perioperative period of hip or knee replacement.

    Background. replacement surgery of a major joint for older people suffering from osteoarthtitis is an established treatment in developed countries. Scientific knowledge is awailable on replacement surgery from several perspectives, but not about older people´s experiences of the entire perioperative period of replacement procedure.

    Method. A qualitative longitudinal study was conducted between 2002 and 2004. Audiotaped interviews were carried out with 12 older people, on five different occasions during the perioperative period. The data was analysed using latent qualitative content analysis.

    Findings. The perioperative period of a hip or knee replacement can be regarded as a process of transition which includes six critical phases. The transition was supported with a dream of becoming as able-bodied as previously in life, by having surgery. In addition, our findings revealed that the care recipients lacked knowledge about the surgical intervention as a whole.

    Conclusion. The meaning of having joint replacement surgery was to overcome the confinement of living with a painful and unreliable body. Furthermore, care recipients struggled to regain a body in charge and control of their lives, yet from a new starting point. The care recipients were not prepared for the transitional changes through the perioperative period. Further research is needed to develop an appropriate programme for patient care during the perioperative period, in order to facilitate the process of transition.

  • 14.
    Kirsebom, Marie
    et al.
    Uppsala University.
    Wadensten, Barbro
    Uppsala University.
    Hedström, Mariann
    Uppsala University.
    Communication and coordination during transition of older persons between nursing homes and hospital still in need of improvement2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 4, p. 886-895Article in journal (Refereed)
    Abstract [en]

    Aim:

    To investigate registered hospital and nursing home nurses' experiencesof coordination and communication within and between care settings when olderpersons are transferred from nursing homes to hospital and vice versa.

    Background:

    It has previously been reported that transfers to hospital from nursing homes and discharge of patients from hospital are surrounded by communication difficulties. However, studies focusing on both hospital and nursing home registered nurses' experiences of communication and coordination within and between nursing homes and hospitals are uncommon.

    Design:

    A descriptive study design with a qualitative approach was used.

    Methods:

    In 2008, three focus group discussions were conducted with registered nurses from hospitals and nursing homes (n=20). Data were analysed using content analysis.

    Results:

    Nursing home registered nurses found it difficult to decide whether the older person should be referred to hospital from the nursing home. Hospitalregistered nurses reported often trying to stop premature discharges or having to carry out the discharge although it had not been fully prepared. Both hospital and nursinghome registered nurses suggested increased collaboration to understand each other's work situation better.

    Conclusion:

    Communication and coordination among hospital andnursing home registered nurses need to be furthered improved. Registered nurses'coordination and planning in the nursing home are extremely important to future elder care. We recommend that the medical care plan be regularly updated and meticulously followed, the aim being to reduce the risk of inappropriate medical treatment and nursingcare and unnecessary transfer and admission to hospital.

  • 15.
    Knutsson, Susanne
    et al.
    Borås Hospital, Sweden.
    Bergbom Engberg, Ingegerd
    Karlstad University, Sweden.
    An evaluation of patients' quality of life before, 6 weeks and 6 months after total hip replacement surgery1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, no 6, p. 1349-59Article in journal (Refereed)
    Abstract [en]

    Annually, throughout the world, more than 800,000 primary total hip replacement surgery procedures are performed on patients suffering from hip joint arthrosis. Since 1991, approximately 11,000 of these procedures are performed annually in Sweden. This study aimed to investigate any changes in the patients' life quality 6 weeks and 6 months after their total hip replacement surgery had been performed, compared to that immediately prior to the operation. It also aimed to examine the reason for surgery, the types of prostheses used, postoperative pain, complications and the actual usage of ambulation support. The Sickness Impact Profile self-appraisal instrument, together with personal patient interviews have been used as the basis of the research. A total of 51 patients responded to the quality of life instrument prior to their operation, 47 of these participated 6 weeks after the operation, and 40 patients 6 months after the operation. Significant differences in patients' total, physical and psychosocial quality of life 6 months postoperatively compared to the situation prior to the operation were found, but not between the situation before and 6 weeks after the total hip replacement surgery. The majority of patients were of the opinion that it was more important that the pain had disappeared or decreased, than any overall increase in the quality of life. Postoperative complications occurred within 6 weeks, and even after 6 months some patients still suffered from these.

  • 16.
    Lindberg, Catharina
    et al.
    Blekinge Institute of Technology ; Lund University.
    Fagerström, Cecilia
    Blekinge Institute of Technology.
    Sivberg, Bengt
    Lund University.
    Willman, Ania
    Blekinge Institute of Technology ; Malmö University.
    Concept analysis: patient autonomy in a caring context2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 10, p. 2208-2221Article in journal (Refereed)
    Abstract [en]

    Aim

    This paper is a report of an analysis of the concept of patient autonomy.

    Background

    Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept.

    Design

    Concept

    Analysis.

    Data sources

    Medline, CINAHL, The Cochrane Library and PsycINFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved.

    Review Methods

    The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context.

    Results

    Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one’s actions’'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom.

    Conclusion

    Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context.

  • 17.
    Nilsson, Gunilla
    et al.
    Lunds universitet, medicinska fakulteten.
    Larsson, Sylvia
    Johnsson, Folke
    Saveman, Britt-Inger
    University of Kalmar, School of Human Sciences.
    Patients' experiences of illness, operation and outcome with reference to gastro-oesophageal reflux disease.2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 40, no 3, p. 307-15Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Describing the illness-story from a patient perspective could increase understanding of living with a chronic disease for health professionals and others, facilitate decision-making about treatment and enhance information about the outcome from a patient perspective. AIM: To illuminate patients' illness experiences of having a gastro-oesophageal reflux disease (GORD), going through surgery and the outcome. METHODS: Twelve patients were interviewed 5 years after having had the operation; six patients had had fundoplication via laparoscopy and six via open surgery. Each patient was asked to talk openly about their experiences, thoughts, feelings and consequences of living with the illness, going through surgery and the period from surgery to the day of interview. A qualitative content analysis was performed concerning the context of the data and its meaning. FINDINGS: Three central categories were identified and nine subcategories: living with GORD- symptoms of the disease affecting daily living, taking medicines, work, family and social life; concerns related to surgery- decision-making about the operation, influence by physicians; life after the operation- outcomes and consequences, side-effects and complications of the operation, sick leave, information and sharing experiences with future patients. All patients were free from symptoms of the illness after surgery independent of type of surgery, but side-effects from surgical treatment varied individually. Interviewees would have liked information concerning side-effects after surgery from previous patients. CONCLUSIONS: This study contributes to knowledge about patients' long-term suffering, their control of symptoms and how they have tried to cure themselves, but also about their concerns about surgery and the importance of surgical treatment to their quality of life. They wanted information about treatment, outcome and consequences, not only from a health care perspective but also from previous patients having had the same treatment.

  • 18.
    Peterson, Ulla
    et al.
    Karolinska Institutet.
    Bergström, Gunnar
    Karolinska Insitutet.
    Samuelsson, Mats
    Karolinska institutet.
    Åsberg, Marie
    Karolinska institutet.
    Nygren, Åke
    Karolinska institutet.
    Reflecting peer-support groups in the prevention of stress and burnout: randomized controlled trial2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 63, no 5, p. 506-516Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to test the effect of participating in a reflecting peer-support group on self-reported health, burnout and on perceived changes in work conditions.

    BACKGROUND: Stress-related conditions are one of the most common causes for long-term sick-leave. There is limited evidence for the effectiveness of person-directed interventions aimed at reducing stress levels in healthcare workers. Prior research in the relationship between support and burnout show somewhat inconsistent results.

    METHOD: A randomized controlled trial with peer-support groups as the intervention was conducted with 660 healthcare workers scoring above the 75th percentile on the exhaustion dimension of the Oldenburg Burnout Inventory. One hundred and fifty-one (22.9%) agreed to participate. The intervention started in 2002 with 51 participants (96.1% were women), 80 of whom constituted the control group. Potential differences in outcome measures 12 months after the intervention were compared using ancova, and data collected was completed in 2004. Qualitative content analyses were used to analyse reported experiences from group participation.

    RESULTS: Statistically significant intervention effects were found for general health, perceived quantitative demands at work, participation and development opportunities at work and in support at work. Seven categories of experiences from participating were identified: talking to others in a similar situation, knowledge, sense of belonging, self-confidence, structure, relief of symptoms and behavioural change.

    CONCLUSION: Peer-support groups using a problem-based method could be a useful and comparatively inexpensive tool in alleviating work-related stress and burnout.

  • 19.
    Peterson, Ulla
    et al.
    Karolinska Institutet.
    Demerouti, Evangelia
    Utrecht University.
    Bergström, Gunnar
    Karolinska Institutet.
    Samuelsson, Mats
    Karolinska Institutet.
    Åsberg, Marie
    Karolinska Institutet.
    Nygren, Åke
    Karolinska Institutet.
    Burnout and physical and mental health among Swedish healthcare workers2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 62, no 1, p. 84-95Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to investigate how burnout relates to self-reported physical and mental health, sleep disturbance, memory and lifestyle factors.

    BACKGROUND: Previous research on the possible relationship between lifestyle factors and burnout has yielded somewhat inconsistent results. Most of the previous research on possible health implications of burnout has focused on its negative impact on mental health. Exhaustion appears to be the most obvious manifestation of burnout, which also correlates positively with workload and with other stress-related outcomes.

    METHOD: A cross-sectional study was conducted, using questionnaires sent to all employees in a Swedish County Council (N = 6118) in 2002. The overall response rate was 65% (n = 3719). A linear discriminant analysis was used to look for different patterns of health indicators and lifestyle factors in four burnout groups (non-burnout, disengaged, exhausted and burnout).

    RESULTS: Self-reported depression, anxiety, sleep disturbance, memory impairment and neck- and back pain most clearly discriminated burnout and exhausted groups from disengaged and non-burnout groups. Self-reported physical exercise and alcohol consumption played a minor role in discriminating between burnout and non-burnout groups, while physical exercise discriminated the exhausted from the disengaged group.

    CONCLUSION: Employees with burnout had most symptoms, compared with those who experienced only exhaustion, disengagement from work or no burnout, and the result underlines the importance of actions taken to prevent and combat burnout.

  • 20.
    Stevenson-Ågren, Jean
    et al.
    Linnaeus University, Faculty of Humanities and Social Sciences, School of Language and Literature.
    Nilsson, Gunilla
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nurses’ perceptions of an electronic patient record from a patient safety perspective: A qualitative study.2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 3, p. 667-676Article in journal (Refereed)
    Abstract [en]

    Aims: The overall aim of this study was to explore nurses’ perceptions of using an electronic patient record in everyday practice, in general ward settings. This paper reports on the patient safety aspects revealed in the study.

    Background: Electronic patient records (EPR) are widely used and becoming the main method of nursing documentation. Emerging evidence suggests that they fail to capture the essence of clinical practice and support the most frequent end-users: nurses. The impact of using EPR in general ward settings is under-explored.

    Method: In 2008, focus group interviews were conducted with 21 registered nurses (RNs). This was a qualitative study and the data were analysed by content analysis. At the time of data collection, the EPR system had been in use for approximately one year.

    Findings: The findings related to patient safety were clustered in one main category: ‘documentation in everyday practise’. There were three sub-categories: vital signs, overview and medication module. Nurses reported that the EPR did not support nursing practice when documenting crucial patient information, such as vital signs.

    Conclusions: Efforts should be made to include the views of nurses when designing an EPR to ensure it suits the needs of nursing practice and supports patient safety. Essential patient information needs to be easily accessible and provide support for decision-making. 

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