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  • 11651.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Hedin, Gita
    Kristianstad University, School of Health and Society.
    Förebyggande och uppsökande verksamhet: Osby kommun2010Report (Other academic)
    Abstract [en]

    Aim: The aim with this report is to explore differences between home living men and women, younger (79 years or younger) and older elderly (80 years or older) that got a preventive home visit.

    Methods: In the fall 2007 one municipality started up with preventive home visits. Elderly persons are visited by district nurses to register and discuss the elderly persons perceived health, medications, living circumstances and social activities. At the same time a checklist is used to access preventive measures taken with respect to fall risk. From year 2010 also a form is used to assess the risk for malnutrition.

    Results: In total 1203 preventive home visits has been made to older persons with a mean age of 81.7 years, 56% women, and 44% men. In comparisons between men and women it was found that men were more dependent in washing, cooking and cleaning. Women perceived their state of health as worse, they had more problems with vision and more pain than men. Women were more physically active than men. More men hade problems hearing. Women were less satisfied with their situation, more tired, more often dejected, felt more worries/anxiety, and had poorer sleep. But, women had more contact with others (by visits/by phone) than men had. Women had more difficulties with mobility-tiredness and more had risk for falling (46.5%, men 39.8%). More women had also made adjustments in their homes to prevent falls. In total 218 persons had been assessed regarding the risk for malnutrition and significantly more women were at risk (82.8% versus men 58.4%). More needs were also identified during the preventive home visits for the women than for the men. In comparison between the younger and the older persons there were more needs for help i daily activities, poorer health, more vision- and hearing problems, less satisfaction with their circumstances, and more tiredness among the older persons. But, the oldest persons had better sleep and more visits from others (or that people called them). It was less persons in the older group that had a permanent contact with a doctor, more used medications and more had problems with mobility-tiredness, and more had fall risk (34.7% among the youngest and 51.0% in the oldest age group). Accordingly more preventive actions had been taken among the oldest persons to prevent falling. More needs were also identified during the preventive home visits for the oldest age group than for the youngest. Out of the 218 persons (all of whom were 79 years or younger) that had been assessed regarding the risk for malnutrition it was 70.5% that had such a risk. In total more persons wanted to, if the need arise, to get continued care and service in their own home. 

    Conclusion: In general women and the oldest (80 years or over) had more physical and psychological health problems than men and the youngest (79 years or under). Thus, women and the oldest are special risk groups. It was also in these groups most needs were identified during the preventive home visits. Risk for malnutrition seems to be an extensive problem among the home living elderly, this needs special attention during the preventive home visits.

  • 11652.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Hedin, Gita
    Kristianstad University, School of Health and Society.
    Nutrition: förekomsten av ätsvårigheter och undernäring: en studie genomförd med hjälp av studenter på sjuksköterskeprogrammetåren 2005, 2007 och 20092010Report (Other (popular science, discussion, etc.))
    Abstract [en]

    Summary: The aim of this study was to explore the prevalence of eating difficulties and malnutrition among persons in hospitals and among those living in special accommodations (long-term care). In addition the aim was to, within special accommodations, explore how different interventions could affect the precision in nutritional care and the occurrence of underweight/overweight, both from a short as well as a long-term perspective.

    Methods: Nurse students collected the data during their clinical education at hospitals and in special accommodations in years 2005, 2007, and 2009. Staff and clinical teachers participated also with the data collection. By participating in the study the students got training in how to provide information to the staff and patients/residents, collect data, and compile results and to give feed-back about the findings to the department. Underweight and overweight was assessed from BMI. Undernutrition risk was assessed based on: unintentional weight loss, low BMI, and/or the occurrence of eating difficulties. Assessments were also made regarding what nutritional care the care recipients got. In the special accommodations interventions with study circles (two municipalities), nutritional care policy (one municipality) and in four municipalities no specific intervention was made. The prevalence of overweight was 39-42%.

    Results: In hospitals the prevalence of moderate/high undernutrition risk was 27-28% and if also those with little risk were included the prevalence was 60-63%. Between 4-7% were provided with protein- and energy enriched food, 25-30% got oral supplements or similar and 12-13% needed eating assistance.

    In special accommodations the prevalence of moderate/high undernutrition risk was 27-35% and if also those with little risk were included the prevalence was 65-70%. The prevalence og overweight was 30-33%. Between 4-14% were provided with protein- and energy enriched food, 11-19% got oral supplements or similar and 47-50% needed eating assistance. Within the special accommodations it was shown that the intervention with study circles lead to improvements in the precision of nutritional care (protein- and energy enriched food and/or oral supplements) and a lower prevalence of underweight was seen, at least shortly after that the intervention was finished. In the same way the anchoring and implementation of the nutritional care policy resulted in improvement in the nutritional care. These improvements remained however also a long time after the implementation. 

    Most of the students (81%) experienced that they did get better understanding for research by participating in the study, more than half (53%) thought that their interest in assessment of eating and nutrition increased and 67% that their knowledge about eating and nutrition increased.

    Conclusion: Many patients and residents are at risk of becoming undernourished. This demands that adequate measures are taken to prevent or treat undernutrition. Such measures can be protein- and energy-dense food and oral supplements or similar. In the special accommodations can study circles for the staff lead to improvements in the nutritional care for more residents in a short-term perspective and by implementing a nutritional care policy also long-term positive effects are likely to be achieved. Combining study circles with implementation of nutritional care policies can be the focus for new studies.

    In general the nursing students experience it as positive to participate in a real research project.

     

  • 11653.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Hedin, Gita
    Kristianstad University, School of Health and Society.
    Undernäring, övervikt och relationer till aktiviteter i dagligt liv: en studie genomförd med hjälp från studenter i sjuksköterskeprogrammet2011Report (Other academic)
  • 11654.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Hedin, Gita
    Kristianstad University College, School of Health and Society.
    Axelsson, Carolina
    Kristianstad University College, School of Teacher Education.
    Långvarig och akut smärta: hos patienter och boende: en studie genomförd av studenter på sjuksköterskeprogrammet2009Report (Other academic)
    Abstract [en]

    The aim of the study was to map out pain and pain treatment among patients in hospitals and persons in special accommodations as well as in ordinary living.

    Method: Nurse students collected the data during their clinical education at hospitals and in special accommodations or in ordinary living. Also the clinical teachers helped out with supporting the students during data collection. The students made assessments of pain where they had their clinical practice during the spring 2009. The students got, though collecting data, a training in how to provide information to the staff and patients/residents, compile results and to give feed-back about the findings to the department. The study was not conducted as a total survey, in other words was a selection of respondents that were included in the results.

    Results: In total 419 assessments of pain was made and 35% of respondents reported long standing pain and 14% reported acute pain. The respondents with long standing pain were older (76 years and 69 years respectively), more women (67% and 53% respectively) and more were in special accommodations or in ordinary living (37% and 17% respectively) than among those with acute pain. The respondents with acute pain more often agreed with that the staff asked about if he/she had pain (84% and 73% respective) while the respondents with long standing pain to a greater extent agreed with that they tried to hide their own pain (acute pain: 43% resp. long standing pain: 59%). The most common strategies to handle the pain among those with acute pain was to ask for something to alleviate the pain (84%), lie down and rest (78%) or to try thinking on something else (64%) while it among those with long standing pain was to lie down and rest (83%), ask for something to alleviate the pain (73%) or to try thinking on something else (70%). Of the students that collected the data and reported the findings to the staff 51 also evaluated their participation in the study. Of these, 74% experienced that their understanding for research increased, 51% that their interest för pain assessment had increased and 55% that their knowledge about pain had increased.

     Conclusion:

    Long standing pain was most common among women and elderly persons. The strategies used among the participants for making staff aware about the pain, and the strategies to handle once own pain differed depending on weather the pain was acute or long standing. Participating in the data collection and other research activities has a positive effect for nursing students understanding for research and to some extent for their interest in the area under study.

  • 11655.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    Hedin, Gita
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    10 år med forskargruppen PRO-CARE: jubileumsskrift2014Report (Other (popular science, discussion, etc.))
  • 11656.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    Hedin, Gita
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Lindgren, Emma
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society.
    Gångsvårigheter, tilltro till balansförmåga, fallrisk och relaterade faktorer på sjukhus och i särskilt boende: en studie genomförd med hjälp från studenter i sjuksköterskeprogrammet2013Report (Other academic)
  • 11657.
    Westergren, Albert
    et al.
    Central Hospital, Kristianstad.
    Jakobsson, Ulf
    Lund University.
    Räkna med det interna bortfallet [Count with the internal drop-out]2006In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 26, no 3, p. 54-56Article in journal (Other academic)
    Abstract [en]

    Missing data is a pragmatic fact

    that must be investigated and not

    a disaster to be mitigated. It is a

    property of the population to

    which we seek to generalize and

    can cause problems not only

    through its impact on the sample

    size available for analysis but

    also through its potential hidden

    biases. Making imputations without

    first analysing the randomness

    of the missing responses can

    even be worse than doing nothing,

    so care is needed while

    imputing missing values. This

    paper reflects on how to prevent,

    analyse and handle missing data

    and how effects of imputation can

    be checked.

  • 11658.
    Westergren, Albert
    et al.
    Kristianstad University, Department of Health Sciences.
    Karlsson, Siv
    Department for Rehabilitation Medicine, Central Hospital Kristianstad, Northeast Skåne Healthcare District.
    Andersson, Pia
    Kristianstad University, Department of Health Sciences.
    Ohlsson, Ola
    Department of Internal Medicine, Central Hospital Kristianstad, Northeast Skåne Healthcare District.
    Hallberg, Ingalill
    Department of Nursing, Faculty of Medicine, Lund University.
    Eating difficulties, need for assisted eating, nutritional status and pressure ulcers in patients admitted for geriatric stroke rehabilitation2001In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 10, no 2, p. 257-269Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the types and extent of eating difficulties, the need for assistance when eating, the nutritional status and pressure ulcers in consecutive patients (n = 162) admitted for stroke rehabilitation over a period of 1 year. Structured observations and assessments of eating, nutritional status (subjective global assessment of nutritional status), pressure ulcers and activities in daily living (Katz ADL-index) were performed by a nurse who also trained the staff to perform these assessments. Difficulties in eating were found in 80%, and 52.5% were unable to eat without assistance. Eating difficulties were: 'eats three-quarters or less of served food' (60%), difficulties in 'manipulating food on the plate' (56%), 'transportation of food to the mouth' (46%), 'sitting position' (29%), 'aberrant eating speed' (slow or forced) (26%), 'manipulating food in the mouth' (leakage, hoarding, chewing difficulties) (24%), 'swallowing difficulties' (18%), 'opening and/or closing the mouth' (16%), and 'alertness' (9%). Thirty-two percent were undernourished (49% of patients needing assisted eating and 13% of those not needing assistance, P < 0.0005). Among patients who were dependent in one or more functions according to the Katz ADL-index, 15% had pressure ulcers. The strongest eating variables for predicting nutritional status were 'alertness', 'swallowing difficulties', 'eats three-quarters or less of served food', and 'aberrant eating speed'. Nutritional status could in turn significantly predict pressure ulcers. Eating difficulties among patients with stroke are complex and the patient's situation before stroke adds to this complexity, especially among those dependent on assisted eating. As difficulties occur both among patients needing and not needing assisted eating, all patients with stroke admitted for rehabilitation need to be systematically assessed for eating difficulties and action needs to be taken to facilitate eating, especially as patients with eating difficulties risk becoming undernourished and in turn developing pressure ulcers.

  • 11659.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Khalaf, Atika
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Al-Hazzaa, H.
    Berggren, Vanja
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Discrepancies between the actual, perceived and ideal body image among female university students in South Western Saudi Arabia2011Conference paper (Refereed)
  • 11660.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    Khalaf, Atika
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    A Swedish version of the SCREEN II for malnutrition assessment among community-dwelling elderly2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 6, p. 667-71Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Seniors in the Community: Risk Evaluation for Eating and Nutrition II (SCREEN II) Questionnaire assesses nutritional risk among elderly people living at home. Our aim was to produce a Swedish language version of the SCREEN II and to examine response patterns, data completeness and the relationship between malnutrition and general health.

    METHODS: The SCREEN II was translated into Swedish using dual panel methodology, and then followed up with field test interviews of 24 seniors (median age, 83 years). We used the survey data (n = 565) to assess item and score distribution, missing responses, and the relationship to the subject's general and nutritional health.

    RESULTS: The Swedish SCREEN II was considered easy to understand, respond to, and relevant (n = 21; 88% of subjects found it so in all three respects) and its median completion time was 5 minutes. The level of survey item data completeness was 94-99%, and 82% of surveys had computable total scores. Of those subjects with completed forms, 35% had no nutritional risk; 35% had moderate risk; and 30% were at high risk. The malnutrition risk increased with poorer perceived health.

    CONCLUSIONS: Our study results are similar to those using previous SCREEN II versions, indicating that the scale adaptation was successful and providing initial support for use of the Swedish SCREEN II questionnaire.

  • 11661.
    Westergren, Albert
    et al.
    Kristianstad University College, Department of Health Sciences.
    Lindholm, Christina
    Kristianstad University College, Department of Health Sciences.
    Axelsson, Carolina
    Kristianstad University College, Department of Health Sciences.
    Ulander, Kerstin
    Kristianstad University College, Department of Health Sciences.
    Både undernäring och övervikt inom vård och omsorg november 2005: en punktprevalensstudie kring ätande och näring2007Report (Other academic)
  • 11662.
    Westergren, Albert
    et al.
    Kristianstad University College, Department of Health Sciences.
    Lindholm, Christina
    Kristianstad University College, Department of Health Sciences.
    Axelsson, Carolina
    Kristianstad University College, Department of Health Sciences.
    Ulander, Kerstin
    Kristianstad University College, Department of Health Sciences.
    Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations2008In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 12, no 1, p. 39-43Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aim of this study was to explore the prevalence of eating difficulties and malnutrition among persons in hospital care and in special accommodations. DESIGN: The cross-sectional observational study was performed in Nov. 2005. SETTING: Hospitals and special accommodations. PARTICIPANTS: Out of 2,945 persons, 2,600 (88%) agreed to participate (1,726 from special accommodations and 874 from hospitals). In total all special accommodations in six municipalities and six hospitals were involved. MEASUREMENTS: Risk of undernutrition was estimated as at least two of: body mass index below recommendation, weight loss and/or eating difficulties. Overweight was graded based on body mass index (if 69 years or younger: 25 or above: if 70 years or older: 27 or above). RESULTS: The mean age of those living in hospitals was 69 years and 53% were women, while the corresponding figures for those in special accommodations were 85 years and 69% women. In hospitals and special accommodations, eating difficulties were common (49% and 56% respectively) and about one quarter had a body mass index (BMI) below the limits (20% and 30% respectively) and one-third above the limit (39% and 30% respectively) thus only about 40% had a BMI within the limits. Both in hospitals and in special accommodations 27% were considered to have a moderate or high risk of undernutrition. CONCLUSION: Only about 40% in special accommodations and hospital care have a BMI within the recommended limits. As both low and high BMI are frequent in both settings, the focus of care should not only be on undernutrition but also on overweight. Using the Swedish criteria for defining risk of undernutrition seems to give a slightly lower prevalence than has been shown in previous Swedish studies, but this can be due to an underestimation of the occurrence of eating difficulties.

  • 11663.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Lindholm, Christina
    Kristianstad University, School of Health and Society.
    Matsson, Anna
    Stroke Unit, Central Hospital Kristianstad.
    Ulander, Kerstin
    Kristianstad University, School of Health and Society.
    Minimal Eating Observation Form: reliability and validity2009In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 13, no 1, p. 6-12Article in journal (Refereed)
    Abstract [en]

    Objectives: Eating difficulties are common for patients in hospitals (82% have one or more). Eating difficulties predict undernourishment, need for assistance when eating, length of hospital stay and level of care after hospital stay. Eating difficulties have through factor analysis (FA) been found to belong to three dimensions (ingestion, deglutition and energy). The present study investigates inter-observer reliability. Other questions at issue are if the findings from the previous FA can be confirmed, if adjustments need to be done and if the Minimal Eating Form (MEOF) can serve as an assessment model for identification of eating difficulties. Previously found associations between eating difficulties and outcomes as well as measures taken to improve oral intake were also investigated. Design: Inter-observer study and cross-sectional observational study. Settings: Hospitals and special accommodations (SAs). Participants and measurements: Inter-observer study: Observers made standardized assessments of eating, independently and at the same time, on a sample of 50 patients with stroke. Survey study: 2600 (88%) out of 2945 persons agreed to participate in a survey of eating and nutrition. All SAs within six municipalities and six hospitals were involved. Nursing students, clinical tutors and staff performed the assessments, supported by the researchers. Results: The average agreement between observers of eating difficulties was 89% (Kappa coefficient 0.70). In the survey study, the mean age of persons (n=1726) living in SAs was 85 years (SD 8) and 69% were women, while the corresponding figures for patients (n=874) in hospitals were 69 years (SD 18) and 53% women. Low Body Mass Index (BMI) was found in 27%, unintentional weight loss in 23% and need of eating assistance in 38% of the persons. Protein- and energy- (PE-) enriched food was given to 4%, adapted consistency of food to 23% and food supplements to 16% of the persons. The new FA confirmed the previous one and minor adjustments of the model were made. Having ingestion difficulties was the strongest predictor of need for eating assistance (OR 14.5). Deglutition difficulties strongly predicted serving of adapted consistency of food (OR 7.3). Poor energy levels and reduced appetite predicted weight loss (OR 6.0), BMI below limits (OR 2.5), supplements (OR 5.3) and PE-enriched food (OR 3.4). Conclusions: The MEOF has satisfying validity and reliability. The earlier model of eating difficulties was confirmed (MEOF-I), and the model was slightly adjusted to a new model, MEOF-II. Providing eating assistance seems effective in preventing malnutrition (weight loss and BMI below limits), and is mainly provided to persons with ingestion difficulties. Difficulties with energy intake and appetite are not associated with eating assistance; indicating that those persons might need support of some other kind. This support can include providing PE-enriched food and supplements, but seems however insufficiently or inadequately delivered, as low energy and appetite problems are also associated with both weight loss and low BMI. Findings from other studies are confirmed.

  • 11664.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Lindholm, Christina
    Kristianstad University College, School of Health and Society.
    Ulander, Kerstin
    Kristianstad University College, School of Health and Society.
    Eating difficulties among elderly persons predict support and outcome2007In: 29th ESPEN Congress, 8-11 sept. 2007. Prag, 2007Conference paper (Refereed)
    Abstract [en]

    Rationale: Difficulties regarding ingestion, deglutition and/or energy predicts malnutrition, assistance when eating, length of hospital stay and level of care after in-hospital rehabilitation. In this study, previously found associations between eating difficulties and outcome as well as actions taken to improve oral intake were investigated.Methods: All special accommodations (SAs) within six municipalities and six hospitals were involved. Out of 2945 persons 2600 (88%) agreed to participate. Students, clinical tutors and staff collected the data. Logistic regression analyses explored associations between eating difficulties (independent variables), support and outcome (dependent variables).Results: Mean age of persons (n=2600) was 79.7 years (SD 14.4) and 63% were women. Low BMI (<20 if /=70 yrs) was found in 27%, unintentional weight loss 23%, eating assistance 38%, protein- and energy (PE-) enriched food 4%, adapted consistency of food 23% and food supplements 16%. Ingestion difficulties was the strongest predictor of eating assistance (OR 14.6). Deglutition difficulties predicted adapted consistency of food (OR 7.4). Energy and appetite predicted BMI below limits (OR 2.5), weight loss (OR 6.0), PE-enriched food (OR 3.4) and supplements (OR 5.3).Conclusions: Eating assistance to elderly persons seems effective in preventing malnutrition (weight loss and low BMI) and is mainly provided to those with ingestion difficulties. Difficulties with energy and appetite are not associated with eating assistance indicating that support of some other kind is needed such as providing PE-enriched food and supplements. This support seems however insufficiently or inadequately delivered as energy and appetite problems are associated with weight loss and low BMI. Findings from other studies are confirmed. Studies comparing “optimised nutritional support” to persons with energy and appetite problems versus “regular support” are needed.

  • 11665.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Malmström, M. M.
    Persson, K. P.
    Patienters upplevelse av information efter operation pga esofagus- eller ventrikelcancer.2009Conference paper (Refereed)
  • 11666.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Malmström, M. M.
    Ulander, Kerstin
    Kristianstad University College, School of Health and Society.
    Patients' experiences of postoperative information after oesophageal or gastric cancer: an interview studyArticle in journal (Refereed)
  • 11667.
    Westergren, Albert
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Melgaard, Dorte
    The Minimal Eating Observation Form – II (MEOF-II) Danish Version.2019Conference paper (Refereed)
  • 11668.
    Westergren, Albert
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Melgaard, Dorte
    The Minimal Eating Observation Form – II (MEOF-II) Danish Version – Psychometric and Metrological Perspectives.2019Conference paper (Refereed)
  • 11669.
    Westergren, Albert
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Melgaard, Dorte
    The Minimal Eating Observation Form – Version II (MEOF-II) Danish Version – psychometric and metrological aspects.2019In: Journal of Nursing MeasurementArticle in journal (Refereed)
  • 11670.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Nilsson, M.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society.
    Lindskov, Susanne
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Adaptation of "Seniors in the community: risk evaluation for eating and nutrition , version ll" (SCREEN ll) for use in  Sweden: report on the translation process and field test2010Conference paper (Refereed)
  • 11671.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Nilsson, Maria
    Lund University.
    Hagell, Peter
    Lund University.
    Adaptation of "Seniors in the community risk evaluation for eating and nutrition, Version II" (SCREEN II) for use in Sweden: report on the translation process2010Report (Other academic)
    Abstract [en]

    This report describes the initial stages of the Swedish adaptation of "Seniors in the community: Risk evaluation for eating and nutrition, Version II" (SCREEN II) that has been developed by Heather Keller.

  • 11672.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Norberg, Erika
    Central Hospital, Kristianstad.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Diagnostic performance of the Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) and Nutritional Risk Screening 2002 (NRS 2002) among hospital inpatients – a cross-sectional study2011In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, p. 24-Article in journal (Refereed)
    Abstract [en]

    Background: The usefulness of the nutritional screening tool Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) relative to Nutritional Risk Screening 2002 (NRS 2002) remains untested. Here we attempted to fill this gap by testing the diagnostic performance and user-friendliness of the MEONF-II and the NRS 2002 in relation to the Mini Nutritional Assessment (MNA) among hospital inpatients. Methods: Eighty seven hospital inpatients were assessed for nutritional status with the 18- item MNA (considered as the gold standard), and screened with the NRS 2002 and the MEONF-II. Results: The MEONF-II sensitivity (0.61), specificity (0.79), and accuracy (0.68) were acceptable. The corresponding figures for NRS 2002 were 0.37, 0.82 and 0.55, respectively. MEONF-II and NRS 2002 took five minutes each to complete. Assessors considered MEONF-II instructions and items to be easy to understand and complete (96- 99%), and the items to be relevant (87%). For NRS 2002, the corresponding figures were 75-93% and 79%, respectively. Conclusions: The MEONF-II is an easy to use, relatively quick and sensitive screening tool to assess risk of undernutrition among hospital inpatients. With respect to user-friendliness and sensitivity the MEONF-II seems to perform better than the NRS 2002, although larger studies are needed for firm conclusions. The different scoring systems for undernutrition appear to identify overlapping but not identical patient groups. A potential limitation with the study is that the MNA was used as gold standard among patients younger than 65 years.

  • 11673.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Norberg, Erika
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Vallén, Christina
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Cut-off scores for the Minimal Eating Observation and Nutrition Form – Version II (MEONF-II) among hospital inpatients2011In: Journal of Food and Nutrition Research, ISSN 1336-8672, E-ISSN 1338-4260, Vol. 55, p. 7289-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVE:

    The newly developed Minimal Eating Observation and Nutrition Form - Version II (MEONF-II) has shown promising sensitivity and specificity in relation to the Mini Nutritional Assessment (MNA). However, the suggested MEONF-II cut-off scores for deciding low/moderate and high risk for undernutrition (UN) (>2 and >4, respectively) have not been decided based on statistical criteria but on clinical reasoning. The objective of this study was to identify the optimal cut-off scores for the MEONF-II in relation to the well-established MNA based on statistical criteria.

    DESIGN:

    Cross-sectional study.

    METHODS:

    The study included 187 patients (mean age, 77.5 years) assessed for nutritional status with the MNA (full version), and screened with the MEONF-II. The MEONF-II includes assessments of involuntary weight loss, Body Mass Index (BMI) (or calf circumference), eating difficulties, and presence of clinical signs ofUN. MEONF-II data were analysed by Receiver Operating Characteristics (ROC) curves and the area under the curve (AUC); optimal cut-offs were identified by the Youden index (J=sensitivity+specificity-1).

    RESULTS:

    According to the MEONF-II, 41% were at moderate or high UN risk and according to the MNA, 50% were at risk or already undernourished. The suggested cut-off scores were supported by the Youden indices. The lower cut-off for MEONF-II, used to identify any level of risk for UN (>2; J=0.52) gave an overall accuracy of 76% and the AUC was 80%. The higher cut-off for identifying those with high risk for UN (>4; J=0.33) had an accuracy of 63% and the AUC was 70%.

    CONCLUSIONS:

    The suggested MEONF-II cut-off scores were statistically supported. This improves the confidence of its clinical use.

  • 11674.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Norberg, Erika
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Vallén, Christina
    Departments of Nutrition and Health, Central Hospital, Kristianstad.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Cut-off scores for the Minimal Eating Observation and Nutrition Form - Version ll (MEONF ll) among hospital inpatients2011Conference paper (Refereed)
  • 11675.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Nyberg, Maria
    Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    När villkoren för ätandet förändras2016In: Svensk Geriatrik, ISSN 2001-2047, no 4, p. 32-34Article, review/survey (Other academic)
  • 11676.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Petersson, K.
    Lindholm, Christina
    Kristianstad University College, School of Health and Society.
    Axelsson, Carolina
    Kristianstad University College, School of Health and Society.
    Ulander, Kerstin
    Kristianstad University College, School of Health and Society.
    "Study circles" improves nutritional care and body mass index2008In: Clinical nutrition supplements, Volume 3, Supplement 1, 2008, page 61: 30th ESPEN Congress, 13-16 sept, 2008. Florence, Italy, 2008, p. 61-Conference paper (Refereed)
    Abstract [en]

    The staffs’ knowledge, experiences and motivation are likely to be important and so is an adaptation to each unit’s context to achieve positive changes in nutritional practice. How do study circles (SCs) and policy documents (PD) affect nutritional interventions for persons with moderate or high risk for undernutrition (UN-risk) in special accommodations (SAs)?

     

    All SAs within six municipalities were involved. UN-risk was defined as the occurrence of at least two of; involuntary weight loss, Body Mass Index below limit (<20 if /=70 yrs) and/or presence of eating difficulties. In year 2005 and 2007 it was 361 (27%) out of 1337 and 322 (35%) out of 920 persons respectively that were at UN-risk and included in this study. Interventions: In 18 of the departments 39 SCs were implemented, involving 8 staff each, in total 315 persons. Each group met for 3 occasions (3 hours each time) to discuss eating and nutrition based on a manual (www.vardalinstitutet.net/scn). The SCs did not focus on the above definition of UN-risk. In four other SAs a PD was politically anchored. No intervention was implemented in the other SAs.

     

    SCs and PD increased the precision in provided nutritional actions significantly for persons at UN-risk.

     

    The precision (percent) in the provision of nutritional actions.

    Intervention

    Year 2005

    Year 2007

    P-value

    No intervention

    n=229, 86 y

    n=202, 87 y

     

      E-food

    10

    11

    .875

      Food supplement

    31

    29

    .751

      Eating assistance

    65

    67

    .611

     

     

     

     

    Study circles

    n=92, 87 y

    n=82, 87 y

     

      E-food

    16

    32

    .012 *

      Food supplement

    24

    39

    .045 *

      Eating assistance

    67

    69

    .870

     

     

     

     

    Policy document

    n=40, 86 y

    n=38, 85 y

     

      E-food

    5

    24

    .023 *

      Food supplement

    52

    53

    .999

      Eating assistance

    72

    68

    .805

    y = mean age in years, * = significant increase in provision (p<0.05), E-food = Energy Enriched

     

    Both study circles and policy documents improves the precision in the provision of correct nutritional actions for those at moderate or high risk for undernutrition. It is likely that a combination of study circles and policy documents can improve the precision of provision of nutritional actions even more.

  • 11677.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Petersson, Karin
    Kost- och restaurangverksamheten, Kristianstads kommun.
    "Från Utspisning till Restaurang": tre år med studiecirklar fokuserade på ätande och näring: personalens erfarenheter, attityder, kunskap samt effekter för vårdtagarna2009Report (Other academic)
    Abstract [en]

    Aim

    The aim with this project was to evaluate study circles with focus on eating and nutrition from different perspectives.

    Method

    Several different methods have been used, for instance did participants in the study circles continuously evaluate their experiences (structured form), comparisons between the first study circles and the later ones were made, comparisons between participants and non-participants were also made, undernourishement and care actions were surveyed before and after implementation of study circles and finally a focus group interview was made with project leaders, participants and study circle leaders.

     

    Results and conclusions

     

    When comparing the early study circles with later ones it was shown that a full day study circle leader education gave a better outcome than a short introduction to leading study circles. It was also indicated that by systematically carrying through study circles by the time it is created a better climate at the place of work which also contributes to a more positive view on what the study circles bring about to oneself and to the team. A metaphor for this could be that the study circles create “circles on the water”, i.e. more study circles with the same focus at the working place – the better results.

     

    When comparing the views from persons that participated in study circles and those who did not it was shown that attitudes and knowledge with respect to food and mealtimes were affected in some aspects in a positive way among those that had participated in a study circle.

     

    In comparisons between three interventions, i.e. no intervention, implementation of a policy document and implementation of study circles to increase the competence among the staff it was concluded that a combination of study circles and implementation of a policy document for screening and treatment/prevention of undernourishment might be the intervention that can give the best outcome by increasing the precision in nutritional care and decreasing the number of residents having a low BMI. In the same way the precision might increase if there is a specific focus on what method to use for detecting undernutrition risk and on what actions that should be taken for persons being at risk for undernutrition. In any intervention it is important to also consider residents being overweight or being at risk for developing overweight.

     

    In total it was 592 persons divided on 71 study circles that participated. Of those it was 98% that regarded the content in the study circles as very interesting/interesting, 94% thought that the content was very relevant/relevant and 92% that the degree of difficulty was just right/easy. When the participants self rated their knowledge about eating and nutrition as it was before and after having participated in the study circle a significant improvement was seen. Before participating it was 72% that thought they had enough/great knowledge and afterwards it was 96%.

     

    The focus group interview showed that study circles contributed to that the staff contemplated eating and nutrition in an equivalent way, prerequisites for and effects from study circles could be described and the need for a continuation was stressed. Many results was shown that are important to consider when implementing study circles as an intervention for improving eating, mealtimes and nutrition. Some of the results confirm what has been shown in the continuous evaluations described above. The study circles were regarded as an outstanding pedagogic method by getting the staff from the same unit to focus on a specific area and setting goals adapted to the working place context. It was expressed that one person alone has difficulties to achieve changes in an organisation, a group has better chances, and if many groups/teams have gone through the same study circles one becomes stronger and have a better chance to achieve changes, one gets the same view.

     

    It was also clear that homogenous groups were to prefer instead of heterogeneous groups, i.e. the participants should come from the same working place. It was also a huge advantage that staff from the kitchens participated. The communication between the staff at the wards and the staff in the kitchens improved, and that was one of the main gains achieved with the intervention.

     

    The study circle seems to be the ideal pedagogic method to achieve improvements in meal, mealtimes and nutrition in special accommodations. One person has little chance to achieve changes at the ward but together the chances increase. It is also described as difficult to alone transform the knowledge from an education day to the own context. Of course, the choice between study circles or any other education must also depend on the aim of the education and of participating in it.

  • 11678.
    Westergren, Albert
    et al.
    Kristianstad University College, Department of Health Sciences.
    Petersson, Karin
    Kost- och restaurangverksamheten, Kristianstads kommun.
    Kunskaper och attityder hos personal som deltagit i studiecirklar kring ätande & näring2007Report (Other academic)
  • 11679.
    Westergren, Albert
    et al.
    Kristianstad University College, Department of Health Sciences.
    Petersson, Karin
    Kost- och restaurangverksamheten, Kristianstads kommun.
    Utvärdering av studiecirklar på temat "Ätande och näring": genomförda vår och höst 2006 samt vår 20072007Report (Other (popular science, discussion, etc.))
  • 11680.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Petersson, Karin
    Lindholm, Christina
    Kristianstad University College, School of Health and Society.
    Axelsson, Carolina
    Kristianstad University College, School of Health and Society.
    Ulander, Kerstin
    Kristianstad University College, School of Health and Society.
    Overweight and risk for undernutrition among persons within special accommodations and hospital care – Year 2005 and 20072008In: Clinical nutrition supplements, Volume 3, Supplement 1, 2008, page 160-161.: 30th ESPEN Congress, 13-16 sept, 2008. Florence, Italy, 2008, p. 160-161Conference paper (Refereed)
    Abstract [en]

    Rationale: Both undernutrition and overweight have major impacts on morbidity and mortality and are thus important to prevent. This study explores the prevalence of undernutrition and overweight among persons in special accommodations (SAs) and hospital care in the year of 2005 and 2007. Methods: Six hospitals and all of the SAs within six municipalities were involved. In the year of 2005, 2600 (88%) out of 2945 persons agreed to participate in the study, and in 2007 there were 2255 (81%) out of 2784 persons participating. Risk for undernutrition was defined as the occurrence of at least two of the following; involuntary weight loss, Body Mass Index (BMI) below limit (<20 if /=70 yrs) and/or presence of eating difficulties. Overweight was defined based on BMI (if /=25: if >/=70 yrs: BMI >/=27)[1]. Nursing students, clinical tutors and staff collected the data. Results: The mean age and the risk for undernutrition increased significantly in SAs between the two years. The prevalence of overweight increased with three percent in hospitals as well as in SAs although this increase was not statistically significant. Table:

    Percent of persons at risk for undernutrition and with overweight

     

    SAs2005 (n=1726)

    SAs2007 (n=1526)

    P-value

    Hospitals2005 (n=874)

    Hospitals2007 (n=728)

    P-value

     

    Agemean (SD)

    85 (8)

    86 (8)

    <0.001

    69 (18)

    69 (16)

    0.987

    At risk forundernutrition

    27

    35

    <0.001

    27

    28

    0.947

    Overweight

    30

    33

    0.089

    39

    42

    0.182

     

    SAs = Special Accommodations

    Conclusion: The society in general and health care professionals in specific needs to consider not only prevention for persons at risk for undernutrition, but also the prevention for persons becoming overweight. Reference(s) Only 3 Lines maximum: 1. Westergren A, Lindholm C, Axelsson C & Ulander K. Prevalence of eating difficulties and malnutrition among persons within hospital care and special accommodations. The Journal of Nutrition Health and Aging 2008, Vol 12, Number 1, Page 39-43.

  • 11681.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Stuhr Olsson, Gunnel
    Findus Sverige AB.
    Debattinlägg: fallolyckor handlar också om vad vi äter2017In: Sydsvenskan, ISSN 1652-814X, no 12 oktoberArticle in journal (Other (popular science, discussion, etc.))
  • 11682.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Stuhr Olsson, Gunnel
    Fallolyckor och näringsbrist2017Other (Other (popular science, discussion, etc.))
  • 11683.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Stuhr Olsson, Gunnel
    Findus Sverige AB.
    Kost och näring borde ta en större del av diskussionen om äldres livskvalitet2017In: Landskronaposten, ISSN 2001-7162, no 12 oktober, p. A3-Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Fokus på motion och läkemedel är givetvis bra för att förebygga fallolyckor bland äldre. Tyvärr har kost- och näringsaspekten fallit bort ur diskussionen. Det skriver Albert Westergren, professor vid Högskolan Kristianstad och Gunnel Stuhr Olsson, Findus Sverige AB.

  • 11684.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Stuhr-Olsson, G
    Kost och näring borde ta en större del av diskussionen om äldres livskvalitet.2017In: Helsingborgs DagbladArticle in journal (Other (popular science, discussion, etc.))
  • 11685.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Stuhr-Olsson, G
    Kost och näring borde ta en större del av diskussionen om äldres livskvalitet2017In: SydsvenskanArticle in journal (Other (popular science, discussion, etc.))
  • 11686.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Torfadóttir, Olina
    Akureyri University Hospital.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Inter- and intrarater reliability of Minimal Eating Observation and Nutrition Form - version II (MEONF-II) nurse assessments among hospital inpatients2014In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 13, p. 18-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Minimal Eating Observation and Nutrition form - version II (MEONF - II) is a recently developed nursing nutritional screening tool. However, its inter- and intrarater reliability has not been assessed.

    METHODS: Inpatients (n = 24; median age, 69 years; 11 women) were assessed by eight nurses (interrater reliability, two nurses scored each patient independently) using the MEONF-II on two consecutive days (intrarater reliability, each patient was scored by the same nurse day 1 and day 2).

    RESULTS: Six patients were at moderate/high undernutrition risk. Inter- and intrarater reliabilities (Gwet's agreement coefficient) for the MEONF-II 2-category classification (no/low risk versus moderate/high risk) were 0.93 and 0.81; for the 3-category classification (no/low - moderate - high risk) reliabilities (Gwet's weighted agreement coefficient) were 0.98 and 0.88; and total score inter- and intrarater reliabilities (intraclass correlation) were 0.92 and 0.84.

    CONCLUSION: Reliability of MEONF-II nurse assessments among adult hospital inpatients was supported and the tool can be used in research and clinical practice.

  • 11687.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    Torfadóttir, Ólina
    Akureyri University Hospital.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Malnutrition and nutritional care in an Icelandic teaching hospital2014In: Research, ISSN 2334-1009, no 1, p. 1270-Article in journal (Refereed)
    Abstract [en]

    Background: About 30% of hospital inpatients are at undernutrition (UN) risk and it is important that sufficient nutritional treatment and care is provided in order to avoid a decline in health. Aim: To explore the prevalence of UN risk, the associations between UN-risk and other factors, and describe the nutritional treatment/care towards those at UN-risk at an Icelandic teaching hospital. An additional aim was to evaluate the user friendliness of a nutritional screening tool. Methods: Inpatients (n=56; median age 69 years; 29 women) were assessed by eight nurses using the Minimal Eating Observation and Nutrition form – version II (MEONF-II), a recently developed nursing nutritional screening tool. Results: In total 23% (n=13) were at moderate/high UN-risk. The prevalence of overweight/obesity was 57%. Among patients at UN-risk, 61% received energy dense food, oral nutritional supplements, and/or artificial nutrition; this figure was 35% among those at no/low risk. MEONF-II total scores correlated with dependency in activities of daily living (rs, 0.350), and UN-risk categories correlated with tiredness (rs, 0.426). The MEONF-II was regarded as easy to use and relevant. Conclusion: There is a need for interventions connecting the nutritional screening with individualised nutritional treatment and care in order to narrow the gap between screening and intervention. The Icelandic version of the MEONF-II is perceived as user-friendly.

  • 11688.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Torfadóttir, Ólina
    Akureyri Hospital, Iceland.
    Ulander, Kerstin
    Kristianstad University, School of Health and Society.
    Axelsson, Carolina
    Kristianstad University, School of Education and Environment, Avdelningen för Naturvetenskap. Kristianstad University, Research Environment PRO-CARE.
    Lindholm, Christina
    Kristianstad University, School of Health and Society.
    Malnutrition prevalence and precision in nutritional care: an intervention study in one teaching hospital in Iceland2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 13-14, p. 1830-1837Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to explore the point prevalence of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk before and after an intervention. Background. Malnutrition risk and the precision in targeting nutritional treatment are indicators of quality of care. Knowledge regarding the in-hospital prevalence of malnutrition and nutritional treatment is meagre for Iceland. Design. Pre- and postintervention study. Methods. The study was performed during one day in 2006 (March) and one day in 2007 (April). In total, 95 (89%) and 92 (88%) patients agreed to participate. Moderate/high undernutrition risk was defined as the occurrence of at least two of the following: involuntary weight loss, body mass index below limit and eating difficulties according to Minimal Eating Observation Form - Version II. Being overweight was graded based on body mass index. Specific nutritional care actions were recorded. Intervention: A five-point programme for nutrition and eating was implemented. Results. Moderate/high risk for undernutrition was found in 25 and 17% in the two years (ns, not significant). A high body mass index was found in 53 and 54% (ns). The number of patients with a documented body mass index significantly increased between the two surveys (1 and 30%, p-value < 0 center dot 0005). The use of oral supplements increased from 11-40% (p < 0 center dot 0005) and especially among those at no/low undernutrition risk, with ingestion or deglutition difficulties (p < 0 center dot 0005 in both cases) but not among those with appetite and energy problems (ns). Conclusion. Implementing a nutritional programme does not necessarily affect the number of in-patients with malnutrition, but it is likely to increase the precision of nutritional care to some extent. Relevance to clinical practice. Greater efforts need to be taken to increase the precision of nutritional care among patients at moderate/high undernutrition risk and among those with appetite and energy problems.

  • 11689.
    Westergren, Albert
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Törmä, Johanna
    Andersson Johanesson, Frida
    Var rädd om dina kilon.2018In: Senioren (SPF Seniorerna)Article in journal (Other (popular science, discussion, etc.))
  • 11690.
    Westergren, Albert
    et al.
    Kristianstad University College, School of Health and Society.
    Wann-Hansson, Christine
    Faculty of Health and Society, Malmö University and Malmö University Hospital.
    Bergh Börgdal, Elisabet
    Department of Medicine, Malmö University Hospital.
    Sjölander, Jeanette
    Department of Clinical Nutrition, Lund University Hospital.
    Strömblad, Rosmarie
    Hospital Management, Blekinge Hospital.
    Klevsgård, Rose-Marie
    Hospital Management, Lund University Hospital.
    Axelsson, Carolina
    Kristianstad University College, School of Health and Society.
    Lindholm, Christina
    Kristianstad University College, School of Health and Society.
    Ulander, Kerstin
    Kristianstad University College, School of Health and Society.
    Malnutrition prevalence and precision in nutritional care differed in relation to hospital volume: a cross-sectional survey2009In: Nutrition Journal, ISSN 1475-2891, E-ISSN 1475-2891, Vol. 8, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To explore the point prevalence of the risk of malnutrition and the targeting of nutritional interventions in relation to undernutrition risk and hospital volume. METHOD: A cross-sectional survey performed in nine hospitals including 2 170 (82.8%) patients that agreed to participate. The hospitals were divided into large, middle, and small sized hospitals. Undernutrition risk and overweight (including obesity) were assessed. RESULTS: The point prevalence of moderate/high undernutrition risk was 34%, 26% and 22% in large, middle and small sized hospitals respectively. The corresponding figures for overweight were 38%, 43% and 42%. The targeting of nutritional interventions in relation to moderate/high undernutrition risk was, depending on hospital size, that 7-17% got Protein- and Energy Enriched food (PE-food), 43-54% got oral supplements, 8-22% got artificial nutrition, and 14-20% received eating assistance. Eating assistance was provided to a greater extent and artificial feeding to a lesser extent in small compared to in middle and large sized hospitals. CONCLUSIONS: The prevalence of malnutrition risk and the precision in provision of nutritional care differed significantly depending on hospital volume, i.e. case mix. It can be recommended that greater efforts should be taken to increase the use of PE-food and oral supplements for patients with eating problems in order to prevent or treat undernutrition. A great effort needs to be taken in order to also decrease the occurrence of overweight.

  • 11691.
    Westergren, Maja
    et al.
    Kristianstad University College, Department of Health Sciences.
    Södergren, Oscar
    Kristianstad University College, Department of Health Sciences.
    Spiritual and Existential needs in palliative care2006Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Background: Previous research has shown that the understanding and knowledge about the spiritual needs is not given high priority among nursing staff. During the latest years the body and its functions has controlled the healthcare and the spiritual needs has been placed in the background. All humans have spiritual needs that must be satisfied irrespective of religious background. Aim: The aim of this study was to in a caring perspective illustrate patients’ spiritual and existential needs in palliative care. Method: The study is a literature review where 12 articles has been analyzed and summarized to give an overview of rescent research. The approach for the work of the analysis of the articles was qualitative content analysis. Results: The spiritual needs increase in palliative care. To handle the increased needs coping strategies are needed. Nursing staff, relatives and religion are considered by the patient to be important resourses in order to handle the situation. The spiritual needs are not always payed attention to because of lack of knowledge among health care personal. Discussion: The older generation are most likely more spiritual and religious convinced. The sum of this becomes that most of the palliative care patients have a religious belief, that might explain the meaning of spirituality in palliative care. Conclusion: The spiritual needs increase in palliative care and the most important as a nurse is to pay attention to and answer these needs. Through education and increased awareness of spiritual needs, the palliative care could improve considerably.

  • 11692.
    Westergård, Ingela
    Kristianstad University College, Department of Teacher Education.
    Lek och lekfulla aktiviteter i barnskolan - möjligheter och hinder2007Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Uppsatsen redovisar en studie vars syfte är att studera pedagogers inställning till lekens betydelse för barns lärande och utveckling, samt deras föresatser när det gäller att ge leken utrymme och använda den som redskap för lärande. Dessutom undersöks hur pedagogernas förklarade föresatser i detta ämne överensstämmer med den faktiska situationen i en barnskoleklass, samt vilka möjligheter och hinder som påverkar lekens utbredning i denna verksamhet. Intervjuer av de fyra pedagoger som arbetar i denna klass har tillsammans med observationer av verksamheten använts som kvalitativ forskningsmetod. Resultaten av intervjuer och observationer har kopplats samman och analyserats utifrån problempreciseringen. Slutresultatet av studien visar att pedagogerna är väl medvetna om lekens betydelse för barns lärande och utveckling, samt att deras strävan är att ge lek och lekfulla aktiviteter utrymme, men olika hinder begränsar möjligheterna till detta.

  • 11693.
    Westergård, Sandra
    et al.
    Kristianstad University, School of Education and Environment.
    Schmidt, Annika
    Kristianstad University, School of Education and Environment.
    Pedagogisk dokumentation: Vad, hur och varför?2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Efter att den reviderade läroplanen för förskolan, Lpfö98/10, trätt i kraft har kravet på pedagogisk dokumentation i förskolan ökat. Denna studie undersöker förskollärares tankar om, och arbete med pedagogisk dokumentation i förskolan, med fokus på de didaktiska frågorna vad, hur och varför? Resultatet visar på en övervägande positiv syn hos förskollärare. Även negativa aspekter så som tidsbrist, kompetensbrist samt olika synsätt på vad den pedagogiska dokumentationen är har framkommit i undersökningen.

  • 11694.
    Westerlin, Sofia
    et al.
    Kristianstad University, School of Health and Society.
    Elgemark, Caroline
    Kristianstad University, School of Health and Society.
    Hundens påverkan på äldre personer på ett särskilt boende2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Every individual regardless of age have human needs that has to be taken in consideration in order to experience well-being. Sometimes an individual has to move to a nursing home, related to special needs. To some people this can be a hard thing to adjust to and may lead to loneliness and depression. Services offered to the elderly should provide for the physical, psychological and social needs. This is why it’s in our interest to increase the knowledge, to be able to provide a positive change, which could be a dog. Objective: The aim of this study was to investigate if and how dogs affect elderly people when they are living in a nursinghome.  Method: A literature study based on the 13 scientific papers. Results: The result presented three categories of Social impact, Psychological impact and Physical impact. Conclusion: The scientific studies showed different results, but assumptions can be made regarding dogs impact on people needs in their everyday life. 

  • 11695.
    Westerman, Linda
    et al.
    Kristianstad University College, Department of Health Sciences.
    Ohlsson, Sofia
    Kristianstad University College, Department of Health Sciences.
    Patienters beskrivning av att vårdas på isoleringsrum -en litteraturstudie2006Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Background: Every day patient´s get isolated in hospitals as a consequense of infection control purposes. Physical isolation can result in lack of human contact and a new unknown environment for the patient. Those two factors can easily cause stress within the patient and create anxiety for the future. Aim: The aim of the study was to describe patient´s experience of being nursed in an isolation room. Method: The method that was used was a literature research, where earlier research findings were read and put together. Results: In most studies patient´s experience negative feelings such as depression, anxiety and other mood disturbances. Positive feelings like being alone was also described. Other categories that occurred was the need for information, the environment and contact with staff and relatives. Discussion: The nurse has a big influence on the patient´s experience and it´s important to have a close relationship with the patient. It´s also important that she can sit down quietly with the patient and have an open discussion regarding the patient´s care and give room for eventual questions. Through knowledge and understanding she can hopefully reduce the negative effects of isolation that might occur.

  • 11696.
    Westford, Marie
    Kristianstad University College, Department of Health Sciences.
    Bjud på en kopp kaffe: .. En fallstudie ur klientperspektiv/ Let´s talk over a cup of coffee A case studie from a clientperspective2006Student thesis
    Abstract [sv]

    The purpose of this essay at bachelor level was to increase the understanding regarding the experiences of a client’s meetings with different public authorities. The method used was a case study viewed from a client’s perspective and based upon three qualitative interviews with one client. Theories were used to create order and to analys the empiric material. The interviewed person talked about feelings such as dishonour, unfair treatment and feeling powerless.

    The informant wanted to reclaim the power of her life, to have influence and self-determination. Being a client and turn to different authorities for help can lead to divergent.

  • 11697.
    Westin, J.
    et al.
    Computer Science, Dalarna University.
    Stenberg, Georg
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Forskningsmiljön ForFame.
    Development of a test for spatial working memory in Parkinson's disease: sensitivity to medication induced periodic performance changes2012In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 19, no Suppl. 1, p. 551-551Article in journal (Refereed)
    Abstract [en]

    Introduction: Spatial working memory is susceptible to impairment early on in Parkinson’s disease (PD). Later on, the wearing off phenomenon of motor function during dopaminergic treatment seems to carry over into working memory.

    Aim: To initialize development of a test capable of capturing the variation in spatial working memory within a patient’s daily functioning.

    Methods: The test consisted of 192 instances of n-back, yes/no tasks, with correctness and latency of response automatically recorded. We collected data from two persons, one PD patient and one healthy control, relatively evenly sampled regarding time-of-day. The patient took levodopa once every three hours and performed tests on 70 occasions (the healthy control on 33 occasions). A frequency band containing period lengths from 2 to 4 hours was defined as the region of interest in regard to the medication cycle. The resulting  time  series  were  digitally  band-pass  filtered allowing only the relevant frequencies to pass. Reasoning that filtering would preserve essential information if the time series were periodic, but eradicate it if they were not, we used as our primary outcome measure the correlations between filtered and unfiltered data.

    Results: Correlations between the pass-band relating to the levodopa intake schedule and the full data were positive and significantly larger for the patient than for the control. These differences applied to both latency and accuracy.

    Conclusion: This supports the hypothesis that the test is able to detect levodopa-dependent variations in spatial working memory.

  • 11698. Westman, A.-K.
    et al.
    Ljung-Djärf, Agneta
    Kristianstad University, School of Education and Environment, Avdelningen för Pedagogik. Kristianstad University, Research environment Learning Design (LeaD). Kristianstad University, Research environment Learning in Science and Mathematics (LISMA). Kristianstad University, Forskningsmiljön Forskning Relationell Pedagogik (FoRP).
    Åberg-Bengtsson, L.
    Ottosson, Torgny
    Kristianstad University, School of Education and Environment, Avdelningen för Pedagogik. Kristianstad University, Research environment Learning in Science and Mathematics (LISMA).
    Beach, D.
    Animationer och illustrationer i datorbaserade läromedel med ett naturvetenskapligt innehåll: studier bland femteklassare och förskoleelever2014Conference paper (Other academic)
  • 11699.
    Westny, Amanda
    Kristianstad University, Faculty of Health Science.
    Emotioner i domstol: en studie om känslors betydelse vid sexualbrottsdomar2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Denna studie handlar om hur emotioner synliggörs och värderas i rättsprocessen. Studien behandlar och analyserar tre stycken rättsfall mellan år 2009 och år 2017. Samtliga rättsfall innefattar sammateman i form av bevisvärdering i sexualbrottmål.

    Frågeställningarna utgår därför ifrån vilka emotionsnormersom återfinns i domar för respektive gärningsman och brottsoffer. Frågeställningarna tar också upp vilka känslor som syns och vems känslor som uppvisas. Materialet har analyserats med hjälp av Hoschilds teori om emotionsregler samt Nils Christies teori om det ideala offret.

    Metoden för arbetet har varit kvalitativ innehållsanalys för tolkandet av domarna. Resultatet för arbetet visade att olika typer av känslor uppvisas samt att de i olika fall ligger till grund för ett juridiskt beslutsfattande.

  • 11700.
    Wetterlöv, Johan
    Kristianstad University College, Department of Behavioural Sciences.
    KBT på behandlingshem: Utkomst av behandling för unga kvinnor med multimodal psykiatrisk problematik.2007Independent thesis Basic level (degree of Bachelor)Student thesis
    Abstract [sv]

    Den psykiska ohälsan ökar bland unga kvinnor och därmed också behovet av evidensbaserade effektiva behandlingsmetoder. Kognitiv beteendeterapi (KBT) är den behandlingsmetod som visat sig vara effektivast för en rad olika psykiatriska problem. För unga kvinnor med multimodal problematik är inte alltid poliklinisk-behandling tillräcklig utan en institutionsbehandling kan vara nödvändig. Forskningen av institutionsbehandlingar ger slutsatsen att de ska grundas på kognitiva och inlärningsteoretiska principer även om väldigt få studier gjorts på målgruppen; unga kvinnor med multimodalproblematik. Målet var att göra en sådan studie och se hur självskadebeteende, mående, psykofarmaka användande och behovet av sluten psykiatrisk vård påverkas hos unga kvinnor med multimodalproblematik som genomgått en KBT behandling på ett behandlingshem. Studien, genomförd som en självskattningsstudie med 19 deltagare, visade signifikanta resultat på dessa problem förutom på behovet av sluten psykiatrisk vård. Studien visade även ökad funktionsgrad hos de behandlade unga kvinnorna. En replikering av studien med andra parametrar och bättre uppföljning vore önskvärd.

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