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  • 151.
    Westergren, Albert
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Verktyg avslöjar dolda ätstörningar2015In: Äldreomsorg, ISSN 1403-7025, no 6, p. 20-21Article, review/survey (Other academic)
  • 152.
    Westergren, Albert
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    What makes a good peer review?: an author’s perspective2006In: Nurse author & editor, ISSN 1750-4910, Vol. 16, no 2, p. 3-3Article in journal (Other academic)
  • 153.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Ätförmåga2012In: Stroke: patienters, närståendes och vårdares perspektiv / [ed] Ann-Cathrin Jönsson, Lund: Studentlitteratur, 2012, p. 85-101Chapter in book (Other academic)
  • 154.
    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.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research environment Oral Health - Public Health - Quality of Life (OHAL). Kristianstad University, Research Platform for Collaboration for Health.
    Att äta och dricka2017In: Omvårdnad & äldre / [ed] Kerstin Blomqvist, Anna-Karin Edberg, Marie Ernsth Bravell, Helle Wijk, Lund: Studentlitteratur, 2017, p. 253-271Chapter in book (Other academic)
  • 155.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Johanssen, A.
    Strategier för tobaksavvänjning - det osynliga munhälsoarbetet2011Conference paper (Refereed)
  • 156.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Blomqvist, Kerstin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Edberg, Anna-Karin
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Petersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Sätt måltidsupplevelsen i centrum2012In: Kristianstadsbladet, ISSN 1103-9523, no 16/6, p. B4-Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Måltidsupplevelsen påverkas av så mycket; ljuset i lokalen, ljud, dukning, servering, bemötande, maten, smakerna, doften och sällskapet. Men hur kan den kunskapen omsättas på sjukhus och äldreboenden? Det skriver Albert Westergren, professor i omvårdnad, Kerstin Blomqvist, biträdande professor i klinisk omvårdnad, Anna-Karin Edberg, professor i omvårdnad, och Pia Petersson, ansvarig för sjuksköterskeprogrammet, samtliga på Högskolan Kristianstad.

  • 157.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Broman, Jan-Erik
    Uppsala universitet.
    Hellström, Amanda
    Blekinge tekniska högskola & Linnéuniversitetet.
    Fagerström, Cecilia
    Blekinge tekniska högskola.
    Willman, Ania
    Blekinge tekniska högskola.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Measurement properties of the Minimal Insomnia Symptom Scale as an insomnia screening tool for adults and the elderly2015In: Sleep Medicine, ISSN 1389-9457, E-ISSN 1878-5506, Vol. 16, no 3, p. 379-384Article in journal (Refereed)
    Abstract [en]

    Background

    The psychometric properties of the three-item Minimal Insomnia Symptom Scale (MISS) were evaluated using the classical test theory. Different cut-offs for identifying insomnia were suggested in two age groups (≥6 and ≥7 among adult and elderly people, respectively). The aim of the present study was to test the measurement properties of the MISS using the Rasch measurement model, with special emphasis on differential item functioning by gender and age.

    Methods

    Cross-sectional MISS data from adult (age 20-64 years, n=1075) and elderly (age 65+, n=548) populations were analysed using the Rasch measurement model.

    Results

    Data generally met Rasch model requirements and the scale could separate between two distinct groups of people. Differential item functioning was found by age but not gender. The difference between the adult and elderly samples was lower for the originally recommended ≥6 points cut-off (0.09 logits) than for the ≥7 points cut-off (0.23 logits), but greater at the lower and higher ends of the scale.

    Conclusions

    This study provides general support for the measurement properties of the MISS. Caution should be exercised in comparing raw MISS scores between age groups, but applying a ≥6 cut-off appears to allow for valid comparisons between adults and the elderly regarding the presence of insomnia. Nevertheless, additional studies are needed to determine the clinically optimal cut-score for identification of insomnia.

  • 158.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Nursing students gain tools for knowledge utilisation through a work and research integrated learning assignment – a qualitative study2013In: Journal of Nursing Education and Practice, ISSN 1925-4040, Vol. 3, no 1Article in journal (Refereed)
    Abstract [en]

    Background: By integrating education, research and collaboration with society, in a learning assignment, the level of nursing students learning can be enhanced.

    Aim: The purpose of this study was to explore nursing students’ experiences of participating in a work and research integrated learning assignment during their clinical practice courses.

    Methods: At the end of their nursing training, in their sixth semester, five nursing students were recruited to the study and interviewed after which the texts of interviews were analysed using content analysis. The participants had been involved in two studies, one during their second semester, where the risk of falling was assessed, and one during their sixth semester where the risk for under nutrition was assessed.

    Results: The students experienced that the two assignments enhanced their learning in how to work as a foreman/supervisor, how to inform and engage in dialogue, about using risk assessment, and further, gave them the opportunity to meet the people behind the diagnosis. Through assignments they could also identify the need for knowledge within the study focus, for instance, the risks for falling or the risk of undernourishment. Further, they described how they tried to live up to the ethical standards and that they had learned about using a scientific approach in their work.

    Conclusion: It is possible to integrate Research, Education and Collaboration in a learning assignment during Nursing education (RECN-assignment) by allowing nursing students to participate in an actual research project during their work integrated learning courses. Such an approach enhances nursing students learning about research and the area being studied in the actual research project.

  • 159.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Hedin, Gita
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Improving nursing students research knowledge through participation in a study about nutrition, its associated factors and assessment2013In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 3, no 8, p. 50-58Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were threefold: 1) to explore nursing students perceptions of knowledge development after participating in an actual research project; 2) to explore undernutrition and its relationship to other clinical factors; 3) to explore the user-friendliness of the Minimal Eating Observation and Nutrition Form (MEONF-II) in relation to dependency in Activities of Daily Living (ADL).

    Methods: A pilot study (Study 1, S1) was conducted in October 2010, including 281 patients. After extending the research protocol a second data collection (S2) was conducted in March 2011, including 236 patients (total n=517). First and third year nursing students (n=188) collected the data, during one day of their clinical practice courses by assessing three patients each in hospitals or nursing homes. Students answered questions about their experiences from participating in the study. Patient related assessments included: MEONF-II; ADL dependency (S1 and S2); insomnia; low-spiritedness; and subjective health (S2). In addition, questions about the user-friendliness of MEONF-II were included (S1 and S2).

    Results: Among the nursing students, 51% experienced that their knowledge about nutrition increased and 67% that their understanding for research increased by participating in the project. Out of the patients, 57% were women, 50% were almost independent, 27% had some dependency, 23% were almost totally dependent in ADL, and 48% were at moderate/ high undernutrition risk. In S2, 32% of patients had insomnia, and 46% experienced low-spiritedness. Dependency in 5-6 and 3-4 ADLs (OR, 2.439 and 2.057, respectively), compared to dependency in 0-2 ADLs, were the strongest predictors for undernutrition risk, followed by insomnia (OR 2.124). Nursing students experienced the MEONF-II as easy to understand (93%), easy to answer (94%) and relevant (94%), and the suggestions for measures to take in case of risk as relevant (95%), independent of the patients’ ADL status.

    Conclusions: By participating in an actual research project nursing students gets an understanding for research and tools for working with quality improvements in their future role as professional nurses. Undernutrition, mental and physical factors constitute coexisting problems in need for further investigation. Nursing students perceive the MEONF-II as user-friendly, independent of patient ADL dependency.

  • 160.
    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.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Norberg, Erika
    Central Hospital Kristianstad.
    Stubbendorff, Anna
    County Council Skane.
    Hedin, Gita
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap.
    Wetterstrand, Martin
    Kristianstad University, School of Health and Society, Avdelningen för Design och datavetenskap.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Long-term effects of a computer-based nutritional training program for inpatient hospital care2017In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 23, no 4, p. 797-802Article in journal (Refereed)
    Abstract [en]

    Rationale

    A previous short-term study showed that a computer-based training in eating and nutrition increased the probability for hospital inpatients at undernutrition (UN) risk to receive nutritional treatment and care without increasing overtreatment (providing nutritional treatment to those not at UN risk).

    The aim of this study was to investigate if a computer-based training in eating and nutrition influences the precision in nutritional treatment and care in a longer-term perspective.

    Method

    A preintervention and postintervention study was conducted with a cross-sectional design at each time points (baseline and 7 months postintervention). Hospital inpatients > 18 years old at baseline (2013; n = 201) and follow-up (2014; n = 209) were included. A computer-based training was implemented during a period of 3 months with 297 (84%) participating registered nurses and nurse assistants. Undernutrition risk was screened for using the minimal eating observation and nutrition form-version II. Nutritional treatment and care was recorded using a standardized protocol.

    Results

    The share of patients at UN risk that received energy-dense food (+ 25.2%) and dietician consultations (+ 22.3%) increased between baseline and follow-up, while fewer received oral nutritional supplements (-18.9%). "Overtreatment" (providing nutritional treatment to those not at UN risk) did not change between baseline and follow-up.

    Conclusion

    The computer-based training increased the provision of energy-dense food and dietician consultations to patients at UN risk without increasing overtreatment of patients without UN risk.

  • 161.
    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.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Norberg, Erika
    Central Hospital Kristianstad.
    Stubbendorff, Anna
    The County Council of Skåne.
    Hedin, Gita
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Wetterstrand, Martin
    Kristianstad University, School of Health and Society, Avdelningen för Design och datavetenskap.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Short-term effects of a computer-based nutritional nursing training program for inpatient hospital care2016In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 22, no 5, p. 799-807Article in journal (Refereed)
    Abstract [en]

    RATIONALE: This study aimed to explore whether a computer-based training in eating and nutrition for hospital nursing staff can influence the precision in nutritional treatment and care.

    METHOD: A pre-intervention and post-intervention study was conducted with a cross-sectional design at each time point. The settings were one intervention (IH) and two control hospitals (CH1 and CH2). Hospital inpatients >18 years old at baseline (2012; n = 409) and follow-up (2014; n = 456) were included. The computer-based training was implemented during a period of 3 months in the IH with 297 (84%) participating registered nurses and nurse assistants. Nutritional risk was screened for using the Minimal Eating Observation and Nutrition Form. Nutritional treatment and care was recorded using a standardized protocol RESULTS: In the IH, there was an increase in the share of patients at UN risk that received energy-dense food (+16.7%) and dietician consultations (+17.3%) between baseline and follow-up, while fewer received feeding assistance (-16.2%). There was an increase in the share of patients at UN risk that received energy-dense food (+19.5%), a decrease in oral nutritional supplements (-30.5%) and food-registrations (-30.6%) in CH1, whereas there were no changes in CH2. 'Overtreatment' (providing nutritional treatment to those not at UN risk) was significantly higher in CH2 (52.7%) than in CH1 (14.3%) and in the IH (25.2%) at follow-up.

    CONCLUSION: The computer-based training seemed to increase the probability for patients at UN risk in the IH to receive nutritional treatment without increasing overtreatment.

  • 162.
    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.
    Edfors, Ellinor
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Norberg, Erika
    Central Hospital Kristianstad .
    Stubbendorff, Anna
    The County Council of Skåne.
    Hedin, Gita
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Wetterstrand, Martin
    Kristianstad University, School of Health and Society, Avdelningen för Design och datavetenskap.
    Rosas, Scott R
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Computer-based training in eating and nutrition facilitates person-centered hospital care: a group concept mapping study2018In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 36, no 4, p. 199-207Article in journal (Refereed)
    Abstract [en]

    Studies have shown that computer-based training in eating and nutrition for hospital nursing staff increased the likelihood that patients at risk of undernutrition would receive nutritional interventions. This article seeks to provide understanding from the perspective of nursing staff of conceptually important areas for computer-based nutritional training, and their relative importance to nutritional care, following completion of the training. Group concept mapping, an integrated qualitative and quantitative methodology, was used to conceptualize important factors relating to the training experiences through four focus groups (n = 43), statement sorting (n = 38), and importance rating (n = 32), followed by multidimensional scaling and cluster analysis. Sorting of 38 statements yielded four clusters. These clusters (number of statements) were as follows: personal competence and development (10), practice close care development (10), patient safety (9), and awareness about the nutrition care process (9). First and second clusters represented "the learning organization," and third and fourth represented "quality improvement." These findings provide a conceptual basis for understanding the importance of training in eating and nutrition, which contributes to a learning organization and quality improvement, and can be linked to and facilitates person-centered nutritional care and patient safety.

  • 163.
    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.
    Garpsäter, Josephine
    Dietisternas riksförbund.
    Stuhr Olsson, Gunnel
    Findus AB.
    Äldre som bor hemma hotas av undernäring: Debattörerna: Nu måste hemtjänsten få hjälp av fler dietister2018In: AftonbladetArticle in journal (Other (popular science, discussion, etc.))
  • 164.
    Westergren, Albert
    et al.
    Division of Gerontology and Caring Sciences, Department of Health Sciences, Faculty of Medicine, Lund University.
    Hagell, Peter
    Division of Gerontology and Caring Sciences, Department of Health Sciences, Faculty of Medicine, Lund University.
    Initial validation of the Swedish version of the London Handicap Scale2006In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 15, no 7, p. 1251-1256Article in journal (Refereed)
    Abstract [sv]

    Objective: To adapt and evaluate the unweighted version of the London Handicap Scale (LHS) for use in Sweden.

    Materials & Methods: Respondent burden, linguistic validity and patient perceived relevance was assessed in 16 neurologically ill patients. Internal consistency reliability and construct validity were evaluated among 89 stroke survivors six months after discharge.

    Results: Patients perceived the LHS as relevant and easy to understand and complete. Mean time to complete the questionnaire was 10 min. Cronbach’s alpha reliability was 0.85. The LHS differentiated between patients living at home and in special accommodations. As expected, scores correlated strongly and weakly with indices of related and more remote constructs, respectively. There were no floor-, but large ceiling effects.

    Conclusions: The observations reported here are in accordance with previous studies using the original British LHS and provide initial support for the reliability and validity of the instrument for use in Sweden. However, ceiling effects may limit its usefulness as an outcome measure.

  • 165.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. 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. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Measurement properties of the 12-item Short-Form Health Survey in stroke2014In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 46, no 1, p. 34-45Article in journal (Refereed)
    Abstract [en]

    Background: The 12-item Short-Form Health Survey (SF-12) was developed to measure perceived physical and mental health. Some studies of the psychometric properties, using classical test theory, of the SF-12 provide support for its use in patients with stroke, but it has not been scrutinized using recommended modern test theory approaches such as the Rasch measurement model among stroke survivors.

    Objectives: This study sought to explore the measurement properties of the SF-12 physical and mental health scales among people with stroke using the Rasch measurement model.

    Design: A cross-sectional design was used in this study.

    Methods: All patients discharged from a dedicated stroke unit in southern Sweden during 6 months were asked to participate 6 months later. Of 120 stroke survivors, 89 (74%) agreed to participate. Rasch analysis was used to assess the measurement properties of the SF-12 physical and mental component summary scores (PCS-12 and MCS-12, respectively).

    Results: For the PCS-12, we identified problems with targeting, overall and item-level fit, representing local response dependency, and multidimensionality. For the MCS-12, there were problems related to targeting (the persons felt better than the scale could conceptualize) and response categories that did not function as expected. However, MCS-12 items displayed reasonable model fit without indications of multidimensionality but with signs of local response dependency.

    Conclusion: The measurement properties of the MCS-12 in stroke appear reasonable unless milder mental health problems are of interest, whereas those of the PCS-12 are less acceptable. Given the interdependence between MCS-12 and PCS-12 that is inherent with the standard SF-12 scoring algorithm, such data should be interpreted with caution.

  • 166.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Screening for nutritional risk among home dwelling elderly people without service from the municipality2011In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 6, no Suppl. 1, p. 87-Article in journal (Refereed)
    Abstract [en]

    Risk factors for malnutrition were frequent mamong elderly persons and calls for preventive actions through information about how to eat healthy. This information can be provided during preventive home visits.

  • 167.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Undernutrition, mental and physical factors form a triad of coexisting problems2012In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 7, no Suppl.1, p. 117-Article in journal (Refereed)
  • 168.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    Hagell, Peter
    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.
    Smärta: en studie genomförd med hjälp från studenter i sjuksköterskeprogrammet2014Report (Other academic)
    Abstract [sv]

    Syfte: Syftet med studien var att undersöka förekomst och grad av smärta hos vårdtagare och att jämföra två metoder för skattning av smärta, verbal skattning av smärta samt skattning med hjälp av VAS (Visuell Analog Skala). Vidare är syftet att sjuksköterskestudenterna ska få träna sig med hjälp av olika bedömningsinstrument identifiera problem med smärta samt reflektera över Metod: Sjuksköterskestudenter från första och sista året i utbildningen genomförde skattningar på vårdtagare vid den praktikplats där de genomförde sin verksamhetsförlagda utbildning (VFU) på sjukhus eller i särskilda boenden (SB, här även inkluderat avancerad sjukvård i hemmet (ASIH)). Vårdtagare gav sitt informerade samtycke till att medverka i studien som genomfördes under en dag. Vårdtagarna fick skatta sin smärta med verbal skattning samt med VAS. Totalt ingick 1769 vårdtagare i studien varav 1432 var på sjukhus och 1337 i SB/ASIH. På sjukhus var 54.3% kvinnor och 45.7% män, inom SB/ASIH var fördelningen 63.8% respektive 35.9%.

    Resultat: På sjukhus upplevde 48.4% av respondenterna sin grad av sjukdom som "svår" respektive 30.1% vid SB/ASIH. Vid sjukhus angav 27.8% någon form av smärta när den "var som värst", respektive 31.8% vid SB/ASIH. När smärtan "var som minst" var det 39.9% vid sjukhus som uppgav "ingen smärta" och inom SB/ASIH var det 43.1%. Vad gäller smärta "i genomsnitt" var det 22.1% som uppgav "ingen smärta" vid sjukhus, och 22.3% vid SB/ASIH.

    Slutsats: Smärta var väldigt vanligt både på sjukhus och i SB/ASIH.

  • 169.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Lindgren, Emma
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Sömnsvårigheter inom vård och omsorg: en studie genomförd med hjälp av studenter i sjuksköterskeprogrammet2012Report (Other academic)
    Abstract [sv]

    Syftet med studien var att undersöka förekomsten av sömnsvårigheter bland personer på sjukhus, särskilt boende samt inom hemsjukvård/kvalificerad vård i hemmet (KVH), samt att jämföra sömnen hemma och på sjukhus för de personer som befann sig på sjukhus. Vidare var syftet att högskolestudenter inom sjuksköterskeprogrammet skulle få träning i kritiskt tänkande, reflektion och  att  introducera  evidensbaserade  verktyg/instrument  för  att  underlätta  beslut  rörande patientsäkerhet.

    Metod:  Datainsamlingen  utfördes  av  sjuksköterskestudenter  i  kurs  6  och  16  under  deras verksamhetsförlagda utbildning på sjukhus, särskilt boende, hemsjukvård och KVH, 2011. Även kliniska adjunkter/kliniska lärare och personal i verksamheterna medverkade till genomförandet. Studenterna fick genom datainsamlingen träning i att ge information till personal och patient/ vårdtagare, sammanställa resultat från enheten/avdelningen, samt att återrapportera och reflektera över resultaten. Screening avseende störd nattsömn (insomni) och dagsömnighet gjordes baserat på bedömninsinstrumenten The Pittsburgh Sleep Quality Index (PSQI), Minimal Insomnia Symptom Scale (MISS), Scales for Outcomes in PArkinson’s disease – Sleep (SCOPA-Sleep), Parkinson’s Disease Questionnaire-39 (PDQ-39) och Epworth Sleepiness Scale (ESS). Varje sjuksköterskestudent tillfrågade cirka fyra patienter/vårdtagare om att medverka i studien.

    Resultat: De på sjukhus och inom hemsjukvård/KVH sover i snitt färre timmar per natt jämfört med de på särskilt boende. Det vanligaste sömnproblemet för alla tre grupper var att vakna under natten och insomni var vanligare på sjukhus och inom hemsjukvård/KVH än på särskilt boende. Det vanligaste problemet under dag- och kvällstid för de på sjukhus och inom hemsjukvård/KVH var att somna under tiden när man tittat på TV eller läst. För de på särskilt boende var det vanligaste problemet att plötsligt somna under dag- eller kvällstid. Vid jämförelse av sömntimmar per natt hemma och på sjukhus bland de deltagare som befann sig på sjukhus skiljde sig sömntimmarna inte markant åt. En något större andel bedömde sin sömnkvalitet som ganska dålig eller mycket dålig under sjukhusvistelsen i jämförelse med sömnkvaliteten hemma. Även insomni var något vanligare att uppleva på sjukhus än hemma. Merparten av deltagarna använde ungefär lika mycket eller mer sömntabletter på sjukhuset än hemma. Majoriteten av medverkande studenter ansåg sig ha fått en bättre vetenskaplig förståelse efter genomförd studie, med en särskilt stor andel hos kurs 16 studenterna. En något större andel avkurs 6 studenterna ansåg sig ha ökat sina kunskaper om sömnvanor/sömnproblem i jämförelsemed kurs 16 studenterna. Åtgärder för att underlätta sömnen hos patienter/vårdtagare som föreslogs utav studenterna fokuserade på personalens bemötande, dokumentation och utvärdering samt miljö och hjälpmedel. Majoriteten av studenterna var positiva till genomförandet av studien, samt upplevde att även patienter och vårdtagare förhöll sig positiva till studien. Det var många som däremot kritiserade att frågorna i frågeformuläret var snarlika och att det saknas frågor om vad eventuella sömnsvårigheter berodde på.

    Konklusion: Sjukhusvistelse var delvis associerad med negativ påverkan på sömnen. Generellt rapporterar äldre personer på särskilt boende att de sover ganska bra. Att vara delaktiga i FUSS-projekt bidrar till en bättre vetenskaplig förståelse hos flertalet sjuksköterskestudenter.

  • 170.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. 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. Kristianstad University, Research Platform for Collaboration for Health.
    Sjödahl Hammarlund, Catharina
    Kristianstad University, School of Health and Society. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Malnutrition and risk of falling among elderly without home-help service: a cross sectional study2014In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 18, no 10, p. 905-911Article in journal (Refereed)
    Abstract [en]

    Objectives

    The aim of this study was to explore the frequency of malnutrition risk and associated risk of falling, social and mental factors among elderly without home-help service. The aim was also to explore factors associated with risk of falling.

    Design

    A cross-sectional design was used.

    Setting

    Elderly persons own homes.

    Participants

    Data were collected during preventive home visits to 565 elderly (age range 73–90 years) without home-help service. Those with complete SCREEN II forms were included in the study (n=465).

    Measurements

    Measurements included rating scales regarding malnutrition risk (SCREEN II) and risk of falling (Downton). In addition, single-items: general health, satisfaction with life, tiredness, low-spiritedness, worries/anxiety and sleeping were used.

    Results

    According to the SCREEN II, 35% of the sample had no malnutrition risk, 35% had moderate risk and 30% had high malnutrition risk. In an ordinal regression analysis, increased malnutrition risk was associated with being a woman living alone (OR 4.63), male living alone (OR 6.23), lower age (OR 0.86), poorer general health (OR 2.03–5.01), often/always feeling tired (OR 2.38), and an increased risk of falling (OR 1.21). In a linear regression analysis, risk of falling was associated with higher age (B 0.020), not shopping independently (B 0.162), and low meat consumption (B 0.138).

    Conclusion

    There are complex associations between malnutrition risk and the gender-cohabitation interaction, age, general health, tiredness, and risk of falling. In clinical practice comprehensive assessments to identify those at risk of malnutrition including associated factors are needed. These have to be followed by individual nutritional interventions using a holistic perspective which may also contribute to reducing the risk of falling.

  • 171.
    Westergren, Albert
    et al.
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health.
    Sjödahl Hammarlund, Catharina
    Department of Health Sciences, Lund University, Lund, Sweden.
    Undernäring och fallrisk - ett förestående folkhälsoproblem bland yngre pensionärer?2014In: Svensk Geriatrik, ISSN 2001-2047, no 1, p. 11-14Article, review/survey (Other academic)
  • 172.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health.
    Wendin, Karin
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Sjödahl Hammarlund, Catharina
    Kristianstad University, School of Health and Society. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Conceptual relationships between the ICF and experiences of mealtimes and related tasks among persons with Parkinson’s disease2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 4, p. 201-208Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate experiences of mealtimes and related tasks among people with Parkinson’s disease (PD) and to link these conceptually to the International Classification of Functioning, Disability and Health (ICF). Data were collected by use of semi-structured interviews of 19 people with PD. Inductive content analysis resulted in five categories: 1) Managing mealtime preparations and related tasks, 2) Compromised physical control, 3) Difficulties enjoying meals, 4) Difficulties eating together with others, and 5) Strategies to maintain conventional norms and independence. Deductive content analysis linked the categories to the ICF categories: body functions (mental, sensory, neuromusculoskeletal and movement-related functions); activities (self-determination and chores); participation (interpersonal interactions and relationships); and environmental factors (conventional norms, attitudes of friends and strangers). Emotional and involuntary movement functions were represented in all five inductively derived categories. Eating difficulties may have negative consequences on participation and the emotional wellbeing of people with Parkinson’s disease.

  • 173.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Hedin, Gita
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön PRO-CARE.
    Användarvänlighet för Minimal Eating Observation and Nutrition Form (MEONF-ll): en pilotstudie genomförd med hjälp av studenter på sjuksköterskeprogrammet2011Report (Other academic)
    Abstract [en]

    The aim of the study was to make a screening of risk for malnutrition among persons in hospitals and among those living in special accommondation (long-term care).

    Method: Nurse student collected the data during their clinical education at hospitals and in the special accommodations in 2010. 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 ant to give feed-back about the findings to the department. The screening of risk for malnutrition was done using Minimal Eating Observation and Nutrition (MEONF) and Active Daily Life (ADL). Each student asked three patients/residents to participate, in the study.

    Results: A total of 266 patients/residents who received ADL-status assessed. 45% of respondents were next independent/dependent on the help of more than 2 ADL-functions, 26% were partially dependent on help in 3-4 ADL-functions and 25% were almost completely dependent on help in 5-6 ADL-functions. The results (Table 2) show that the respondents has no/low risk of malnutrition, they were almost completely independent/dependent in aid. In the case of those respondents with a high risk for portable so it was no more (39%) witch was almost entirely dependent on aid. The majority of students believe that assessment-manual were easy to understand, that the proposed measurement were easy and relevant regardless of which group the patients/residents belonged.

    Conclusion: The patients/residents who had high risk for malnutrition had even greater need of help. One group that must not be overlooked is the patients/residents who are obese but still high risk of malnutrition. Assessment instruments seem to be useful and easy to use. For the students perceived it as positive to participate in actual research projects.

     

     

     

  • 174.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Hedin, Gita
    Kristianstad University, School of Health and Society.
    Do study circles and a nutritional care policy improve nutritional care in a short- and long-term perspective in special accommodations?2010In: Food & nutrition research, ISSN 1654-661X, Vol. 54, p. 5402-Article in journal (Refereed)
    Abstract [en]

    Study circles give positive short-term effects and a NCP gives positive short- and long-term effects on NC. Whether a combination of study circles and the implementation of a NCP can give even better results is an area for future studies.

  • 175.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Hedin, Gita
    Kristianstad University, School of Health and Society.
    Fallriskbedömning: med Downton Fallrisk Index: n studie genomförd med hjälp av studenter på sjuksköterskeprogrammet2010Report (Other academic)
    Abstract [en]

    The aim of this study was to make an assessment of fall risk among persons in hospitals and among those living in special accommodation (long-term care).

    Method: Nurse students collected the data during their clinical education at hospitals and in special accommodations in 2008 and 2010. 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. The assessment of fall risk was done using the Downton Fallrisk Index (risk of fall >3 points). Both years all patients/residents were there were nurse students were asked to participate, in the study.

    Results: In the entire sample the prevalence of fall risk in year 2008 was 73% an in year 2010 was 69%. The mean score in the Downton Fallrisk Index in year 2008 was 3,7 and in year 2010 it was 3,5. At the hospitals in year 2008 and 2010 it was 66% and 58% respectively that had risk of fall while the corresponding prevalence in the special accommodations was 86% and 85%. The average time to carry out the assessment of fall risk was 10 minutes (median). The majority of the students agreed that the questions in Downton were relevant, easy to understand and that the answer alternatives also were easy to understand.

    The majority of the students 2008 and 2010 (2008, course 6: 76% respectively course 16: 65% and in 2010, course 6: 38% respectively course 16: 61%) stated that they received better scientific-knowledge, through participating in the study. It is of importance too note that the course 6 students in 2010 did not receive any verbal information before the study, which probably negatively influenced the experience of contributing in the study.

    Conclusion: In special accommodations the prevalence of fall was higher than in hospitals. The Downton Fallrisk Index seems to bee a useful and simple instrument to use. In general the nursing students experience is positive to participate in a real research project. However, a pre-requisite for the positive experiences from participating is most likely that they get, verbal information goof before participating in the study.

  • 176.
    Westergren, Albert
    et al.
    Kristianstad University, School of Health and Society.
    Hedin, Gita
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Förebyggande och uppsökande verksamhet i Osby kommun: slutrapport2014Report (Other academic)
  • 177.
    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.

  • 178.
    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.

     

  • 179.
    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)
  • 180.
    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.))
  • 181.
    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)
  • 182.
    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.

  • 183.
    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.

  • 184.
    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)
  • 185.
    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.

  • 186.
    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.

  • 187.
    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.

  • 188.
    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. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Melgaard, Dorte
    Danmark.
    The Minimal Eating Observation Form – II (MEOF-II) Danish Version2019Conference paper (Refereed)
  • 189.
    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)
  • 190.
    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)
  • 191.
    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)
  • 192.
    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.

  • 193.
    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.

  • 194.
    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.

  • 195.
    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)
  • 196.
    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)
  • 197.
    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.

  • 198.
    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.

  • 199.
    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.))
  • 200.
    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.))
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