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  • 1.
    Bala, Sidona-Valentina
    et al.
    Lund University.
    Forslind, Kristina
    Lund University.
    Fridlund, Bengt
    Jönköping University.
    Hagell, Peter
    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.
    Measuring person-centred care in nurse-led outpatient rheumatology clinics2018In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 296-304Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum).

    OBJECTIVE: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics.

    METHODS: The 24-item PCCoc/rheum was administered to 343 persons with rheumatoid arthritis from six nurse-led outpatient rheumatology clinics. Its measurement properties were tested by Rasch measurement theory.

    RESULTS: Ninety-two per cent of individuals (n = 316) answered the PCCoc/rheum. Items successfully operationalized a quantitative continuum from lower to higher degrees of perceived PCC. Model fit was generally good, including lack of differential item functioning (DIF), and the PCCoc/rheum was able to separate individuals with a reliability of 0.88. The four response categories worked as intended, with the exception of one item. Item ordering provided general empirical support of a priori expectations, with the exception of three items that were omitted owing to multidimensionality, dysfunctional response categories and unexpected ordering. The 21-item PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories and no DIF, and its reliability was 0.86.

    CONCLUSION: We found general support for the appropriateness of the PCCoc/rheum as an outcome measure of patient-perceived PCC in nurse-led outpatient rheumatology clinics. While in need of further testing, the 21-item PCCoc/rheum has the potential to evaluate outpatient PCC from a patient perspective.

  • 2.
    Bala, Sidona-Valentina
    et al.
    Lund University.
    Forslind, Kristina
    Lund University.
    Fridlund, Bengt
    Jönköping University.
    Samuelson, Karin
    Lund University.
    Svensson, Björn
    Lund University.
    Hagell, Peter
    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.
    Person-centred care in nurse-led outpatient rheumatology clinics: conceptualization and initial development of a measurement instrument2018In: Musculoskeletal Care, ISSN 1478-2189, E-ISSN 1557-0681, Vol. 16, no 2, p. 287-295Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Person-centred care (PCC) is considered a key component of effective illness management and high-quality care. However, the PCC concept is underdeveloped in outpatient care. In rheumatology, PCC is considered an unmet need and its further development and evaluation is of high priority. The aim of the present study was to conceptualize and operationalize PCC, in order to develop an instrument for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.

    METHODS: A conceptual outpatient PCC framework was developed, based on the experiences of people with rheumatoid arthritis (RA), person-centredness principles and existing PCC frameworks. The resulting framework was operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum), which was tested for acceptability and content validity among 50 individuals with RA attending a nurse-led outpatient clinic.

    RESULTS: The conceptual framework focuses on the meeting between the person with RA and the nurse, and comprises five interrelated domains: social environment, personalization, shared decision-making, empowerment and communication. Operationalization of the domains into a pool of items generated a preliminary PCCoc/rheum version, which was completed in a mean (standard deviation) of 5.3 (2.5) min. Respondents found items easy to understand (77%) and relevant (93%). The Content Validity Index of the PCCoc/rheum was 0.94 (item level range, 0.87-1.0). About 80% of respondents considered some items redundant. Based on these results, the PCCoc/rheum was revised into a 24-item questionnaire.

    CONCLUSIONS: A conceptual outpatient PCC framework and a 24-item questionnaire intended to measure PCC in nurse-led outpatient rheumatology clinics were developed. The extent to which the questionnaire represents a measurement instrument remains to be tested.

  • 3.
    Bala, Sidona-Valentina
    et al.
    Helsingborg Central Hospital.
    Forslind, Kristina
    Helsingborg Central Hospital.
    Samuelson, Karin
    Lund University.
    Svensson, Björn
    Lund University, Helsingborg.
    Fridlund, Bengt
    Jönköping University.
    Hagell, Peter
    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.
    Measuring person-centered care in nurse-led outpatient rheumatology clinics2018In: International Conference on Probabilistic Models for Measurement, 2018Conference paper (Other academic)
    Abstract [en]

    BACKGROUND: Person-centered care (PCC) is a key component to effective illness management and high-quality care but conceptually underdeveloped in outpatient care settings for long-term disorders such as rheumatoid arthritis (RA), and there is a lack of instruments measuring patient perceived PCC.

    AIM: To conceptualize and operationalize outpatient PCC as a basis for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.

    DESIGN: A conceptual outpatient PCC framework was developed based on theory and patient experiences.The resulting framework was operationalizedinto items that were tested regarding their accordancewith the theoretical framework and their measurement properties according to Rasch measurement theory (RMT) using the RUMM2030 software. 

    RESULTS: The conceptual framework comprised five intermingled domains (personalization, shared decision-making, empowerment, communication, and social environment) that were operationalized into a 24-item PCC instrument for outpatient care in rheumatology (PCCoc/rheum). RMT analyses found items to successfully map out a quantitative continuum from lower to higher PCC levels, with generally acceptable model fit and a reliability of 0.88. Three items exhibiting multidimensionality, dysfunctional response categories, and/or unexpected hierarchical ordering were omitted. The revised PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories, and no DIF; reliability was 0.86.

    SUMMARY AND IMPLICATIONS: We found support for the PCCoc/rheum as a conceptually based outcome measure of patient perceived PCC. Results implied minor theoretical reconsiderations, and related scale revisions improved theoretical and clinical clarity. While in need of further testing, the PCCoc/rheum has great potential as a measure of outpatient PCC from a patient perspective.

  • 4.
    Bjernstål, Ellen
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Johannesson, Amanda
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    När sjukdomen skiljer oss åt: en litteraturstudie om närståendes upplevelser när partner med demenssjukdom flyttar till boende2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Demenssjukdom är en progredierande och obotlig sjukdom som ger en kognitiv påverkan. I ett system där den ena individen påverkar den andra kommer en demenssjukdom inte bara förändra livet hos den som är sjuk, utan i stor utsträckning även de närstående. Närstående får ofta inta rollen som vårdare till sin partner men allt eftersom sjukdomen fortskrider kan omvårdnadsarbetet bli övermäktigt och beslut om flytt till särskilt boende kan behöva tas. Syfte: Syftet var att beskriva närståendes upplevelser när deras partner med demenssjukdom flyttar till särskilt boende. Metod: En allmän litteraturstudie baserad på kvalitativa artiklar som hittades genom en systematisk sökning i omvårdnadsrelaterade databaser. Artiklarna granskades via HKR:s granskningsmall för kvalitativa artiklar. Analysen följde Friberg (2017) trestegsmodell. Resultat: Upplevelsen förändrades över tid och delades upp i två innehållsområden och sex kategorier. Upplevelser före flytt: Att sätta sig själv i andra hand och ett smärtsamt beslut. Upplevelser efter flytt: Att slitas mellan motstridiga känslor, svårt att släppa kontrollen, förlora en del av sig själv och slutligen besvikelse och farhågor inför framtiden. Diskussion: Metoden diskuteras utifrån Shentons (2004) trovärdighetsbegrepp. Vidare lyfts de tre fynden att sätta sig själv i andra hand, ett smärtsamt beslut samt svårt att släppa kontrollen i resultatdiskussionen och diskuteras utifrån en systemteoretisk ansats samt personcentrerad omvårdnadsmodell. Det är betydelsefullt att samhället och omvårdnadspersonal blir medvetna om närståendes upplevelser som en process för att kunna inge rätt stöd. 

  • 5.
    Blücher, Anna
    et al.
    Linnéuniversitetet.
    Borgenstierna, Catharina
    Camanio Care AB.
    Lindborg, Ann-Louise
    Mälardalens Högskola.
    Lindén, Maria
    Mälardalens Högskola.
    Nyberg, Maria
    Mälardalens Högskola.
    Olsson, Viktoria
    Kristianstad University, Faculty of Natural Science. Kristianstad University, Faculty of Natural Science, Research Environment Food and Meals in Everyday Life (MEAL).
    Wendin, Karin
    Kristianstad University, Faculty of Natural Science, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, Faculty of Natural Science, Avdelningen för mat- och måltidsvetenskap.
    Westergren, Albert
    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.
    Mat och måltidsteknik för ett hälsosamt och oberoende åldrande2018Book (Other academic)
  • 6.
    Burén, Elin
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Johansson, Hanna
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Att operera bort livmodern i fertil ålder: en litteraturstudie om kvinnors erfarenheter2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: En hysterektomi innebär att kvinnans livmoder opereras bort. Indikationer är exempelvis stora blödningar och cancer. Kvinnan befinner sig i fertil ålder från det att hon fått sin första menstruation till den upphör. Operationen medför att kvinnan inte längre är fertil. Efter operationen är kvinnan inlagd på sjukhuset där sjuksköterskan har ansvaret för omvårdnaden och efter någon dag får hon åka hem. Sjuksköterskor kan möta kvinnor som genomgått en hysterektomi i sitt arbete, därför kan de vara viktigt att ha kunskap om deras erfarenheter. Syfte: Att belysa erfarenheter efter en hysterektomi hos kvinnor i fertil ålder. Metod: En allmän litteraturöversikt, med strukturerade blocksökningar i tre databaser som bygger på tio vetenskapliga artiklar. Resultat: Ur analysen identifierades sex kategorier: “en förlust av kvinnligheten”, “en förlust över att inte längre vara fertil”, “trauma efter en akut genomförd operation”, “förbättrat välmående efter upphörda symtom”, “acceptans av operationens förändring av livet” och “tacksamma över livet och personalens hjälp”. Diskussion: Metoden diskuteras utifrån tillförlitlighet, verifierbarhet, pålitlighet och överförbarhet. De centrala fynden “en förlust av kvinnligheten” och “en förlust av fertiliteten” påvisar lidande vilket kopplas till en lidandeteori. “Tacksamhet över personalens hjälp” kopplas till teorin om caring-uncaring. Mer forskning och utbildning inom ämnet behövs för att patientgruppen ska mötas med kunskap och professionalitet.

  • 7.
    Carina, Hellqvist
    et al.
    Linköping University.
    Dizdar, Nil
    Linköping University.
    Hagell, Peter
    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.
    Berterö, Carina
    Linköping University.
    Sund-Levander, Märta
    Linköping University.
    A national Swedish self- management program for people with Parkinson’s disease: patients and relatives view2017In: Movement Disorders, 2017, Vol. 32, p. 175-176Conference paper (Refereed)
    Abstract [en]

    Objective: To identify and describe experiences that people with PD and their relatives after participation inthe self-management intervention NPS (National Parkinson School) find valuable for managing daily life.

    Background: A self-management program called NPS was developed as a collaboration of healthcare providers, researchers and patient organizations. NPS is aiming to provide tools and strategies for people with PD and their relatives to increase ability to manage symptoms and consequences of disease and thereby improving conditions for a good life. Self-monitoring and self-management are central concepts. NPS focuses on life with PD, which via 7 sessions consisting of education/lectures and group discussions are mediated. Home assignments make participants practice the new skills in their own life.

    Methods: The last session, evaluation of the NPS, was audio recorded in its whole and transcribed verbatim. Data was collected from five separate clinics and analysed both inductively and deductively using Thematic Analysis and by applying the Self-and Family management theory.

    Results: Through inductive analysis three themes; Exchanging experiences and feeling support, Adjustment and acceptance of PD for managing daily life and Promoting life satisfaction, were identified and described. The themes are capturing the meaning, value and experience of being a participant of NPS. Deductive analysis indicated thatthe Self-and Family management theory was useful and valid for this group of patients and generated a modified framework applicable for patients with PD and their families [figure1].

    Conclusions: Living with PD affects patients as well as relatives. Meeting others in the same situation gives support and strengthen their self- image. Having the opportunity sharing experiences and practical advices showed that there was a hopeful future to come. Techniques to accept and manage life with PD included seeking information about disease and treatments, self-monitoring in order to adjust to new situations and improve symptoms of disease and having a positive mind-set. Living an active life, participating in enjoyable social, cultural, and physical activities were important to feel happy and satisfied with life. Participation in NPS covered many areas of importance for the ability of self-management in PD. The framework for self-management in chronic disease was found relevant also for the PD population

  • 8.
    Clausson, Eva
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Hedin, Gita
    Kristianstad University, School of Health and Society, Avdelningen för Oral hälsa och folkhälsovetenskap. Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Health supportive family conversation: intended to turn Negative weight development in preschool children.2015Conference paper (Other academic)
  • 9.
    Dagner, Viveka
    et al.
    Lund University.
    Clausson, Eva
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Jakobsson, Liselotte
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Prescribed physical activity maintenance following exercise based cardiac rehabilitation: factors predicting low physical activity2018In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Physical activity is important to reduce mortality, morbidity and risk factors in patients with coronary heart disease. This report evaluates to what extent patients are still physically active following an exercise-based cardiac rehabilitation programme 12-14 months post-myocardial infarction and factors predicting why not.

    METHODS: Data from the National Quality Registry Swedeheart with post-myocardial infarction patients ( n=368) admitted from July 2012 to November 2014 were collected with outcomes of physical activity after 12-14 months. Baseline data included demographics, clinical variables, participation in exercise programmes, prescribed physical activity, health-related quality of life and self-reported health (EQ-5D-3L/EQ-VAS). A direct binary logistic regression analysis was used to identify indicators of low physical activity.

    RESULTS: Physical activity frequency per week (PA/week) was low, i.e. zero to three times, in older patients over 64 years ( P=0.00) and in those having problems with pain/discomfort (138 PA/week vs. 195) ( P=0.01), problems with mobility (60 PA/week vs.273) ( P=0.04) and anxiety/depression (128 PA/week vs. 205) ( P=0.04).

    CONCLUSION: Indicators predicting low physical activity can be used targeting improved post-myocardial infarction care outlining person-centred rehabilitation programmes and specialist nursing-led programmes.

  • 10.
    Edvardsson, Ewa
    et al.
    Kristianstad University, Faculty of Health Science.
    Johansson, Carolin
    Kristianstad University, Faculty of Health Science.
    Clausson, Eva
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    En skyldighet men inte en självklarhet: barnhälsovårdssjuksköterskanserfarenhet av att överväga anmälan till socialtjänsten vid misstanke om att barn far illa2018Report (Other academic)
    Abstract [sv]

    Bakgrund: Kunskapen om att vissa barn far illa finns och Barnhälsovårdssjuksköterskan har en skyldighet att anmäla vid oro eller vetskap om detta. Barn kan fara illa genomföräldrars bristande omsorg, och/eller genom fysiska och psykiska kränkningar. Detta kan ge upphov till livslångt lidande. BHVsjuksköterskans roll är att identifiera och uppmärksammabarn som riskerar att eller far illa, för att dessa barn ska få den hjälp dehar rätt till av socialtjänsten. Syftet med studien var att undersöka BHVsjuksköterskan serfarenhet av att överväga anmälan till socialtjänsten vid misstanke om att barn far illa. Metod: Tio BHVsjuksköterskor intervjuades och kvalitativ innehållsanalys med induktiv ansats användes för att analysera data. Resultat: Studien resulterade i ett övergripandetema, tre huvudkategorier och åtta underkategorier. Det övergripande tematblev "En skyldighet men inte en självklarhet", huvudkategorierna är, Perspektiv utifrånyrkesrollen, Perspektiv utifrån personliga erfarenheter och Mötet med barn och föräldrar. Slutsats: Samtliga BHVsjuksköterskor ansåg att det inte alltid var lätt att se vilka barn som for illa. De upplevde det tråkigt och sorgligt att behöva göra en anmälan. De satte alltid barnet främst och menade att det inte kunde bli sämre för barnet om en anmälan gjordes. En återkommande beskrivning hos samtliga BHVsjuksköterskor som medverkade i intervjun var att de fick en känsla av att något inte stämde.

  • 11.
    Einberg, Eva-Lena
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO).
    To promote health in children with experience of cancer treatment2016Conference paper (Other academic)
  • 12.
    Einberg, Eva-Lena
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    To promote health in children with experience of cancer treatment2016Doctoral thesis, comprehensive summary (Other academic)
  • 13.
    Einberg, Eva-Lena
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Lidell, Evy
    Clausson, Eva
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Awareness of demands and unfairness and the importance of connectedness and security: teenage girls' lived experiences of their everyday lives2017Conference paper (Other academic)
  • 14.
    Einberg, Eva-Lena
    et al.
    Halmstad University.
    Lidell, Evy
    Halmstad University.
    Clausson, Eva
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Awareness of demands and unfairness and the importance of connectednessand security2015In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10Article in journal (Refereed)
  • 15.
    Ekberg, Elias
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Frohm, Jacob
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    “They suck the life out of you to be perfectly honest...”: sjuksköterskors upplevelser av att vårda personer med emotionellt instabilt personlighetssyndrom.2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: En upplevelse är subjektiv vilken värderas och tolkas utifrån individens förförståelse och dessa upplevelser behöver sjuksköterskan tillvarata för att kunna bedriva professionell omvårdnad. Omvårdnadsprocessen används av sjuksköterskor för att bedriva omvårdnad på ett optimalt sätt och en del av denna process är mötet mellan människor. Ett gott möte leder till ett bättre informationsutbyte vilket i sin tur är en central del i omvårdnadsarbetet. Emotionellt instabilt personlighetssyndrom, även förkortat EIPS, är en psykisk funktionsnedsättning där de allmänna kriterierna för personlighetssyndrom samt fem av nio EIPS-specifika kriterier ska vara uppfyllda för att ställa diagnos. Syfte: Syftet var att belysa sjuksköterskors upplevelse av att vårda personer med emotionellt instabilt personlighetssyndrom. Metod: Kvalitativ litteraturstudie grundad på nio empiriska studier. Artikelgranskningen genomfördes enligt Högskolan i Kristianstads granskningsmall för kvalitativa studier. Analysen utgick från Fribergs (2012a) fem-stegs metod. Resultat: Resultatet sammanställdes i fyra huvudteman; Upplevda känslor, Upplevelse av kunskap, Upplevelse av arbetssätt samt Upplevelse av beteenden hos personer med EIPS. Sjuksköterskors upplevelser av att vårda personer med EIPS varierade. Känslor som obehag, frustration och optimism uppstod i samband med vårdandet. När sjuksköterskor upplevde att de hade lämplig kunskap skapades självförtroende i vårdandet. Brist på kunskap bidrog till osäkerhet kring hur personalen ska förhålla sig till personer med EIPS. Diskussion: Studiens styrkor och svagheter diskuteras i relation till Shentons (2004) trovärdighetsbegrepp. I resultatdiskussionen diskuteras fynden Hoppfull optimism, Kunskap underlättar vårdandet samt Frustration i relation till omvårdnadsteorier, samhällsperspektiv samt etisk teori.

  • 16.
    Ericsson, Ulf
    et al.
    Kristianstad University, Research environment Governance, Regulation, Internationalization and Performance (GRIP. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Business, Avdelningen för arbetsliv.
    Bengtsson-Tops, Anita
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Working with stories: Street-Level bureaucrats and their work with individuals with psychiatric disability exposed to interpersonal violence2017In: Journal of Social Work in Disability & Rehabilitation, ISSN 1536-710X, E-ISSN 1536-7118, Vol. 16, no 3-4, p. 325-346Article in journal (Refereed)
    Abstract [en]

    The focus of our attention is the meeting between street-level bureaucrats and individuals with psychiatric disability exposed to interpersonal violence. Based on eleven interviews, we illustrate how stories are understood, used and made meaningful to the street-level bureaucrat. The contribution of this article is first of all that of being a framework, from a storytelling point of view, for the work and organizational experiences of street-level bureaucrats. Secondly, by paying attention to the story part of these relationships, we can better understand the situation of individuals with psychiatric disability exposed to interpersonal violence given their interaction with different street-level bureaucrats.

  • 17.
    Eriksson, Felicia
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Berggren, Ebba
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    “These things, of course, they leave a mark on you”: en litteraturstudie om sjuksköterskors erfarenheter av hot och våld2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hot och våld är något som ökar inom sjukvården. Sjuksköterskan har ett huvudansvar för omvårdnaden och det patientnära arbetet sätter sjuksköterskan i en mer utsatt position. I Sverige är det den somatiska vården som har flest anställda inom hälso- och sjukvården, trots detta saknas det kunskap och utbildning för att möta hot och våld. Syfte: Att belysa sjuksköterskors erfarenheter av hot och våld inom somatisk vård. Metod: En litteraturstudie baserad på kvalitativa artiklar. Sökningar har gjorts i Cinahl Complete och Pubmed vilket resulterade i tio artiklar. Artiklarna har granskats med Högskolan Kristianstads granskningsmall och analyserats utifrån Fribergs analysmodell. Resultat:Sjuksköterskor erfor verbala hot och fysiskt våld från patienter. Att utsättas för hot och våld ledde till känslor av rädsla, otrygghet, frustration samt att inte bli respekterad. Hot och våld ansågs även vara en del av arbetet. Det fanns situationer där hot och våld hade en ökad acceptans men ibland gav det en negativ inställning till yrkesrollen och gjorde att omvårdnadsåtgärder omprioriterades. Sjuksköterskorna erfor även att det saknades stöd från organisation och rättssystem. Diskussion: Studiens fynd visade att verbala hot och fysiskt våld ledde till negativa konsekvenser i form av rädsla och otrygghet. Sjuksköterskorna ansåg att hot och våld var en del av arbetet som ledde till att yrkesrollen påverkades och förändrades. För ett förebyggande arbete kan organisationen med fördel använda RRR-modellen som står för Relationen, Ryggsäcken och Ramen. Ett förebyggande arbete kan ses positivt utifrån både sjuksköterske-, patient-, organisation- och samhällsperspektiv.

  • 18. Eriksson, Johanna
    et al.
    Strömblad, Annika
    Andersson, Magdalena
    Beck, Ingela
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Närståendes upplevelser på ett vård- och omsorgsboende: en kvalitativ intervjustudie2018Report (Other academic)
    Abstract [sv]

    Det blir allt fler äldre personer i samhället idag eftersom vi lever längre. Ett större antaläldre personer kan innebära att fler närstående blir involverade i den äldre personenslivssituation och vård. Den personcentrerade omvårdnadsmodellen visar att närståendeär en viktig resurs för den äldre och för den äldres välbefinnande. Idag ska närståendekunna vara ett naturligt inslag i vården av den äldre personen. Sedan år 2009när nya bestämmelsen i Socialtjänstlagen kom, har vården ett ansvar att ge närståendestöd och vägledning. Detta leder till att en dialog mellan vårdpersonal och närståendeär betydande för att främja den äldres hälsa, men också för att främja närståendes delaktighetoch välbefinnande. Syftet med studien var att undersöka närståendes upplevelserav att ha en äldre person vid ett vård- och omsorgsboende. Studien har en kvalitativstudiedesign. Tre fokusgruppsintervjuer och två enskilda intervjuer genomfördesmed sammanlagt 26 närstående till en äldre person på ett vård- och omsorgsboende.Intervjuerna analyserades med en konventionell innehållsanalys. Ett gott bemötandeoch en öppen kommunikation med vårdpersonalen gjorde att de närstående kände sigvälkomna och sedda som en viktig del i vården. Närstående upplevde trygghet då desjälva och den äldre personen kände sig hemmastadda på vård- och omsorgsboendet.Slutsats: Personalen har en betydelsefull roll för närståendes välbefinnande och delaktigheti vården på ett vård- och omsorgsboende.

  • 19.
    Gardsten, Cecilia
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Linnéuniversitetet.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Mörtberg, Christina
    Linnéuniversitetet.
    Personcentrerad IKT-tjänst för personer med typ 2-diabetes2018Conference paper (Other academic)
    Abstract [sv]

    Diabetestyp 2 är en vanlig kronisk sjukdom med stort fokus på egenvård. Sjukdomen kräver livslång och regelbunden kontakt med hälso- och sjukvården för rådgivning och uppföljning. För att kunna erbjuda en tjänst som svarar upp till behoven vid egenvård behövs insikter om hur personer med typ 2-diabetes uppfattar sin situation. Det finns därför behov av att utveckla hälsovård ur ett användarcentrerat perspektiv. Deltagarbaserad design är en forskningsstrategi som har för avsikt att involvera människor för att ge dem inflytande i designprocessen.

  • 20.
    Gardsten, Cecilia
    et al.
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Linnéuniversitetet.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Rask, Mikael
    Linnaeus University.
    Larsson, Åse
    Region Skåne.
    Lindberg, Agneta
    Hässleholm Hospital Organization.
    Olsson, Gith
    Hässleholm Hospital Organization.
    Challenges in everyday life among recently diagnosed and more experienced adults with type 2 diabetes: a multistage focus group study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 19-20, p. 3666-3678Article in journal (Refereed)
    Abstract [en]

    AIM AND OBJECTIVES: The aim of this study was to identify perceived challenges related to self-management among recently diagnosed adults and those with longer experience of type 2 diabetes as a foundation for the future development of a person-centred information and communication technology service.

    BACKGROUND: Learning self-management of type 2 diabetes includes mastering the skills required to complete complex emotional and physical tasks. A service developed with the participation of stakeholders may be an alternative way to meet rising needs for self-management.

    DESIGN: Qualitative descriptive design influenced by a participatory approach.

    METHODS: Multistage focus group interviews among one group of recently diagnosed (≤3yrs, n=4) adults and one group with longer experience (≥5yrs, n=7) of type 2 diabetes.

    RESULTS: Challenges in self-management in everyday life with type 2 diabetes were identified: understanding; developing skills and abilities; and mobilizing personal strengths. Both groups described challenges in understanding the causes of fluctuating blood glucose and in, developing and mobilizing skills for choosing healthful food and eating regularly. The recently diagnosed group was more challenged by learning to accept the diagnosis and becoming motivated to change habits while the experienced group was mainly challenged by issues about complications and medications.

    CONCLUSION: Adults with diabetes have different needs for support during different phases of the disease. From a person-centred perspective, it would be desirable to meet individual needs for self-management on peoples' own terms through a technological service that could reach and connect to a large number of people. This article is protected by copyright. All rights reserved.

  • 21.
    Garmy, Pernilla
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    School nurses' Experiences in working with students with mental health problems2017Conference paper (Refereed)
  • 22.
    Garmy, Pernilla
    et al.
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Clausson, Eva
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    DISA: ett skolbaserat program som förebygger depressiva symtom hos ungdomar2018Conference paper (Other academic)
    Abstract [sv]

    DISA – ett skolbaserat program som förebygger depressiva symtom hos ungdomar

    Pernilla Garmya,b, Eva K Claussona, Agneta Berga, Katarina Steen Carlsson b, och Ulf Jakobsson b

    a Fakulteten för Hälsovetenskaper, Högskolan Kristianstad

    b Medicinska fakulteten, Lunds universitet

    Kontakt: pernilla.garmy@hkr.se

    Vad är DISA?

    DISA är ett skolbaserat program som bygger på tekniker hämtade från kognitiv beteendeterapi, och leds av skolsköterskor, kuratorer och lärare. Programmet ges under skoltid, vid ett tillfälle á 2 timmar i veckan under 10 veckor i årskurs 8.

     

    Fungerar DISA?

    Syftet var att undersöka användbarheten och kostnadseffektiviteten av det skolbaserade programmet DISA vas mål är att förebygga stress och depressiva symtom hos ungdomar.

     

    Hur genomfördes studien?

    Deltagande eleverna gick i årskurs 8 (medianålder: 14 år). 462 elever deltog i DISA (79% flickor) och 486 elever gick i jämförelseskolor och deltog därför inte i DISA (46% flickor). Eleverna besvarade enkäter om sin självskattade hälsa vid start och avslut av DISA, samt efter ett år. Eleverna i jämförelseskolorna besvarade enkäter vid samma intervaller.

     

    Resultat:

    Självskattade depressiva symtom minskade och den självskattade hälsan ökade hos de elever som deltagit i DISA i signifikant större utsträckning än hos de som inte deltagit i DISA.

     

    Slutsats:

    Resultatet tyder på att DISA minskar depressiva symtom och stärker ungdomars självskattade hälsa. Kostnaden är låg i förhållande till dess effekt, vilket indikerar att DISA kan anses vara kostnadseffektivt.

    Referens:

    Garmy, P., Clausson, EK., Berg, A., Steen Carlsson K., Jakobsson, U. (2017) Evaluation of a school-based cognitive behavioral depression prevention program. Scand J Public Health. doi: 10.1177/1403494817746537. [Epub ahead of print]

    https://www.ncbi.nlm.nih.gov/pubmed/29226799

  • 23.
    Garmy, Pernilla
    et al.
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Clausson, Eva
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    För lite sömn och lång skärmtid har samband med övervikt hos skolbarn2018Conference paper (Other academic)
    Abstract [sv]

    För lite sömn och lång skärmtid har samband med övervikt hos skolbarn

    Pernilla Garmya,b, Eva K Claussona, Per Nyberg b, och Ulf Jakobsson b

    a Fakulteten för Hälsovetenskaper, Högskolan Kristianstad

    b Medicinska fakulteten, Lunds universitet

     

    Kontakt: pernilla.garmy@hkr.se

     

    Syfte: I studien undersöktes sömn, tv och datorvanor, och övervikt hos elever i årskurs 4.

    Metod: I denna tvärsnittsstudie besvarade 1260 tio-åriga skolbarn en enkät som sömn och medievanor i samband med hälsosamtalet hos skolsköterskan i årskurs 4. I samband med detta besök vägdes och mättes även 1097 av barnen. Beskrivande och analytisk statistik användes.

    Resultat:

    • I genomsnitt sov barnen 9½ timma på skolnätter.
    • Ungefär 40 % av barnen rapporterade att de sov mindre än 9 timmar per natt.
    • I genomsnitt gick barnen och lade sig klockan 21:00 på vardagkvällar, och en timma senare på helgen.
    • I genomsnitt tillbringade barnen 1 timma vid tv:n och 1 timma vid datorn varje dag.
    • Förekomsten av övervikt (inklusive fetma) var 18%.
    • Rekommendationen för skolbarn är att sova minst 9 timmar per natt, och kortare sömn än 9 timmar på skolnätter var associerat med övervikt, och skärmtid mer än 2 timmar per dag, samt sömnsvårigheter och trötthet i skolan.

    Slutsats: Skolbarn som får för lite sömn har större risk för att ha en övervikt och att spendera mycket tid framför tv och dator. Skolsköterskor har en viktig uppgift att lyfta betydelsen av sunda sömnvanor och rimliga skärmvanor.

     

    Referens:

    Garmy, P., Clausson EK., Nyberg P., Jakobsson U. (2018) Insufficient Sleep is Associated with Obesity and Excessive Screen time Amongst Ten-year-old Children in Sweden. Journal of Pediatric Nursing. doi: 10.1016/j.pedn.2017.11.009.

    https://www.ncbi.nlm.nih.gov/pubmed/29157744

  • 24.
    Garmy, Pernilla
    et al.
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Clausson, Eva
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Nyberg, Per
    Lund University.
    Jakobsson, Ulf
    Lund University.
    Insufficient sleep is associated with obesity and excessive screen time amongst ten-year-old children in Sweden2018In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 39Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study investigated sleep, television, computer habits, and obesity in school-age children.

    DESIGN AND METHODS: This was a cross-sectional self-report survey of 1260 children in grade 4 (mean age, 10.1) living in southern Sweden (49.1% boys). The heights and weights of 1097 (87.1%) of the children were recorded. Descriptive statistics, bivariate analyses, and multiple logistic regression were employed.

    RESULTS: The median length of self-reported sleep on weeknights was 9.5h. Approximately 40% of the children reported receiving <9h of sleep. The median bedtime was 9PM (21:00). On weekends, the median bedtime was 1 h later, and they delayed getting up by 1.5h. The median time spent watching TV and using a computer was 1 h each. The prevalence of being overweight (including obesity) was 18%. Insufficient sleep (<9h) was associated with being overweight, watching TV, or using a computer for two or more hours each day, difficulty falling asleep, and being tired at school.

    CONCLUSIONS: School-age children who receive less sleep are more likely to be overweight and report excessive television and computer use. A strong and urgent need exists to highlight the importance of healthy sleep and media habits. It is challenging for pediatric nurses and school nurses to teach children and their families about healthy sleep and media habits.

  • 25.
    Garmy, Pernilla
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Jakobsson, Liselotte
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Experiences of cancer rehabilitation: a cross-sectional study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 9-10, p. 2014-2021Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To investigate the cancer rehabilitation experiences of working-age cancer survivors.

    BACKGROUND: Cancer survivors have extremely complex needs, spanning physical, vocational, and sexual domains. Although cancer rehabilitation services have been found to eliminate or reduce these strains, these services are often underutilized.

    DESIGN: A cross-sectional study design was employed.

    METHODS: A survey of persons over the age of 18 with a cancer diagnosis, enrolled in the Social Insurance Agency in a municipality in southern Sweden (n =168, 68% women) was conducted.

    RESULTS: Patients who used the cancer rehabilitation service (57%) were generally satisfied with it. Of participants, 26% reported not having received an offer of rehabilitation. Of those who reported that they received information about cancer rehabilitation services, most also reported that they received this information from a healthcare service professional (69%): for example, from the oncology nurse or the oncologist, whereas 20% claimed they received the information from the administrator of the Swedish Social Insurance Agency. A minority of children and family members of patients received support from the healthcare system.

    CONCLUSIONS: More efforts should be taken to reach patients in need of cancer rehabilitation. Additionally, more attention should be directed toward family members and young children.

    RELEVANCE TO CLINICAL PRACTICE: More than one in four patients claimed to not have received an offer of cancer rehabilitation, and an even greater number of patients claimed that their spouses and children had never received an offer for this service either. Hence, there is a communication barrier that needs to be overcome. Health providers should be aware that information needs to be repeated several times, and presented both orally and in writing. This article is protected by copyright. All rights reserved.

    The full text will be freely available from 2019-03-31 14:03
  • 26.
    Garmy, Pernilla
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Olsson Möller, Ulrika
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Winberg, Cecilia
    Lunds universitet.
    Magnusson, Lina
    Lunds universitet, Göteborgs universitet.
    Kalnak, Nelli
    Lunds universitet.
    Experience of participating in a mastermind group2018Conference paper (Other academic)
  • 27.
    Garmy, Pernilla
    et al.
    Kristianstad University, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Vilhjálmsson, Rúnar
    Island.
    Kristjánsdóttir, Guðrún
    Island.
    Bullying in school-aged children in Iceland: a cross-sectional study2018In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 38, p. 30-34Article in journal (Refereed)
    Abstract [en]

    PURPOSE: We describe the frequency and variations in bullying among a representative national sample of school-age children and examine whether sociodemographic characteristics are associated with bullying.

    DESIGN AND METHODS: This study is based on a cross-sectional school-based survey-the Icelandic contribution to the international research network Health Behaviour in School-aged Children (HBSC). The study population included all students in Iceland in grades 6, 8 and 10 (mean ages: 11, 13 and 15years, respectively) (participation rate: 84%; n=11,018). The students completed an anonymous standardized questionnaire administered in the classroom.

    RESULTS: The self-reported frequency of being victimized by bullying at least 2-3 times every month was 5.5%. A younger age, speaking a foreign language at home, not living with one's parents, and living in a rural area, were all associated with higher frequencies of being bullied.

    CONCLUSIONS: Despite efforts to reduce bullying in school, experiences of being victimized through bullying are still too common among Icelandic school-age children. Stakeholders and school health administrators should consider sociodemographic antecedents when planning interventions to reduce bullying at school.

  • 28.
    Green, Nina
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Larsson, Martina
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Är jag mitt missbruk?: patienters upplevelse av mötet med sjukvårdspersonal inom somatisk vård2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Många patienter med substansbrukssyndrom lever ett utsatt och farofyllt liv, där de löper stor risk att drabbas av allvarliga sjukdomar som kan förvärras vid utebliven behandling. 2017 rapporterades det klagomål om ökade brister i bemötandet hos sjukvårdspersonal, främst inom somatiken. Tidigare forskning visar att ett dåligt bemötande från sjukvårdspersonal kan leda till att patienter avstår att söka vård. Detta blir problematiskt då sjukdomar förblir oupptäckta eller underbehandlad och därför blir det intressant att undersöka hur patienter med substansbrukssyndrom upplever mötet. Syfte: Syftet var att beskriva hur patienter med substansbrukssyndrom upplever mötet med sjukvårdspersonal inom somatisk vård. Metod: Studien genomfördes som en litteraturöversikt baserad på kvalitativa vetenskapliga artiklar. Resultat: Det framkom två huvudkategorier om hur patienter med substansbrukssyndrom erfar mötet med somatisk sjukvårdspersonal. Den ena är Upplevelsen av stigmatisering, där patienter på olika sätt känner sig dåligt bemötta av sjukvårdspersonal, vilket presenteras i underkategorierna Att bli särbehandlad, Att bli märkt och Att inte vilja söka vård. Den andra är Upplevelsen av förståelse, och utgörs av två underkategorier, vilka innehåller både positiva och negativa aspekter av Att bli missförståddalternativt Att bli förstådd, i sin sjukdom. Diskussion: I metoddiskussionen diskuteras bland annat huruvida studien svarar på syftet, i vilken utsträckning resultatet kan appliceras i andra vårdsammanhang, samt hur forskningsetiska ställningstagande har beaktats. Sammantaget anses litteraturöversiktens kvalité vara god. I resultatdiskussionen lyfts varför patienter väljer att inte söka vård, vad sjukvårdspersonalens kunskapsnivå har för betydelse i mötet med patienter med substansbrukssyndrom samt att detta diskuteras gentemot omvårdnadsteoretiska ansatser och annan forskning.

  • 29.
    Hagell, Peter
    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.
    Is the activities of daily living (ADL) section of the unified Parkinson’s disease rating scale valid for measuring ADL in Parkinson's disease?2017Conference paper (Other academic)
    Abstract [en]

    Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor as well as non-motor symptoms. While available symptomatic therapy is effective, PD is associated with increasing disability and limitations in performance of activities of daily living (ADL). Maintaining and improving activity performance is therefore a major goal in available symptomatic therapy. The most commonly used rating scale for quantification of ADL outcomes is the ADL section (part II) of the Unified PD Rating Scale (UPDRS). However, the UPDRS II does not only include activity but also impairment items. The consequences of this does not appear to have been addressed from a measurement perspective. This paper describes results from Rasch Measurement Theory analyses of complete UPDRS II (full scale, Activity and Impairment) data (n=675-687). Results show poor fit of the full UPDRS II with, e.g., disordered response thresholds, significant misfit and DIF (reliability, 0.82). The 6 Activity items showed no disordered thresholds, significant misfit or DIF (reliability, 0.86), whereas Impairment items did (reliability, 0.51). In conclusion, dividing the UPDRS II into two scales improves ADL measurement, but alternative approaches are needed and the UPDRS II cannot be recommended for measuring ADL in PD as it may yield misleading outcomes.

  • 30.
    Hagell, Peter
    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.
    Measuring activities of daily living in Parkinson's disease: on a road to nowhere and back again?2019In: Measurement, ISSN 0263-2241, E-ISSN 1873-412X, Vol. 132, p. 109-124Article in journal (Refereed)
    Abstract [en]

    Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with increasing disability and limitations in performance of activities of daily living (ADL) despite availability of effective symptomatic therapy. Following an overview of classical test theory (CTT) and Rasch measurement theory (RMT), the case of a clinical PD trial aiming to demonstrate ADL improvements by using the ADL section (part II) of the Unified PD Rating Scale (UPDRS) to measure ADL outcomes is considered and central questions related to its validity and interpretation are addressed. It is found that while CTT did not detect any issues, RMT in combination with conceptual considerations seriously challenged the role of the UPDRS II as an ADL outcome measure. Results are discussed from historical, methodological and clinical perspectives. (C) 2018 Elsevier Ltd. All rights reserved.

  • 31.
    Hagell, Peter
    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.
    Role of the unified Parkinson’s disease rating scale as a tool for measuring clinical motor outcomes in Parkinson's disease2017Conference paper (Other academic)
    Abstract [en]

    Parkinson’s disease (PD) is a neurodegenerative disorder characterized by motor symptoms such as bradykinesia, rigidity, tremor and postural instability. Available therapy is symptomatic, although several approaches have been investigated as potential disease-modifying therapies. Clinical trial outcomes are typically measured by means of rating scales, of which the Unified PD Rating Scale (UPDRS) is the most commonly used, particularly part III, its motor examination section. Despite its central role, the UPDRS has not been examined regarding its role as a measurement instrument. This paper describes results from an analysis according to Rasch Measurement Theory (RMT) of 804 complete clinical UPDRS III assessments. Results show that the scale exhibits mistargeting, with the vast majority of people being located at the lower half (i.e., less severe symptoms) of its measurement range. Furthermore, evidence suggests multidimensionality as well as redundancy, and problems with the empirical functioning of rating scale categories. It is concluded that the UPDRS represents a clinical assessment tool rather than a measurement instrument, which may contribute to a range of missed opportunities regarding therapeutic developments as well as understanding of the disease itself. Potential remedies include separation into symptom specific scales and reconceptualization in order to expand its range of measurement.

  • 32.
    Hagell, Peter
    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.
    Hariz, Gun-Marie
    Umeå University.
    Sandlund, Birgitta
    Skåne University Hospital.
    Direct dopaminergic responsiveness of activity performance2017In: Movement Disorders, 2017, Vol. 32, p. 460-460Conference paper (Other academic)
    Abstract [en]

    Objective: To assess the direct dopaminergic responsiveness of motor and process aspects of activity performance in people with parkinsonian disorders, and to compare this to the symptomatic motor response. 

    Background: Parkinsonian disorders are associated with limitations in daily activity performance. However, while the dopaminergic responsiveness of motor symptoms is well established, the direct dopaminergic responsiveness of aspects of activity performance appears unaddressed since assessments of activity performance typically are retrospective. This is a limitation since impairment (symptoms and signs) is a separate construct from activity limitations, and the latter is not only related to the former. 

    Methods: Twenty-seven people with parkinsonian disorders (18 men; mean age and disease duration, 68 and 8 years, respectively) underwent a clinical dopaminergic drug response test (median (range) L-dopa dose, 150 (100-300) mg) following 12 hours of dopaminergic drug withdrawal. Participants were tested according to the Unified PD Rating Scale (UPDRS) motor examination and the Assessment of Motor and Process Skills (AMPS) scale in the defined ”off” and best ”on” states. Similar to the UPDRS motor examination, AMPS ratings are based on direct observations of activity performance. Average ”off”, ”on” and change scores were compared, and magnitudes of responsiveness were estimated using Cohen’s dzeffect size (ES). Correlations between outcomes were also computed. 

    Results: Motor symptoms (mean UPDRS motor scores) improved from 36.2 in the defined “off” to 22.5 in the best “on” state, representing an ES of 0.74. Mean AMPS motor scores improved from 1.46 (defined “off”) to 2.34 (best “on”) and mean process scores improved from 1.37 to 1.85, representing ESs of 1.13 (motor) and 0.79 (process). Absolute correlations between UPDRS motor scores and AMPS motor/process scores ranged between 0.40-0.61 for defined “off”, best “on” and change scores.

    Conclusions: The dopaminergic responsiveness was more pronounced for activity performance than for motor symptoms, although motor symptom responsiveness was similar to that of process aspects of activity performance. Correlations suggest that symptomatic motor response is a relatively weak predictor of daily activity performance. These observations argue for the need to specifically address activity performance outcomes in clinical studies.

  • 33.
    Hagell, Peter
    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.
    Höglund, Arja
    Karolinska University Hospital.
    Hellqvist, Carina
    Linköping University Hospital.
    Johansson, Eva-Lena
    Karlstad Central Hospital.
    Löwed, Berit
    Karlstad Central Hospital.
    Sjöström, Ann-Christine
    Sahlgrenska University Hospital.
    Karlberg, Carina
    Sahlgrenska University Hospital.
    Lundgren, Maragreth
    Karolinska University Hospital.
    Dizdar, Nil
    Linköping University Hospital.
    Johansson, Anders
    Karolinska University Hospital.
    Willows, Thomas
    Karolinska University Hospital.
    Rådberg, Johan
    Karlstad Central Hospital.
    Bergquist, Filip
    Sahlgrenska University Hospital.
    Apomorphine formulation influences subcutaneous complications in continuous apomorphine pump therapy for Parkinson’s disease2017In: Movement Disorders, 2017Conference paper (Other academic)
    Abstract [en]

    Objective: To explore if the occurrence and severity of subcutaneous (sc) nodules is influenced by the pharmaceutical formulation of apomorphine used for sc infusion in advanced Parkinson’s disease (PD).

    Background: Apomorphine infusion is an effective therapy in advanced PD, but a limitation is troublesome sc nodules. Various chemically non-identical apomorphine formulations are available. Anecdotal clinical experience has suggested that shifting from one of these (Apo-Go PumpFill; apoGPF) to another (Apomorphine PharmSwed; apoPS, developed in Sweden) may influence the occurrence and severity of sc nodules.

    Methods: In this multicenter open-label prospective observational study, 15 people with advanced PD (mean PD- duration, 13.4 years; median Hoehn & Yahr, IV) on apoGPF since a mean of 2.1 years and with troublesome sc nodules were switched to apoPS. Ongoing interventions to treat existing nodules (ultrasound, massage, Hirudoid cream) continued, and apomorphine as well as other drugs was managed according to clinical routines. Data were collected between May 2015 and March 2017; at baseline, at the time of switching (about 2 weeks later), and up to 1.7-4.2 (mean, 2.5) months post-switch follow-up. Primary outcomes were total nodule numbers, size (mm diameter for the 5 worst nodules), consistency (scored 0-3 for the 5 worst nodules), and associated skin changes (scored 0-4 for the 5 worst nodules) and pain (scored 0-5). Patients also rated their perceived PD severity and motor complications (UPDRS IV). Patient preferences 5-12 months post-switch (2-9 months after follow-up) were also recorded.

    Results: Apomorphine and L-dopa doses did not change over the observation period (P≥0.400). Baseline nodule numbers (7.4 vs. 4.6; P<0.003), size (92.9 vs. 54.1 mm; P=0.016), consistency (11 vs. 5; P=0.003), skin changes (3 vs. 1.5; P=0.205), and average pain (1 vs. 0; P=0.020) improved 11 weeks post-switch. Patient-reported PD severity (P=0.020) and motor fluctuations improved (P=0.051), whereas dyskinesias tended to increase (P=0.205). At 5-12 months post-switch, 13 patients had decided to remain on apoPS; mainly due to improved nodules.

    Conclusions: These observations suggest that apoPS may have a better safety profile compared to apoGPF in terms of sc nodule occurrence and severity. There is a need for larger, randomized controlled studies for firmer conclusions.

  • 34.
    Hagell, Peter
    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.
    Nilsson, Maria
    Lund University.
    Chaudhuri, Ray
    England.
    Odin, Per
    Lund University.
    The non-motor symptoms questionnaire and non-motor symptoms scale for use in Sweden2017In: Movement Disorders, 2017, Vol. 32, p. 74-74Conference paper (Other academic)
    Abstract [en]

    Objective: To translate the Non-Motor Symptoms Questionnaire (NMSQ) and the Non-Motor Symptoms Scale (NMSS) into Swedish, and test their linguistic validity and user-friendliness.

    Background: Non-motor symptoms (NMS) are common but under recognized among people with Parkinson’sdisease (PwPD). The NMSQ and NMSS were developed to ease NMS detection and assessment. The NMSQ is a patient-reported checklist regarding the presence of 30 NMS. The NMSS is a clinician-administered interview based rating scale regarding the frequency and severity of 30 NMS. Both are widely used, but Swedish versions have been lacking.

    Methods: The English NMSQ and NMSS were translated into Swedish in two stages. First, Swedish translations were produced by a professional translator and 3 bilingual PD-clinicians. Second, translations were reviewed by 3 independent PD-clinicians, resulting in minor revisions. The subsequent Swedish versions were then field-tested by 4 PD-clinicians on 5 PwPD each (n=20; 15 men; mean age and PD duration 67.6 and 9 years; HY stages II-IV). Evaluations included user burden (completion time), content relevance, and easiness to understand and use.

    Results: PwPD completed the NMSQ in a mean (range) of 4.8 (2-8) minutes. NMSQ content was considered relevant by 19 PwPD; 19 found instructions easy to understand and 17 found items easy to understand and respond to. The NMSS was completed in 13 (8-25) minutes. All 4 clinicians considered NMSS contents as relevant and instructions easy to understand; 1 considered items easy to rate. Two clinicians reported NMSS items as easy to understand for PwPD, and 1 clinician reported items as easy to answer for PwPD. Two clinicians considered theNMSS “very much” or “moderately”, and 2 considered it “a little” useful for clinical research. One clinician considered the NMSS “moderately”, and 3 considered it “a little” useful for clinical practice, but none would use it themselves. Translators, reviewers and field-test clinicians highlighted ambiguities with the NMSS not related to the translation.

    Conclusions: The NMSQ and NMSS were translated into Swedish and the linguistic validity of both translations was supported. There was also support for the user-friendliness of the NMSQ, but not for the NMSS. Issues detected with the NMSS do not appear to be specific for the Swedish version. Further evaluations of the NMSS in larger samples are needed.

  • 35.
    Hagell, Peter
    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.
    Rouse, Mathew
    England.
    McKenna, Stephen P.
    England.
    Measuring the impact of caring for a family member with Alzheimer's disease2017Conference paper (Other academic)
  • 36.
    Hagell, Peter
    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.
    Rouse, Matthew
    England.
    McKenna, Stephen P.
    England.
    Measuring the impact of caring for a spouse with Alzheimer's disease: validation of the Alzheimer’s patient partners life impact questionnaire (APPLIQue)2018In: Journal of Applied Measurement, ISSN 1529-7713, Vol. 19, no 3Article in journal (Refereed)
    Abstract [en]

    Alzheimer’s disease (AD) is the most common form of dementia, characterized by cognitive, psychiatric and behavioral symptoms and increasing dependency. Family members typically assume increasing caregiving responsibilities, with considerable quality of life (QoL) impact. This article describes the testing of a needs-based QoL questionnaire for AD family caregivers. Initial analyses according to Rasch measurement theory suggested that items applied to spousal rather than non-spousal caregivers. Following removal of non-spousal responders, a 25-item questionnaire was identified that exhibited acceptable model fit, a mean (SD) person location of 0.194 (1.42) logits, residual correlations ≤0.173 and absence of DIF by age, gender or administration. Reliability was 0.85. This new measure, the Alzheimer’s Patient Partners Life Impact Questionnaire (APPLIQue), may fill an important gap in assessing the impact of AD on spousal caregivers and outcomes of interventions aimed at caregivers as well as persons with AD.

  • 37.
    Hagell, Peter
    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.
    Westergren, Albert
    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.
    Hariz, Gun-Marie
    Umeå University.
    Hobart, Jeremy
    England.
    Wictorin, Klas
    Lund University.
    Measuring the impact of drug-induced dyskinesias in Parkinson’s disease: the PDYS-26 revisited2018In: International Conference on Probabilistic Models for Measurement, 2018Conference paper (Other academic)
    Abstract [en]

    BACKGROUND: Drug-induced dyskinesias (DID) are a common long-term complication of dopaminergic drug therapy for Parkinson’s disease (PD). The 26-item PD dyskinesia scale (PDYS-26) is a patient-reported rating scale intended to quantify the everyday impact of DID. However, its measurement properties have not been scrutinized since its development some 10 years ago.

    AIM: To examine the measurement properties of the PDYS-26 using Rasch Measurement Theory (RMT).

    DESIGN: The PDYS-26 was administered to people with PD and varying degrees of DID recruited from six Swedish (n=172) and three British (n=150) outpatient movement disorder clinics. RMT analyses were conducted using the RUMM2030 software.

    RESULTS: RMT model fit was generally good with only three items exhibiting relatively minor misfit. Response categories worked as intended and targeting was acceptable and reliability was 0.96. There was no differential item functioning (DIF) by age, PD duration or time, but three items exhibited DIF by country and one by sex, neither of which appear to notably bias person measurement. Item hierarchy review suggested a variable of dubious clinical/theoretical coherence. Therefore, a recently proposed three-dimensional reduced (21-item) PDYS version was explored. Results were similar to those from the original scale but with improved conceptual coherence, albeit with close to a 2- to 3-fold decrease in measurement precision. 

    SUMMARY AND IMPLICATIONS: The PDYS-26 appears useful for measuring the impact of DID, and yields sufficiently invariant measurement across core patient subgroups. Scale reconceptualization improves the meaning of scores, but at the cost of measurement uncertainty.

  • 38.
    Hansen, Monika
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Klahn, Sofie
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    "Ett löfte är ett löfte": en litteraturstudie om närståendes upplevelser av palliativ vård i livets slutskede i hemmet2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Idag väljer allt fler att vårdas sista tiden i livet i hemmet, det innebär att den drabbades närstående involveras i olika grader av vården och detta kan resultera i stora förändringar hos de närstående. Att ge stöd till närstående är en av grundpelarna i den palliativa vården. Syfte: Var att beskriva närståendes upplevelser av palliativ vård i livets slutskede i hemmet. Metod: Studien var en allmänlitteraturöversikt och resultatet baseras på data utifrån elva vetenskapliga originalartiklar med kvalitativ ansats. Resultat: Utgörs av två kategorier och sex underkategorier. 1, Upplevelsen av en ny vardag vid livets slut i det egna hemmet, beskriver närståendes upplevelser av komplexitet av två roller samt upplevelsen av begränsningar och behov som sätts åt sidan. 2, Upplevelsen av en känslovåg i livet slutskede, beskriver känslor av maktlöshet, rädslor och ångest samt upplevelsen av hopp och trygghet vid livets slut. Diskussion: Närstående utsätts för en komplex situation av vården i livets slut. Närstående har svårt att känna välbefinnande och upplever en rädsla och ångest i livet slutskede. Dessutom finns risken att närstående själv drabbas av psykisk ohälsa. Vidare forskning behövs kring närståendes behov av stöd och insatser för att kunna förbättra deras livssituation i hemmet när palliativ vård i livets slutskede bedrivs.

  • 39. Hantoft, Jennie
    et al.
    Larsson, Linda
    Beck, Ingela
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Omvårdnadspersonals upplevelser av att möta döende äldre personer inom hemvården: en kvalitativ intervjustudie2018Report (Other academic)
    Abstract [sv]

    Äldre personers omvårdnadsbehov blir alltmer komplexa och majoriteten av de äldreönskar att få vård i hemmet den sista tiden i livet och att få lov att dö hemma. Vård aväldre personer med komplexa omvårdnadsbehov och vård i livets slut ställer särskildakrav på omvårdnadspersonal. Syftet med studien var att beskriva omvårdnadspersonalsupplevelser av att möta döende äldre personer inom hemvården. En kvalitativintervjustudie med induktiv ansats har använts för insamling av data. Tio semistruktureradeintervjuer genomfördes i en kommun i nordöstra Skåne som inkluderadehemvårdsområden både på landsbygd och i stadskärna. Resultatet består av följandekategorier: Att vara betydelsefull, Att känna sig otillräcklig, Att känna olust, Att kännalättnad och Att känna sorg och saknad. Omvårdnadspersonal behöver adekvat stödbåde från sjuksköterskan och från det tvärprofessionella teamet samt från organisationoch ledning. För att personalen ska kunna tillgodose döende äldres behov krävsresurser såsom stöd, handledning och ökat kunskapsstöd. Detta behövs för att personalenska kunna utföra god vård men även kunna bearbeta känslor för att utveckla ettempatiskt förhållningssätt när de möter döende äldre personen i hemmet.

  • 40.
    Heaney, Alice
    et al.
    England.
    Hagell, Peter
    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.
    McKenna, Stephen P.
    England.
    Measuring fatigue in Crohn’s disease: the importance of a coherent theoretical measurement model2017Conference paper (Other academic)
  • 41.
    Heaney, Alice
    et al.
    England.
    McKenna, Stephen P.
    England.
    Hagell, Peter
    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.
    Sengupta, Raj
    England.
    Using Rasch analysis to determine the internal validity of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)2018In: International Conference on Probabilistic Models for Measurement, 2018Conference paper (Other academic)
  • 42.
    Hellqvist, Carina
    et al.
    Linköping University Hospital.
    Dizdar, Nil
    Linköping University.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Berterö, Carina
    Linköping University.
    Sund Levander, Märta
    Linköping University.
    Improving self-management for persons with Parkinson's disease through education focusing on management of daily life: patients' and relatives' experience of the Swedish National Parkinson School.2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 19-20, p. 3719-3728Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVE: The two folded aim of this study was firstly to identify and describe experiences valuable for managing daily life after participation in the NPS self-management intervention. The second part was to explore the applicability of the Self- and family management framework by Grey and colleagues for persons with Parkinson's Disease and their relatives.

    BACKGROUND: The impact of PD is evident on the lives of both patients and relatives. The National Parkinson School (NPS) is a Swedish self-management program designed for patients and relatives, aiming at teaching strategies helpful for the ability of self-management, in order to promote life satisfaction.

    DESIGN: Qualitative explorative with inductive and deductive analysis.

    METHODS: Five group discussions with NPS participants were audio-recorded. Verbatim transcriptions were analysed inductively with thematic analysis according to Braun and Clarke, and the findings were then applied deductively to the existing model for patients with chronic disease.

    RESULTS: Through the first step of inductive analysis three themes capturing the meaning, value and experience of being a participant at the NPS were identified: Exchanging experiences and feeling support, Adjustment and acceptance of PD for managing daily life, and Promoting life satisfaction. The deductive analysis applied the inductive findings to the Self-and family management framework of chronically ill to explore the fit to persons with PD and relatives attending the NPS program.

    CONCLUSIONS: The NPS program is a promising approach for helping persons with PD and their relatives to achieve better self-management of disease and improved life satisfaction. Further evaluations of program outcomes in clinical practice are warranted.

    RELEVANCE OF CLINICAL PRACTICE: Self-management programs like the NPS is a promising approach in facilitating a positive mind-set and outlook on life and gain knowledge to understand, adapt and handle chronic disease, such as PD, better. This article is protected by copyright. All rights reserved.

  • 43.
    Holmgren, Linnéa
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Eliasson, Eliasson
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Patientens upplevelser av informationen om Diabetes typ 22018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Diabetes typ 2 debuterar vanligen i vuxen ålder och många personer är omedvetna om att de haft sjukdomen under en längre tid när diagnostiseringen inträffar. Personen kan vid diagnostiseringstillfället uppleva en kris. Det är en krävande process att lära sig leva med en kronisk sjukdom och personen måste anamma en ny förståelse för kroppen. Detta medför att informationen om sjukdomen blir en nödvändig del för patienten. Sjuksköterskan måste här stötta patienten för att återta kontroll över situationen. För att sjuksköterskan ska kunna stödja patienter behövs kunskap om hur patienter upplever informationen. Syfte: Belysa hur patienter upplever informationen om diabetes typ 2.Metod: Litteraturstudie som bygger på tio vetenskapliga originalartiklar. Resultat: Två kategorier och fyra underkategorier framkom; Upplevelser av information vid diagnostiseringstillfället beskriver otydlig information skapar missnöje hos patienterna och att få personcentrerad vård har betydelse. Upplevelser av information genom sjukdomsförloppet beskriver grupputbildningar saknar den personcentrerade informationen och patienten söker sig till andra informationskällor för att uppnå förståelse. Diskussion: Genom subjektivitet och objektivitet, medvetenhet, empowerment och känslan av sammanhang diskuteras resultatet. Efter en patientens unika behov bör informationen anpassas så denne kan uppleva att informationen är hanterbar. Detta för en optimal och personcentrerad informationsöverföring mellan sjuksköterska och patient. Om fler fortlöpande utbildningar och diskussioner om informationshantering med tid för etisk reflektion ges till personal tror vi det kan påverka personalens förståelse och agerande för patientens hantering av information vid diabetes typ 2.

  • 44.
    Johansson, Maurits
    et al.
    Lund University.
    Johansson, Per
    Lund University.
    Stomrud, Erik
    Lund University.
    Hagell, Peter
    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.
    Hansson, Oskar
    Lund University.
    Psychometric testing of a Swedish version of the Apathy Evaluation Scale in three clinical cohorts2017Conference paper (Refereed)
  • 45.
    Jönsson, Malin
    et al.
    Kristianstad University, Faculty of Health Science.
    Lindvall, Lina
    Kristianstad University, Faculty of Health Science.
    Clausson, Eva
    Kristianstad University, Faculty of Health Science, Research Environment Children's and Young People's Health in Social Context (CYPHiSCO). Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Skolsköterskors dokumentation i skolhälsovårdsjournalen: en tioårsuppföljning2016Conference paper (Other academic)
  • 46.
    Kumlien, Christine
    et al.
    Malmö University.
    Miller, Michael
    Lund University.
    Fagerström, Cecilia
    Blekinge County Council.
    Hagell, Peter
    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.
    Evaluation of self-management program outcomes: Adaptation and testing of a Swedish version of the Health Education Impact Questionnaire (heiQ)2018In: Journal of Applied Measurement, ISSN 1529-7713, Vol. 19, no 3, p. 303-319Article in journal (Refereed)
    Abstract [en]

    Self-management programs require a range of indicators to evaluate their outcomes. The Health Education Impact Questionnaire (heiQ) was developed to meet this need. The heiQ contains 40 items with 4 response categories, representing eight scales. We developed a Swedish version of the heiQ that was tested by cognitive interviews (n=15) and psychometrically (n=177) using classical test theory (CTT) and Rasch measurement theory (RMT). The Swedish heiQ was easily understood by interviewees and met CTT criteria, with supported scaling assumptions (corrected item-total correlations, ≥0.37) and reliability (ordinal alpha ≥0.78). General support was demonstrated for the measurement properties of the eight heiQ scales by acceptable RMT fit. However, there were signs of malfunctioning response categories for four items in two scales, and of suboptimal item coverage of the measurement continua. The Swedish heiQ appears comparable to other available language versions. Further efforts may be needed to optimize response categories and measurement precision. 

  • 47.
    Larsson, Mathilda
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Ly, Bonnie
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    ”How do you say that in Swedish?”: en litteraturstudie om patienters upplevelser av att kommunicera med hjälp av tolk2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Kommunikation med hjälp av tolk är ett behov som ständigt ökar inom hälso- och sjukvården. Sjuksköterskan ska kunna föra dialog med patienten baserad på respekt, lyhördhet och empati. För att kunna arbeta efter dessa riktlinjer krävs tolk om patienten har bristande språkkunskaper i svenska. Att undersöka patienters upplevelse av att kommunicera med hjälp av tolk i möten med sjuksköterskor kan uppmärksamma tolksamtalens styrkor och brister och på så vis förbättra patientens säkerhet, integritet och delaktighet. Syfte: Syftet var att belysa patienters upplevelser av att kommunicera med hjälp av tolk i möten med sjuksköterskor. Metod: En allmän litteraturstudie som baserades på vetenskapliga kvalitativa artiklar och en artikel med mixad metod. Resultat: Tre huvudkategorier med tre subkategorier vardera framträdde. 1. Tolken ger empowerment: Tolken skapar förutsättningar för att uttrycka sig, Att känna sig stärkt och Att bli bemött med respekt. 2. Tolken – ett nödvändigt ont: Att tvingas förlita sig på någon annan, Att känna sig som en börda och Att hamna vid sidan av. 3. Tolken hindrar: Ett hinder mot fri kommunikation, Ett hot mot integriteten och Språkhinder som består. Diskussion: Tolken är betydelsefull för patientens delaktighet. Patienter upplever ibland ett missnöje över tolkens bristande kompetens. Det är viktigt för patienten att få avgöra huruvida professionell tolk eller närstående ska användas som tolk i mötet med sjuksköterskan. Resultatet diskuteras delvis utifrån modellen personcentrerad vård.

  • 48.
    Lemoine, J E
    et al.
    Frankrike.
    Konradsen, H
    Karolinska institutet.
    Lunde Jensen, A
    Danmark.
    Roland-Lévy, C
    Frankrike.
    Ny, Pernilla
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Khalaf, Atika
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Torres, S
    Portugal.
    Factor structure and psychometric properties of the Body Appreciation Scale-2 among adolescents and young adults in Danish, Portuguese, and Swedish2018In: Body image, ISSN 1740-1445, E-ISSN 1873-6807, Vol. 26Article in journal (Refereed)
    Abstract [en]

    In recent years, the study of body image shifted from focusing on the negative aspects to a more extensive view of body image. The present study seeks to validate a measure of positive body image, the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a) in Denmark, Portugal, and Sweden. Participants (N = 1012) were adolescents and young adults aged from 12 to 19. Confirmatory factor analyses confirmed the one-dimensional factor structure of the scale. Multi-group confirmatory factor analyses indicated that the scale was invariant across sex and country. Further results showed that BAS-2 was positively correlated with self-esteem, psychological well-being, and intuitive eating. It was negatively correlated with BMI among boys and girls in Portugal but not in Denmark and Sweden. Additionally, boys had higher body appreciation than girls. Results indicated that the BAS-2 has good psychometric properties in the three languages.

  • 49.
    Lindh, Inga-Britt
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Blomqvist, Kerstin
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Challenges faced in daily life by persons with type 2 diabetes: a meta-synthesis2018In: Chronic Illness, ISSN 1742-3953, E-ISSN 1745-9206Article in journal (Refereed)
    Abstract [en]

    Objectives

    To derive improved understanding of the implicit meanings of challenges in daily life from the perspective of persons with type 2 diabetes.

    Methods

    A meta-synthesis was conducted with an interpretive and constructivist approach. Four databases were searched for articles published between 2007 and 2011, producing 37 articles for analysis. Van Deurzen's life world theory was applied as an analytic grid.

    Results

    Challenges in daily life with type 2 diabetes could be understood as living in a tension between opposing forces, implying a struggle with inevitable paradoxes: living in the present and for the future, trusting oneself while relying on others, and being normal while feeling changed and different.

    Discussion

    This synthesis adds knowledge to previous understanding of living with type 2 diabetes, revealing the complexity of daily life when struggling with a lifelong illness. Person-centred care could be used to understand what challenges diabetes may cause in family and working life and the ambivalent feelings the illness can lead to. Future research is needed to implement and evaluate a person-centred care in practice. Since new qualitative research is continuously added to this topic, metasyntheses should be undertaken regularly.

  • 50.
    Lindholm, Beata
    et al.
    Lund University.
    Nilsson, Maria H
    Lund University.
    Hansson, Oskar
    Lund University.
    Hagell, Peter
    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.
    The clinical significance of 10-m walk test standardizations in Parkinson's disease2018In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 265, no 8, p. 1829-1835Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The 10-m walk test (10MWT) is a widely used measure of gait speed in Parkinson's disease (PD). However, it is unclear if different standardizations of its conduct impact test results.

    AIM OF THE STUDY: We examined the clinical significance of two aspects of the standardization of the 10MWT in mild PD: static vs. dynamic start, and a single vs. repeated trials. Implications for fall prediction were also explored.

    METHODS: 151 people with PD (mean age and PD duration, 68 and 4 years, respectively) completed the 10MWT in comfortable gait speed with static and dynamic start (two trials each), and gait speed (m/s) was recorded. Participants then registered all prospective falls for 6 months.

    RESULTS: Absolute mean differences between outcomes from the various test conditions ranged between 0.016 and 0.040 m/s (effect sizes, 0.06-0.14) with high levels of agreement (intra-class correlation coefficients, 0.932-0.987) and small standard errors of measurement (0.032-0.076 m/s). Receiver operating characteristic curves showed similar discriminate abilities for prediction of future falls across conditions (areas under curves, 0.70-0.73). Cut-off points were estimated at 1.1-1.2 m/s.

    CONCLUSIONS: Different 10MWT standardizations yield very similar results, suggesting that there is no practical need for an acceleration distance or repeated trials when conducting this test in mild PD.

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