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  • 1. Drevin, Jennifer
    et al.
    Kristiansson, Per
    Stern, Jenny
    Sophiahemmet University.
    Rosenblad, Andreas
    Measuring pregnancy planning: A psychometric evaluation and comparison of two scales2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2765-2775Article in journal (Refereed)
    Abstract [en]

    AIMS: To psychometrically test the London Measure of Unplanned Pregnancy and compare it with the Swedish Pregnancy Planning Scale.

    BACKGROUND: The incidence of unplanned pregnancies is an important indicator of reproductive health. The London Measure of Unplanned Pregnancy measures pregnancy planning by taking contraceptive use, timing, intention to become pregnant, desire for pregnancy, partner agreement, and pre-conceptual preparations into account. It has, however, previously not been psychometrically evaluated using confirmatory factor analysis. The Likert-scored single-item Swedish Pregnancy Planning Scale has been developed to measure the woman's own view of pregnancy planning level.

    DESIGN: Cross-sectional design.

    METHODS: In 2012-2013, 5493 pregnant women living in Sweden were invited to participate in the Swedish Pregnancy Planning study, of whom 3327 (61%) agreed to participate and answered a questionnaire. A test-retest pilot study was conducted in 2011-2012. Thirty-two participants responded to the questionnaire on two occasions 14 days apart. Data were analysed using confirmatory factor analysis, Cohen's weighted kappa and Spearman's correlation.

    RESULTS: All items of the London Measure of Unplanned Pregnancy contributed to measuring pregnancy planning, but four items had low item-reliability. The London Measure of Unplanned Pregnancy and Swedish Pregnancy Planning Scale corresponded reasonably well with each other and both showed good test-retest reliability.

    CONCLUSION: The London Measure of Unplanned Pregnancy may benefit from item reduction and its usefulness may be questioned. The Swedish Pregnancy Planning Scale is time-efficient and shows acceptable reliability and construct validity, which makes it more useful for measuring pregnancy planning.

  • 2.
    Egberg, Louise
    et al.
    Sophiahemmet University.
    Andreassen, Sissel
    Sophiahemmet University.
    Mattiasson, Anne-Cathrine
    Living a demanding life - spouses' experiences of living with a person suffering from intermittent claudication2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 3, p. 610-618Article in journal (Refereed)
    Abstract [en]

    Aim.  To report a study of family members’ experiences of living with a person suffering from intermittent claudication caused by peripheral arterial disease.

    Background.  Intermittent claudication is a symptom caused by peripheral arterial disease. Walking ability is reduced due to pain and this also affects the family members and leads to consequences such as isolation and a restricted life.

    Design.  This study has a qualitative descriptive design.

    Methods.  Ten spouses living with a person suffering from intermittent claudication were interviewed between December 2009–June 2010. The interviews were then analysed using qualitative thematic analysis.

    Findings.  Four themes were identified: ‘Frustrating to not meet intentions’, ‘Undergoing changes in social life’, ‘Being a person on the side of things’ and ‘Intertwining of circumstances’. The overall theme ‘Living a demanding life’ illustrates that intermittent claudication has great impact on daily life among spouses.

    Conclusion.  This study gives an insight into the complexities and the difficulties of living together with someone suffering from intermittent claudication, a symptom that has great impact on both the spouses’ and the ill persons’ lives. According to the findings in this study, it is important to gain knowledge about the spouses’ experiences because an holistic perspective is essential to treat and support the ill persons and their spouses.

  • 3. Forsman, Henrietta
    et al.
    Jansson, Inger
    Leksell, Janeth
    Lepp, Margret
    Sundin Andersson, Christina
    Engström, Maria
    Nilsson, Jan
    Sophiahemmet University.
    Clusters of competence: Relationship between self-reported professional competence and achievement on a national examination among graduating nursing students2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIMS: To identify clusters based on graduating nursing students' self-reported professional competence and their achievement on a national examination. Furthermore, to describe and compare the identified clusters regarding sample characteristics, students' perceptions of overall quality of the nursing programme and students' general self-efficacy.

    DESIGN: A cross-sectional study combining survey data and results from a national examination.

    METHODS: Data were collected at two universities and one university college in Sweden in January 2017, including 179 students in the final term of the nursing programme. The study was based on the Nurse Professional Competence Scale, the General Self-Efficacy scale and results from the National Clinical Final Examination. A Two-Step Cluster Analysis was used to identify competence profiles, followed by comparative analyses between clusters.

    RESULTS: Three clusters were identified illustrating students' different competence profiles. Students in Cluster 1 and 2 passed the examination, but differed in their self-assessments of competence, rating themselves under and above the overall median value respectively. Students in Cluster 3 failed the examination but rated themselves at the overall median level or higher.

    CONCLUSION: The study illustrates how nursing students' self-assessed competence might differ from competency assessed by examination, which is challenging for nursing education. Self-evaluation is a key learning outcome and is, in the long run, essential to patient safety.

    IMPACT: The study has identified clusters of students where some overestimate and others underestimate their competence. Students who assessed their competence low but passed the exam assessed their general self-efficacy lower than other students. The findings illuminate the need for student-centered strategies in nursing education, including elements of self-assessment in relation to examination to make the students more aware of their clinical competence.

  • 4. Georgsson, Susanne
    et al.
    Carlsson, Tommy
    Sophiahemmet University.
    Pain and pain management during induced abortions: a web-based exploratory study of recollections from previous patients2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 75, no 11, p. 3006-3017Article in journal (Refereed)
    Abstract [en]

    AIMS: To explore recollections of pain and pain management during induced abortions.

    DESIGN: Mixed-methods exploratory study in Sweden.

    METHODS: A web-based survey was distributed between October 2017 - July 2018 via Swedish discussion boards and social media. Open-ended questions were asked about recollection of pain and pain management, followed by self-report ratings. The survey was answered by 185 participants, responses analyzed with qualitative content analysis.

    FINDINGS: Recollections of pain intensity illustrated considerable pain and a traumatic event, described in temporal aspects and likened to other painful conditions such as dysmenorrhea and childbirth. Recollections of pain management illustrated experiences of insufficient treatment of pain and dissatisfaction with pain management, including inefficient treatment and lack of professional attendance. Psychological aspects and consequences illustrated that participants related psychological distress to physical pain, felt unprepared for the physical pain and emphasized the importance of psychological support. Those who experienced intense pain described long-term psychological consequences, including fear of childbirth.

    CONCLUSION: Physical pain and psychological distress can manifest as considerable challenges during induced abortion. Abortion-related pain is a multidimensional phenomenon involving physical and psychological components that needs to be rigorously treated. When physical pain is unsuccessfully treated, women may experience long-term psychological consequences after an abortion.

    IMPACT: The results illustrate the importance of holistic abortion care where the multidimensional components of abortion-related pain are considered. Patients need to be offered sufficient preparatory information about potential physical pain and psychological distress. This study indicates that there is room for improvement in pain management. Larger studies are needed. This article is protected by copyright. All rights reserved.

  • 5. Georgsson, Susanne
    et al.
    van der Spoel, Linde
    Ferm, Johanna
    Carlsson, Tommy
    Sophiahemmet University.
    Quality of web pages about second-trimester medical abortion: A cross-sectional study of readability, comprehensiveness, and transparency2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIMS: To investigate the readability, comprehensiveness and transparency of web pages about medical abortion in the second trimester of pregnancy.

    DESIGN: A cross-sectional descriptive study of Swedish web pages.

    METHODS: Six systematic searches were performed in Google during January 2017. The first 10 hits of each search were screened, resulting in 46 included Swedish web pages. The web pages were analyzed with readability index (LIX) to investigate readability, inductive manifest content analysis to investigate comprehensiveness, and Journal of the Medical Association benchmarks to investigate transparency.

    RESULTS: Median LIX was 29.0 and the largest proportion had LIX 31-40 (N = 17), indicating moderate readability. Visual components were observed in 13 websites. Content analysis resulted in 12 categories illustrating comprehensiveness, but eight of these were only included in ≤50% web pages. With regard to transparency, 29 (63%) adhered to no benchmark, 15 (33%) adhered to one benchmark, and 2 (4%) adhered to two benchmarks. Most web pages were written or reviewed by laypersons (N = 25) and health professionals (N = 11).

    CONCLUSION: The results indicate that web pages about medical abortion have moderate readability, varied comprehensiveness and poor transparency.

    IMPACT: Health professionals need to acknowledge the risk of contact with web-based information about poor quality. There is a need for research that aims to increase the chances that patients encounter high-quality web-based information about medical abortion in the second trimester of pregnancy.

  • 6.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University.
    Adamson, Ulf
    Lins, Per-Eric
    Wredling, Regina
    Sophiahemmet University.
    Patient management of long-term continuous subcutaneous insulin infusion2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 51, no 2, p. 112-8Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reports a study of patients' current practice with continuous subcutaneous insulin infusions, particularly with respect to the management of the pump. BACKGROUND: Successful implementation of continuous subcutaneous insulin infusion requires a motivated patient with a range of technical skills and self-management capabilities. The therapy should be prescribed, implemented and monitored by a skilled professional team familiar with it and capable of supporting the patient. METHODS: A questionnaire was mailed to 102 continuous subcutaneous insulin infusion treated patients at a Swedish university hospital with experience of pump treatment for at least 6 months. RESULTS: The questionnaire was answered by 88% of the patients, 53 women and 37 men, aged 22-71 years with a duration of continuous subcutaneous insulin infusion use of between 7 months and 19 years. The changing interval for soft infusion set ranged from 2.0 to 10.0 days (mean 4.8) and for metal needles from 1.5 to 7.5 days (mean 3.8), P = 0.001. Catheter occlusions were significantly more often reported in patients with presence of bleeding at the infusion site (P = 0.011) and among those using insulin lispro (P = 0.032). CONCLUSIONS: Patients having long-term continuous subcutaneous insulin infusion should be carefully audited with respect to the management of the insulin pump and its accessories. In patients who frequently experience problems, shorter intervals between changes of infusion sets are strongly advocated and type of insulin preparation may be of importance in some cases.

  • 7.
    Johansson, Unn-Britt
    et al.
    Sophiahemmet University.
    Kaila, Päivi
    Ahlner-Elmqvist, Marianne
    Leksell, Janeth
    Isoaho, Hannu
    Saarikoski, Mikko
    Clinical learning environment, supervision and nurse teacher evaluation scale: psychometric evaluation of the Swedish version2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 66, no 9, p. 2085-93Article in journal (Refereed)
    Abstract [en]

    This article is a report of the development and psychometric testing of the Swedish version of the Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale. Background. To achieve quality assurance, collaboration between the healthcare and nursing systems is a pre-requisite. Therefore, it is important to develop a tool that can measure the quality of clinical education. The Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale is a previously validated instrument, currently used in several universities across Europe. The instrument has been suggested for use as part of quality assessment and evaluation of nursing education. Methods. The scale was translated into Swedish from the English version. Data were collected between March 2008 and May 2009 among nursing students from three university colleges, with 324 students completing the questionnaire. Exploratory factor analysis was performed on the 34-item scale to determine construct validity and Cronbach's alpha was used to measure the internal consistency. Results. The five sub-dimensions identified in the original scale were replicated in the exploratory factor analysis. The five factors had explanation percentages of 60.2%, which is deemed sufficient. Cronbach's alpha coefficient for the total scale was 0.95, and varied between 0.96 and 0.75 within the five sub-dimensions. Conclusion. The Swedish version of Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale has satisfactory psychometric properties and could be a useful quality instrument in nursing education. However, further investigation is required to develop and evaluate the questionnaire.

  • 8.
    Lööf, Helena
    et al.
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Welin Henriksson, Elisabet
    Lindblad, Staffan
    Saboonchi, Fredrik
    Sophiahemmet University.
    Development and psychometric testing of the Swedish version of the Body Awareness Questionnaire2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 7, p. 1643-1651Article in journal (Refereed)
    Abstract [en]

    Aim

    This paper is a report of the development and psychometric testing of the Swedish version of the Body Awareness Questionnaire to measure bodily focus of attention.

    Background

    The Body Awareness Questionnaire has been identified as an instrument with excellent psychometric properties within the concept of body awareness. It has been used in both research and clinical settings in different contexts. However, a validated Swedish version is not available.

    Method

    A cross-sectional design was applied for adaptation of the Body Awareness Questionnaire and psychometric validation. Data were collected between autumn 2009 and spring 2011 from 120 patients diagnosed with rheumatoid arthritis, and from 120 students. The ‘concurrent think aloud’ method was used in a pre-test to determine the usability of the questionnaire. Cronbach's alpha was used to test the internal consistency, and confirmatory factor analysis was performed to test the construct validity.

    Results

    According to the confirmatory factor analysis, neither the one-factor model nor the four-factor model tested in this study fulfilled the pre-specified criteria in accordance with the Comparative Fit Index, Standardized Root Mean Squared Residual and the Root Mean Square Error of Approximation. The value of Cronbach's alpha for the Swedish version of the Body Awareness Questionnaire was satisfactory.

    Conclusion

    Our results indicate that the two models tested in this study do not provide a good fit to the observed data. Further refinement and testing of the Swedish version of the Body Awareness Questionnaire is therefore required. The concept of body awareness may

  • 9.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet University College.
    Andersson, L
    Organizational environment and the support of patient autonomy in nursing home care1995In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 22, no 6, p. 1149-57Article in journal (Refereed)
    Abstract [en]

    This study examined how patient autonomy is associated with the organizational environment in nursing homes, particularly the organizational climate, organization of work and selected staff characteristics, such as age and experience of health care. Staff from 13 nursing homes in the county of Stockholm, Sweden, were included. The organizational climate was described by staff from two of the nursing homes that, on the basis of staff judgement, were rated as creative, and from two of the nursing homes that were rated as lacking innovation. Regarding organization of work, which included the number of patients who required to be fed, together with the incidence of pressure sores and indwelling urinary catheters, there appeared to be no difference in care from both types of nursing home. The statistical analyses showed that nursing homes characterized as significantly creative supported patient autonomy to a high degree, and that the staff's experience with health care was associated with the organizational climate.

  • 10.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet University College.
    Andersson, L
    Quality of nursing home care assessed by competent nursing home patients1997In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 26, no 6, p. 1117-24Article in journal (Refereed)
    Abstract [en]

    Interviews were conducted with 60 chronically ill but cognitively competent nursing home patients with a mean age of 80 years, living in 13 nursing homes in the county of Stockholm, Sweden. Quality of nursing home care was assessed through discrepancy between individual priorities (i.e. degree of perceived personal autonomy) and institutional possibility. The results show that there was a high degree of satisfaction with quality of care with regard to meal and shower routines, as well as with the possibilities to watch television, listen to the radio and feel secure. Social relations, on the other hand, was a subject which exposed large discrepancies. Most respondents believed in the importance of social relations whereas results point to a lack of intimacy in the daily living.

  • 11. Mattiasson, Anne-Cathrine
    et al.
    Andersson, L
    Staff attitude and experience in dealing with rational nursing home patients who refuse to eat and drink1994In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 20, no 5, p. 822-7Article in journal (Refereed)
    Abstract [en]

    This paper describes the personal attitudes of nursing home staff and their experience of coping with rational nursing home patients who refused to eat and drink. Professional caregivers in 13 nursing homes and nursing home units in the county of Stockholm, Sweden, were asked to judge an ethical conflict involving a situation in which a patient of sound mind refused to eat and drink. Two questions were raised: (a) What would your unit's decision be in this case? (b) What is your personal opinion in this case? Answers to question (a) showed that 20% believed that the patient's autonomy would be respected, i.e. the patient would be allowed to die without medical intervention. Concerning question (b), the results showed that approximately 50% believed that the patient's wishes regarding food refusal must be respected. Furthermore, the results suggested that both professional category and number of years' service made a difference to the staff views on patient autonomy. Finally, the findings indicated that the nursing homes included in the study did not show any distinct policy with regard to the autonomy of elderly nursing home patients in refusing to eat and drink.

  • 12.
    Medin, Jörgen
    et al.
    Sophiahemmet University.
    Windahl, Jenny
    von Arbin, Magnus
    Tham, Kerstin
    Wredling, Regina
    Sophiahemmet University.
    Eating difficulties among patients 3 months after stroke in relation to the acute phase2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 3, p. 580-589Article in journal (Refereed)
    Abstract [en]

    Aim.  This paper is a report of a study comparing eating difficulties among patients 3 months after stroke in relation to the acute phase. Background.  There is limited knowledge of patients with eating problems early after stroke, hence the progress of eating abilities needs to be further explored. Method.  From March 2007 to June 2008 36 stroke patients with 2-7 eating difficulties or problems with reduced alertness or swallowing in the acute phase were included. Eating difficulties were detected using a structured protocol of observation of meals. In addition, stroke severity (National Institute of Health Stroke Scale), functional status (Barthel Index), unilateral neglect (Line Bisection test and Letter Cancellation test), psychological well-being (The Well-being Questionnaire-12), nutritional status (Mini Nutritional Assessment) and oral status (Revised Oral Assessment Guide) were assessed. Results.  There were 36 participants (58% female) with a median age of 74·5 years. The proportion of eating difficulties decreased significantly from the acute phase to the 3-month follow-up in 'sitting position', 'managing food on the plate' and 'manipulating food in the mouth' and increased regarding inadequate food consumption. Improvements were shown at 3 months in stroke severity, functional status, nutritional status and neglect. Oral status and psychological well-being remained unchanged. Conclusion.  The majority of eating problems persisted 3 months after stroke despite a marked improvement in most of the physical functions. The unchanged psychological well-being and sustained problems with food consumption indicate that factors other than physical function should be taken into account regarding eating difficulties poststroke.

  • 13.
    Randers, Ingrid
    et al.
    Sophiahemmet University College.
    Mattiasson, Anne-Cathrine
    Sophiahemmet University College.
    Autonomy and integrity: upholding older adult patients' dignity2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 45, no 1, p. 63-71Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to deepen understanding of the relationship between autonomy and integrity in interactions between patients and individual health care workers in real-life care situations. METHOD: The data reported here are from a 6- and 12-month follow-up of the teaching of ethics to health care professionals working with older people. The data collection method used was participant observation. Health professionals' caring behaviour in everyday situations was observed from the point of view of patients' autonomy and integrity. Theoretical frameworks relating to autonomy and integrity were used to analyse the data. FINDINGS: The structural framework was useful for identifying the two concepts and their relationship in everyday situations. The data suggest that the two concepts are ethically complex. Autonomy is grounded in respect for patients' ability to choose, decide and take responsibility for their own lives. Autonomy varies within and between individuals and is dependent on context and on those involved. It stresses the intrinsic value of patients, which marks their worth independently of others. Integrity, however, is bound to patients' very existence, no matter what their physical and mental conditions, and must be respected regardless of their ability to act autonomously. CONCLUSION: The concepts of autonomy and integrity appear to presuppose one another and to be indivisible if older adult patients' dignity is to be maintained. This implies that when patients' autonomy is supported their integrity is protected and, consequently, their dignity upheld.

  • 14. Österlund Efraimsson, Eva
    et al.
    Fossum, Bjöörn
    Sophiahemmet University.
    Ehrenberg, Anna
    Larsson, Kjell
    Klang, Birgitta
    Use of motivational interviewing in smoking cessation at nurse-led chronic obstructive pulmonary disease clinics2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 4, p. 767-782Article in journal (Refereed)
    Abstract [en]

    efraimsson e.ö., fossum b., ehrenberg a., larsson k. & klang b. (2011) Use of motivational interviewing in smoking cessation at nurse-led chronic obstructive pulmonary disease clinics. Journal of Advanced Nursing. ABSTRACT: Aim.  This paper is a report of a study to describe to what extent Registered Nurses, with a few days of education in motivational interviewing based communication, used motivational interviewing in smoking cessation communication at nurse-led chronic obstructive pulmonary disease clinics in primary health care. Background.  For smokers with chronic obstructive pulmonary disease the most crucial and evidence-based intervention is smoking cessation. Motivational interviewing is often used in healthcare to support patients to quit smoking. Method.  The study included two videotaped consultations, the first and third of three at the clinic, with each of 13 smokers. Data were collected from March 2006 to April 2007. The nurses' smoking cessation communication was analysed using the Motivational Interviewing Treatment Integrity scale. To get an impression of the consultation, five parameters were judged on a five-point Likert-scale, with five indicating best adherence to Motivational Interviewing. Results.  Evocation', 'collaboration', 'autonomy-support' and 'empathy' averaged between 1·31 and 2·23 whereas 'direction' scored five in all consultations. Of communication behaviours, giving information was the most frequently used, followed by 'closed questions', 'motivational interviewing non-adherent' and 'simple reflections'. 'Motivational interviewing adherent', 'open questions' and 'complex reflections' occurred rarely. There were no important individual or group-level differences in any of the ratings between the first and the third consultations. Conclusion.  In smoking cessation communication the nurses did not employ behaviours that are important in motivational interviewing.

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