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  • 1.
    Andreassen, Sissel
    et al.
    Sophiahemmet Högskola.
    Randers, Ingrid
    Sophiahemmet Högskola.
    Näslund, Erik
    Stockeld, Dag
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Family members' experiences, information needs and information seeking in relation to living with a patient with oesophageal cancer2005Inngår i: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 14, nr 5, 426-34 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A qualitative study was conducted with the aim to describe family members' experiences, information needs and information seeking in relation to living with a patient suffering from oesophageal cancer. Data were collected by means of semi-structured interviews with nine family members. A content analysis was used in order to organize data. It was found that family members were not aware of the severe diagnosis and the illness caused intrusions on the family. The time following diagnosis family members' information seeking was low. They used interpersonal as well as mass media sources to obtain knowledge about and handle the uncertainty related to the illness. Some family members did not actively seek information. In conclusion, healthcare professionals are expected to improve quality of cancer care. These improvements are unlikely to occur without an understanding of family members' needs. This study shows that the family members were unprepared of receiving a diagnosis of oesophageal cancer. They emphasized the importance of including the children in the care given. Moreover, the whole family was faced with uncertainty, which led to intrusion on everyday life. Therefore, family members used different strategies for managing the uncertainty, whereof one was searching for information. The primary source of information was the physician.

  • 2.
    Andreassen, Sissel
    et al.
    Sophiahemmet Högskola.
    Randers, Ingrid
    Sophiahemmet Högskola.
    Näslund, Erik
    Stockeld, Dag
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Information needs following a diagnosis of oesophageal cancer; self-perceived information needs of patients and family members compared with the perceptions of healthcare professionals: a pilot study2007Inngår i: European Journal of Cancer Care, ISSN 0961-5423, E-ISSN 1365-2354, Vol. 16, nr 3, 277-85 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This pilot study was undertaken to describe patients' and family members' information needs following a diagnosis of oesophageal cancer and healthcare professionals' (HCP) perceptions concerning patients' and family members' information needs. Another aim was to describe patients' and family members' satisfaction with information provided. Data were collected by means of a self-report questionnaire. A total of 15 patients, 16 family members and 34 HCP participated. Patients and family members consider most information to be important. The high rating for information about tests/treatment and self-care means that both patients and family members consider this to be the most important areas of information. Healthcare professionals tend to underestimate both patients' and family members' needs for information. Patients and family members were only partly satisfied with the information received, with patients in general more satisfied with information given compared with family members. Patients' and family members' needs for information following a diagnosis of oesophageal cancer are substantial and have not been adequately met by HCP. A qualitative study might be helpful to complete the description of patients' and family members' needs. If a questionnaire is employed, it ought to be less extensive.

  • 3.
    Andreassen, Sissel
    et al.
    Sophiahemmet Högskola.
    Randers, Ingrid
    Sophiahemmet Högskola.
    Näslund, Erik
    Stockeld, Dag
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Patients' experiences of living with oesophageal cancer2006Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, nr 6, 685-95 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: The aim of this study is to describe patients' experiences of living with oesophageal cancer and how they seek information. BACKGROUND: Oesophageal cancer is a devastating disease with poor prognosis. Nursing care for individuals with oesophageal cancer requires increased knowledge of how they experience illness and how it affects them. METHOD: Data were collected by semi-structured, qualitative interviews with 13 participants. Content analysis was used to analyse data. RESULTS: Four themes were identified: (i) Experiences of becoming a patient diagnosed with oesophageal cancer is distinguished by the participants' experiences of vague symptoms, of receiving the diagnosis and of existential concerns evoked by the illness. (ii) Experiences of undergoing investigations and treatment consist of the participants' experiences of extreme tiredness in relation to investigations and treatment. (iii) Experiences of intrusions in daily life is conceptualized by the participants' experiences of how the illness influenced their daily life. (iv) Managing a life-threatening illness consists of a variety of strategies, which the participants employed to manage their life-threatening illness. CONCLUSIONS: The participants were unprepared of receiving a diagnosis of oesophageal cancer. Dysphagia, fatigue and uncertainty influenced the participants' everyday life. To manage the illness one of their strategies was seeking for information. The physicians were considered the main source of information, but family as well as friends with medical knowledge were also acknowledged as valuable sources. RELEVANCE TO CLINICAL PRACTICE: Understanding patients' experiences of living with oesophageal cancer is important to improve nursing care. When caring for these patients, focus ought to be on the whole family. In nursing care, it is important to be aware of the effects of dysphagia and fatigue. Health-care professionals ought to organize meetings with fellow patients and recommend literature and websites that provide patients with high quality information.

  • 4.
    Andreassen, Sissel
    et al.
    Sophiahemmet Högskola.
    Randers, Ingrid
    Sophiahemmet Högskola.
    Ternulf Nyhlin, Kerstin
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    A meta-analysis of qualitative studies on living with oesophageal and clinically similar forms of cancer, seen from the perspective of patients and family members2007Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, Vol. 2, nr 2, 114-27 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study is part of a research programme of which the aim is to generate knowledge about patients' and family members' experiences of living with oesophageal cancer from their perspective. The aim of the present study was to extend this knowledge by adding other forms of cancer: other upper gastrointestinal cancer, and head and neck cancer. These cancer forms have clinical similarities with oesophageal cancer and the survival rates are similar. This study is a qualitative meta-analysis that examines the results reported in 13 qualitative original research reports, published in peer-reviewed nursing journals between April 1998 and June 2006. We used thematic analysis. Three themes were formulated: “running into an unpredictable enemy”, “enduring a fading body” and “entering social silence”. Patients and family members gave voice to a suffering that involved the whole person. Our findings show that the whole person must be given care, and this care must include the whole family

  • 5.
    Axelsson, Lena
    et al.
    Sophiahemmet Högskola.
    Björvell, Catrin
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Randers, Ingrid
    Sophiahemmet Högskola.
    Swedish Registered Nurses' incentives to use nursing diagnoses in clinical practice2006Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 15, nr 8, 936-45 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: The purpose of this study was to describe Registered Nurses' incentives to use nursing diagnoses in clinical practice. BACKGROUND: The use of nursing diagnoses is scarce in Swedish patient records. However, there are hospital wards were all nurses formulate and use nursing diagnoses in their daily work. This leads to the question of what motivates these nurses who do use nursing diagnoses in clinical practice. DESIGN: A qualitative descriptive design. METHODS: A purposeful sampling of 12 Registered Nurses was used. Qualitative interviews to collect data and a content analysis were performed. RESULTS: Five categories were identified: identification of the patient as an individual and as a whole, a working tool for facilitating nursing care, increasing awareness within nursing, support from the management and influence on the professional role. The principle findings of this study were: (i) that the Registered Nurses perceived that nursing diagnoses clarified the patient's individual needs and thereby enabled them to decide on more specific nursing interventions, (ii) that nursing diagnoses were found to facilitate communication between colleagues concerning patient care and thus promoted continuity of care and saved time and (iii) that nursing diagnoses were perceived to increase the Registered Nurses' reflective thinking leading to a continuous development of professional knowledge. CONCLUSIONS: The present findings suggest that the incentives to use nursing diagnoses originate from effects generated from performing a deeper analysis of the patient's nursing needs. Further research is needed to test and validate the usability and consequences of using nursing diagnoses in clinical practice. Motivating factors found in this study may be valuable to Registered Nurses for the use and development of nursing diagnoses in clinical care. Moreover, these factors may be of relevance in other countries that are in a similar situation as Sweden concerning application of nursing diagnoses.

  • 6. Berglund, Britta
    et al.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Ehlers-Danlos syndrom: vad är det?2003Inngår i: Svensk Rehabilitering, ISSN 1403-4468, nr 3, 44-7 s.Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 7. Berglund, Britta
    et al.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Nordström, Gun
    Acceptance of disability and sense of coherence in individuals with Ehlers-Danlos syndrome2003Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, Vol. 12, nr 5, 770-7 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Ehlers-Danlos syndrome (EDS) is a relatively rare, inherited connective tissue disorder and skin hyperextensibility, joint hypermobility, chronic joint and limb pain, blood vessel and tissue fragility are frequent symptoms. The aims of this study were to describe the degree to which individuals with EDS accept and cope with perceived limitations related to the syndrome, and to determine the relationships between acceptance of disability (AD), sense of coherence (SOC), functional health status and background data. Four questionnaires were mailed: the AD scale Modified (ADM), the SOC Scale, the Sickness Impact Profile (SIP) and a background form. The respondents with EDS were recruited through the EDS National Association in Sweden and the response rate was 74% (69 females and eight males). The Ethical Committee at Huddinge University Hospital (ref. no. 152/95) approved the study. This study has shown that the level of AD and SOC in individuals with EDS is similar to other patient groups, e.g. individuals with ostomy and with diabetes. Further, the SOC was in concordance with that of the general population. Those working full-time accepted their disability to a greater degree than those on sick leave or disability pension. A multiple regression analysis showed that a greater AD was associated with a higher level of SOC and a better functional health status. The SOC and SIP together accounted for 50% of the variance in the ADM. For health promotion in nursing practice it is important to have insight into the problem areas which may influence the overall life situation for an individual with EDS. A key issue for nurses is to identify individuals with low acceptance of their disease and/or low SOC in order to support these persons' adaptation process. Future research on EDS may be directed towards projects focusing on the development and implementation of models to strengthen the level of AD and SOC in this group.

  • 8. Berglund, Britta
    et al.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Randers, Ingrid
    Sophiahemmet Högskola.
    Dignity not fully upheld when seeking health care: experiences expressed by individuals suffering from Ehlers-Danlos syndrome2010Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, nr 1, 1-7 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim. The principle of human dignity has assumed importance in ethics and constitutional law throughout the 20th century in the Western world. It calls for respect of each individual as unique, and of treating him or her as a subject, never as a mere object. As such, the principle constitutes an ethical cornerstone in health care. Patients suffering from Ehlers-Danlos syndrome (EDS) challenge medical care and knowledge in health-care professionals' as symptoms sometimes are vague. Individuals with this disorder have reported not being respected when seeking health care. Purpose. To describe encounters in health-care situations when individuals suffering from EDS experienced that their dignity was not fully upheld. A further aim was to describe the long-term consequences of these experiences. Method. A study-specific questionnaire was designed, where individuals with EDS described their encounters with health care from a personal perspective. Results. After qualitative content analysis, the following five categories were identified: 'Being ignored and belittled by health-care professionals,' 'Being assigned psychological and/or psychiatric explanations', 'Being treated and considered merely as an object', 'Being trespassed in one's personal sphere' and 'Being suspected of family violence'. Consequences of these encounters were 'Mistrusting the physician' and 'Risking bad health'. Conclusions. The memory of not being respected is substantial for individuals with EDS and can last for years. As a result, lack of trust for the health-care system is created and they may experience difficulties in future encounters with health care. Therefore, health-care professionals should base their actions on norms that protect human dignity and confirm each patient as a unique human being with resources and abilities to master their own life.

  • 9. Berglund, Britta
    et al.
    Nordström, Gun
    Hagberg, Catharina
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Foot pain and disability in individuals with Ehlers-Danlos syndrome (EDS): impact on daily life activities2005Inngår i: Disability and Rehabilitation, ISSN 0963-8288, Vol. 27, nr 4, 164-9 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    PURPOSE: To investigate the amount and severity of podiatric problems in individuals with EDS as well as the consequences on daily life activities, and to compare these results with the results from a comparison group of the general population. METHOD: The Manchester Foot Pain and Disability Schedule (MFPDS) and a demographic and foot-specific form were mailed. RESULTS: One hundred and thirty-six individuals with EDS and 292 from the comparison group responded. The median MFPDS total score in the EDS group was 33 (range 17-49) (mean 32, SD 8) and in the comparison group 17 (range 17-41) (mean 19, SD 4) (P < 0.001). The items most frequently marked with 3 points in the EDS group were: 'I avoid standing for a long time', 'I catch the bus or use the care more often', and 'I get irritable when my feet hurt' (56, 46 and 43%, respectively). When comparing the NRS score (i.e. Numeric Rating Scale) regarding pain intensity between the EDS group (median 5) and the comparison group (median 0), a statistically significant difference was found (P < 0.001). Other foot problems than pain were reported by 73% (n = 100) of the EDS group and by 21% (n = 60) of the comparison group (P < 0.001). The presence of flat feet in the EDS group and the comparison group was reported by 55% (n = 75) and 8% (n = 23) respectively. CONCLUSION: Individuals' with EDS endure difficulties with their mobility due to their foot problems and related disability. It is therefore of utmost importance to find ways to assess the actual foot status for this group and to support the individuals with solutions to their problems with ambulation.

  • 10.
    Egberg, Louise
    et al.
    Sophiahemmet Högskola.
    Andreassen, Sissel
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Experiences of living with intermittent claudication2012Inngår i: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 30, nr 1, 5-10 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Intermittent claudication is a symptom caused by peripheral arterial disease (PAD) and is associated with pain, impaired mobility and loss of control. Walking ability is reduced due to the pain, and both physical and social functions are often negatively affected, which may lead to patients feeling they are a burden to others. An interview study using a qualitative descriptive design to describe experiences of living with intermittent claudication caused by PAD was carried out during Winter and Spring 2009/2010. Fifteen people suffering from intermittent claudication were interviewed, and the interviews were analyzed using qualitative thematic analysis. Intermittent claudication greatly affects daily living. Six themes were identified: "Experiencing discomfort in the legs," "Moving around in a new way," "Feeling inconvenient when forced to stop," "Missing previous life," "Incorporating intermittent claudication in daily life," and "To lead a strenuous life." The main theme was "Adjusting to a restricted life." The findings show that intermittent claudication has a major impact on daily life. Apart from the severity of symptoms, how the illness is experienced differs among patients, depending on how active the ill person is or wants to be. These findings suggest that increased knowledge about living with intermittent claudication is important to understand the effects on the ill person's life, as a complement to physical examinations when planning individual treatment.

  • 11.
    Egberg, Louise
    et al.
    Sophiahemmet Högskola.
    Andreassen, Sissel
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Living a demanding life - spouses' experiences of living with a person suffering from intermittent claudication2013Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, nr 3, 610-618 s.Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 12.
    Egberg, Louise
    et al.
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Ljungström, Karl Gösta
    Styrud, Johan
    Percutaneous transluminal angioplasty between 1998 and 2002: outcomes of interventions proximal and distal to the inguinal ligament2008Inngår i: Open Access Surgery, ISSN 1178-7082, Vol. 1, 9-19 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim of this study was to examine patients who have undergone percutaneous transluminal angioplasty (PTA) in order to describe patient characteristics and outcomes of interventions proximal and distal to the inguinal ligament and to assess whether different living situations may be associated with the outcome of PTA-intervention.

    Design: A retrospective descriptive chart review.

    Setting: A Swedish University Hospital between January 1998 and December 2002.

    Participants: All patients who have undergone PTA.

    Main outcome measure: Medical and nursing records from medical, surgical, orthopedic, and geriatric clinics were reviewed to obtain data. A study-specific protocol was developed.

    Results: Eighty-seven patients were treated with PTA proximal and 101 distal to the inguinal ligament. No significant differences regarding outcome were found. Fifty-two patients had hematoma/bruise as a complication, which was more common among non-diabetic patients; 46 without diabetes versus 6 diagnosed with diabetes (p = 0.001). When comparing patients living situations and mortality, 76 of the deceased patients had been living alone compared to 38 of the survivors (p = 0.001).

    Conclusions: The patients were younger in the proximal group, however no differences in outcome were found between patients who had undergone PTA whether proximal or distal to the inguinal ligament. Hematomas/bruises as a complication were more common among nondiabetic patients. Amputation was a strong predictor of death during follow-up.

  • 13.
    Egberg, Louise
    et al.
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Ljungström, Karl-Gösta
    Styrud, Johan
    Health-related quality of life in patients with peripheral arterial disease undergoing percutaneous transluminal angioplasty: a prospective one-year follow-up2010Inngår i: Journal of Vascular Nursing, ISSN 1062-0303, E-ISSN 1532-6578, Vol. 28, nr 2, 72-7 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Measuring Health Related Quality of Life has become more and more important in evaluating patients with peripheral arterial disease. This prospective longitudinal survey aimed to investigate health related quality of life over time in patients with peripheral arterial disease (PAD) undergoing percutaneous transluminal angioplasty (PTA) between December 2005 and June 2008. Health Related Quality of life was assessed using the Claudication Scale (CLAU-S) and EQ5D and the Sense of Coherence Scale was used to estimate the patients' sense of coherence. The findings of this study shows that the total CLAU-S score was improved both at one-month follow-up (p < 0.0001) and one-year follow-up (p < 0.0001) compared to baseline. There were significant differences regarding all five dimensions: every day life, pain, social life, illness-specific fears and psychological wellbeing. The EQ5D computed by index improved significantly both at one-month follow-up (p = 0.0006) and one-year follow-up (p = 0.0019) compared to baseline. Differences were found between the groups with low and moderate sense of coherence (p = 0.0169) as well as between the groups with low and high sense of coherence (p = 0.0208) regarding health related quality of life (HRQoL). This study showed that PTA improves HRQoL among individuals suffering from PAD and that the effect is sustainable over time. For more accurate results, a disease-specific instrument should be used to evaluate HRQoL.

  • 14. Hylin, Uffe
    et al.
    Nyholm, Helena
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Ponzer, Sari
    Interprofessional training in clinical practice on a training ward for healthcare students: a two-year follow-up2007Inngår i: Journal of Interprofessional Care, ISSN 1356-1820, Vol. 21, nr 3, 277-88 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This follow-up study describes the former students' lasting impressions of a two-week interprofessional course on a training ward aimed at enhancing the understanding of the roles of other professions and the importance of communication for teamwork and for patient care as well as providing an opportunity for profession-specific training. A questionnaire with both closed and open-ended questions was sent to 633 former students two years after the course and 348 (55%) responded. The course was rated as very good and most of the former students had lasting and positive impressions. Ninety-two percent of respondents encouraged teamwork in their present work and 90% wanted to retain the course. The qualitative analysis of the open-ended questions resulted in five categories describing students' perceptions: professional role development, working in teams, tutoring, patient care and future aspects of the course and real world practice. Our results suggest that interprofessional training during undergraduate education provides lasting impressions that may promote teamwork in students' future occupational life.

  • 15.
    Lauffs, Monica
    et al.
    Sophiahemmet Högskola.
    Ponzer, Sari
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Lonka, Kirsti
    Hylin, Uffe
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Cross-cultural adaptation of the Swedish version of Readiness for Interprofessional Learning Scale (RIPLS)2008Inngår i: Medical education, ISSN 1365-2923, Vol. 42, nr 4, 405-11 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    CONTEXT: Interprofessional learning activities in health care are being gradually introduced on an international basis and therefore cross-cultural and internationally collaborative research into the outcomes of these activities is needed. Hence, it is necessary not only to translate research instruments into the language of the culture in which they are to be used, but also to adapt them culturally if they are to fulfil the testing purposes for which they are intended. It is also necessary to test a translated instrument in order to ensure that it retains its intended psychometric properties. METHODS: In the present study, the Readiness for Interprofessional Learning Scale (RIPLS) was adapted for use in a Swedish student population. Cross-cultural adaptation was performed according to recommended guidelines. The Swedish version was tested on a group of students from various health care professions (n = 214). Cronbach's alpha coefficient was adopted to ensure internal consistency. RESULTS: Minor discrepancies during the different translation processes were identified and corrected. Confirmatory factor analysis suggests that the model had an acceptable fit, implying that the factor structure of the scale did not undergo any significant changes by being subjected to translation. The psychometric qualities of the instrument were comparable with those of the English-language version. CONCLUSIONS: This study presents the cross-cultural adaptation of the RIPLS and demonstrates that its subscale Teamwork and Collaboration is the only reliable subscale. The other 2 subscales (Professional Identity, and Roles and Responsibilities) probably require further scrutiny and development, at least in the Swedish population.

  • 16.
    Löfvenmark, Caroline
    et al.
    Sophiahemmet Högskola.
    Billing, Ewa
    Edner, Magnus
    Mattiasson, Anne-Cathrine
    Evaluation of an educational programme for family members of patients living with chronic heart failure2015Konferansepaper (Annet vitenskapelig)
  • 17.
    Löfvenmark, Caroline
    et al.
    Sophiahemmet Högskola.
    Billing, Ewa
    Edner, Magnus
    Mattiasson, Anne-Cathrine
    Family members' experience of a group-based multi-professional educational programme about chronic heart failure2015Inngår i: Clinical Nursing Studies, ISSN 2324-7940 (Print) 2324-7959 (ESSN), Vol. 3, nr 3, 9-16 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim was to evaluate how family members of persons with chronic heart failure (CHF) experienced a group-based multi-professional educational programme.Methods: Family members who participated in an educational programme filled in an evaluation form directly after completing the programme (n = 53). One year after the completed programme family members (n = 11) who participated in 5-6 of six sessions were interviewed about their experience. The interviews were analysed by qualitative content analysis. Results: The evaluation form showed that most family members reported satisfaction with session structure and content, but a majority would have preferred to share the education together with the ill person. Interview findings are presented in three categories and eight subcategories identified through the analysis. Results showed that family members’ increased knowledge about heart failure and thereby attained a greater understanding of the ill person’s situation with an increased tolerance. Furthermore the family members acquired a better self-confidence and became a resource for the ill person and they described that they were more actively involved in the ill person’s self-care. Family members experienced it positive to meet others in the same situation. They also gained an insight into the importance of taking care of their own health. Conclusions: The educational programme produced valuable knowledge and understanding about heart failure among family members. With this newly acquired knowledge, family members had the possibility of working out appropriate support for the ill person. Being part of a group with others in the same situation was a positive experience.

  • 18.
    Löfvenmark, Caroline
    et al.
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Billing, Ewa
    Edner, Magnus
    Perceived loneliness and social support in patients with chronic heart failure2009Inngår i: European Journal of Cardiovascular Nursing : Journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, ISSN 1873-1953, Vol. 8, nr 4, 251-8 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Self-reported conditions have become increasingly important in patient care, and perceived loneliness and social relationships in patients with chronic heart failure (CHF) are not sufficiently investigated. AIM: The aim was to investigate perceived loneliness and social support in patients with CHF. Further, to investigate whether loneliness and social support might be associated with gender, age, healthcare utilization and mortality. METHODS: One hundred and forty nine patients with CHF, hospitalised at least once during a 4-month period in 2006, completed a self-reported questionnaire including measurements about loneliness and social support. Healthcare utilization was assessed prospectively by frequency of readmissions and number of days hospitalised during 1 year. RESULTS: Loneliness was reported by 29 (20%) participants. They were more often women (p<0.001) and younger (p=0.024). Patients who perceived loneliness had fewer social contacts (p=0.033), reported lower occurrence of emotional contacts (p=0.004), were less satisfied with social contacts and close relationships (p<0.001). Those reporting loneliness had more days hospitalised (p=0.044), and more readmissions to hospital (p=0.027), despite not having more severe CHF. CONCLUSION: Loneliness is a health-related risk indicator in that patients with CHF who perceived loneliness have more healthcare utilization than those who do not report loneliness despite not having more severe CHF.

  • 19.
    Löfvenmark, Caroline
    et al.
    Sophiahemmet Högskola.
    Rydell Karlsson, Monica
    Sophiahemmet Högskola.
    Edner, Magnus
    Billing, Ewa
    Mattiasson, Anne-Cathrine
    A group-based multi-professional education programme for family members of patients with chronic heart failure: effects on knowledge and patients' health care utilization2011Inngår i: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 85, nr 2, e162-8 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: The aim was to investigate if family members of patients with chronic heart failure (CHF) increased knowledge about CHF through a group-based multi-professional educational programme and whether there was an effect on patients' health care utilization. METHODS: Family members (n=128) were randomly assigned to intervention-group (IG) who received CHF education programme or control-group (CG) who received information according to hospital routines. Programme effects were evaluated with CHF knowledge questionnaire, patient readmissions and number of days hospitalised during 18 months. RESULTS: Knowledge about CHF increased in both groups, significantly higher in IG at second assessment (IG 16±1.9 vs. CG 14.9±2.1, p=0.006), and knowledge maintained at third assessment. In IG 17 patients were re-admitted at least once and 28 patients in CG due to CHF (p=0.085). There were no differences in frequency of readmissions or number of days hospitalised. CONCLUSION: A group-based multi-professional education programme increased family members' knowledge about CHF. Despite this, effect on patient's health care utilization could not be seen during follow-up period. PRACTICAL IMPLICATIONS: We suggest that CHF education programmes for family members should be provided at clinics, with information preferably repeated 2-3 times during a period of six months to maintain knowledge level.

  • 20.
    Löfvenmark, Caroline
    et al.
    Sophiahemmet Högskola.
    Saboonchi, Fredrik
    Sophiahemmet Högskola.
    Edner, Magnus
    Billing, Ewa
    Mattiasson, Anne-Cathrine
    Evaluation of an educational programme for family members of patients living with heart failure: a randomised controlled trial2013Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, nr 1-2, 115-126 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims and objectives.  To evaluate the effect of a group-based multi-professional educational programme for family members of patients with chronic heart failure with regard to quality of life, depression and anxiety. The secondary aim was to investigate the impact of social support and sense of coherence on changes in quality of life, anxiety and depression during the period of the study. Background.  When a person is diagnosed with heart failure, the daily life of the family members is also affected. Design.  Randomised controlled trial. Methods.  A total of 128 family members were randomly assigned to participate in a multi-professional educational programme or a control group. Analysis of variance and regression analysis were used. Results.  There were no significant differences in anxiety, depression or quality of life between the intervention group and control group. Adequacy of social network was the only independent variable that explained levels of anxiety and depression after 12 months beyond baseline levels of anxiety (p < 0·001, R(2)  = 0·35) and depression (p = 0·021, R(2)  = 0·37). Younger family members were found to have a higher quality of life (p < 0·01). Conclusion.  Improved disease-related knowledge may need to be combined with other target variables to induce desired effects on depression, anxiety and quality of life of family members. Antecedents of depression and anxiety, such as sense of control, may need to be specifically targeted. Our results also suggest that intervention aimed at enhancing social support may be beneficial for family members. Relevance to clinical practice.  Anxiety and depression did not decrease nor did quality of life improve after the intervention. An educational programme for family members with a component specifically targeting anxiety, depression and quality of life warrants testing. Furthermore, it is important that health care providers understand the influence of social support on anxiety, depression and quality of life when interacting with family members.

  • 21.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet Högskola.
    Andersson, L
    Moral reasoning among professional caregivers in nursing homes1995Inngår i: Western Journal of Nursing Research, ISSN 0193-9459, Vol. 17, nr 3, 277-91 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article examines the responses from a sample of Swedish nursing home staff workers to a hypothetical ethical conflict highlighting the issue of restraint. The responses were analyzed in two ways: first, Piaget's theory of moral development was used to differentiate between "autonomous" and "heteronomous" awareness, and second, the responses were analyzed from the perspective of ethical principles, that is, autonomy, beneficence, nonmaleficence, and justice. The findings indicate that autonomous ethical awareness took precedence over heteronomous ethical awareness. The dominant moral values were the principle of beneficence, followed by the principle of autonomy.

  • 22.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet Högskola.
    Andersson, L
    Nursing home staff attitudes to ethical conflicts with respect to patient autonomy and paternalism1995Inngår i: Nursing Ethics, ISSN 0969-7330, Vol. 2, nr 2, 115-30 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Six case studies on nursing home staff attitudes to patient autonomy have been analysed. The case studies are based on six polarities within autonomy, as developed by Collopy. In total, 189 professional caregivers, comprising the staff of 13 nursing homes in the county of Stockholm, Sweden, responded to questions based on the case studies. Results show that the attitudes within each professional category had a high level of internal correspondence. Nurses consistently supported patient preferences to the highest degree, followed by assistant nurses and auxiliary staff. Nurses' aides ranked lowest in supporting patient preferences. In only one of the cases were background variables of significance.

  • 23.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet Högskola.
    Andersson, L
    Organizational environment and the support of patient autonomy in nursing home care1995Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 22, nr 6, 1149-57 s.Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 24.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet Högskola.
    Andersson, L
    Quality of nursing home care assessed by competent nursing home patients1997Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 26, nr 6, 1117-24 s.Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 25.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet Högskola.
    Andersson, L
    Mullins, L C
    Moody, L
    A comparative empirical study of autonomy in nursing homes in Sweden and Florida, USA1997Inngår i: Journal of Cross-Cultural Gerontology, ISSN 0169-3816, Vol. 12, nr 4, 299-316 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This study seeks to comparatively examine how autonomy is evaluated by a sample of nursing staff in both Sweden and Florida, USA. In both cultures support for patient autonomy was generally greater from an individual point of view than from the anticipated institutional perspective. Comparisons between the cultures revealed that individual staff members in the Swedish nursing homes generally gave higher priority to patient preference than did their American counterparts. On the other hand, support for patient preference was generally greater in the American nursing homes in regard to institutionally anticipated decision. There were statistically significant mean value differences between Swedish nursing staff's personal opinion and anticipated institutional decisions in five of six case studies. Nursing staff's personal opinion showed a stronger support for patient's preferences. There was a statistically significant mean value difference between American nursing staffs' personal opinion and anticipated institutional decisions in only one of the six case studies. In spite of cultural differences the reported results to some degree reflect a common value-system regarding both the anticipated institutional perspective and nursing staffs' personal opinion.

  • 26.
    Mattiasson, Anne-Cathrine
    et al.
    Sophiahemmet Högskola.
    Hemberg, M
    Intimacy--meeting needs and respecting privacy in the care of elderly people: what is a good moral attitude on the part of the nurse/carer?1998Inngår i: Nursing Ethics, ISSN 0969-7330, Vol. 5, nr 6, 527-34 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article explores notions of intimacy in the caring context. The aspects discussed are: privacy and intimacy; intimacy as emotional and/or physical closeness; intimacy as touch; sexual intimacy and normal ageing; sexual intimacy and patients suffering from dementia; and intimacy as trust. Examples are given and problems are identified, with reflection on the attitude and behaviour of the carer. It is suggested that when trying to make moral decisions in concrete situations it is imperative that the carer is aware of the values upon which his or her own thinking is based. It is argued that the guiding principle should be the moral assumption that the carer's responsibility can never be interpreted as a right to disregard the wishes of the patient. Hence, the key word in daily care is 'respect'.

  • 27. Mullins, L-C
    et al.
    Moody, L
    Colguitt, R
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Andersson, L
    An examination of nursing home personnel's perceptions of residents' autonomy1998Inngår i: Journal of Applied Gerontology, ISSN 0733-4648, Vol. 17, nr 84, 527-34 s.Artikkel i tidsskrift (Fagfellevurdert)
  • 28. Nordemar, Rolf
    et al.
    Berglund, B
    Ordell, L N
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    "Jag skulle vilja bevisa att jag var sjuk men hur? Jag har väl inget blixtlås i nacken"2000Inngår i: Läkartidningen, ISSN 0023-7205, Vol. 97, nr 41, 4605-6 s.Artikkel i tidsskrift (Annet (populærvitenskap, debatt, mm))
  • 29. Nymark, Carolin
    et al.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Henriksson, Peter
    Kiessling, Anna
    The turning point: from self-regulative illness behaviour to care-seeking in patients with an acute myocardial infarction2009Inngår i: Journal of clinical nursing, ISSN 1365-2702, Vol. 18, nr 23, 3358-65 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS AND OBJECTIVES: To describe the care-seeking process from interpretation of an initial symptom to the decision to seek medical care in patients with an acute myocardial infarction. BACKGROUND: Patients afflicted by symptoms of an acute myocardial infarction delay in seeking care far exceeding the desired time limits. This results in avoidable loss of life. There is thus a need to understand these patients' initial discomfort, appraisal and behaviour to design interventions that could reduce delay in care-seeking. DESIGN: Focus group discussions with patients who had had a recent acute myocardial infarction. METHODS: The analysis of the transcribed text was inspired by the self-regulatory model of illness behaviour. RESULTS: Patients with acute myocardial infarction describe problems to identify the exact time of onset of often vague symptoms. Their experiences of symptoms did not match their expectations. These patients exhibit self-regulatory illness behaviour that seems to cause a considerable delay in care-seeking. CONCLUSIONS: We found indications of a pertinent shift in appraisal and coping-strategy when a patient changes from self-regulative illness behaviour to seeking care - the turning point. This shift seems to be affected by several partly contradictory influences and it takes a considerable time for a person to reach this stage. All aspects of the patients' self-regulative illness behaviour have to be considered if we want patients to seek medical care more rapidly. RELEVANCE TO CLINICAL PRACTICE: Our findings are important to consider in future design of public health and rehabilitation strategies to save patient lives. To identify the turning point is a profitable way to deepen the understanding of patient behaviour during the initial phase of an acute myocardial infarction.

  • 30. Ponzer, Sari
    et al.
    Hylin, Uffe
    Kusoffsky, Ann
    Lauffs, Monica
    Sophiahemmet Högskola.
    Lonka, Kirsti
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Nordström, Gun
    Interprofessional training in the context of clinical practice: goals and students' perceptions on clinical education wards2004Inngår i: Medical Education, ISSN 0308-0110, Vol. 38, nr 7, 727-36 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: This paper describes the context of interprofessional training on clinical education wards (CEWs) and reports students' perceptions of this type of interprofessional and professional training. CONTEXT: A 2-week interprofessional clinical course was designed for medical students in their surgical eighth term, and nursing, occupational therapy and physiotherapy students, all in their sixth term. Clinical tutors were responsible for the patients and also supervised the students. The goals for the students included: to provide the patients with good medical care, nursing and rehabilitation; to develop their own professional roles; to enhance their level of understanding of the other professions; to stress the importance of good communication for teamwork and for patient care; to enhance understanding of the role of the patient, and to become more aware of ethical aspects of health care. MATERIAL AND METHODS: A questionnaire developed by teachers from the 4 educational departments was used. A total of 962 students responded (78%). RESULTS: The CEWs provided the students with good clinical practice in terms of training in their own professions as well in learning more about the other professions. The importance of good communication for teamwork and for patient care was recognised. The quality of supervision and students' perception of their own professional roles were important factors regarding satisfaction with the CEW course. CONCLUSIONS: The CEW course seemed to provide the students with an opportunity to develop their own professional roles and their functions as team members.

  • 31.
    Randers, Ingrid
    et al.
    Sophiahemmet Högskola.
    Krakau, Ingvar
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    The activating instructional approach: a practical strategy for teaching ethical geriatric health care2004Inngår i: International Nursing Perspectives, ISSN 1592-6478, Vol. 4, nr 1, 21-32 s.Artikkel i tidsskrift (Annet vitenskapelig)
  • 32.
    Randers, Ingrid
    et al.
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Autonomy and integrity: upholding older adult patients' dignity2004Inngår i: Journal of Advanced Nursing, ISSN 0309-2402, Vol. 45, nr 1, 63-71 s.Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 33.
    Randers, Ingrid
    et al.
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Den Aristoteliska Etiken: förståelsegrund för den enskilda sjuksköterskans moraliskt goda handlande i vården och omsorgen om den gamla människan1999Inngår i: Vård i Norden, ISSN 0107-4083, Vol. 19, nr 1, 18-23 s.Artikkel i tidsskrift (Fagfellevurdert)
  • 34.
    Randers, Ingrid
    et al.
    Sophiahemmet Högskola.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    The experiences of elderly people in geriatric care with special reference to integrity2000Inngår i: Nursing Ethics, ISSN 0969-7330, Vol. 7, nr 6, 503-19 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to obtain an increased understanding of the experiences of elderly people in geriatric care, with special reference to integrity. Data were collected through qualitative interviews with elderly people and, in order to obtain a description of caregivers' integrity-promoting or non-promoting behaviours, participant observations and qualitative interviews with nursing students were undertaken. Earlier studies on the integrity of elderly people mainly concentrated on their personal and territorial space, so Kihlgren and Thorsén opened up the possibility of considering the concept of integrity from a broader view by recognizing its relationship to the larger framework of the self-concept. Based on this, findings in the present study indicate that elderly people's integrity relating to their corporal self were the least violated. On the other hand, their psychological, information and cultural selves were the most exposed. The study also identified a further dimension (i.e. one relating to social self), which should be included in the concept of integrity because respecting elderly people's social self reduces their feelings of loneliness, isolation and seclusion. In summary, the results indicate that the concept of integrity is complex and has several dimensions.

  • 35.
    Randers, Ingrid
    et al.
    Sophiahemmet Högskola.
    Olson, TH
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    The 'Social self': the 11th category of integrity - implications for enhancing geriatric care2003Inngår i: Journal of Applied Gerontology, ISSN 0733-4648, Vol. 22, nr 2, 289-309 s.Artikkel i tidsskrift (Fagfellevurdert)
  • 36.
    Randers, Ingrid
    et al.
    Sophiahemmet Högskola.
    Olson, Tina H
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Confirming older adult patients' views of who they are and would like to be2002Inngår i: Nursing Ethics, ISSN 0969-7330, Vol. 9, nr 4, 416-31 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    This article reveals a 91-year-old cognitively intact man's lived experiences of being cared for in a geriatric context in which the majority of the patients were cognitively impaired. A narrative patient story was analysed phenomenologically. The findings indicate that this patient's basic needs for ethical care were not met. The staff did not see him as a unique individual with his own preferences, resources and abilities to master his life. In order to survive this lack of ethical care, he played the role of an 'old cognitively impaired man', which provided him with at least the understanding and attention the cognitively impaired patients received from the staff. The findings also indicate that ethical care is independent of whether or not older cognitively intact and impaired patients stay or live in the same unit, but it is more dependent on a caregiver's ability to respect and confirm each and every patient for who he or she is and would like to be.

  • 37.
    Samuelsson, Bodil
    et al.
    Sophiahemmet Högskola.
    Hedström, Margareta
    Ponzer, Sari
    Söderqvist, Anita
    Al-Ani, Amer
    Ekström, W
    Mattiasson, Anne-Cathrine
    Thorngren, Karl-Göran
    Cederholm, Tommy
    Dalén, N
    Gender differences in comorbidity and complications after hip fracture: a prospective cohort study of 1,955 Swedish patientsManuskript (preprint) (Annet vitenskapelig)
  • 38. Winge, Charlotte
    et al.
    Mattiasson, Anne-Cathrine
    Sophiahemmet Högskola.
    Shultz, Inkeri
    After axillary surgery for breast cancer: is it safe to take blood samples or give intravenous infusions?2010Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, nr 9-10, 1270-4 s.Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: To investigate the occurrence of complications after a needle puncture or intravenous injection in the ipsilateral arm of women who have undergone axillary lymph node clearance for breast cancer.

    BACKGROUND: After axillary lymph node clearance in patients with breast cancer, some women experience lymphoedema and recurrent infections. To reduce the risk of these postoperative complications, most women are advised to not have intravenous infusions in, or blood samples taken from, the arm in the operated side. Very little published data are available regarding the incidence of lymphoedema after intravenous procedures under clean conditions in the hospital setting. This study set out to investigate the occurrence of complications after a needle puncture or intravenous injection in the ipsilateral arm of women who have undergone axillary lymph node clearance for breast cancer is therefore important.

    DESIGN: Descriptive.

    METHODS: Self-reported questionnaire.

    RESULTS: Most of the reported complications were minor, including itching, bruises and vomiting at the time of the intravenous procedure. The most serious complication was infection in one patient needing antibiotic treatment and subsequent arm swelling.

    CONCLUSIONS: This study indicates that if a blood sample is taken or intravenous injection is given according to the current Swedish guidelines for health care professionals, there should be a very low risk of complications.

    RELEVANCE TO CLINICAL PRACTICE: If intravenous procedures are performed without any disadvantage in the arm of the operated side in women who have undergone axillary surgery, the clinical problem of finding a proper vein and the psychological concern of the women can be reduced.

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