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  • 101.
    Lööf, Helena
    Sophiahemmet University.
    Pain, fatigue and fear-avoidance beliefs in relation to physical activity and body awareness in persons diagnosed with rheumatoid arthritis2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: Pain and fatigue are highly common and a major concern for persons diagnosed with rheumatoid arthritis (RA). Having physical limitations, which have a significant effect on daily life, is also described as a major problem for persons with RA. Research findings show that a minority of persons with RA perform maintained health-enhancing physical activity (HEPA), and that psychosocial factors seem to be the most salient and consistent factors to explain variations in HEPA. Furthermore, fear of physical activity and exercise has been described as major barriers for persons with chronic pain. The ability to notice bodily inner sensations and stimuli (body awareness, BA) is described in the literature as having either a positive or a negative impact on a person’s health and well-being. However, the concept of BA is complex and therefore greater insight into this phenomenon is needed.

    Aim: The overall aim of this thesis was to investigate pain, fatigue and fear-avoidance beliefs in relation to physical activity and their correlates in persons with RA. A further overall aim was to develop a psychometric measurement of BA. A final overall aim was to deepen our understanding of BA in persons with RA.

    Methods: Study I was a psychometric evaluation of a Swedish version of the Body Awareness Questionnaire (BAQ) in a student population and in adults with RA. Studies II - III were a cross-sectional survey studies in adults with RA. Study IV was a phenomenological study using the empirical phenomenological psychological (EPP) method in adults with RA.

    Results: In study I, the value of Cronbach's alpha coefficients for the total score in the Swedish version of the BAQ was satisfactory. According to confirmatory factor analysis (CFA), neither a one-factor model nor a four-factor model tested in this study fulfilled the pre-specified criteria. In study II, pain was significantly associated with health-related quality of life (HRQoL) and disease activity. Fatigue was significantly associated with disease activity, BA and positive affect. The adjusted R2 was 28.6% for fatigue and 50.0% for pain. Study III showed that, for socio-demographic factors, being male and having a below average income were associated with an increased risk of high fear-avoidance beliefs about physical activity (mFABQ high). Moreover, the two disease-specific factors, which are most indicative of mFABQ high, were high level of pain and poor health. Concerning psychosocial factors, low HRQoL and low exercise self- efficacy were significantly associated with mFABQ high. The model fit was 0.27 (Nagelkerkés R2). In study IV, some general characteristics were found, which had to do with the disease giving rise to a higher degree of negatively toned BA. BA was a reactive process of searching or controlling for disease-related symptoms, or a reactive process that was triggered by emotions. In addition, BA was an active process in the sense of taking an inventory of abilities. All the participants had the ability to shift focus from BA to the outside world.

    Conclusions: This thesis showed that pain, fatigue and fear-avoidance beliefs about physical activity in persons with RA have several potential correlates, including socio-demographic, disease-specific and psychosocial factors for the variables investigated. The Swedish version of the BAQ is simple to administer and should be used as a tool to measure self-reported attentiveness to normal body processes. Cronbach’s alpha coefficient for the total score was satisfactory; nevertheless, since neither of the models fulfilled the pre-specified criteria further testing of the Swedish version of the BAQ is required. BA was found to be both positively and negatively toned in persons with RA, though RA resulted in a higher degree of negatively toned BA. Thus, the ability to shift attention, from BA to activities in the outside world, could sometimes be beneficial for the person’s general health and well-being. Having the opportunity to participate in meaningful and purposeful daily real-world activities keeps the mind busy (and distracted) and can decrease the negative BA.

  • 102.
    Lööf, Helena
    Sophiahemmet University.
    Rädsla-undvikande-föreställningar i relation till kroppsmedvetande och fysisk aktivitet hos personer med reumatoid artrit2015In: Best Practice, ISSN 1329-1874, Vol. 7, no 24, 20-21 p.Article in journal (Other academic)
  • 103.
    Lööf, Helena
    et al.
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Kroppsmedvetande hos personer med reumatoid artrit2014In: Best Practice, ISSN 1329-1874, Vol. 6, no 21, 22-23 p.Article in journal (Other academic)
  • 104. Melin-Johansson, Christina
    et al.
    Henoch, Ingela
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Österlind, Jane
    Browall, M
    Vård i livets slutskede: specialistsjuksköterskors attityder - en longitudinell multicenterstudie2016Conference paper (Other academic)
  • 105.
    Molin, Beata
    Sophiahemmet University.
    Farmakologisk behandling av smärta2014In: Om smärta: ett fysiologiskt perspektiv / [ed] Cecilia Norrbrink & Thomas Lundeberg, Lund: Studentlitteratur AB, 2014, 2, 129-149 p.Chapter in book (Other academic)
  • 106.
    Molin, Beata
    Sophiahemmet University.
    Smärta i den åldrande populationen2014In: Om smärta: ett fysiologiskt perspektiv / [ed] Cecilia Norrbrink & Thomas Lundeberg, Lund: Studentlitteratur AB, 2014, 2, 165-170 p.Chapter in book (Other academic)
  • 107.
    Molin, Beata
    et al.
    Sophiahemmet University.
    Lund, Iréne
    Lundeberg, Stefan
    Om smärta: ett fysiologiskt perspektiv2010 (ed. 1)Book (Other academic)
  • 108.
    Molin, Beata
    et al.
    Sophiahemmet University.
    Norrbrink, Cecilia
    Lundeberg, Thomas
    Sensoriska nervsystemets uppbyggnad och funktion: en översikt2014In: Om smärta: ett fysiologiskt perspektiv / [ed] Cecilia Norrbrink & Thomas Lundeberg, Lund: Studentlitteratur AB, 2014, 2, 15-20 p.Chapter in book (Other academic)
  • 109.
    Molin, Beata
    et al.
    Sophiahemmet University.
    Therborn, Marie
    Sophiahemmet University.
    Andersson, Ingegerd
    Träna läkemedelsberäkning2016 (ed. 5)Book (Other academic)
  • 110.
    Molin, Beata
    et al.
    Sophiahemmet University.
    Therborn, Marie
    Sophiahemmet University.
    Andersson, Ingegerd
    Träna läkemedelsberäkning2015 (ed. 4)Book (Other academic)
  • 111.
    Niklasson, Boel
    Sophiahemmet University.
    Pain relief following cesarean section: short and long term perspectives2015Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

    Postoperative pain treatment in women undergoing cesarean section (CS) needs to be effective to enable fast and smooth recovery without adverse outcomes and to improve breastfeeding and bonding between mother and child. It is also important that pain treatment should have minimal impact on the newborn.

    The overall aim

    The overall aim of this thesis was to investigate how to improve pain management in women undergoing cesarean section.

    Specific aims were:

    * To investigate if a single injection of bupivacaine with adrenaline close to the fascia could decrease opiate consumption and pain in patients undergoing CS in spinal anesthesia and whether the same treatment influences the need for opiates in women operated in general anesthesia (paper 1 and 3).

    * To study the overall incidence and risk factors for persistent pain after CS and to characterize the persistent pain, regarding intensity, body location and impact on daily life (paper 2).

    * To clarify whether oral oxycodone (OXY) can provide equal/better and safe postoperative pain relief after CS compared to intravenous morphine followed by oral codeine (IVM) (paper 4).

    * To study pharmacokinetic aspects of postoperative OXY treatment of mothers after CS and to investigate possible drug exposure through breast milk, including the effects on the newborn (paper 5).

    Methods and results:

    Study I: Two hundred and sixty women undergoing CS were randomized to receive injection ofeither 40 ml bupivacaine (2.5 mg/ml) with adrenaline (5 μg/ml) (n=130) or 40 ml saline solution (0.9%) (n=130), close to the fascia before closure of the wound. Morphine consumption, pain assessment by Numerical Rating Scale (NRS) and time to mobilization were recorded. Morphine requirements were significantly less for up to 12 h postoperatively and mean and maximum pain intensity lower during the first 6 h in the group receiving local anesthesia (p ≤0.05).

    Study II: A prospective follow up study of the women participating in study I. A questionnaire consisting of the Brief Pain Inventory (BPI) was posted to all women at 3, 6 and 12 months after surgery. Women rated pain intensity as well as interference with factors related to general function and quality of life. Women reported pain in one or more locations, in the CS surgical site as well as in other parts of the body. At 3 months 40% had pain and at 6 and 12 months 27% and 21%, still had pain. CS on maternal request i.e. psychological indication as well as a first CS were significant (p ≤0.05) risk factors for persistent pain at 3 months. Severe postoperative pain in the immediate postoperative period (0-48 h) or undergoing a first CS were significant independent risk factors for the development of persistent pain up to 6 months after CS. Parameters related to quality of life such as sleeping difficulties were significantly impaired in women with persistent pain.

    Study III: A retrospective study (2008-2014) was conducted at the Karolinska University Hospital, Huddinge where medical records of women who underwent CS in general anesthesia were reviewed. After applying exclusion criteria 250 medical records remained. Information 3 about women receiving local anesthesia in the surgical wound, 20 or 40 ml bupivacaine/adrenaline (36 and 42 women in each group), were collected and data from women receiving no local treatment were identified and served as controls (n=172). A significantly lower morphine consumption during the 6 first postoperative hours was seen in patients receiving 40 ml local anesthetics when compared with controls (p ≤0.05) but no difference was seen for the 20 ml group or between treatment groups.

    Study IV: Eighty women scheduled for elective CS were recruited and randomized to receive extended release tablets and short acting OXY (n=40) or IVM (n=40). All patients received a multimodal therapy with ibuprofen and paracetamol and the opiates were administered as needed. Outcome measures were safety parameters for mother and child, opioid requirements, pain intensity by NRS, time to mobilization and time consumption to administer drugs. To evaluate safety for the newborns Apgar scores, acid base status in the umbilical cord, weight development and the Neurological Adaptive Capacity Score were used. A significantly lower postoperative pain intensity measured by NRS was observed 0-6 hours and 25-48 hours in the OXY group (p ≤0.05). Opioid consumption was significantly less in the OXY than in the IVM group 0-5 days postoperatively. Total time to administer analgesics was significantly shorter in the OXY group. There was a significant difference in common opiate related adverse effects between the two groups (3 women in the OXY group compared to 15 in the IVM/codeine group). No negative effects in the newborns related to opioid treatment were observed in either of the two groups.

    Study V: The material was obtained in study IV. Maternal blood and breastmilk were sampled at 24 and 48 hours and neonatal blood was collected at 48 hours postpartum. All samples were analyzed for OXY and the metabolites noroxycodone, oxymorphone and noroxymorphone. Detectable plasma levels of OXY and its metabolites were found in all women and even if there were small quantities of breastmilk detectable levels were found also here. In most cases there were low or non-detectable levels of OXY in the plasma of the neonates.

    Conclusions: A single injection of bupivacaine with adrenaline in the surgical wound decreases the need for rescue morphine postoperatively and was demonstrated to be a safe and effective pain management in women undergoing CS both in spinal and general anesthesia. Standardized postoperative treatment with oral OXY after CS was shown to be time effective and to give a better pain control, with lower opioid intake than a protocol using IVM/codeine, both as components of a multimodal analgesic regime. Our clinical data and the pharmacokinetic analyses support the view that OXY treatment is safe for mothers and neonates. As severe postoperative pain is a risk factor for long term pain the initial pain relief is crucial and we found that experiences related to quality of life were significantly impaired in women with persistent pain. We suggest that our findings can be of clinical importance, not least in women who have their CS performed in general anesthesia.

  • 112.
    Niklasson, Boel
    et al.
    Sophiahemmet University.
    Molnar, P
    Blanck, Agneta
    A single dose of bupivacaine-adrenaline decreases opioid consumption after caesarean section in general anesthesiaManuscript (preprint) (Other academic)
  • 113. Olin Lauritzen, Sonja
    et al.
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Saltvedt, Sissel
    A normal pregnancy?: women's experiences of being at high risk after ultrasound screening for Down's syndrome2007In: Medical technologies and the life world: the social construction of normality / [ed] Sonja Olin Lauritzen & Lars-Christer Hydén, Abingdon: Routledge , 2007, 115-40 p.Chapter in book (Other academic)
  • 114. Olsen, Marie
    et al.
    Anderbro, Therese
    Sophiahemmet University.
    Amsberg, Susanne
    Sophiahemmet University.
    Leksell, Janet
    Moberg, E.
    Lisspers, Jan
    Gudbjörnsdottir, S.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Psychometric evaluation of the "Fear of complications questionnaire"2012In: FEND  17th Annual Conference, 2012, 25- p.Conference paper (Other academic)
  • 115. Piper, Barbara F
    et al.
    Olson, Karin
    Lundh Hagelin, Carina
    Sophiahemmet University.
    Cancer-related fatigue2011In: The MASCC textbook of cancer supportive care and survivorship / [ed] Olver, Ian N., New York: Springer , 2011, 23-32 p.Chapter in book (Other academic)
    Abstract [en]

    This chapter describes what is currently known about cancer-related fatigue (CRF) in cancer survivors. Significance and prevalence rates are reviewed and definitions are discussed within the context of the need to develop case definitions and phenotypes to advance the science and practice of CRF. Two conceptual frameworks/models for CRF are identified based on emerging evidence that unify the seemingly disparate underlying mechanisms proposed in the literature. While further testing of these models and their propositions are needed, these models can be used to guide future studies investigating CRF and its underlying relationships with other symptoms such as pain, depression, and insomnia. The National Comprehensive Cancer Network (NCCN) guidelines for the assessment and management of CRF are reviewed. Particular emphasis is given to the assessment and management of the common contributing and treatable factors associated with CRF (i.e., anemia, comorbidities, deconditioning, emotional distress, nutrition, pain, sleep disturbance/insomnia, symptom clusters, and cognitive impairment). Barriers to guideline adherence and exercise prescription are discussed, and patient and provider education is emphasized.

  • 116.
    Prahl, Charlotte
    Sophiahemmet University.
    Den frånvarande dialogen: Om en utbildningssatsning inom demensvård2010Licentiate thesis, monograph (Other academic)
    Abstract [en]

    Educational investments may serve several purposes. They can be carried out in order to increase the students’ knowledge within a specific discipline, but also to increase the level of knowledge within an organization. ’Silviahemmet’ in Stockholm, which was inaugurated in the year of 1996, had as one of its objectives to become a school for education of assistant nurses working in the area of dementia care. The educational program had the aim to educate assistant nurses to become supervisors in dementia care, the assistant nurses should acquire an edge competence in the close care of patients with dementia. This educational investment has been investigated in order to study the significance an educational investment may have for a health care organization in which some of the health care personnel has participated in an education and moreover, to study how this knowledge is communicated within the organization.

    Thus, the overall purpose of my study is to describe and analyse the significance an educational investment is given, by the participating assistant nurses as well as by other health care personnel. The study was carried out during the year 2005 and concerned assistant nurses educated in the years between 1996 and 2001. Four different data gathering techniques were used; questionnaires, interviews, observations at two workplaces and conversations with health care personnel. The questionnaire concerned all 34 assistant nurses who had participated in specialist training in dementia care during this period. Seven persons were interviewed.

    Summing up my results, the knowledge that the assistant nurses have achieved from the education is theoretical and social knowledge of dementia. This constituted a platform to stand on for the assistant nurses in their work when meeting the patient

    An important result of the study, concerning the importance of the assistant nurses specialist training for other categories of health care personnel, is the lack of verbal communication between personnel categories that seems to be at hand. Furthermore, dialogues or shared reflections among the personnel could not be noticed. Often it was solely one-way communication that existed on the wards. A knowledge creating dialogue was missing. Questions were asked, but only regarding about "what" and "when" a work task should be performed, not "why" something should be carried out.

    An obstacle regarding the communication of new knowledge appears to be the gap existing between an educational investment and the everyday reality of the health care organization. The result of the study shows the importance of adopting the theoretical knowledge to the reality that the health care personnel is facing. Other obstacles seem to be status and hierarchies.

    The study showed that the assistant nurses working hours did not allow for educating health care personnel in dementia. There ought to be possibilities within the organization to make space for the use and communication of new knowledge through the supervising of health care personnel caring for elderly with dementia. This in turn may lead to better health care for elderly. This supervision could take the form of a dialogue and shared reflections concerning the patients and their need of health care.

  • 117.
    Randers, Ingrid
    Sophiahemmet University.
    Upholding Older Adults' Innate and Inherent Dignity within a Caring Context2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In the ethical ideals of autonomy and integrity reducing the level of abstraction is necessary in order to more easily be able to follow them in every day care practices. This is especially true concerning the effort of upholding older adult patients dignity. Creative intervention programs may help to increase health care professionals ethical competence. In the first study (I) 12 older adults experiences of care are described, with special reference to their integrity. In addition, four student nurses were interviewed and participant observations were performed in order to describe the health care professionals integrity- promoting or non-promoting behaviours. The findings confirmed, in relation to a theoretical model, which determined ten categories of integrity related to the self-concept the complexity of the concept, but they also indicated that in relation to older patients a further category should be included namely one relating to their social self Therefore, the purpose of the second study (II) was to deepen the understanding of the identified eleventh category, social self, and how it may effect the ethical care in older adult patients. Two themes were identified: Social exchange, which was described as the older adult informants wish to be respected for their needs of meaningful social and human contacts, but also for their needs of meaningful social activities. Social experiences included the older informants wish to be respected for their needs of talking about themselves, recalling and sharing memories, moreover, to be respected for their needs of being a part of the world outside the hospital. Thus, the findings indicate the relevance of the new identified category. In the third study (III) the aim was to achieve a deeper understanding of an older cognitively intact mans lived experiences of being a patient in a geriatric context, where the majority of the patients were cognitively impaired. An earlier qualitative interview from study I was used and analysed from a phenomenological approach that illustrated health care professionals lack of meeting and confirming individual patients needs to be met as unique individuals with personal preferences, own resources and the ability to take charge over their own life. The health care professionals care actions tended to depend upon the needs of the cognitively impaired. In the fourth study (IV) the aim was to teach ethics from an activating instructional approach and then to evaluate whether or not this was a practicable strategy to influence individual health care members attitudes as well as their ethical caring behaviour with a special focus on the patients autonomy and integrity. A 6 and 12 months follow up was performed including group-interviews and participant observations. The findings indicate that the attitudes of individual participants had actually changed into a more patient-centred perspective and that their caring behaviour agreed to their attitudes. Based on real- life care situations taken from the fields of geriatrics, where the majority of the patients were cognitively impaired the aim of the fifth study (V) was to examine the relationship between autonomy and integrity resulting from the interactions between the individual health care member and the patients. These findings indicate that the relationship was ethically complex and that they were inseparable for maintaining a patients dignity. Consequently, this meant that if the health care professionals respected the older adult patients autonomy their integrity was protected and thereby, their innate and inherent dignity.

  • 118.
    Randers, Ingrid
    et al.
    Sophiahemmet University College.
    Krakau, Ingvar
    Mattiasson, Anne-Cathrine
    Sophiahemmet University College.
    The activating instructional approach: a practical strategy for teaching ethical geriatric health care2004In: International Nursing Perspectives, ISSN 1592-6478, Vol. 4, no 1, 21-32 p.Article in journal (Other academic)
  • 119.
    Rossen, Jenny
    Sophiahemmet University.
    "But now it is a habit": Participants' experiences of Sophia Step Study2017Conference paper (Other academic)
  • 120.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Johansson, Unn-Britt
    Sophiahemmet University.
    Lööf, Helena
    Sophiahemmet University.
    Hagströmer, Maria
    Yngve, Agneta
    Exploration of study participants experiences following Sophia Step Study: A two-year physical activity intervention2016Conference paper (Other academic)
  • 121.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Lööf, Helena
    Yngve, Agneta
    Hagströmer, Maria
    Brismar, Kerstin
    Johansson, Unn-Britt
    Sophiahemmet University.
    Support for self-management of physical activity in persons with prediabetes and type 2 diabetes: Experiences from Sophia Step Study2017Conference paper (Other academic)
  • 122.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Lööf, Helena
    Sophiahemmet University.
    Yngve, Agneta
    Sophiahemmet University.
    Hagströmer, Maria
    Brismar, Kerstin
    Johansson, Unn-Britt
    Sophiahemmet University.
    Using pedometers for self-management of physical activity: Participants' experiences from Sophia Step Study: A physical activity promotion intervention in pre- and type 2 diabetes2017Conference paper (Other academic)
  • 123.
    Rossen, Jenny
    et al.
    Sophiahemmet University.
    Yngve, Agneta
    Sophiahemmet University.
    Hagströmer, M
    Brismar, Kerstin
    Ainsworth, B
    Möller, P
    Iskull, C
    Johansson, Unn-Britt
    Sophiahemmet University.
    Sophia step study: An RCT using pedometers to increase daily steps in subjects with pre and type 2 diabetes2015Conference paper (Other academic)
  • 124.
    Rydell Karlsson, Monica
    et al.
    Sophiahemmet University.
    Edner, Magnus
    Henriksson, Peter
    Patient-based vs. nurse-based NYHA classification of patients with chronic heart failure: influence of mood2008In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 7, no Suppl 1, S17- p.Article in journal (Other academic)
    Abstract [en]

    Patients' symptom perceptions and grade of depression have recently been recognized to hold otherwise unrecognized prognostic information in patients with chronic heart failure (CHF)

  • 125.
    Rydell-Karlsson, Monica
    Sophiahemmet University.
    Knowledge Acquisition in Patients with Heart Disease2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The general aim was to evaluate different aspects of the knowledge acquisition process in patients with heart disease. Three different education programs were evaluated.

    In Paper I 208 patients with systolic heart failure (HF) aged >60 years, were included. They were randomized to the nurse-based outpatient clinic or to the patients´ general practitioners (GP). The aim was to assess effects of a nurse-based management program – intended to increase the knowledge of the HF disease and its self-care – and relate the results to gender and cognitive function. The results showed that the nurse-based outpatient clinic has an important role in patient education, and increases patients´ knowledge about self-care and the disease. The results indicate that females have more to gain than men from such management programs. Patients demonstrating signs of cognitive dysfunction when in hospital did also benefit.

    In Paper II 224 patients, aged <75 years suffering from an acute AMI or who had underwent coronary artery by-pass grafting, were randomized to intervention (an expanded cardiac rehabilitation program) or to control (usual care). The aim was to investigate the effect of an expanded cardiac rehabilitation program on psychosocial characteristics including depression, anxiety, and quality of life (QoL) in type D and non-type D coronary artery disease (CAD) patients. The results show that an expanded rehabilitation program significantly reduces type D score, improves QoL, and decreases self-estimated depression and anxiety in CAD patients in the highest quartile of type D score.

    In Paper III and IV 182 patients with chronic heart failure (CHF) were included and referred to the nurse-based outpatient clinic. They were randomized to intervention (patients decided on how they should be informed and by which information technique) or to control (the nurse decided according to usual routine).

    The aim in Paper III was to compare patient-based selection of information with nurse-based selection of information in patients with HF and to evaluate the effects on knowledge acquisition, QoL, visits to the outpatient clinic, drug therapy and readmissions. Patients had fewer visits to the nurse-based outpatient clinic and a trend to a more flexible diuretic regimen, if patients were involved in the decision on how to be informed. Both groups increased QoL, knowledge their doses of relevant medication, and readmissions did not differ between the two groups.

    The aim in Paper IV was to compare patient-based and nurse-based New York Heart Association (NYHA) classification and its relation to grade of depression and knowledge acquisition in patients with HF. The results show a mismatch between the NYHA classifications performed by patients respectively by the nurse. Furthermore, patients in a depressed mood at baseline had more clinical events during the first year after hospitalization due to CHF. However, there was no difference in knowledge acquisition between patients in a depressed mood as compared to patients in a normal mood.

    The conclusion is that information given at a nurse-based outpatient clinic has an important role in patient education. Females and patients with in-hospital cognitive dysfunction had the greatest gains Patients who are involved in the decision on how to be informed had fewer visits to the nurse-based outpatient clinic. The fewer visits did not affect knowledge, QoL, readmissions, or medical treatment in a negative way. Patients assessed a higher NYHA class than a nurse. Patients who were depressed had an increased incidence of clinical events during the first year after hospitalisation due to HF. There was no difference in knowledge acquisition between patients in a depressed mood as compared to patients in a normal mood. An expanded rehabilitation program significantly reduces type D score, improves quality of life, and decreases self-estimated depression and anxiety in patients with CAD in the upper quartile of type D score.

  • 126.
    Rådestad, Ingela
    Sophiahemmet University.
    Fetal movements in the third trimester: important information about wellbeing of the fetus2010In: Sexual & Reproductive HealthCare: Official Journal of the Swedish Association of Midwives, ISSN 1877-5756, EISSN 1877-5764, Vol. 1, no 4, 119-121 p.Article in journal (Other academic)
    Abstract [en]

    It can be quite natural for pregnant women to believe that a decrease in the frequency of fetal movements at the end of pregnancy is normal if they have been so informed. There is also probably scope for interpretation concerning what is to be regarded as a decrease in the number of movements. Non-evidence-based information that a decrease in fetal movements is normal during the third trimester poses a threat to the unborn baby's life. If the mother does not react to a decrease in frequency and if she waits too long before contacting healthcare professionals, the window of opportunity to save the baby's life may be closed.

  • 127.
    Rådestad, Ingela
    Sophiahemmet University.
    Fostrets rörelser2016In: Reproduktiv hälsa: barnmorskans kompetensområde / [ed] Helena Lindgren, Kyllike Christensson & Anna-Karin Dykes, Lund: Studentlitteratur AB, 2016, 1, 284-288 p.Chapter in book (Other academic)
  • 128.
    Rådestad, Ingela
    Sophiahemmet University.
    Intrauterin fosterdöd2016In: Reproduktiv hälsa: barnmorskans kompetensområde / [ed] Helena Lindgren, Kyllike Christensson & Anna-Karin Dykes, Lund: Studentlitteratur AB, 2016, 1, 417-425 p.Chapter in book (Other academic)
  • 129.
    Rådestad, Ingela
    Sophiahemmet University.
    Mindfetalness: Structured observation of fetal movements2017Conference paper (Other academic)
  • 130.
    Rådestad, Ingela
    Sophiahemmet University.
    När ett nyfött barn dör2016In: Reproduktiv hälsa: barnmorskans kompetensområde / [ed] Helena Lindgren, Kyllike Christensson & Anna-Karin Dykes, Lund: Studentlitteratur AB, 2016, 1, 740-742 p.Chapter in book (Other academic)
  • 131.
    Rådestad, Ingela
    et al.
    Sophiahemmet University.
    Henley, K
    Sormunen, Taina
    Sophiahemmet University.
    Perinatal palliative care after a stillbirth: Midwives experiences of using Cubitus baby2017Conference paper (Other academic)
  • 132. Rådestad, Ingela
    et al.
    Säflund, Karin
    Wredling, Regina
    Sophiahemmet University.
    Onelöv, Erik
    Steineck, Gunnar
    Holding a stillborn baby: mother's feelings of tenderness and grief2009In: British Journal of Midwifery, ISSN 0969-4900, Vol. 17, no 3, 178-80 p.Article in journal (Other academic)
    Abstract [en]

    Actions by health professionals and the atmosphere surrounding the birth of a stillborn baby may determine the nature of the mother’s contact with her baby. A questionnaire studied mothers’ feelings when holding their stillborn baby. A total of 33 mothers of stillborn babies born after 22 weeks completed the questionnaire three months after the birth. All mothers saw their baby. Before meeting the baby, 23 women had feelings of being afraid. Thirty-one mothers held their baby. When holding their baby all mothers felt tenderness and grief, 29 warmth and 25 prides. Fifteen mothers at the same time felt insecure when holding the baby, 12 had feelings of discomfort and 11 feelings of fear. A hypothesis for future investigations is that the more that a mother can be prepared for what is to come after birth, the better the chance that feelings of fear or discomfort can be diminished.

  • 133.
    Rüter, Anders
    Sophiahemmet University.
    Incident site command and control2013In: Disaster management: medical preparedness, response and homeland security / [ed] Rajesh Arora & Preeti Arora, Wallingford: CABI Publishing, 2013, 164-180 p.Chapter in book (Other academic)
  • 134. Sahlin, Ellika
    et al.
    Nordenskjöld, Magnus
    Gustavsson, Peter
    Wincent, Josephine
    Georgsson, Susanne
    Sophiahemmet University.
    Iwarsson, Erik
    Positive attitudes towards non-invasive prenatal testing (NIPT) in a Swedish cohort of 1,003 pregnant women2016Conference paper (Other academic)
  • 135.
    Samuelsson, Bodil
    Sophiahemmet University.
    Gender differences in patients with hip fracture: aspects on care and recovery2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Hip fractures in the elderly are common and impose a substantial burden on the healthcare system. This fracture population consists of many subgroups that often require differentiated and extensive acute and postfracture care. The aim of this thesis was to basically characterise a hip fracture population at time of admission, present postoperative results and discuss aspects that may influence recovery. Gender differences are specifically addressed.  Study I, II and IV derive from a consecutive series of 2213 patients with hip fracture admitted to four major hospitals in Stockholm, while Study III was a small pilot study.      In Study I we investigated the effect of time-to-surgery on: ability to return to own home, incidence of pressure ulcers, length of stay (LOS), and mortality. Patients who had surgery within 24, 36 or 48 hours were compared with those who had surgery later. The ability to return to own home was affected in patients who had to wait longer than 36 and 48 hours. The incidence of pressure ulcers and LOS increased at all time limits. In Study II we investigated gender differences in two subgroups, characterized by normal cognitive function versus cognitive dysfunction, and whether such differences influenced patient ability to: return to own home, regain walking ability and perform activities of daily living (ADL). Cognitive function was assessed by the Short Portable Mental Status Questionnaire (SPMSQ). Dysfunction was equally common by gender. Patients with normal function (SPMSQ 8-10) were younger and healthier, resided more often in their own homes and were able to manage ADL independently, with no gender differences. In patients with dysfunction (SPMSQ 0-7), men had more comorbidity on admission, greater loss of walking ability and higher mortality after the fracture episode. We found that cognitive status was the overarching most important factor for predicting outcome. In Study III we examined gastric emptying time of 400 ml carbohydrate rich drink in ten elderly women with acute hip fracture, and compared results with two reference groups of healthy women. The mean half gastric emptying time in the study group was 57 ± 5 (39-82) minutes, to be compared with 58 ±4 (41-106) and 58 ±5 (33-72) in the two reference groups. No adverse event was observed during anesthesia. Consequently, it should be possible to give patients a carbohydrate-rich drink before surgery instead of ordering strict fasting (NPO), which in turn could improve the patients’ chances to recover and regain prefracture status. In Study IV we focused on gender differences in complications; specifically on factors associated with common general complications. Complications were common with an incidence of 59% in men and 56% in women (ns). Most common were urinary tract infection, pressure ulcer, cardiac complications and pneumonia. Male gender emerged as an independent risk factor for suffering from pneumonia, and female gender for urinary tract infection. Besides gender, time-to-surgery, cognitive function, cardiovascular and pulmonary disease on admission were independent risk factors for suffering complication. In conclusion, there are gender differences among patients admitted to a hospital for acute hip fracture, both with regard to status on admission and outcome. Cognitive dysfunction, equally common among women and men, has a major impact on incidence of complication and functional recovery. Men with cognitive dysfunction are at greater risk. With increased awareness of risk factors and gender bias, along with reduced waiting time for surgery, it should be possible to decrease complication incidence and improve outcome. We found no evidence for prolonged gastric emptying time of a carbohydrate-rich beverage, which implies it may be possible to provide patients with a carbohydrate-rich drink before surgery instead of adhering to strict fasting

  • 136.
    Samuelsson, Bodil
    et al.
    Sophiahemmet University College.
    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 patientsManuscript (preprint) (Other academic)
  • 137. Sandgren, Anna
    et al.
    Axelsson, Lena
    Sophiahemmet University.
    Bylund Grenklo, Tove
    Benzein, Eva
    Family members' expressions of dignity in palliative care2017Conference paper (Other academic)
  • 138. Segerdahl, Märta
    et al.
    Niklasson, Boel
    Sophiahemmet University.
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Blanck, Agneta
    Boström, E
    Oxycodone for postoperative pain control after Cesarean section: oxycodone and metabolites' distribution into breast milk and effect on neonate NACS scoreManuscript (preprint) (Other academic)
  • 139. Simon, Michael
    et al.
    Griffiths, Peter
    Kottner, Jan
    Unbeck, Maria
    Sterner, Eila
    Sophiahemmet University.
    Elg, Mattias
    Fossum, Bjöörn
    Sophiahemmet University.
    Thor, Johan
    PukkHärenstam, Karin
    Beckstead, Jason W
    'Choose your tool wisely: U charts are more informative than run charts with or without tests of significance. A comment on Unbeck et al. (2014), Unbeck et al. (2013) and Kottner (2014)': Authors' response (Unbeck and colleagues)2015In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 52, no 1, 481-486 p.Article in journal (Other academic)
  • 140.
    Siouta, Eleni
    Sophiahemmet University.
    Communication in Patient Involvement in Decision making: Examples from consultations on atrial fibrillation2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Abstract

    Background: Further knowledge is needed regarding communication that occurs in practice between patients with atrial fibrillation (AF) and health professionals in consultations to understand the issue of patient involvement in treatment decisions.

    Overall aim: The overall aim of this thesis is to contribute knowledge on communication between patients and health professionals (cardiology nurses and cardiologists), focussing on how they create involvement in decision making in consultations.

    Specific aims: (1) To describe (i) the topics that patients with AF discuss with cardiology nurses and cardiologists; (ii) the use of discursive space in consultations between these participants; and (iii) the frequency at which patients, cardiology nurses, and cardiologists introduce identified topics. (2) To describe the different types of resistance by patients to treatment with warfarin and how cardiologists respond to such resistance. (3) To examine how patients describe involvement and communication in decision making regarding treatment in consultations with cardiology nurses and cardiologists. (4) To examine how cardiologists describe their views on patient involvement in AF treatment decisions, their perceptions regarding efforts to involve patients, and how they handle decisions.

    Methods: A qualitative design was used. In study I, the sample consisted of 23 videotaped consultations between patients with AF and cardiology nurses and cardiologists at six nurse-led cardiology outpatient clinics. Content analysis was used to obtain a description of topics that were discussed. The patterns of dominance for the various topics and participants were examined. In study II, the sample consisted of 11 videotaped consultations between patients with AF and cardiologists. Conversation analysis was used to describe interactions concerning resistance to treatment with warfarin. In study III, 22 patients with AF were interviewed directly after their consultations with cardiology nurses and cardiologists. Content analysis was used for the resulting data. In study IV, 10 cardiologists were interviewed in cardiology clinics at four Swedish hospitals and qualitative content analysis was used.

    Findings: In study I, a medically driven agenda dominated the patient-driven agenda. However, when the patients initiated conversations about their life with AF (the topic that received the least amount of space on the agenda), involvement was created. In study II, the patients’ resistance could be viewed as a source of knowledge about patients’ real-life situations and what motivates them. In study III, despite not being actively involved in the decision-making process, the patients experienced a sense of involvement when they felt understood and were listened to. In study IV, by taking into account the patients’ feelings in the consultations, and by actively encouraging the patients to be involved, the cardiologists contributed to patient involvement.Conclusions: Patients, cardiology nurses, and cardiologists create involvement in decision making in consultations as communicative projects. Patients strive for space and create involvement by showing resistance to the decisions suggested by health professionals. However, involvement is not only an issue about obtaining space in the consultations, but is also associated with obtaining clarification, building confidence, feeling understood, trusting cardiology nurses and cardiologists, and having confidence in receiving consistent care within an established relationship. On a theoretical level, this thesis sheds light on the interaction between the concepts of communication, involvement, and decision making.

  • 141. Siouta, Eleni
    et al.
    Hellström Muhli, Ulla
    Fossum, Bjöörn
    Sophiahemmet University.
    Karlgren, Klas
    Cardiologists' experiences and perceptions of patient involvement and communication related to shared decision-making regarding atrial fibrillation treatmentManuscript (preprint) (Other academic)
  • 142. Skavberg Roaldsen, Kirsti
    et al.
    Lindholm, Christina
    Sophiahemmet University.
    Fysisk aktivitet och träning vid venös och arteriell insufficiens och bensår2012In: Äldres hälsa: ett sjukgymnastiskt perspektiv / [ed] Elisabeth Rydwik, Lund: Studentlitteratur, 2012, 1, 259-270 p.Chapter in book (Other academic)
  • 143.
    Sormunen, Taina
    et al.
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    Aanesen, A
    Karlgren, K
    Infertility related communication and coping strategies among women affected by fertility problems in Sweden2016Conference paper (Other academic)
  • 144.
    Stern, Jenny
    Sophiahemmet University.
    The reproductive life plan2017Conference paper (Other academic)
  • 145.
    Sterner, Eila
    Sophiahemmet University.
    Pressure ulcers - role of the nurse to improve patient safety: prevalence, risk factors, classification and documentation in patients undergoing hip surgery2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Pressure ulcer is a common complication in hip fracture surgery and convalescence. Earlier prevalence studies have demonstrated a lower prevalence in Southern Europe than in Northern Europe. In patients with hip fractures, specific risk factors for developing pressure ulcers, apart from those included in standardised risk assessment are not fully understood. Correct classification of Category I pressure ulcers is a prerequisite for planning preventive measures. It is also mandatory for the reliability of prevalence studies. Until now subjective tests such as finger-press test and visual assessment have been utilised in clinical practice. An objective method has hitherto been lacking. Planning and delivering good nursing care to patients who are at risk of, or already have, manifest pressure ulcers should be built on proper documentation. Degree of documentation of pressure ulcer prevalence and risk factors in patients with hip fractures versus elective hip replacement surgery has hitherto not been investigated. Scrutiny of medical records for these diagnoses and identification of potential differences should therefore be of interest.Aim: - To investigate prevalence and incidence of pressure ulcers upon arrival and at discharge from hospital, and to identify potential intrinsic and extrinsic risk factors for the development of pressure ulcers in patients admitted for hip fracture surgery. To establish the inter-rater reliability between blanching and non-blanching erythema, assessed by two independent assessors. The secondary purpose was to investigate potential correlations between risk factors and pressure ulcers. - To explore if a non-invasive objective method could differentiate between blanching/nonblanching erythema in the sacral area of patients undergoing hip fracture surgery. - To investigate the degree of documentation regarding risk assessment, preventive measures taken, prevalence and severity of pressure ulcers, in patients undergoing surgery for hip fractures or elective hip replacements at admission and during hospital care at an orthopaedic unit.Results: The prevalence of pressure ulcers in Southern Europe was lower compared to Northern Europe. Specific risk factors such as dehydration (p=.005), moist skin (p=.004), pulmonary disease (p=.006) and diabetes (p=.005) were identified. The finger-press test and visual assessment of Category I pressure ulcers were both unreliable methods with low interrater reliability. The proportion of patients with persistent discoloration differed significantly between the assessors from Day 1 to Day 5 (p = .013). Reflectance spectrophotometer used was proven to deliver high precision regarding classification of non-blanchable erythema (Category I pressure ulcers). Documentation of pressure ulcers, risk assessment, body mass index and prevention at admittance was unsatisfactory in patients undergoing hip surgery.

  • 146.
    Sterner, Eila
    Sophiahemmet University College.
    Regionalt vårdprogram: trycksår : prevention och behandling2010Report (Other academic)
  • 147.
    Sterner, Eila
    et al.
    Sophiahemmet University.
    Unbeck, M
    Lindholm, Christina
    Sophiahemmet University.
    Stark, A
    Gordon, M
    Fossum, Bjöörn
    Sophiahemmet University.
    Poor documentation of risk factors and prevention strategies for pressure ulcers in orthopedic inpatientsManuscript (preprint) (Other academic)
  • 148.
    Styrwoldt, Eva
    et al.
    Sophiahemmet University.
    Hybinette, Caroline
    Sophiahemmet University.
    Läkemedel inom ambulanssjukvården2016In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud & Lars Lundberg, Stockholm: Liber, 2016, 2, 534-539 p.Chapter in book (Other academic)
  • 149.
    Stålvant, Johan
    Sophiahemmet University.
    Palliativ omvårdnad2014In: Sjuksköterskans omvårdnadskunnande: en praktisk och teoretisk grundbok / [ed] Birgitta Klang Söderkvist & Ingrid Thorell-Ekstrand, Harlow: Pearson Education Limited , 2014, 343-358 p.Chapter in book (Other academic)
  • 150. Svantesson, Lena
    et al.
    Georgsson Öhman, Susanne
    Sophiahemmet University.
    Psykologiska aspekter på fosterdiagnostik2009In: Lärobok för barnmorskor / [ed] Annette Kaplan et al., Lund: Studentlitteratur , 2009, 3, 216-17 p.Chapter in book (Other academic)
1234 101 - 150 of 169
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