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  • 2451. Åhlund, Susanne
    et al.
    Rothstein, Emilia
    Rådestad, Ingela
    Sophiahemmet University.
    Zwedberg, Sofia
    Sophiahemmet University.
    Lindgren, Helena
    Urinary incontinence after uncomplicated spontaneous vaginal birth in primiparous women during the first year after birth2019In: International Urogynecology Journal, ISSN 0937-3462, E-ISSN 1433-3023Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION AND HYPOTHESIS: Urinary incontinence (UI) is associated with pregnancy and parity and can cause health problems for women. Our objective was to explore risk factors for UI and its effect on women's daily activities, psychological health and wellbeing 9-12 months postpartum in a low-risk primiparous population.

    METHODS: In this prospective cohort study, first-time mothers in a low-risk population with a spontaneous vaginal birth reported the occurrence of UI and its effect on daily activities and on their psychological health and wellbeing in a questionnaire completed 1 year after birth. Descriptive and comparative statistics were employed for the analysis.

    RESULTS: A total of 410 women (75.7%) completed the questionnaire. The self-reported rates of stress urinary incontinence, urge urinary incontinence and mixed urinary incontinence were 45.4%, 38.0% and 27.0% respectively. Neither the duration of the second stage of labour, the baby's head circumference or its birth weight were associated with the incidence of UI. There was an association between reported negative impact on daily activities and more negative psychological wellbeing (p < 0.001).

    CONCLUSIONS: Urinary incontinence was common among primiparous women at 9-12 months postpartum. Women whose symptoms had a negative impact on their daily activities reported more psychological suffering.

  • 2452. Åhlund, Susanne
    et al.
    Rådestad, Ingela
    Sophiahemmet University.
    Zwedberg, Sofia
    Sophiahemmet University.
    Edqvist, Malin
    Lindgren, Helena
    Haemorrhoids - A neglected problem faced by women after birth2018In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 18, p. 30-36, article id S1877-5756(18)30042-9Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the prevalence and severity of haemorrhoids after birth among first-time mothers in relation to management during the second stage of labour and to describe the women's experiences with haemorrhoids.

    METHOD: A mixed method explanatory sequential design was used. Nulliparous women were allocated to an intervention group for whom the second-stage of labour practice followed the MIMA model (Midwives management during second stage of labour) or to a control group for whom standard-care practice was followed. Data were collected three weeks and 1.5 years after birth.

    RESULT: A total of 496 (82.1%) women responded to the questionnaire three weeks after birth, 120 (70%) responded to the questionnaire 1.5 years after the birth. The women in the intervention group had fewer symptoms from haemorrhoids three weeks after birth compared to the women in the control group (adj. OR 0.6 95% CI 0.4-0.9). Half of the women in the intervention and control group (50.8%) who reported problems with haemorrhoids three weeks after birth still experienced problems after 1.5 years. The majority of all women did not seek medical care due to their symptoms. The women who described that they experienced haemorrhoids as a problem after birth felt neglected by the healthcare system.

    CONCLUSION: A substantial percentage of women had symptoms from haemorrhoids after birth. Many of these women felt that their problems were neglected. Women who experienced a slow birth of the baby's head and spontaneous pushing suffered less from haemorrhoids 3 weeks after birth.

  • 2453. Åhlund, Susanne
    et al.
    Rådestad, Ingela
    Sophiahemmet University.
    Zwedberg, Sofia
    Sophiahemmet University.
    Lindgren, Helena
    Perineal pain the first year after childbirth and uptake of post-partum check-up: A Swedish cohort study2019In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 78, p. 85-90, article id S0266-6138(19)30208-6Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this prospective cohort study was to investigate the prevalence of perineal pain related to the perineal injury within the first year after childbirth. The study further explored the rates of postpartum check-up attendance, and whether they had undergone a vaginal examination, pelvic floor assessment and exercise advice.

    RESEARCH DESIGN: The primary outcome was women's self-perceived and selfreported occurrence of pain related to perineal injuries (within three, six and 12 months) after birth. Secondary outcomes were uptake of postpartum check-up six to 12 weeks after birth and care received at the check-up. A postal questionnaire was completed one year after birth. Descriptive data was used to present data.

    FINDINGS: A total of 461 Swedish women (77%) were included in the study. The majority of women with severe perineal injuries (75.0%), and 61.8% of those with moderate injuries II suffered from perineal pain three months postpartum, while 60% with severe injuries and 38.7 with moderate injuries II still had perineal pain six months after birth. The postpartum check-up was attended by 90.6%. However, one out of four had not been given a pelvic examination or advised about pelvic floor exercises.

    KEY CONCLUSION: Many primiparas suffer from pain related to perineal injuries during the first year after birth. One out of ten women has problems with perineal pain one year postpartum. It is essential to investigate and recognize the impact of perineal pain on women's daily life and psychological and emotional wellbeing at the postpartum checkup.

  • 2454. Åhlund, Susanne
    et al.
    Zwedberg, Sofia
    Sophiahemmet University.
    Hildingsson, Ingegerd
    Edqvist, Malin
    Lindgren, Helena
    Midwives experiences of participating in a midwifery research project: A qualitative study2018In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 31, no 2, p. e115-e121, article id S1871-5192(17)30140-3Article in journal (Refereed)
    Abstract [en]

    PROBLEM AND BACKGROUND: In an earlier research project midwives were asked to perform women-centered care focusing on the assumption that the physiological process in the second stage of labour could be trusted and that the midwives role should be encouraging and supportive rather than instructing. There is no knowledge about how midwives participating in such a research project, uses their skills and experience from the study in their daily work.

    AIM: The aim in this study was to investigate how midwives experienced implementing woman-centered care during second stage of labour.

    METHODS: A qualitative study was designed. Three focus groups and two interviews were conducted. The material was analysed using content analysis.

    FINDINGS: The participating midwives' experiences were understood as increased awareness of their role as midwives. The overarching theme covers three categories 1) establishing a new way of working, 2) developing as midwife, 3) being affected by the prevailing culture. The intervention was experienced as an opportunity to reflect and strengthen their professional role, and made the midwives see the women and the birth in a new perspective.

    CONCLUSIONS: Implementing woman-centered care during second stage of labour gave the midwives an opportunity to develop in their professional role, and to enhance their confidence in the birthing women and her ability to have a physiological birth. To promote participation in, as well as conduct midwifery research, can enhance the development of the midwives professional role as well as contribute new knowledge to the field.

  • 2455.
    Åhs, Ulrika
    et al.
    Sophiahemmet University College.
    Öijvall, Erika
    Sophiahemmet University College.
    Smärta hos personer med demenssjukdom: smärtindikatorer och smärtskattningsinstrument2005Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2456.
    Åkerholm, Marcus
    Sophiahemmet University College.
    Ambulanssjuksköterskans dokumentation och behandling med spinal immobilisering prehospitalt: En retrospektiv studie i Uppsala län2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 2457.
    Åkerlund, Susanne
    Sophiahemmet University.
    Sjuksköterskans arbete i frontlinjen: - och hur detta arbete dokumenteras i akutjournalen på akutmottagning2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 2458.
    Åkerman, Madeleine
    Sophiahemmet University.
    Att vårda personer med demenssjukdom i sluten hälso- och sjukvård: en litteraturöversikt utifrån sjuksköterskors upplevelse2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I sluten hälso- och sjukvård har sjuksköterskan som ansvar att tillgodose patienternas omvårdnadsbehov. Symtom kopplat till demenssjukdom innebär att drabbade personer har ett komplext vårdbehov. Det rekommenderas att vården av personer med demenssjukdom ska genomsyras av ett personcentrerat förhållningssätt. 

     

    Syftet var att belysa sjuksköterskors upplevelse av att vårda personer med demenssjukdom inom sluten hälso- och sjukvård

     

    Som metod har en litteraturöversikt använts. Inkluderade artiklar har sökts i databaserna Cinahl, PsycINFO och MEDLINE. Sammanlagt inkluderades 15 artiklar i studien.

     

    Resultatet visar att sjuksköterskornas upplevelse av att vårda personer med demenssjukdom bottnar i tre teman, Upplevelse av att vårda, Upplevelse av frustration och emotionell stress samt Upplevelse av att sätta patientsäkerhet före patientens behov. Sjuksköterskor önskade ökade kunskaper om demenssjukdom. De försökte skapa individuellt anpassad vård genom att tolka patienternas signaler och behov. Detta kunde vara svårt på grund av kommunikationshinder. Frustration och emotionell stress orsakades av organisatoriska faktorer och av en vårdmiljö som inte var anpassad till personer med demenssjukdom. Sjuksköterskor upplevde att vården av personer med demenssjukdom tog mycket av deras tid i anspråk vilket även gick ut över medpatienter. Det framkom att patienternas säkerhet prioriterades före deras behov, ofta användes begränsningsåtgärder för att värna om patientsäkerheten.

     

    Slutsatsen visar att sjuksköterskor i sluten hälso- och sjukvård upplever att vården av personer med demenssjukdom ärr tidskrävande och på grund av vårdens organisatoriska struktur och rutiner skapas frustration och emotionell stress. Sluten hälso- och sjukvård med dess organisation och rutiner främjar inte vården för personer med demenssjukdom. Utifrån personcentrerad omvårdnad får sjuksköterskor ett förhållningssätt att anpassa vården för denna patientgrupp, för det är vården som organisation som måste anpassas till personer med demenssjukdom, inte tvärt om. En anpassning skapar vinster för personer med demenssjukdom, sjuksköterskor och andra yrkeskategorier.

  • 2459.
    Åkerström, Susanne
    Sophiahemmet University College.
    Att få vara tillsammans: effekten av samvård på pappors emotionella välbefinnande, en randomiserad kontrollerad studie2009Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 2460. Årestedt, Kristofer
    et al.
    Alvariza, Anette
    Boman, Kurt
    Öhlén, Joakim
    Goliath, Ida
    Håkanson, Cecilia
    Sophiahemmet University.
    Fürst, Carl Johan
    Brännström, Margareta
    Symptom Relief and Palliative Care during the Last Week of Life among Patients with Heart Failure: A National Register Study2018In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 21, no 3, p. 361-367Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Heart failure is a disease with high morbidity, mortality, and physical and psychological burden. More knowledge about the care provided for patients with heart failure close to death is needed.

    OBJECTIVE: The aim was to describe key aspects of palliative care during the last week of life in patients with heart failure, as reported by healthcare professionals.

    DESIGN: This is a national register study.

    SETTING/SUBJECTS: The study included 3981 patients with diagnosed heart failure as the underlying cause of death.

    MEASUREMENTS: Data were obtained from the Swedish Register of Palliative Care, a national quality register that focuses on patients' last week of life, independent of diagnosis or care setting. The register includes information about care interventions connected with key aspects of palliative care. Data are reported retrospectively by a nurse or physician at the healthcare unit where the patient dies.

    RESULTS: Only 4.2% of patients with heart failure received specialized palliative care. In their last week of life, symptom prevalence was high, validated scales were seldom used, and symptoms were unsatisfactorily relieved. Around one-fifth (17%) of the patients in the study died alone. Less than half of family members had been offered bereavement support (45%). Moreover, one-third (28%) of the patients and more than half (61%) of the family members were reported to have had end-of-life discussions with a physician during the illness trajectory.

    CONCLUSION: The results indicate inadequate palliative care for patients with heart failure during their last week of life.

  • 2461.
    Åslev, Helena
    Sophiahemmet University.
    Hälsorelaterad livskvalitet före och efter laparoskopisk tarmresektion vid koloncancer2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 2462.
    Åslund, Christian
    Sophiahemmet University.
    Det prehospitala mötet mellan två specialistkompetenser: ambulanssjuksköterskans och anestesisjuksköterskans upplevelser av samarbetet vid omhändertagandet av den svårt sjuke eller skadade patienten2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    When assessing and caring for a critically ill or injured patient, it is essential that the cooperation and interaction within the group of pre-hospital providers functions at its best. Questions about competencies and who will be medically in charge of the case plays an important role. In Stockholm County Council (SCC) emergency medical services (EMS) two specialist nurse competencies meet, the nurse anesthetist in the rapid response unit and the ambulance nurse in the ambulance. Both specialist nurses are formally equal concerning the highest medical competence. The medical guidelines in SCC states that the highest formal medical competence is also in charge of the case. When two formally equal, but clinically different nurse competencies collaborate, the nurse most suited for the task is also considered to be in charge. There is room for interpretation, which can lead to unclarity in who should be in charge, based on different competencies.

    The aim of the study was to describe the experiences of the two specialist nurse competencies on cooperation and interaction when attending the same priority 1 case, concerning who is in charge and to identify factors influencing the cooperation and interaction.

    The method used was qualitative interview. Using an interview guide based on critical incident technique (CIT) three focus group interviews were conducted. Six ambulance nurses and four nurse anesthetists participated. The interviews resulted in 31 critical incidents. The data were analyzed with qualitative inductive content analysis.

    In the results two themes emerged. Situational management from the categories; perception of competence, perception of the division of responsibility and the perception of confidence generating factors. Also, management by resource optimization from the categories leadership and cooperation.

    The conclusions that can be drawn from the results are that the specialist nurses can create a functioning cooperation and interaction through collegial respect for each other’s competencies, situational adaption and the use of resources available at the time being. This way a conflict is avoided in the question on who should be in charge.

  • 2463.
    Åslund, Christian
    Sophiahemmet University.
    Larynxmasken som hjälpmedel för ambulanssjuksköterskan vid omvårdnaden av patienten med luftvägs- och andningsproblematik: en litteraturöversikt2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2464.
    Öberg, Helena
    et al.
    Sophiahemmet University College.
    Eriksson-Roxfur, Charlotte
    Sophiahemmet University College.
    Musikens betydelse i omvårdnaden av personer med demenshandikapp2005Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 2465.
    Öhlen, Jenny
    Sophiahemmet University.
    Sjuksköterskestudenters förväntningar av att ge palliativ vård: hur förbereder en kurs inom palliativ vård sjuksköterskestudenter, en kvalitativ deskriptiv studie2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Background: To train as a nurse is not just an education that is completed and when done there is a nurse ready for everything. There is a process for many students and things might happen that changes the student as a person. Caring for the dying patient changes student's attitude towards nursing. Students wish that education in palliative care should be included in the foundation of nursing. Students should be able to understand both the patient and the nursing process which is the goal of clinical training (CT). Unless the student is well prepared for meeting with the dying patient, there is a risk that the student avoids these meetings. Students describes that they have feelings such as anxiety and frustration associated with palliative care. To raise students' experience of palliative care, it is important to share their feelings, thoughts and experience. Aim: The aim of this study was to illuminate nursing students' expectations of giving palliative care and how dose a course in palliative care prepare the student for their first CT in hospitals and their future role as a nurse Method: Data has been collected through qualitative method with an inductive approach. Data were collected during December 2014 from a university in Sweden through a focus group discussion and through selected parts from the nursing students' reflection data. Descriptive study design was used. The collected data were analysed by qualitative content analysis. Results: The own experience, both personal and professional, affecting nursing student's expectations of palliative care. It was considered important to gather experience in palliative care. The nursing student's expected new knowledge. However, they did not expect to be affected as they were. Feelings and thoughts were raised during the course that moved from sadness and despair to joy and love. Preparatory face of death was described in which death is something beautiful where worry and anxiety do not exist. It was considered important as the foundation of care balance between compassion and professionalism and that the nurse must be able to communicate. The nurse working in palliative care should not be afraid of death. Death should be seen as a normal process where life is affirmed. Everyone have the same right to palliative care regardless of diagnosis or culture. A course in palliative care prepares the student for future CT and the future role as a nurse and is considered as an important part of education. The course in palliative care caught some of the student's interest and strengthened an already existing interest. Different forms of education should be mixed for a good result and most importantly in the education is time for reflection and to share experiences. Students reflected about their own death, and also family member's eventual death, this was considered as important and part of the process and the maturity of the students. Conclusions: Nursing students in the present study discloses that palliative care is important and interesting topic where life is affirmed and death is seen as a normal process. Nursing students get the opportunity to reflect on feelings. Given opportunity to reflect on their own or family members' possible death is what emerges strongly in the results. The students describe the importance of varying forms of training where reflection and shared experience is highlighted as the main components of the program. The expectation of palliative care is about curiosity to meet with the dying patient and his relatives.

  • 2466. Öhlén, Joakim
    et al.
    Reimer-Kirkham, Sheryl
    Astle, Barbara
    Håkanson, Cecilia
    Sophiahemmet University.
    Lee, Joyce
    Eriksson, Marjukka
    Sawatzky, Richard
    Person-centred care dialectics-Inquired in the context of palliative care2017In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 18, no 4Article in journal (Refereed)
    Abstract [en]

    Although a widely used concept in health care, person-centred care remains somewhat ambiguous. In the field of palliative care, person-centred care is considered a historically distinct ideal and yet there continues to be a dearth of conceptual clarity. Person-centred care is also challenged by the pull of standardization that characterizes much of health service delivery. The conceptual ambiguity becomes especially problematic in contemporary pluralistic societies, particularly in the light of continued inequities in healthcare access and disparities in health outcomes. Our aim was to explicate premises and underlying assumptions regarding person-centred care in the context of palliative care with an attempt to bridge the apparently competing agendas of individualization versus standardization, and individuals versus populations. By positioning person-centredness in relation to the hermeneutics of the self according to Paul Ricœur, dialectics between individualization and standardization, and between individuals and populations were constructed. The competing agendas were related in a dialectic manner in the way that population health is of importance for the individual, and standardization is of importance for the population. The analysis suggests that person-centred care is an ethical stance, which gives prominence to both suffering and capability of the individual as a person. The dialectic analysis points towards the importance of extending person-centred care to encompass population and societal perspectives and thereby avoiding a problematic tendency of affiliating person-centred care with exclusively individualistic perspectives. Considerations for person-centred palliative care on micro-, meso- and macrolevels conclude the paper.

  • 2467. Öhlén, Joakim
    et al.
    Sawatzky, Richard
    Pettersson, Monica
    Sarenmalm, Elisabeth Kenne
    Larsdotter, Cecilia
    Sophiahemmet University.
    Smith, Frida
    Wallengren, Catarina
    Friberg, Febe
    Kodeda, Karl
    Carlsson, Eva
    Preparedness for colorectal cancer surgery and recovery through a person-centred information and communication intervention: a quasi-experimental longitudinal design.2019In: PLoS ONE, E-ISSN 1932-6203, Vol. 14, no 12, article id e0225816Article in journal (Refereed)
    Abstract [en]

    To meet patients' information and communication needs over time in order to improve their recovery is particularly challenging for patients undergoing cancer surgery. The aim of the study was to evaluate whether an intervention with a person-centred approach to information and communication for patients diagnosed with colorectal cancer undergoing surgery can improve the patients' preparedness for surgery, discharge and recovery during six months following diagnosis and initial treatment. The intervention components involving a novel written interactive patient education material and person-centred communication was based on critical analysis of conventional information and communication for these patients. During 2014-2016, 488 consecutive patients undergoing elective surgery for colorectal cancer were enrolled in a quasi-experimental longitudinal study. In three hospitals, first a conventional care group (n = 250) was recruited, then the intervention was introduced, and finally the intervention group was recruited (n = 238). Patients' trajectories of preparedness for surgery and recovery (Preparedness for Colorectal Cancer Surgery Questionnaire-PCSQ) health related quality of life (EORTC QLQ-C30) and distress (NCCS Distress Thermometer) were evaluated based on self-reported data at five time points, from pre-surgery to 6 months. Length of hospital stay and patients' behavior in seeking health care pre- and post-surgery were extracted from patient records. Longitudinal structural equation models were used to test the hypothesized effects over time. Statistically significant positive effects were detected for two of the four PCSQ domains (patients searching for and making use of information, and making sense of the recovery) and for the role functioning domain of the EORTC QLQ-C30. Patients in the intervention group were also more likely to contact their assigned cancer "contact nurse" (a.k.a. nurse navigator) instead of contacting a nurse on duty at the ward or visiting the emergency department. In conclusion, the overall hypothesis was not confirmed. Further research is recommended on written and oral support tools to facilitate person-centred communication.

  • 2468.
    Östergren, Alice
    Sophiahemmet University.
    Sex- och samliv för personer med multipel skleros: en litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund

    Att ges möjligheter att bejaka sin sexualitet är en mänsklig rättighet som kan komma att äventyras vid sjukdom. Multipel skleros är en kronisk och degenerativ sjukdom i centrala nervsystemet som påverkar kroppens normala funktioner. Många personer med multipel skleros lider av sexuell dysfunktion, fatigue, känselrubbningar och ångest. Sjuksköterskans personcentrerade förhållningssätt ska utgå ifrån hela människan och dennes livsvärld.

    Syfte

    Syftet med litteraturöversikten var att belysa faktorer som påverkar sex- och samlivet för personer med multipel skleros.

    Metod

    Allmän litteraturöversikt valdes som metod. Databassökningar gjordes i PubMed, CinAHL och PsychINFO. Resultatet baserades på 16 inkluderade artiklar. Dessa artiklar bearbetades, kvalitetsgranskades och sammanställdes i en matris. Dataanalys omfattade granskning, sammanställning av artiklarnas resultat, identifiering av essens och en jämförande analys som resulterade i beskrivande kategorier.

    Resultat

    Flera faktorer påverkade sex- och samlivet för personer med multipel skleros. Resultatet presenteras i fem kategorier: "en förändrad kropp" , "att inte uppleva lust", "en förändrad självbild", "sjukvårdens bristande engagemang" och "anhörigas stöd".

    Slutsats

    Sex- och samlivet för personer med multipel skleros påverkades negativt av deras förändrade kropp, självbild och upplevelse av lust. Sjukvården tenderade att ignorera området vilket också var en faktor som påverkade tillvaron. Personernas närmast anhöriga hade möjligheter att främja sex- och samlivet genom en god kommunikation och stöd. Belysta faktorer ger en bredare förståelse för patientgruppen och deras tillvaro. Denna förståelse förväntas utveckla sjuksköterskans möjligheter att tillämpa ett personcentrerat förhållningssätt i omvårdnaden för dessa personer.

  • 2469. Österlund Efraimsson, Eva
    et al.
    Fossum, Bjöörn
    Sophiahemmet University.
    Ehrenberg, Anna
    Larsson, Kjell
    Klang, Birgitta
    Use of motivational interviewing in smoking cessation at nurse-led chronic obstructive pulmonary disease clinics2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 4, p. 767-782Article in journal (Refereed)
    Abstract [en]

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

  • 2470. Österlund Efraimsson, Eva
    et al.
    Klang, Birgitta
    Ehrenberg, Anna
    Larsson, Kjell
    Fossum, Bjöörn
    Sophiahemmet University.
    Olai, Lena
    Nurses' and patients' communication in smoking cessation at nurse-led COPD clinics in primary health care2015In: European Clinical Respiratory Journal, ISSN 2001-8525 (Electronic), Vol. 2, p. 27915-Article in journal (Refereed)
    Abstract [en]

    Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes.

    Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care.

    Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations.

    Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communication was mainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation.

    Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking.

    Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.

  • 2471. Österlund Efraimsson, Eva
    et al.
    Klang, Birgitta
    Larsson, Kjell
    Ehrenberg, Anna
    Fossum, Bjöörn
    Sophiahemmet University.
    Communication and self-management education at nurse-led COPD clinics in primary health care2009In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 77, no 2, p. 209-17Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the study was to explore the structure, content in communication and self-management education in patients' first consultations at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary healthcare. METHOD: Thirty consultations performed by seven registered nurses were videotaped; structure and content in the consultation was analyzed using Pendleton's Consultation Map. Nurses' self-management education was assessed from the content of the conversation: whether important and relevant information and self-management education was given, and how investigations were performed. RESULTS: Each consultation lasted for a mean time of 37.53 min. Communication about reasons for consultations concerned mainly medical and physical problems and to a certain extent patients' perceptions. Teaching about self-management and smoking cessation was of an informative nature. Two consultations ended with shared understanding, and none of the patients received an individual treatment-plan. CONCLUSION: Nurses rarely planned the consultations on an individual basis and rarely used motivational dialogue in self-management education and in smoking cessation. PRACTICE IMPLICATIONS: The findings could be used to help nurses to reflect on how to improve the structure of the visit, self-management education, smoking cessation and patient communication.

  • 2472. Östh, Josefine
    et al.
    Diwan, Vinod
    Jirwe, Maria
    Sophiahemmet University.
    Diwan, Vishal
    Choudhary, Anita
    Mahadik, Vijay Khanderao
    Pascoe, Michaela
    Hallgren, Mats
    Effects of yoga on well-being and healthy ageing: Study protocol for a randomised controlled trial (FitForAge)2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 5, article id e027386Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Due to ageing populations worldwide, the burden of disability is increasing. It is therefore important to develop interventions that improve healthy ageing, reduce disability onset and enhance life quality. Physical activity can promote healthy ageing and help maintain independence, yet many older adults are inactive. Yoga is a form of physical activity that aims to improve health and may be particularly suitable for older adults. Research indicates positive effects of yoga on several health-related outcomes; however, empirical studies examining the benefits of yoga on well-being among the elderly remain scarce. This study protocol reports the methodology for a 12-week yoga programme aimed to improve health and well-being among physically inactive older adults.

    METHODS AND ANALYSIS: Three group parallel, single-blind randomised controlled trial. Two comparison groups are included: aerobic exercise and a non-active wait-list control. In total, 180 participants aged 65-85 years will be recruited. Assessments will be performed at baseline and postintervention (12-week follow-up). The primary outcome is subjective well-being. Secondary outcomes include physical activity/sedentary behaviour, mobility/fall risk, cognition, depression, anxiety, mood, stress, pain, sleep quality, social support and cardiometabolic risk factors. Data will be analysed using intention-to-treat analyses, with mixed linear modelling.

    ETHICS AND DISSEMINATION: This study is approved by the Ethical Review Board in Stockholm (2017/1862-31/2). All participants must voluntarily agree to participate and are free to withdraw from the study at any point. Written informed consent will be obtained from each participant prior to inclusion. Results will be available through research articles and conferences. A summary of key results will be publicly available through newspaper articles.

    TRIAL REGISTRATION NUMBER: DRKS00015093, U1111-1217-4248.

  • 2473.
    Östlinder, Sophia
    Sophiahemmet University College.
    Sjuksköterskans stöd till anhöriga som vårdar demenssjuka personer i hemmet2004Independent thesis Basic level (degree of Bachelor), 5 credits / 7,5 HE creditsStudent thesis
  • 2474.
    Östlund, Caritha
    Sophiahemmet University College.
    Omvårdnadsplanering av muslimsk patient utifrån VIPS dokumentationsmodell2003Independent thesis Basic level (degree of Bachelor), 5 credits / 7,5 HE creditsStudent thesis
  • 2475.
    Östlund, Petra
    Sophiahemmet University.
    Patienters upplevelser av delaktighet i vården: en intervjustudie på en akutvårdsavdelning2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Sammanfattning

    Patienter har enligt lag rätt att vara delaktiga i hälso- och sjukvården. Akutsjukvården är en speciell del av vårdkedjan där det är viktigt med snabba beslut och interventioner för att åtgärda akuta sjukdomar och skador. När en person blir patient hamnar personen i en viss beroendeställning till personalen. Sjuksköterskan och övrig personal i vården har möjligheten att stärka eller försvaga patientens roll genom sitt agerande. I jämförelse med andra likvärdiga länder är svenska patienters möjlighet till delaktighet i vården eftersatt.

    Syftet med studien var att beskriva patienters upplevelser av delaktighet i vården på en akutvårdsavdelning.

    Studien bygger på tio intervjuer med patienter på en akutvårdsavdelning. En intervjuguide med semistrukturerade frågor användes och det insamlade materialet analyserades med kvalitativ innehållsanalys.

    Respondenterna beskrev att ett vänligt bemötande, dialog och information var handlingar och attityder som möjliggjorde delaktighet i vården. Stress, nonchalans och bristande empati från personalens sida beskrevs som hinder för delaktighet. Respondenterna beskrev även två helt olika strategier för hur de själva kunde påverka sin delaktighet i vården.

    Patienters delaktighet inom akutsjukvården är ingen självklarhet. För att delaktighet ska uppstå krävs vilja från båda parter och en förutsättning för medbestämmande är möten och samtal. Ansvaret för att skapa dialog ligger hos hälso- och sjukvårdspersonalen men långt ifrån alla patienter vill eller orkar vara aktivt delaktiga i beslut om sjukvården, vilket också måste respekteras. Stress och tidsbrist är reella hinder i vården idag, men det finns fortfarande mycket personalen kan göra för att möjliggöra delaktighet för patienterna. Även inom akutsjukvården finns hela tiden möjligheter till delaktighet både i stora beslut och i små dagliga val, det gäller bara att se dem.

  • 2476. Östlund, Petra
    et al.
    Rüter, Anders
    Sophiahemmet University.
    Franklin Larsson, Lise-Lotte
    Sophiahemmet University.
    Patienters upplevelser av delaktighet i vården: En intervjustudie på en akutvårdsavdelning2016Conference paper (Other academic)
  • 2477.
    Överby, Ida
    et al.
    Sophiahemmet University College.
    Lundin, Åsa
    Sophiahemmet University College.
    Allmänsjuksköterskans undervisning vid osteoporos: en jämförelse av tre modeller utifrån patient empowerment2002Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
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