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  • 1. Choudhary, Anita
    et al.
    Pathak, Ashish
    Manickam, Ponnaiah
    Purohit, Manju
    Rajasekhar, Thomas Daniel
    Dhoble, Parag
    Sharma, Ashish
    Suliya, Juhi
    Apsingekar, Dhanashree
    Patil, Vandana
    Jaiswal, Ashish
    Gwarikar, Sudhir
    Östh, Josefine
    Jirwe, Maria
    Sophiahemmet University.
    Diwan, Vinod Kumar
    Hallgren, Mats
    Mahadik, Vijay
    Diwan, Vishal
    Effect of yoga versus light exercise to improve well-being and promote healthy aging among older adults in central india: a study protocol for a randomized controlled trial2019In: Geriatrics (Basel, Switzerland), ISSN 2308-3417, Vol. 4, no 4, article id E64Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Aging is a natural process associated with many functional and structural changes. These changes may include impaired self-regulation, changes in tissues and organs. Aging also affects mood, physical status and social activity. There are adverse changes in cognitive behavior, perceived sensation and thinking processes. Regular physical activity can alleviate many health problems; yet, many older adults are inactive. Yoga is one of the scientific and popular lifestyle practice considered as the integration of mind, body and soul. Results of previous studies reported positive effects of yoga on multiple health outcomes in elderly. However, there is scarcity of scientific information where yoga's effect is examined on over well-being and on multiple health outcomes simultaneously in elderly. This protocol describes methods for a 12-week yoga-based intervention exploring the effects of yoga on well-being in physically inactive elderly living in community. Methods and analysis: This two group parallel single blind randomized controlled trial that will be conducted at a designated facility of R.D. Gardi Medical College, Ujjain, Madhya Pradesh, Central India. A 12-week 60-min yoga intervention three times weekly is designed. Comparison group participants will undergo a 60-min program comprising light exercise focusing on conventional stretching to improve mobility. After screening, 144 participants aged 60-80 years will be recruited. The primary outcome is subjective well-being. Secondary outcomes include mobility, fall risk, cognition, anxiety and depression, mood and stress, sleep quality, pain, physical activity/sedentary behavior and cardio-metabolic risk factors. Assessments will be conducted at baseline (0 week), after the intervention (12+1 week) and at follow-up (36+1 week). Intention-to-treat analyses with mixed linear modeling will be applied.

    DISCUSSION: Through this trial, we aim to determine whether elderly people in the intervention group practicing yoga show more favorable primary (well-being) and secondary outcomes than those in the light exercise focusing on conventional stretching group. We assume that yoga may be practiced to maintain health, reduce particular symptoms commonly associated with skeletal pain, assist in pain relief and enhance well-being. We anticipate that practicing yoga will improve well-being and mental health and may lead to significant improvement in depression, pain and sleep quality.Ethics and dissemination: This study is approved by the Institutional Ethics Committee of R.D. Gardi Medical College, Ujjain, IEC Ref No. 09/2018. All participants would be provided with written and verbal information about the purpose of the project and would be free to withdraw from the study at any time. Refusal to participate in the study would not have any negative consequences. Confidentiality of the information of each participant would be ensured. Knowledge obtained would be disseminated to stakeholders through workshops, meetings and relevant scientific conferences.

    TRIAL REGISTRATION: The trial is prospectively registered with the Indian Council of Medical Research Trial Registry CTRI/2018/07/015051.

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  • 2. De Lima, Sara
    et al.
    Kugelberg, Maria
    Jirwe, Maria
    Sophiahemmet University.
    Congenital cataract in newborns: A qualitative study on parents' experiences of the surgery and subsequent care2020In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 98, no 6, p. 585-591Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Having a child with congenital cataract that requires surgery, contact lens treatment, and frequent medication is a life-altering experience. The aim of this study was to provide more in-depth knowledge of parents' experiences of diagnosis, surgery, and subsequent care, in order to find the areas for improvement.

    METHODS: Data were collected via semi-structured interviews with parents recruited from St. Erik Eye Hospital, Sweden. The children were operated for congenital cataract before 3 months of age and were aged 12-24 months at the time of the interviews. The interviews were analysed using qualitative content analysis with an inductive approach.

    RESULTS: Three themes emerged from the data: living in a turbulent time before the diagnosis, coping during the time of initial treatment, and managing the responsibility of their child's visual development. All parents expressed confidence in the operating unit. However, there was a clear need for reliable information on the condition, the surgery, and likely the long-term outcome in the time between receiving the preliminary diagnosis at the maternity ward and getting it confirmed by a paediatric ophthalmologist.

    CONCLUSION: Much of the parents' concern in this turbulent time is linked to poor information before the visit to the eye hospital. We, therefore, recommend earlier contact with the eye hospital, preferably at the time of writing the referral. Moreover, the possibility of providing up-to-date information via alternative information channels such as smartphone apps should be investigated.

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  • 3. Epstein, Majken
    et al.
    Söderström, Marie
    Jirwe, Maria
    Sophiahemmet University.
    Tucker, Philip
    Dahlgren, Anna
    Sleep and fatigue in newly graduated nurses: Experiences and strategies for handling shiftwork2020In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 1-2, p. 184-194Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore newly graduated nurses' strategies for, and experiences of, sleep problems and fatigue when starting shiftwork. A more comprehensive insight into nurses' strategies, sleep problems, fatigue experiences and contributing factors is needed to understand what support should be provided.

    BACKGROUND: For graduate nurses, the first years of practice are often stressful, with many reporting high levels of burnout symptoms. Usually, starting working as a nurse also means an introduction to shiftwork, which is related to sleep problems. Sleep problems may impair stress management and, at the same time, stress may cause sleep problems. Previously, sleep problems and fatigue have been associated with burnout, poor health and increased accident risk.

    DESIGN AND METHODS: Semi-structured interviews were conducted with nurses (N = 11) from four different Swedish hospitals, and qualitative inductive content analysis was used. The study was approved by the Regional Ethical Review Board in Stockholm. The COREQ checklist was followed.

    RESULTS: Many nurses lacked effective strategies for managing sleep and fatigue in relation to shiftwork. Various strategies were used, of which some might interfere with factors regulating and promoting sleep such as the homeostatic drive. Sleep problems were common during quick returns, often due to difficulties unwinding before sleep, and high workloads exacerbated the problems. The described consequences of fatigue in a clinical work context indicated impaired executive and nonexecutive cognitive function.

    CONCLUSION: The findings indicate that supporting strategies and behaviours for sleep and fatigue in an intervention for newly graduated nurses starting shiftwork may be of importance to improve well-being among nurses and increase patient safety.

    RELEVANCE TO CLINICAL PRACTICE: This study highlights the importance of addressing sleep and fatigue issues in nursing education and work introduction programmes to increase patient safety and improve well-being among nurses.

  • 4. Georg, Carina
    et al.
    Welin, Elisabet
    Jirwe, Maria
    Sophiahemmet University.
    Karlgren, Klas
    Ulfvarson, Johanna
    Psychometric properties of the virtual patient version of the Lasater Clinical Judgment Rubric2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 38, p. 14-20, article id S1471-5953(18)30362-7Article in journal (Refereed)
    Abstract [en]

    A number of studies attest to the effectiveness of virtual patients in fostering and assessing students' development of clinical reasoning. An objective assessment of students' clinical reasoning is, however, challenging. This study focused on determining the psychometric properties of the virtual patient version of the Lasater Clinical Judgment Rubric, a rubric that is aimed at assessing nursing students' clinical reasoning processes when encountering virtual patients. A nonexperimental design was used in which data from 125 students' reflections on solving two different virtual patient scenarios were included in the analysis. First, a deductive content analysis was conducted using the categories of the rubric as a lens. After that, each student's performance was quantified according to the different levels of the rubric. Exploratory factor analysis and test of normality and reliability, including the Kaiser-Meyer-Olkin test, Bartlett's test, the Shapiro-Wilk test, and Cronbach's alpha were used in the analysis. The result suggested three factors: "Understanding the patient", "Care planning" and "Reflecting" that explained 81.8% of the variance. Cronbach's alpha was 0.931. The result showed the rubric to be a valid assessment instrument for assessing nursing students' clinical reasoning when encountering virtual patients.

  • 5.
    Jirwe, Maria
    Sophiahemmet University.
    Delphi som forskningsmetod2019In: Ventilen, ISSN 0348-6257, no 4, p. 6-10Article in journal (Other (popular science, discussion, etc.))
  • 6.
    Jirwe, Maria
    Sophiahemmet University.
    Kulturell mångfald2019In: Omvårdnadens grunder: Perspektiv och förhållningssätt, Lund: Studentlitteratur AB, 2019, 3, p. 361-380Chapter in book (Other academic)
  • 7.
    Murphy, Jason
    et al.
    Sophiahemmet University.
    Rådestad, Monica
    Kurland, Lisa
    Jirwe, Maria
    Sophiahemmet University.
    Djalali, Ahmadreza
    Rüter, Anders
    Sophiahemmet University.
    Emergency department registered nurses' disaster medicine competencies. An exploratory study utilizing a modified Delphi technique2019In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 43, p. 84-91, article id S1755-599X(18)30135-6Article in journal (Refereed)
  • 8. Nassef, Sari Kokkonen
    et al.
    Blennow, Mats
    Jirwe, Maria
    Sophiahemmet University.
    Parental viewpoints and experiences of therapeutic hypothermia in a neonatal intensive care unit implemented with Family-Centered Care2020In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 29, no 21-22, p. 4194-4202Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore parental experiences of therapeutic hypothermia (TH) in their newborn infant suffering from hypoxic ischaemic encephalopathy following perinatal asphyxia.

    BACKGROUND: Since more than a decade, newborn infants are treated with TH following perinatal asphyxia to reduce mortality and disabilities and to improve neurological outcome. The infants' body temperature is lowered to 33.5°C for 72 hr, and the infant is usually cared for in an open incubator. The parents are not able to hold their infant skin to skin, which risks causing emotional reactions in parents and a loss of normal parent-infant bonding.

    DESIGN: A qualitative descriptive design using semi-structured interviews.

    METHODS: Up to 7 months after the event, interviews were conducted with 14 parents of seven infants who had received TH in a neonatal intensive care unit (NICU) in Sweden. The interviews were transcribed and analysed using framework approach. Findings were reported following the Standard for Reporting Qualitative Research (SRQR) checklist.

    RESULTS: From the interviews, an overall theme was found: Transition through a life-altering time, and three categories: (a) trepidation about prognosis, (b) transitioning into parenthood supported by the caring philosophy of family-centred care (FCC) and (c) rewarming as a milestone.

    CONCLUSIONS: Parental experiences of TH are based on the immediate emotions and stress of uncertainty of the infant's prognosis. The values of FCC in the NICU append a natural transitioning into parenthood by parental involvement in nursing care and decisions. The rewarming of the infant is seen as a restart to more or less normal circumstances from the critical period of delivery and TH.

    RELEVANCE FOR CLINICAL PRACTICE: The management of NICUs should update the awareness of and deepen knowledge about FCC. The emphasis ought to be on adequate information about TH and the values of FCC to parents in the NICU context.

  • 9. 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, 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.

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