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Nygren, Björn
Publications (10 of 28) Show all publications
Boman, E., Lundman, B., Nygren, B., Årestedt, K. & Santamäki Fischer, R. (2017). Inner strength and its relationship to health threats in ageing: a cross-sectional study among community-dwelling older women. Journal of Advanced Nursing, 73(11), 2720-2729
Open this publication in new window or tab >>Inner strength and its relationship to health threats in ageing: a cross-sectional study among community-dwelling older women
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2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2720-2729Article in journal (Refereed) Published
Abstract [en]

Aim: To explore the relationship between inner strength and health threats among community-dwelling older women. Background: Inner strength is described as a resource that promotes experiences of health, despite adversities. Inner strength and its dimensions (i.e. connectedness, creativity, firmness and flexibility) can be assessed using the Inner Strength Scale (ISS). Exploring attributes of weaker inner strength may yield valuable information about areas to focus on in enhancing a person's inner strength and may ultimately lead to the perception of better health. Design: Cross-sectional questionnaire survey. Methods: The study is based on responses from 1270 community-dwelling older women aged 65 years and older; these were collected in the year 2010 and describe the situation that still exists today for older women. The questionnaire included the ISS, background characteristics and explanatory variables known to be health threats in ageing. Data were analysed using descriptive and inferential statistics. Results: Poorer mental health was related to weaker inner strength in total and in all the dimensions. Symptoms of depressive disorders and feeling lonely were related to three of the dimensions, except firmness and creativity respectively. Furthermore, poor physical health was associated with the dimensions firmness and flexibility. Other health threats were significantly related to only one of the dimensions, or not associated at all. Conclusion: Mental ill health has overall the strongest association with weaker inner strength. Longitudinal studies are recommended to confirm the results. However, the ISS does not only estimate inner strength but can also be a tool for discovering where (i.e. dimension) interventions may be most profitable.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
connectedness, creativity, firmness, flexibility, health threats, inner strength, mental ill health, nursing, old age, women
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-143949 (URN)10.1111/jan.13341 (DOI)000418363000023 ()28513995 (PubMedID)2-s2.0-85020430693 (Scopus ID)
Available from: 2018-01-15 Created: 2018-01-15 Last updated: 2023-03-24Bibliographically approved
Nygren, B., Aléx, L., Jonsén, E., Gustafson, Y., Norberg, A. & Lundman, B. (2017). Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. In: Martin Orrell; Aimee Spector (Ed.), Psychology of aging: (pp. 85-93). Routledge
Open this publication in new window or tab >>Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old
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2017 (English)In: Psychology of aging / [ed] Martin Orrell; Aimee Spector, Routledge, 2017, p. 85-93Chapter in book (Refereed)
Abstract [en]

Different concepts have been presented which denote driving forces and strengths that contribute to a person’s ability to meet and handle adversities, and keep or regain health. The aim of this study, which is a part of The Umea 85+ study, was to describe resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health in a sample of the oldest old. The study sample consisted of 125 participants 85 years of age or older, who ranked themselves on the Resilience Scale, Sense of Coherence Scale, Purpose in life Scale and Self-Transcendence Scale and answered the SF-36 Health Survey questionnaire. The findings showed significant correlations between scores on the Resilience Scale, the Sense of Coherence Scale, the Purpose in Life Test, and the Self-Transcendence Scale. Significant correlations were also found between these scales and the SF-36 Mental Health Summary among women but not among men. There was no significant correlation between perceived physical and mental health. The mean values of the different scales showed that the oldest old have the same or higher scores than younger age groups. Regression analyses also revealed sex differences regarding mental health. The conclusions are that, the correlation between scores on the different scales suggests that the scales measure some dimension of inner strength and that the oldest old have this strength at least in the same extent as younger adults. Another conclusion is that the dimensions that constitute mental health differ between women and men.

Place, publisher, year, edition, pages
Routledge, 2017
Series
The International Library of Psychology
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-203581 (URN)10.4324/9781315245706-15 (DOI)2-s2.0-85145829623 (Scopus ID)9781351907859 (ISBN)9780754627890 (ISBN)
Note

Published in printed form 2009.

Available from: 2023-01-19 Created: 2023-01-19 Last updated: 2023-01-19Bibliographically approved
Viglund, K., Jonsén, E., Lundman, B., Nygren, B. & Strandberg, G. (2017). Sources and expressions of inner strength among old people who have experienced a crisis in life associated with a disease. Nordic journal of nursing research, 37(1), 20-26
Open this publication in new window or tab >>Sources and expressions of inner strength among old people who have experienced a crisis in life associated with a disease
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2017 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, no 1, p. 20-26Article in journal (Refereed) Published
Abstract [en]

Inner strength is reported as an important resource associated with aging, health, and disease management. The aim was toexplore inner strength in people (n ¼ 12) aged 65 years and older, who had experienced a crisis in life associated with a disease. The participants had self-rated their inner strength as high. We found that sources of inner strength were mutual love and support, and the fact that tough times have been managed before. Expressions of inner strength comprised focusing on possibilities instead of brooding, facing and take an active part in care and treatment, and being able to confront reality and pick yourself up again. Inner strength is a complex phenomenon. Increased knowledge of inner strength can serve as an aid inefforts to identify the need to promote inner strength.

Place, publisher, year, edition, pages
Sage Publications, 2017
Keywords
disease management, experiences, inner strength, old people, qualitative content analysis
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-124961 (URN)10.1177/2057158516659839 (DOI)
Available from: 2016-08-31 Created: 2016-08-31 Last updated: 2018-06-07Bibliographically approved
Boman, E., Häggblom, A., Lundman, B., Nygren, B. & Santamäki Fischer, R. (2016). Identifying variables in relation to health-related quality of life among community-dwelling older women: knowledgebase for health-promoting activities. Nordic journal of nursing research, 36(1), 20-26
Open this publication in new window or tab >>Identifying variables in relation to health-related quality of life among community-dwelling older women: knowledgebase for health-promoting activities
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2016 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 1, p. 20-26Article in journal (Refereed) Published
Abstract [en]

The aim of the present study was to explore health-related quality of life (HRQoL) and associated variables among all community-dwelling older women (565 years) (n¼2724) on A ° land, a Finnish self-governing island community. A total of 1023 women participated (mean age 72.96.8 years). Absence of depression, absence of diagnosed disease(s), having the opportunity to engage in meaningful leisure activities, and never or seldom feeling lonely explained, together with socioeconomic control variables (i.e. age, education and economic situation), 34.4% of the variation in physical health. Absence of depression, strong inner strength, and never or seldom feeling lonely explained, together with socio-economic control variables, 27.7% of the variation in mental health. HRQoL was rated as relatively good, although special attention should be paid to women aged 80þ years. To promote HRQoL, interventions aimed at preventing, detecting and treating depression should be prioritised. In addition, interventions aimed at reducing feelings of loneliness are also recommended in order to enhance overall HRQoL.

Place, publisher, year, edition, pages
Sage Publications, 2016
Keywords
health-related quality of life, health promotion, nursing, old age, women
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-109722 (URN)10.1177/0107408315599691 (DOI)
Available from: 2015-10-05 Created: 2015-10-05 Last updated: 2018-06-07Bibliographically approved
Melder, C., Santamäki Fischer, R., Nygren, B. & DeMarinis, V. (2016). Validating WHOQOL-SRPB in Sweden: instrument adaption for measuring existential aspects of health-related quality of life [HRQL] in secular contexts. Paper presented at 23rd Annual Conference of the International Society for Quality of Life Research, Copenhagen, Denmark, October 19-22, 2016. Quality of Life Research, 25(Suppl 1), 100-100, Article ID 1056.
Open this publication in new window or tab >>Validating WHOQOL-SRPB in Sweden: instrument adaption for measuring existential aspects of health-related quality of life [HRQL] in secular contexts
2016 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 25, no Suppl 1, p. 100-100, article id 1056Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Aims: To present the validation process of WHOQOL-SRPB andWHOQOL-SRPB BREF in Sweden, one of the most secular countriesin the world though multi-religious, thus emphasising the need forprerequisite adjustments for cultural validation of the spirituality,religiousness and personal beliefs facets [SRPB].

Methods: Theprocess adopted here follows WHO guidelines for translation andadaptation of instruments: Forward and Back translation, Pre-testing,Cognitive Interviewing, and Final version. Four bilingually and biculturally experienced researchers worked in two groups, comprisingexperience of either the Swedish translation of WHOQOL-100, -Brefand -OLD, or research into existential public health. Based on initialindependent translations from each, a final version was then developed through consensus translation, which was then back-translated.A pre-testing phase was conducted with individuals representingdifferent religious and non-religious worldviews. The final Swedishversion was completed by 170 persons, aging between 21 and 89(m = 46.6), with 105 women, and comprising both ‘‘healthy’’ individuals and individuals with mental health or somatic issues.

Results:It was found that the instruction and particularly SRPB items thatused religious terminology needed adjustment. For example, ‘‘Spiritual being’’ was replaced with ‘‘Spiritual dimension’’, ‘‘Belief’’ with‘‘Your belief/idea’’, and ‘‘higher and more powerful’’ (instructiontext) was translated to ‘‘force/power/dimension’’. The pre- test resultswere useful in this process, especially qualitative information fromindividuals representing secular existential worldviews includingdifferent philosophical and political traditions. The internal consistency reliability of the overall SRPB-module was high (alpha = .97)as well as for the 8 facets (alpha ranging .80–.97). Test- retest(n = 19) showed r = .83 (p\.01). There were strong correlationsbetween all facets, the overall SRPB-module, and the overall qualityof life general health perceptions. No difference was found betweenwomen and men in the overall SRPB-module but in the ‘‘Connect’’facet, women scored higher (p = .02) whereas in ‘‘Peace’’ menscored higher (p = .04).

Conclusions: The significance found throughusing existing translation/adaption guidelines, confirms that not onlyis it possible, but also relevant to include culturally validated existential aspects in studies of HRQL even in contexts that are largelysecular.

Place, publisher, year, edition, pages
Springer, 2016
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Religious Studies
Identifiers
urn:nbn:se:umu:diva-134294 (URN)10.1007/s11136-016-1390-7 (DOI)000398451600241 ()
Conference
23rd Annual Conference of the International Society for Quality of Life Research, Copenhagen, Denmark, October 19-22, 2016
Available from: 2017-05-09 Created: 2017-05-09 Last updated: 2021-08-09Bibliographically approved
Boman, E., Haggblom, A., Lundman, B., Nygren, B. & Santamäki Fischer, R. (2015). Inner Strength as Identified in Narratives of Elderly Women A Focus Group Interview Study. Advances in Nursing Science, 38(1), 7-19
Open this publication in new window or tab >>Inner Strength as Identified in Narratives of Elderly Women A Focus Group Interview Study
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2015 (English)In: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 38, no 1, p. 7-19Article in journal (Refereed) Published
Abstract [en]

By identifying sources of inner strength, health care personnel can be given valuable information about elderly people's capacities regardless of frailty. The focus of this interview-based study was to explore how inner strength and its dimensions can be identified in narratives of elderly women. The analysis was based on a theoretical model where inner strength is composed of 4 interacting dimensions of connectedness, creativity, firmness, and flexibility. Our findings add nuance to the notion of inner strength and deepen empirical knowledge about the concept.

Keywords
concept-driven approach, connectedness, content analysis, creativity, elderly women, firmness, exibility, focus groups, inner strength
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-100977 (URN)10.1097/ANS.0000000000000057 (DOI)000349468700004 ()25635502 (PubMedID)2-s2.0-84927635913 (Scopus ID)
Available from: 2015-03-16 Created: 2015-03-16 Last updated: 2023-03-24Bibliographically approved
Boman, E., Gustafson, Y., Häggblom, A., Santamäki Fischer, R. & Nygren, B. (2015). Inner strength: associated with reduced prevalence of depression among older women. Aging & Mental Health, 19(12), 1078-1083
Open this publication in new window or tab >>Inner strength: associated with reduced prevalence of depression among older women
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2015 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 12, p. 1078-1083Article in journal (Refereed) Published
Abstract [en]

Objectives: The aim of this study was to explore if inner strength is independently associated with a reduced prevalence of depression after controlling for other known risk factors associated with depression.

Methods: A population-based cross-sectional study was performed, where all women living in Åland, a Finnish self-govern island community in the Baltic Sea, aged 65 years or older were sent a questionnaire including the Geriatric Depression Scale and the Inner Strength Scale along with several other questions related to depression. Factors associated with depression were analyzed by means of multivariate logistic regression.

Results: The results showed that 11.2% of the studied women (n = 1452) were depressed and that the prevalence increased with age and was as high as 20% in the oldest age group. Non-depressed women were more likely to never or seldom feel lonely, have a strong inner strength, take fewer prescription drugs, feeling needed, being able to engage in meaningful leisure activities, as well as cohabit.

Conclusion: Our results showed an association between stronger inner strength and being non-depressed. This can be interpreted to mean that inner strength might have a protective effect against depression. These findings are interesting from a health-promotion perspective, yet to verify these results, further longitudinal studies are required.

Place, publisher, year, edition, pages
Taylor & Francis, 2015
Keywords
GDS-15, depression, inner strength, old age, women
National Category
Nursing Geriatrics Psychiatry
Identifiers
urn:nbn:se:umu:diva-108077 (URN)10.1080/13607863.2014.977775 (DOI)000360694500005 ()25402943 (PubMedID)2-s2.0-84940961051 (Scopus ID)
Available from: 2015-09-03 Created: 2015-09-03 Last updated: 2023-03-24Bibliographically approved
Niklasson, J., Conradsson, M., Hörnsten, C., Nyqvist, F., Padyab, M., Nygren, B., . . . Gustafson, Y. (2015). Psychometric properties and feasibility of the Swedish version of the Philadelphia Geriatric Center Morale Scale. Quality of Life Research, 24(11), 2795-2805
Open this publication in new window or tab >>Psychometric properties and feasibility of the Swedish version of the Philadelphia Geriatric Center Morale Scale
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2015 (English)In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 24, no 11, p. 2795-2805Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Morale is related to psychological well-being and quality of life in older people. The Philadelphia Geriatric Center Morale Scale (PGCMS) is widely used to assess morale. The purpose of this study was to evaluate the psychometric properties and feasibility of the Swedish version of the 17-item PGCMS among very old people.

METHODS: The Umea 85+/GERDA study included Swedish-speaking people aged 85, 90 and 95 years and older, from Sweden and Finland. Participants were interviewed in their own homes using a predefined set of questions. In the main sample, 493 individuals answered all 17 PGCMS items (aged 89.0 +/- 4.3 years). Another 105 answered between 1 and 16 questions (aged 89.6 +/- 4.4 years). A convenience sample was also collected, and 54 individuals answered all 17 PGCMS items twice (aged 84.7 +/- 6.7 years). The same assessor restated the questions within 1 week.

RESULTS: Cronbach's alpha was 0.74 among those who answered all 17 questions in the main sample. Confirmatory factor analysis was used to test the construct validity of the most widely used version of the PGCMS, with 17 items and three factors, and showed a generally good fit. Among those answering between 1 and 17 PGCMS questions, 92.6 % (554/598) answered 16 or 17. The convenience sample was used for intra-rater test-retesting, and the intraclass correlation coefficient (ICC) was 0.89. The least significant change between two assessments, with 95 % confidence interval, was 3.53 PGCMS points.

CONCLUSION: The Swedish version of the PGCMS seems to have satisfactory psychometric properties and feasibility among very old people.

Keywords
Aged 80 and over, Feasibility studies, Morale, Psychological well-being, Psychometrics, Quality of life
National Category
Gerontology, specialising in Medical and Health Sciences Nursing
Research subject
Geriatrics
Identifiers
urn:nbn:se:umu:diva-111119 (URN)10.1007/s11136-015-1009-4 (DOI)000362289300024 ()26031833 (PubMedID)2-s2.0-84942989305 (Scopus ID)
Available from: 2015-11-06 Created: 2015-11-05 Last updated: 2024-07-02Bibliographically approved
Viglund, K., Jonsén, E., Strandberg, G., Lundman, B. & Nygren, B. (2014). Inner strength as a mediator of the relationship between disease and self-rated health among old people. Journal of Advanced Nursing, 70(1), 144-152
Open this publication in new window or tab >>Inner strength as a mediator of the relationship between disease and self-rated health among old people
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2014 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 1, p. 144-152Article in journal (Refereed) Published
Abstract [en]

AIM: To explore inner strength as a mediator of the relationship between disease and self-rated health among older people.

BACKGROUND: Qualitative research has indicated that inner strength is an essential resource for an individual affected by disease. A hypothesis of inner strength as a mediator of the relationship between disease and self-rated health was proposed. The theoretical framework of inner strength was based on the Model of Inner Strength.

DESIGN: A cross-sectional design was used.

METHOD: The sample included 6119 participants from Finland and Sweden, in the ages of 65, 70, 75 and 80 years. The GERDA-Botnia questionnaire, which included the Inner Strength Scale and items related to diseases and self-rated health, was sent out between October and December 2010. Structural equation modelling was used to test a hypothesized model.

RESULTS: The result indicated that having a disease was associated with poorer self-rated health and a lower degree of inner strength and a higher degree of inner strength was associated with better self-rated health. The result supported the hypothesis by indicating that inner strength partially mediated the relationship between disease and self-rated health.

CONCLUSION: This large cross-sectional study with participants from 65 to 80 years of age from Finland and Sweden showed that inner strength can be a resource for older people affected by disease. Increasing inner strength in older people affected by disease may be one intervention to support experiences of health despite disease.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
Disease, health, inner strength, mediating, nursing, older people, structural equation modelling
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-74491 (URN)10.1111/jan.12179 (DOI)000327900300015 ()23718213 (PubMedID)2-s2.0-84889652849 (Scopus ID)
Available from: 2013-07-01 Created: 2013-07-01 Last updated: 2023-03-23Bibliographically approved
Viglund, K., Jonsén, E., Lundman, B., Strandberg, G. & Nygren, B. (2013). Inner strength in relation to age, gender and culture among old people: a cross-sectional population study in two Nordic countries.. Aging & Mental Health, 17(8), 1016-1022
Open this publication in new window or tab >>Inner strength in relation to age, gender and culture among old people: a cross-sectional population study in two Nordic countries.
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2013 (English)In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 17, no 8, p. 1016-1022Article in journal (Refereed) Published
Abstract [en]

Objectives: The theoretical framework for the study was the Model of Inner Strength, and the Inner Strength Scale (ISS)developed based on the Model was used. The aim was to examine inner strength in relation to age, gender and culture among old people in Sweden and Finland.

Method: This study forms part of the GErontological Regional DAtabase (GERDA)-Botnia project that investigates healthy ageing with focus on the dignity, social participation and health of old people. The participants (N = 6119) were 65-, 70-, 75- and 80-year old and living in two counties in Sweden or Finland. The ISS consists of 20 items relating to four interrelated dimensions of inner strength, according to the Model of Inner Strength. The range of possible ISS scores is 20-120, a higher score denoting higher inner strength.

Result: The result showed that the 65-year-old participants had the highest mean ISS score, with a decrease in score for every subsequent age. The lowest score was achieved by the 80-year-old participants. Women had slightly but significantly higher mean ISS scores than men. Only small differences were found between the counties.

Conclusion: The study population came from Sweden and Finland; still, despite the different backgrounds, patterns in the distribution of inner strength were largely similar. The present study provides basic and essential information about inner strength in a population of old people.

Place, publisher, year, edition, pages
Routledge, 2013
Keywords
Inner strength, old people, gender, culture
National Category
Public Health, Global Health, Social Medicine and Epidemiology Geriatrics
Identifiers
urn:nbn:se:umu:diva-81053 (URN)10.1080/13607863.2013.805401 (DOI)000326352500014 ()23750849 (PubMedID)2-s2.0-84887440222 (Scopus ID)
Available from: 2013-10-01 Created: 2013-10-01 Last updated: 2023-03-24Bibliographically approved
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