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  • 1.
    Ahlm, Kristin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Lindqvist, Per
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Saveman, Britt-inger
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Suicidal drowning deaths in Northern Sweden 1992-2009Manuscript (preprint) (Other academic)
  • 2.
    Ahlm, Kristin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Lindqvist, Per
    Division of Social and Forensic Psychiatry, Karolinska Institutet, Stockholm, Sweden; Dalarna University, Falun, Sweden.
    Saveman, Britt-inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Suicidal drowning deaths in northern Sweden 1992-2009: the role of mental disorder and intoxication2015In: Journal of Forensic and Legal Medicine, ISSN 1752-928X, E-ISSN 1878-7487, Vol. 34, p. 168-172Article in journal (Refereed)
    Abstract [en]

    Suicides by drowning have received limited attention by researchers. A recent finding that almost onethird of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.

  • 3.
    Ahlm, Kristin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Drowning deaths in Sweden with emphasis on the presence of alcohol and drugs: a retrospective study, 1992-20092013In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13, p. 216-Article in journal (Refereed)
    Abstract [en]

    Background: Drowning deaths constitute a significant proportion of unnatural deaths globally. In Sweden and other high-income countries, drowning deaths have decreased. This study investigates the epidemiology and current trends of unintentional, intentional, and undetermined drowning deaths with emphasis on the presence of alcohol and other drugs.

    Methods: During an 18-years period, 5,125 drowning deaths were autopsied in Sweden. Data on cases including toxicological analysis on alcohol, pharmaceutical drugs, and illicit drugs were obtained from the National Board of Forensic Medicine.

    Results: During the study period, the annual incidence of drowning deaths in Sweden was 3.1/100,000 inhabitants and decreased on average by about 2% each year (p<0.001). The highest incidence was found among males and in middle/older age groups. The incidence increased 3% for each year of age. Children/adolescents (<= 18 years) constituted 5% of all drowning deaths. Of all drowned females in the study, 55% (847/1,547) committed suicide, which was a significantly higher proportion compared with males (21%, 763/3,578) (p<0.001). In total, 38% (1,656/4,377) of tested drowned persons had alcohol in their blood and the mean concentration was 1.8 g/l. In the unintentional drowning group, intentional drowning group, and the undetermined group, the proportion of alcohol positive was 44%, 24%, and 45%, respectively. One or several psychoactive drugs were present in the blood in 40% (1,688/4,181) of all tested persons and in 69% (965/1,394) of tested persons who died from suicidal drowning. The most common drug was benzodiazepines (21%, 891/4,181). Illicit drugs were detected in 10% (82/854) of tested persons.

    Conclusion: Presence of alcohol and drugs were frequent and may have contributed to the drowning deaths. The incidence of drowning deaths significantly decreased during the study period. Males and the middle/older age groups had a higher incidence compared to females and children. Suicidal drowning was common especially among women. Alcohol and drugs are significant contributors in drowning deaths in Sweden and should be considered as part of a comprehensive prevention program.

  • 4.
    Alex, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Effect evaluation of a heated ambulance mattress-prototype on body temperatures and thermal comfort - an experimental study2014In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, p. 43-Article in journal (Refereed)
    Abstract [en]

    Background:

    Exposure to cold temperatures is, often, a neglected problem in prehospital care. One of the leading influences of the overall sensation of cold discomfort is the cooling of the back. The aim of this study was to evaluate the effect of a heated ambulance mattress-prototype on body temperatures and thermal comfort in an experimental study.

    Method: Data were collected during four days in November, 2011 inside and outside of a cold chamber. All participants (n = 23) participated in two trials each. In one trial, they were lying on a stretcher with a supplied heated mattress and in the other trial without a heated mattress. Outcomes were back temperature, finger temperature, core body temperature, Cold Discomfort Scale (CDS), four statements from the state-trait anxiety - inventory (STAI), and short notes of their experiences of the two mattresses. Data were analysed both quantitatively and qualitatively. A repeated measure design was used to evaluate the effect of the two mattresses.

    Results:

    A statistical difference between the regular mattress and the heated mattress was found in the back temperature. In the heated mattress trial, the statement "I am tense" was fewer whereas the statements "I feel comfortable", "I am relaxed" and "I feel content" were higher in the heated mattress trial. The qualitative analyses of the short notes showed that the heated mattress, when compared to the unheated mattress, was experienced as warm, comfortable, providing security and was easier to relax on.

    Conclusions:

    Heat supply from underneath the body results in increased comfort and may prevent hypothermia which is important for injured and sick patients in ambulance care.

  • 5.
    Aléx, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University. Center for Disaster Medicine, Umeå University, Umeå, Sweden.
    Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care - an intervention study2015In: International Journal of Circumpolar Health, ISSN 2242-3982, E-ISSN 2242-3982, Vol. 74, article id 28878Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients' exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients' temperatures in the prehospital emergency care.

    METHODS: A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures.

    RESULTS: Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001). At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes.

    CONCLUSIONS: The use of active heat from underneath increases the patients' thermal comfort and may prevent the negative consequences of cold stress.

  • 6.
    Aléx, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Patients' experiences of cold exposure during ambulance care2013In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 21, article id 44Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Exposure to cold temperatures is often a neglected problem in prehospital care. Cold exposure increase thermal discomfort and, if untreated causes disturbances of vital body functions until ultimately reaching hypothermia. It may also impair cognitive function, increase pain and contribute to fear and an overall sense of dissatisfaction. The aim of this study was to investigate injured and ill patients' experiences of cold exposure and to identify related factors.

    METHOD: During January to March 2011, 62 consecutively selected patients were observed when they were cared for by ambulance nursing staff in prehospital care in the north of Sweden. The field study was based on observations, questions about thermal discomfort and temperature measurements (mattress air and patients' finger temperature). Based on the observation protocol the participants were divided into two groups, one group that stated it was cold in the patient compartment in the ambulance and another group that did not. Continuous variables were analyzed with independent sample t-test, paired sample t-test and dichotomous variables with cross tabulation.

    RESULTS: In the ambulance 85% of the patients had a finger temperature below comfort zone and 44% experienced the ambient temperature in the patient compartment in the ambulance to be cold. There was a significant decrease in finger temperature from the first measurement indoor compared to measurement in the ambulance. The mattress temperature at the ambulance ranged from -22.3°C to 8.4°C.

    CONCLUSION: Cold exposure in winter time is common in prehospital care. Sick and injured patients immediately react to cold exposure with decreasing finger temperature and experience of discomfort from cold. Keeping the patient in the comfort zone is of great importance. Further studies are needed to increase knowledge which can be a base for implications in prehospital care for patients who probably already suffer for other reasons.

  • 7.
    Aléx, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundgren, Peter
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Henriksson, Otto
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Being cold when injured in a cold environment: patients' experiences2013In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 21, no 1, p. 42-49Article in journal (Refereed)
    Abstract [en]

    Background: Patients in prehospital care, irrespective of diseases or trauma might experience thermal discomfort because of a cold environment and are at risk for decreasing body temperature which can increase both morbidity and mortality.

    Objective: To explore patients' experiences of being cold when injured in a cold environment.

    Method: Twenty persons who had been injured in a cold environment in northern Sweden were interviewed. Active heat supply was given to 13 of them and seven had passive heat supply. The participants were asked to narrate their individual experience of cold and the pre- and post-injury event, until arrival at the emergency department. The interviews were transcribed verbatim, then analyzed with qualitative content analysis.

    Results: Patients described that they suffered more from the cold than because of the pain from the injury. Patients who received active heat supply experienced it in a positive way. Two categories were formulated: Enduring suffering and Relief of suffering.

    Conclusion: Thermal discomfort became the largest problem independent of the severity of the injuries. We recommend the use of active heat supply to reduce the negative experiences of thermal discomfort when a person is injured in a cold environment.

  • 8.
    Aléx, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundin, Helena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Joansson, Charlotta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Preparedness of Swedish EMS Personnel for Major Incidents in Underground Mines2017In: Journal of Health Science, E-ISSN 2328-7136, Vol. 5, p. 239-243Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to survey the EMS (emergency medical services) personnel preparedness for major incidents in the underground mining industry in Sweden. Every year, a high number of incidents, workplace accidents and fires are reported from the Swedish mining industry. Taking care of patients located in an underground mine represents a challenge to EMS personnel. Today, knowledge about EMS personnel preparedness for major incidents in the mining industry is limited. The study design was a cross-sectional survey. The questionnaires were distributed to EMS personnel working in ambulance stations geographically located near an underground mine. Thirteen ambulance stations were included and 137 of 258 personnel answered. Demographic data were analyzed using descriptive statistics. Differences among groups were analyzed with the Chi-Squared test, continuity correction and t-test. Results showed about half of the participants reported that they do not feel prepared to work in a major incident in an underground mine. The majority wished to receive educational training to enhance their preparedness. The most commonly requested type of education was practical drills on the scene, in an underground mine. The reported preparedness was significantly higher among the participants who had received some kind of education, or had authentic experience of a mission in an underground mine than those who did not. This study reveals shortcomings in the preparedness of EMS personnel. The perceived low preparedness of EMS personnel may affect their ability to work in a major incident in the mining industry. Study findings may be used in planning the future education, including practical drills, of EMS personnel.

  • 9.
    Aléx, Jonas
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Uppstu, Tom
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Arctic Research Centre at Umeå University. Umeå University, Faculty of Medicine, Department of Nursing.
    The opinions of ambulance personnel regarding using a heated mattress for patients being cared for in a cold climate - An intervention study in ambulance care2017In: International Journal of Circumpolar Health, ISSN 1239-9736, E-ISSN 2242-3982, Vol. 76, article id 1379305Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to describe the opinions of ambulance personnel regarding differences between using a heated mattress and a standard ambulance mattress. This study was an intervention study with pre- and post-evaluation. Evaluations of the opinions of personnel regarding the standard unheated mattress were conducted initially. After the intervention with new heated mattresses, follow-up evaluations were conducted. Ambulance personnel (n=64) from an ambulance station in northern Sweden took part in the study, which ran from October 2014 until February 2016. There were differences in opinions regarding the standard unheated mattress and the new heated mattress. The evaluation of the proxy ratings by the personnel showed that the heated mattress was warmer than the standard mattress, more pleasant to lie on and that patients were happier and more relaxed than when the standard mattress was used. The ambulance personnel in this study rated the experience of working with the heated mattress as very positive and proxy rated that it had a good effect on patient comfort. A heated mattress can be recommended for patients in ambulance care, even if more research is needed to receive sufficient evidence.

  • 10. Arestedt, Kristofer
    et al.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing.
    Johansson, Peter
    Blomqvist, Kerstin
    Social support and its association with health-related quality of life among older patients with chronic heart failure2013In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 12, no 1, p. 69-77Article in journal (Refereed)
    Abstract [en]

    Background: Social support is generally known to influence health-related quality of life (HRQoL), but this association is not well explored among older patients with chronic heart failure. Aims: (1) To describe social support in older patients with chronic heart failure in relation to gender. (2) To investigate if age, gender, cohabitation, perceived financial situation, and disease severity are associated with social support. (3) To investigate if social support is associated with HRQoL after controlling for age, gender, and disease severity. Methods: Data were collected in a sample of 349 patients (>= 65 years) with chronic heart failure. Patients' HRQoL was measured with the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. The Interview Schedule for Social Interaction measured social support. Data were analysed with descriptive statistics, repeated-measure ANOVA, and multiple linear regression analyses with robust standard errors. Results: Social support was generally rated high, although being a man, living alone, perceiving a problematic financial situation, and high disease severity (NYHA) were associated with lower levels of social support. Age was not associated with social support. Social support was generally associated with HRQoL, in particular the emotional dimensions. Conclusion: Taking social support into account when caring for older patients with heart failure can be of importance for improving or maintaining HRQoL.

  • 11. Bengtsson-Tops, A
    et al.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Nursing.
    Tops, D
    Staff experience and understanding of working with abused women suffering from mental illness.2009In: Health & social care in the community, ISSN 1365-2524, Vol. 17, no 5, p. 459-65Article in journal (Refereed)
    Abstract [en]

    The phenomenon of abused women with mental illness is often unrecognised by staff working within welfare services. This may be explained by staff members' attitudes, insecurity or lack of awareness. Today, there are shortcomings in the knowledge of staff members' experiences and interpretations of abuse against women suffering from mental illness. The aim of this qualitative study was to describe how staff members experience and understand their work with abused women suffering from mental illness. Thematic interviews were conducted with 13 staff members from various welfare services. Data were subject to content analysis. The findings showed that working with abused women was experienced as ambiguous and painful and made the staff act pragmatically. Feelings of ambiguity were mainly related to the lack of theoretical frameworks for interpreting why women with mental illness are exposed to abuse. Painful experiences involved intertwined feelings of distress, frustration, worthlessness, ambivalence and powerlessness. These were all feelings that emerged in the direct encounters with the abused women. In response to the abused women's comprehensive needs, staff members acted pragmatically, implying networking without any sanction from the leaders of the organisation, compliance with routines and taking action in here-and-now situations. By acting pragmatically, staff members could achieve concrete results through their interventions. It is concluded that staff members, working with abused women with mental illness, are in a vulnerable situation and in need of formally accepted and implemented support and legitimacy as well as theoretical knowledge regarding causes and consequences of abuse in this particular group of women.

  • 12. Benzein, E
    et al.
    Hagberg, M
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Familj och sociala relationer2009In: Omvårdnadens grunder: perspektiv och förhållningssätt / [ed] Febe Friberg & Joakim Öhlén, Lund: Studentlitteratur , 2009, p. 65-86Chapter in book (Other academic)
  • 13. Benzein, E
    et al.
    Hagberg, M
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Familj och sociala relationer2010In: Omvårdnadens grunder: en specialutgåva för sjuksköterskor / [ed] Anna-Karin Edberg, Lund: Studentlitteratur , 2010, p. 107-128Chapter in book (Other academic)
  • 14. Benzein, Eva Gunilla
    et al.
    Hagberg, Margaretha
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    'Being appropriately unusual': a challenge for nurses in health-promoting conversations with families.2008In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 15, no 2, p. 106-115Article in journal (Refereed)
    Abstract [en]

    This study describes the theoretical assumptions and the application for health-promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family-focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families' resources, and the relationship between the family and its environment. By posing reflective questions, reflection is made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co-creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced.

  • 15. Benzein, Eva Gunilla
    et al.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Health-promoting conversations about hope and suffering with couples in palliative care.2008In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 14, no 9, p. 439-445Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Families living with a dying relative face existential challenges which need to be met by caregivers in a dialogue. AIM: To describe couples' experiences of participating in nurse-initiated health-promoting conversations about hope and suffering during home-based palliative care. METHOD: Data comprised semi-structured evaluative interviews with six couples. Each couple together had previously participated in three health-fostering conversations with nurses. Data were analyzed by content. RESULT: Talking with nurses about existential issues such as hope and suffering made couples feel that they were part of a trustful relationship, and that it was a healing experience. It gave them the opportunity to unburden themselves, as well as a way of learning and finding new strategies for managing daily life. CONCLUSION: Health-promoting conversations about hope and suffering should be implemented as a natural part of the caring relationship between caregivers and families in the palliative context.

  • 16. Benzein, Eva
    et al.
    Johansson, Pauline
    Arestedt, Kristofer Franzen
    Berg, Agneta
    Saveman, Britt-Inger
    School of Human Sciences, Kalmar University, Kalmar, Sweden .
    Families' importance in nursing care: nurses' attitudes - an instrument development2008In: Journal of Family Nursing, ISSN 1074-8407, E-ISSN 1552-549X, Vol. 14, no 1, p. 97-117Article in journal (Refereed)
    Abstract [en]

    This article describes the development and testing of a research instrument, Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA), designed to measure nurses' attitudes about the importance of involving families in nursing care. The instrument was inductively developed from a literature review and tested with a sample of Swedish nurses. An item-total correlation and a first principal component analysis were used to validate the final instrument, including a second principal component analysis to analyze dimensionality, and Cronbach's alpha was used to estimate internal consistency. The instrument consists of 26 items and reveals four factors: families as a resource in nursing care, family as a conversational partner, family as a burden, and family as its own resource. Cronbach's alpha was 0.88 for the total instrument and 0.69 to 0.80 for the subscales. The instrument requires further testing with other nurse populations.

  • 17.
    Bylund, Per-Olof
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Rolfsman, Ewa
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Departement of Educational Measurement.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Injuries before and after the implementation of traffic safety countermeasures: a case study of a pedestrian and bicycle bridge2013In: Safety Science Monitor, ISSN 1443-8844, Vol. 17, no 2, p. 5-Article in journal (Refereed)
    Abstract [en]

    The implementation of community injury prevention programs in order to reduce injuries caused by road traffic incidents has been a public health priority for many years. The purpose of this case-study was to investigate whether the implementation of traffic safety countermeasures on a bridge for bicyclists and pedestrians was effective in reducing the number and severity of injuries. The study was based on data from the injury database at the University Hospital of Umeå and includes data from 74 injured persons. Injury incidence, injury severity and the circumstances associated with injury incidences are reported. There was an increase in the incidence of both moderate and more serious injuries, such as brain injuries and fractures of upper extremities, after the safety countermeasures were put in place. Falls due to overturning with the bicycle dominated among single crashes. Collisions and crashes caused by giving way to pedestrians or other bicyclists were the most common types of crash. The main finding is that the modification of the bridge, which aimed to reduce injuries, has not been successful, in particular with reference to the incidence of severe injuries.

  • 18.
    Bölenius, Karin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vestin, Christin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gyllencreutz, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Validating a questionnaire - prehospital preparedness for pediatric trauma patients2017In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 34, p. 2-6Article in journal (Refereed)
    Abstract [en]

    In recent decades, prehospital emergency care has undergone extensive development. Today, prehospital emergency nurses (PENs) are well trained and provide advanced care to patients of all ages. Caring for pediatric trauma patients is considered to be particularly demanding. However, in Sweden and internationally, there is a lack of research regarding PENs' preparedness for caring for pediatric trauma patients.

    Objective: The development and testing of a questionnaire on self-reported preparedness among PENs caring for pediatric trauma patients in a prehospital emergency setting.

    Methods: Questionnaire development included face and content validity tests resulting in 38 questions. Eighteen of these questions were analyzed by test-retest. The content of the questionnaire was statistically analyzed.

    Results: Fifteen questions were considered valid after reliability and validity tests. Three questions did not fulfill the stability criteria. The content analyses show a low degree of experience with pediatric trauma patients and half of the participants reported stress symptoms when responding to such alarms.

    Conclusion: The questionnaire assessing PENs preparedness caring for pediatric trauma patients in Sweden is considered to be suitable for research and clinical practice to improve the care of pediatric trauma patients and the health of PENs, although further testing of the questionnaire is required.

  • 19.
    Doohan, Isabelle
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Östtlund, Ulrika
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study2017In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 32, no 2, p. 165-174Article in journal (Refereed)
    Abstract [en]

    Objective The aim of this study was to explore physical and mental consequences and injury mechanisms among bus crash survivors to identify aspects that influence recovery. Methods The study participants were the total population of survivors (N=56) from a bus crash in Sweden. The study had a mixed-methods design that provided quantitative and qualitative data on injuries, mental well-being, and experiences. Results from descriptive statistics and qualitative thematic analysis were interpreted and integrated in a mixed-methods analysis. Results Among the survivors, 11 passengers (20%) sustained moderate to severe injuries, and the remaining 45 (80%) had minor or no physical injuries. Two-thirds of the survivors screened for posttraumatic stress disorder (PTSD) risk were assessed, during the period of one to three months after the bus crash, as not being at-risk, and the remaining one-third were at-risk. The thematic analysis resulted in themes covering the consequences and varying aspects that affected the survivors' recoveries. The integrated findings are in the form of four core cases of survivors who represent a combination of characteristics: injury severity, mental well-being, social context, and other aspects hindering and facilitating recovery. Core case Avery represents a survivor who had minor or no injuries and who demonstrated a successful mental recovery. Core case Blair represents a survivor with moderate to severe injuries who experienced a successful mental recovery. Core case Casey represents a survivor who sustained minor injuries or no injuries in the crash but who was at-risk of developing PTSD. Core case Daryl represents a survivor who was at-risk of developing PTSD and who also sustained moderate to severe injuries in the crash. Conclusion The present study provides a multi-faceted understanding of mass-casualty incident (MCI) survivors (ie, having minor injuries does not always correspond to minimal risk for PTSD and moderate to severe injuries do not always correspond to increased risk for PTSD). Injury mitigation measures (eg, safer roadside material and anti-lacerative windows) would reduce the consequences of bus crashes. A well-educated rescue team and a compassionate and competent social environment will facilitate recovery.

  • 20.
    Doohan, Isabelle Marie
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing. Affiliated to Arctic Research Centre, Umeå University, Umeå, Sweden.
    Gyllencreutz, Lina
    Umeå University, Faculty of Medicine, Department of Nursing. Affiliated to Arctic Research Centre, Umeå University, Umeå, Sweden.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Affiliated to Arctic Research Centre, Umeå University, Umeå, Sweden.
    Survivors' experiences of consequences and recovery five years after a major bus crash2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 3, p. 1179-1187Article in journal (Refereed)
    Abstract [en]

    Rationale: There is a lack of long-term follow-up studies focused on injured and uninjured survivors’ experiences of the recovery process after major traffic crashes.

    Aim/objective: To explore survivors’ experiences of long-term physical and psychological consequences and recovery five years after a major bus crash.

    Methodological design and justification: A qualitative design was used to explore experiences in a 5-year follow-up study.

    Research methods: Participants were 54 survivors of a bus crash with 56 survivors and six fatalities. Telephone interviews were analyzed with qualitative content analysis.

    Results: The theme overarching the categories is “visible and existential marks in everyday life” and it represents the range of the crash’s influence in the survivors’ lives. The first category, “health consequences in daily life,” has four subcategories covering quick recovery, suffering in daily life, distress in traffic situations, and long-term pain. Described reasons for quick recovery among survivors were previous crisis experiences, traveling alone, being uninjured, and not being exposed to traumatic impressions. For the other survivors, being reminded of the crash caused disturbing reactions, such as sweating, anxiety, and flashbacks. Survivors avoided going by bus if they could. A group of the injured survivors were still suffering from limiting and painful injuries. The second category, “oneself and social connection,” has three subcategories that include self-awareness, impact on relationships, and connectedness. Survivors developed a stronger bond to their significant other or separated from their partner within the first couple of years. Friendships and a sense of connectedness among survivors were sources of long-lasting comfort and support.

    Conclusion: There is a need for more information about disruptive long-lasting consequences, such as travel anxiety, and available treatments. Initially, health-promoting connectedness can be facilitated by treating survivors as a group of people who belong together, from the day of the crash and throughout the recovery process. 

  • 21.
    Doohan, Isabelle
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Centre for Research and Development in Disaster Medicine, Umeå University.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Impact on life after a major bus crash - a qualitative study of survivors' experiences2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 1, p. 155-163Article in journal (Refereed)
    Abstract [en]

    Background Crashes occur regularly throughout the world and can result in multiple fatalities and many injuries. Research into how survivors experience a crash is very limited. AimTo describe and analyse the nonphysical consequences of a multifatality bus crash in Sweden and the subsequent effect on the surviving passengers' lives. MethodThe participants were all (n=56) of the survivors of a major bus crash. The passengers were interviewed approximately one month after the bus crash. The interviews were analysed using a qualitative content analysis. ResultsPrior to the arrival of rescue personnel at the crash site, helpfulness emerged among the passengers. Further, the crash generated an impact on the surviving passengers' lives from a short-term perspective. The passengers displayed a diverse need for crisis support; informal support from family and friends was essential for the early healing process. Sleep difficulties and a change in travel routines were the most common consequences. Lastly, passengers sought closure in order to move on with their lives. ConclusionThe passengers' reactions to and behaviour following a crash offer an insight into the, relatively unexplored, interaction between people experiencing a major road traffic crash. It is necessary to have a flexible crisis support system, and the vital role of family support ought to be upgraded.

  • 22.
    Doohan, Isabelle
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Need for compassion in prehospital and emergency care: a qualitative study on bus crash survivors' experiences2015In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 23, no 2, p. 115-119Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the survivors' experiences after a major bus crash. Background: Survivors' experiences of emergency care after transportation related major incidents are relatively unexplored, with research involving survivors mainly focused on pathological aspects or effects of crisis support. Methods: Semi-structured telephone interviews were conducted with 54 out of 56 surviving passengers 5 years after a bus crash in Sweden. Interviews were analyzed using qualitative content analysis. Results: Prehospital discomfort, lack of compassionate care, dissatisfaction with crisis support and satisfactory initial care and support are the categories. Lack of compassion in emergency departments was identified as a main finding. Lack of compassion caused distress among survivors and various needs for support were not met. Survivors' desire to be with their fellow survivors the day of the crash was not facilitated after arriving at emergency departments. Conclusions: Connectedness among survivors ought to be promoted upon arrival at emergency departments. There is a need for emergency department professionals to be sufficiently educated in compassionate care.

  • 23. Englund, L
    et al.
    Forsberg, Rebecca
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Nursing.
    Survivors´ experiences of media coverage after traumatic injury events2012In: International emergency nursing, ISSN 1755-599XArticle in journal (Refereed)
  • 24. Englund, Liselotte
    et al.
    Forsberg, Rebecca
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Survivors' experiences of media coverage after traumatic injury events2014In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 22, no 1, p. 25-30Article in journal (Refereed)
    Abstract [en]

    Survivors' experiences of media at traumatic events, is still a limited research area. The aim of this study is to explore survivors' experiences of interacting with journalists and media coverage, including their experiences of being portrayed in the media, following two Swedish train crashes. Qualitative interviews were conducted with passengers from two train crashes in Sweden. A qualitative content analysis generated meaning units, subcategories, and categories. Survivors experienced interacting with journalists mainly in three ways: harmful, inconsequential, and helpful. Media content and personal media exposure was experienced in a similar way: uncomfortable, insignificant, and useful. Journalists and media coverage have a large impact on survivors' experiences following a traumatic event. It is important that emergency responders, such as ambulance nurses, are aware of how victims are affected by journalists' presence and the media coverage that follows so that negative outcomes can be reduced and the positive can be enhanced. The present study also shows that media coverage in the long term can become important pieces of information for the victim in order to understand and process the traumatic event. (C) 2013 Elsevier Ltd. All rights reserved.

  • 25.
    Engström, Karl Gunnar
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Angrén, John
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mass casualty incidents in the underground mining industry: applying the Haddon Matrix on an integrative literature review2018In: Disaster Medicine and Public Health Preparedness, ISSN 1935-7893, E-ISSN 1938-744X, Vol. 12, no 1, p. 138-146Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Underground mining is associated with obvious risks that can lead to mass casualty incidents. Information about such incidents was analyzed in an integrated literature review.

    METHODS: A literature search (1980-2015) identified 564 modern-era underground mining reports from countries sharing similar occupational health legislation. These reports were condensed to 31 reports after consideration of quality grading and appropriateness to the aim. The Haddon matrix was used for structure, separating human factors from technical and environmental details, and timing.

    RESULTS: Most of the reports were descriptive regarding injury-creating technical and environmental factors. The influence of rock characteristics was an important pre-event environmental factor. The organic nature of coal adds risks not shared in hard-rock mines. A sequence of mechanisms is commonly described, often initiated by a human factor in interaction with technology and step-wise escalation to involve environmental circumstances. Socioeconomic factors introduce heterogeneity. In the Haddon matrix, emergency medical services are mainly a post-event environmental issue, which were not well described in the available literature. The US Quecreek Coal Mine incident of 2002 stands out as a well-planned rescue mission.

    CONCLUSION: Evaluation of the preparedness to handle underground mining incidents deserves further scientific attention. Preparedness must include the medical aspects of rescue operations.

  • 26. Erlingsson, Christen
    et al.
    Carlson, Sharon L
    Åström, Sture
    Umeå University, Faculty of Medicine, Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Nursing.
    Dilemmas in Witnessing Elder Abuse in Caregiving Situations: A Family Member Perspective2009In: Southern Online Journal of Nursing Research, Vol. 9, no 1Article in journal (Refereed)
  • 27.
    Erlingsson, Christen
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Carlson, Sharon
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    The secret shame of witnessing elder abuse in the familyManuscript (preprint) (Other academic)
  • 28. Erlingsson, Christen
    et al.
    Ono, Mitsu
    Sasaki, Akiko
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    An international collaborative study comparing Swedish and Japanese nurses' reactions to elder abuse2012In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 68, no 1, p. 56-68Article in journal (Refereed)
    Abstract [en]

    Aim.  This paper reports an analysis of aggregated data from two national studies on Swedish community-based nurses' and Japanese Public Health Nurses' responses to hypothetical elder abuse cases.

    Background.  Elder abuse is an under-researched area despite being globally recognized as a serious and escalating problem. Yet research, adding needed socio-cultural perspectives to current knowledge has been limited.

    Methods.  Eighty-one community-based nurses in Sweden and 124 Public Health Nurses in Japan responded to a questionnaire based on three hypothetical elder abuse cases. Swedish and Japanese results (data collection 2006-2007) were combined and the aggregated data were analysed using manifest and qualitative content analyses.

    Results.  Nurses' response patterns in the aggregated data were similar across all three hypothetical cases and within themes Awareness, Assessment and Intervention. However, there were also noteworthy differences between Swedish and Japanese responses, e.g. Swedish responses were generally practical, action oriented and involved increased levels of suspicion and personal intervention to achieve increased control; whereas Japanese responses concerned better understanding that involved the family members and their situation, focusing on interventions grounded in collaboration.

    Conclusion.  Despite cultural differences, responses of Swedish and Japanese nurses were very similar which points to a global 'humanness' of the problem of, and nurses' responses to, elder abuse. Results endorse the value of international collaborations that give information and inspiration to nursing colleagues across cultural boundaries. Results also give hope that global tools for elder abuse assessment and intervention can be developed.

  • 29.
    Forsberg, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Survivors' experiences from a train crash2011In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, no 4, p. 8401-Article in journal (Refereed)
    Abstract [en]

    Rarely described are people's lived experiences from severe injury events such as train crashes. The number of train crashes named disasters with ≥10 killed and/or ≥100 nonfatally injured grows globally and the trend shows that more people survive these disasters today than did so in the past. This results in an increased number of survivors needing care. The aim of the study was to explore survivors' experiences from a train crash. Narrative interviews were performed with 14 passengers 4 years after a train crash event. Qualitative content analysis was used to analyse the interviews. Experiences were captured in three main themes: (1) Living in the mode of existential threat describes how the survivors first lost control, then were thrown into a state of unimaginable chaos as they faced death. (2) Dealing with the unthinkable described how survivors restored control, the central role of others, and the importance of reconstructing the event to move forward in their processing. (3) Having cheated death shows how some became shackled by their history, whereas others overcame the haunting of unforgettable memories. Furthermore, the result shows how all experienced a second chance in life. Experiencing a train crash meant that the passengers experienced severe vulnerability and a threat to life and interdependence turned out to play a crucial role. Focusing on helping other passengers on site was one way to regain the loss of control and kept the chaos at bay. Family, friends, and fellow passengers turned out to be extremely important during the recovery process why such closeness should be promoted and facilitated.

  • 30.
    Gyllencreutz, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Johanna
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Rolfsman, Ewa
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Outdoor pedestrian fall-related injuries among Swedish senior citizens: injuries and preventive strategies2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 2, p. 225-233Article in journal (Refereed)
    Abstract [en]

    Senior citizens get around, to a large extent, as pedestrians, and safe walking is desirable for senior citizens allowing them to stay mobile, independent and healthy in old age. Senior citizens are over-represented in injury statistics, and fall-related injuries are common. The aim of this study was to investigate fall-related injuries including healthcare costs among senior citizen pedestrians injured when walking in public outdoor environments and to describe their self-reported causes and suggested preventive strategies. The data were based on a combination of information from injury data and a questionnaire. Three hundred senior citizens attended one emergency department after sustaining injuries from pedestrian falls; 60% suffered nonminor injuries, mostly fractures. One-fifth of the pedestrians were hospitalised for an average of 8 days with an indirect hospital cost of 6.2 million EUR (55 million SEK). Environmental factors such as ice were the most commonly described cause of the injury incident. Forty per cent of the respondents indicated that the municipality was responsible for the cause of the injury incident. Fewer respondents mentioned their own responsibility as a preventive strategy. Thirty per cent described a combination of improvements such as better road maintenance, changes in human behaviour and use of safety products as preventive strategies. It is of great importance to highlight general safety, products and preventive strategies to minimise injury risks, so that pedestrians can safely realise the known health benefits of walking and thereby limit healthcare costs.

  • 31.
    Gyllencreutz, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Pedersen, Ida
    Umeå University, Faculty of Medicine, Department of Nursing.
    Enarsson, Elisabeth
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bölenius, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    The experience of healthcare staff of incident reporting with respect to venous blood specimen collection practices’2019In: Policy and Practice in Health and Safety, ISSN 1477-3996, E-ISSN 1477-4003, Vol. 17, no 2, p. 146-155Article in journal (Refereed)
    Abstract [en]

    Venous blood specimen collection is an important practical task that results in an analysis response that often leads to a clinical decision. Errors due to inaccurate venous blood specimen collection are frequently reported and can jeopardize patient safety because inaccurate specimens may result in a delayed or incorrect diagnosis and treatment. However, few healthcare personnel have written an error report regarding venous blood specimen collection practices. The aim of this study is to describe the experiences of healthcare personnel with incident reporting of venous blood specimen collection practices in primary health care. Our study is based on 30 individual interviews with healthcare personnel from 10 primary health care centres. Data were analysed using qualitative content analyses. Personnel experiences of incident reporting were summarized in three categories; Uncertainties in the planning and organization, High workload and low priority and, A need for support and guidance. More specifically, barriers hinder personnel in reporting mistakes. An interpretation based on the results is that surrounding circumstances within the organization influence whether personnel report mistakes or not. The result indicates a need for parallel systems, to identify and report errors or near-misses to prevent mistakes. Processed incidents should be returned promptly to the personnel to use as a learning experience. Having a valid questionnaire and a key person to write an incident report, might reduce the burden on the health care staff and increase the numbers of incident reports and patient safety.

  • 32.
    Gyllencreutz, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rolfsman, Ewa
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Frånberg, Gun-Marie
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Approve or disapprove risky outdoor play among school children: a field studyManuscript (preprint) (Other academic)
  • 33.
    Gyllencreutz, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rolfsman, Ewa
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Frånberg, Gun-Marie
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Injury risks during outdoor play among Swedish schoolchildren: teachers’ perceptions and injury preventive practices2018In: Education 3-13, ISSN 0300-4279, E-ISSN 1475-7575Article in journal (Refereed)
    Abstract [en]

    Approximately 36,000 Swedish children seek medical care annually because of injuries during school time. The purpose of this field study is to investigate risky outdoor play at the school yard and to describe teachers’ perceptions of risk and safety in relation to learning and development. The study includes observations of children (6–12 years old) during outdoor activities as part of the school’s activities and includes focus-group interviews with teachers and children. Children were seen climbing high in play facilities, speeding down slides, or competing with sticks in the woods. Different views of risk and safety among the participants influence outdoor play activities. Teachers’ knowledge of risk seems to be derived from common sense and personal experiences rather than from a professional perspective. A joint approach of educational and medicine disciplines is desirable when it comes to children’s health and development.

  • 34.
    Gyllencreutz, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rolfsman, Ewa
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Non-minor injuries among children sustained in an outdoor environment: a retrospective register study2015In: International Journal of Injury Control and Safety Promotion, ISSN 1745-7300, E-ISSN 1745-7319, Vol. 22, no 1, p. 3-10Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate non-minor injuries sustained during outdoor activities among 0-12 year old children and to explore self-reported circumstances surrounding these incidents. During 2007-2009, the Umea University Hospital injury database (IDB) registered 795 children with moderate (n = 778) and serious (n = 17) injuries, such as fractures. The IDB includes data from a questionnaire completed in the emergency department by the injured child or a parent. The open-ended questions catch the injured child's description of what circumstances precede the injury incident. The most commonly reported activities contributing to injuries were play, sport, and transport. Surface impacts were also reported as contributing factors along with products such as trampolines, bicycles, and downhill skis. By achieving a deeper knowledge about the activities and circumstances that precede non-minor injury incidents, creating safer outdoor environments may be feasible.

  • 35.
    Gyllencreutz, Lina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Everyday outdoor mobility in old age: focus group interviews with active senior citizens2015In: Healthy Aging Research, ISSN 2261-7434, Vol. 4, article id 32Article in journal (Refereed)
    Abstract [en]

    Background: Senior citizens are over-represented in injury statistics, and fall-related injuries are globally recognized as a major threat to their health and wellbeing. Outdoor falls are likely to occur among those who are active and healthy when walking or cycling. The objective of this study was to explore active senior citizens’ experiences and perceptions of how their safety could be increased and their risk reduced in outdoor environments.

    Methods: Six focus-group interviews with 31 healthy and active senior citizens were conducted in northern Sweden. Data were analyzed via a qualitative content analysis method.

    Results: Participants adjusted to age-related changes in order to stay safe during outdoor mobility. Outdoor activities were facilitated by having confidence of safety within the environment, and by using safety devices. Fear of, for example, falling and dangerous environments, such as uneven surfaces, as well as the shortcomings of safety devices, were constraining elements for outdoor activity.

    Conclusions: It is of great importance to raise awareness of healthy aging and to illuminate directions for environmental changes. Asking old people about their experiences allows the researcher to identify with their perspective, and may give a more comprehensive understanding of the most appropriate recommendations for health and safety improvements.

  • 36.
    Hanberger, Anders
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Umeå Centre for Evaluation Research (UCER).
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bylund, Per-Olof
    Akut och katastrofmedicinskt centrum, Norrlands universitetssjukhus, Umeå.
    Metodologiska utgångspunkter för forskningsprogrammet ”Säkerhetsarbetets relevans och effekter”2010Report (Other academic)
    Abstract [sv]

    Rapporten har utvecklat och sammanfattat programmets metodologiska utgångspunkter. Centrala begrepp har definierats och motiverats. Principiella frågor kring utvärdering av relevans och effekter av säkerhetsarbeten och säkerhetsprogram har också diskuterats. De överväganden som diskuteras och de ställningstaganden som gjorts i rapporten kommer att vägleda arbetet och konkretiseras i forskningsprocessen. Utgångspunkterna kommer att vid behov anpassas till de utmaningar som forskarna ställs inför. I slutrapporten kommer programmets metodologiska lärdomar att redovisas och diskuteras.

  • 37.
    Hanberger, Anders
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Umeå Centre for Evaluation Research (UCER).
    Gyllencreutz, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Studies of effects of local safety policy: an overview and narrative synthesis2013Report (Other academic)
    Abstract [en]

    The objective is to describe existing studies of effects of local safety policy (LSP), aimed at reducing risks, preventing injuries and improving the safety in a community, in an overview. LSP refers to all kinds of safety interventions including one- and multi-component interventions.

    Methods: We screened six databases for publications published 2000-2011 and selected publications through title/abstract and full-text exam. The search terms corresponded to the concept LSP. Studies of health care, crime, fire prevention, industry, terrorism, and traffic with motorized vehicles were excluded. The main findings were categorized as positive, mixed, and no intervention effects.

    Results: 22 reviews and 45 primary studies were selected. The safety domains/target groups evaluated in these studies include: home (n=272), child (n=253), whole population/community (n=142), elderly (n=130), bicyclist (n=67), pedestrian (n=40), and school safety (n=15). Education was the most frequently studied intervention followed by exercise/training and safety inspection/assessment. Bicycle helmet legislation, safety education, burn prevention, traffic calming, and fall prevention exercise programs were found to be effective for some age groups of the population.

    Conclusion: Positive intervention effects are contingent, dependent on many factors, and require a valid intervention theory and successful implementation. There is a need to support continuing collection of local intervention and outcome data, and to develop evaluation of local safety interventions.

    Implications: A policy implication of this overview is the need for supporting improved monitoring and evaluation of LSP. Support for continuing collection of high-quality data, preferably disaggregated, on safety interventions,   incidents, and injuries on the local level would allow for better conclusions on intervention effects.

  • 38.
    Hanberger, Anders
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Umeå Centre for Evaluation Research (UCER).
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bylund, Per-Olof
    Lundström, Ulf
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Umeå Centre for Evaluation Research (UCER).
    Mårald, Gunilla
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Umeå Centre for Evaluation Research (UCER).
    Rolfsman, Ewa
    Umeå University, Faculty of Social Sciences, Department of applied educational science, Departement of Educational Measurement.
    Säkerhetsarbetets relevans och effekter: slutrapport från ett femårigt forskningsprogram2013Report (Other academic)
  • 39.
    Henriksson, Otto
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundgren, Peter J.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Protection against cold: a survey of available equipment in Swedish pre-hospital services2017In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, no 10, p. 1354-1360Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to survey the current equipment used for prevention, treatment and monitoring of accidental hypothermia in Swedish pre-hospital services.

    Methods: A questionnaire was sent to all road ambulance services (AS), the helicopter emergency medical services (HEMS), the national helicopter search and rescue service (SAR) and the municipal rescue services (RS) in Sweden to determine the availability of insulation, active warming, fluid heating, and low-reading thermometers.

    Results: The response rate was 77% (n = 255). All units carried woollen or polyester blankets for basic insulation. Specific windproof insulation materials were common in the HEMS, SAR and RS units but only present in about half of the AS units. Active warming equipment was present in all the SAR units, but only in about two-thirds of the HEMS units and about one-third of the AS units. About half of the RS units had the ability to provide a heated tent or container. Low-reading thermometers were present in less than half of the AS and HEMS units and were non-existent in the SAR units. Pre-warmed intravenous fluids were carried by almost all of the AS units and half of the HEMS units but infusion heaters were absent in most units.

    Conclusion: Basic insulation capabilities are well established in the Swedish pre-hospital services. Specific wind and waterproof insulation materials, active warming devices, low-reading thermometers and IV fluid heating systems are less common. We suggest the development and implementation of national guidelines on accidental hypothermia that include basic recommendations on equipment requirements.

  • 40.
    Holgersson, Annelie
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Forsberg, Rebecca
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Inre säkerheten i tåg eftersatt: fallstudie efter tågkraschen i Kimstad2012In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 109, no 1-2, p. 24-26Article in journal (Refereed)
    Abstract [sv]

    Delar av tågnätet i Sverige är i dag överbelastat, vilket försvårar möjligheterna till underhåll samtidigt som slitaget ökar. Tåghastigheten ökar, liksom antalet skadehändelser och deras allvarlighetsgrad, medan säkerhetsarbetet halkar efter. Inredning, glas och bagage hade stor inverkan på skadebilden vid tågkraschen i Kimstad år 2010. Avståndet till banvallen utgjorde sekundär skaderisk vid evakueringen. Inredningen orsakade allvarligast skador, bagaget moderata skador och glas många, men lindriga skador. Energiabsorberande ytor, luckor för bagageförvaring samt antilacerativa fönster kan reducera antalet skador vid en tågkrasch. Evakueringen kan underlättas av tillgång till utfällbara stegar.

  • 41.
    Holgersson, Annelie
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Sahovic, Dzenan
    Umeå University, Faculty of Social Sciences, Department of Political Science.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Factors influencing responders' perceptions of preparedness for terrorism2016In: Disaster Prevention and Management, ISSN 0965-3562, E-ISSN 1758-6100, Vol. 25, no 4, p. 520-533Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this paper is to analyse factors influencing perceptions of preparedness in the response to terrorist attacks of operational personnel in Swedish emergency organizations. Design/methodology/approach: Data were collected using a questionnaire distributed to operational personnel from the police, rescue and ambulance services in eight Swedish counties; 864 responses were received and analysed. Findings: Three aspects of the perception of preparedness for terrorist attacks among Swedish emergency responders were studied: willingness to respond; level of confidence with tasks; and estimated management capability. Factors which positively influenced these perceptions were male sex, training in first aid and dealing with mass casualty incidents, terrorism-related management training (MT), table-top simulations, participation in functional exercises, and access to personal protective equipment (PPE); work experience was inversely related. Occupation in police or rescue services was positively associated with willingness to respond whereas occupation within the emergency medical services was positively associated with estimated management capability. Practical implications: These findings show that terrorism-related MT and access to PPE increase the perceptions of preparedness for terrorism among the emergency services, aiding judgements about investments in preparedness by crisis management planners. Originality/value: Limited research in disaster management and hazard preparedness has been conducted in a European context, especially regarding terrorism. Little is known about aspects of preparedness for terrorism in Sweden, particularly from the perspective of the emergency responders.

  • 42.
    Holgersson, Annelie
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kunskapsöversikt - passagerarsäkerhet i tåg2011Report (Refereed)
  • 43.
    Johansson, Pauline
    et al.
    Linnaeus Univ, SE-39182 Kalmar, Sweden.
    Petersson, Goran
    Linnaeus Univ, SE-39182 Kalmar, Sweden.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nilsson, Gunilla
    Linnaeus Univ, SE-39182 Kalmar, Sweden.
    Using advanced mobile devices in nursing practice - the views of nurses and nursing students2014In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 20, no 3, p. 220-231Article in journal (Refereed)
    Abstract [en]

    Advanced mobile devices allow registered nurses and nursing students to keep up-to-date with expanding health-related knowledge but are rarely used in nursing in Sweden. This study aims at describing registered nurses' and nursing students' views regarding the use of advanced mobile devices in nursing practice. A cross-sectional study was completed in 2012; a total of 398 participants replied to a questionnaire, and descriptive statistics were applied. Results showed that the majority of the participants regarded an advanced mobile device to be useful, giving access to necessary information and also being useful in making notes, planning their work and saving time. Furthermore, the advanced mobile device was regarded to improve patient safety and the quality of care and to increase confidence. In order to continuously improve the safety and quality of health care, advanced mobile devices adjusted for nursing practice should be further developed, implemented and evaluated in research.

  • 44. Johansson, Pauline
    et al.
    Petersson, Göran
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nilsson, Gunilla
    Experience of mobile devices in nursing practice2012In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 32, no 4, p. 50-54Article in journal (Refereed)
    Abstract [en]

    Background: In nursing care, the steady increase of healthrelated information implies that there is need for useful tools thateasily provide mobile access to accurate information.Aim: This study is aimed at exploring nurses’ and nursingstudents’ experience of using a mobile device in nursing practice,with the emphasis on usefulness, information retrieval, savingtime, patient safety, the quality of care, and confidence in thework performed.Methods: In this descriptive intervention study, registered nurses(RN) (n=14) and nursing students (NS) (n=7) used mobiledevices in nursing practice during a period of 15 weeks, andreplied to questionnaires prior to and after the intervention.Results and conclusion: We found that the mobile device wasperceived as useful and was presumed to imply increased confidenceand time savings, and to contribute to improved patientsafety and quality of care by enhancing access to necessaryinformation. To facilitate nursing practice, mobile devicesadjusted for technical, statutory, cultural, and language countryspecificconditions, should be further developed and implementedfor RNs and NSs. Furthermore, future research shouldinclude the end-users’ views.

  • 45.
    Jong, Mats
    et al.
    Department of Nursing, Mid Sweden University and Mid Sweden Research & Development Centre, Västernorrland County Council, Sundsvall.
    Westman, Anton
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Experiences of Injuries and Injury Reporting among Swedish Skydivers2014In: Open Access Journal of Sports Medicine, ISSN 1179-1543, E-ISSN 1179-1543, p. 102645-Article in journal (Refereed)
    Abstract [en]

    The objective was to illuminate the experience of injuries and the process of injury reporting within the Swedish skydiving culture. Data contained narrative interviews that were subsequently analyzed with content analysis. Seventeen respondents (22–44 years) were recruited at three skydiving drop zones in Sweden. In the results injury events related to the full phase of a skydive were described. Risk of injury is individually viewed as an integrated element of the recreational activity counterbalanced by its recreational value. The human factor of inadequate judgment such as miscalculation and distraction dominates the descriptions as causes of injuries. Organization and leadership act as facilitators or constrainers for reporting incidents and injuries. On the basis of this study it is interpreted that safety work and incident reporting in Swedish skydiving may be influenced more by local drop zone culture than the national association regulations. Formal and informal hierarchical structures among skydivers seem to decide how skydiving is practiced, rules are enforced, and injuries are reported. We suggest that initial training and continuing education need to be changed from the current top-down to a bottom-up perspective, where the individual skydiver learns to see the positive implications of safety work and injury reporting.

  • 46.
    Karlsson, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Gyllencreutz, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Engström, Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Björnstig, Ulf
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Preparedness for mining injury incidents: interviews with Swedish rescuers2017In: Safety Science Monitor, ISSN 1443-8844, Vol. 20, no 1, article id 5Article in journal (Refereed)
    Abstract [en]

    Objectives. To explore the perceptions and experiences of mining-, rescue service- (RS), and emergency medical service (EMS) personnel regarding how to handle incidents in an underground mine.

    Methods. Six focus-group interviews and 10 individual interviews were carried out with groups of mining-, RS and EMS personnel, who served the underground mining industry located in small municipalities in a sparsely populated area of northern Sweden. The transcripts of the interviews were analysed using qualitative content analysis.

    Results. The three groups mostly described experiences of minor incidents and announced a limited preparedness for handling major mining incidents. Collaboration was described as being difficult because of limited knowledge about the others’ responsibilities and capacities. Few non-mining personnel were trained, or prepared to fulfil their tasks in an underground environment, and some expressed that they would even refuse to go underground because of concerns for their own safety.

    Conclusions. There is a need for more collaboration and joint practices between and among the groups involved in rescue operations. Collaboration between mine- and RS personnel exists, but the EMS personnel is largely excluded from this interaction. Therefore, the EMS personnel are insecure about how to handle underground mining incidents. A closer collaboration between all organizations in preparing for mining incidents is emphasized, and would have positive effects on the rescue operation. Some experiences may also be used under similar circumstances, such as incidents in railway and road tunnels.

  • 47.
    Lindh, Viveca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Persson, Chatrin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences. Umeå University, Faculty of Medicine, Department of Nursing.
    Englund, Claire
    Umeå University, Umeå University Library, Centre for teaching and learning (UPL).
    Idberger, Karl
    Umeå University, Umeå University Library, Centre for teaching and learning (UPL).
    Östlund, Ulrika
    Umeå University, Faculty of Medicine, Department of Nursing.
    An initiative to teach family systems nursing using online health-promoting conversations: A multi-methods evaluation2013In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 3, no 2, p. 54-66Article in journal (Refereed)
    Abstract [en]

    Background: Family systems nursing embraces the view that one family member’s illness affects other family members and vice versa. Family nursing developed as a way for nurses to work with families to promote health. Previously, teachers performed most of the education on health-promoting conversations with families on campus. Because online education is increasingly requested in nursing, this article evaluates teaching family systems nursing by using synchronous online health-promoting conversations.

    Methods: Fifteen registered nurses attended the course “Health-Promoting Family Focused Nursing”, an advanced-level nursing elective 10-week course. The course used technology enhanced learning and was evaluated qualitatively and quantitatively. Students and teachers participated in semi-structured focus group interviews analyzed qualitatively. The students filled in a traditional course evaluation. Students responded before and after the course to the multidimensional research instrument “Families’ Importance in Nursing Care—Nurse’s Attitudes” (FINC-NA).

    Results: The students were satisfied with the course and the synchronous health-promoting conversations. They learned to “think family” and acknowledged the importance of inviting families to take part in the care of a family member. They stated that the online practice had helped them gain a useful tool for their future family nursing practice. The teachers appreciated working in a team to develop the course. At the start of the project they viewed the online technology as a challenge. However, during the course they saw many pedagogical possibilities with the synchronous meetings and that the online family conversation training worked well. The ability to record the meetings offered educational advantages and the opportunity for students to reflect on the conversations. Even if the students rated families importance in nursing care positively prior to the course on FINC-NA, the students still gave the following domains even stronger support post-course: Family as a resource in nursing care, Family as a burden, and Family as own resource.

    Conclusions: Family systems nursing and health-promoting conversations with families, comprising interaction between several participants, can be learned using online pedagogical methods. Furthermore, the belief that health-promoting family conversations need to be held with all participants in the same room has been challenged.

  • 48. Lindquist, Anna M
    et al.
    Johansson, Pauline E
    Petersson, Göran I
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Nilsson, Gunilla C
    The use of the Personal Digital Assistant (PDA) among personnel and students in health care: a review2008In: Journal of Medical Internet Research, ISSN 1438-8871, E-ISSN 1438-8871, Vol. 10, no 4, article id e31Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health care personnel need access to updated information anywhere and at any time, and a Personal Digital Assistant (PDA) has the potential to meet these requirements. A PDA is a mobile tool which has been employed widely for various purposes in health care practice, and the level of its use is expected to increase. Loaded with suitable functions and software applications, a PDA might qualify as the tool that personnel and students in health care need. In Sweden today, despite its leadership role in mobile technologies, PDAs are not commonly used, and there is a lack of suitable functions and software applications.

    OBJECTIVE: The aim of the present review was to obtain an overview of existing research on the use of PDAs among personnel and students in health care.

    METHODS: The literature search included original peer-reviewed research articles written in English and published from 1996 to 2008. All study designs were considered for inclusion. We excluded reviews and studies focusing on the use of PDAs in classroom situations. From March 2006 to the last update in May 2008, we searched PubMed, CINAHL, Cochrane, IngentaConnect, and a local search engine (ELIN@Kalmar). We conducted a content analysis, using Nielsen's Model of System Acceptability as a theoretical framework in structuring and presenting the results.

    RESULTS: From the 900 references initially screened, 172 articles were selected and critically assessed until 48 articles remained. The majority originated in North-America (USA: n=24, Canada: n=11). The categories which emerged from our content analysis coincided to a certain extent to Nielsen's Model of System Acceptability (social and practical acceptability), including usefulness (utility and usability) subcategories such as learnability, efficiency, errors, and satisfaction. The studies showed that health care personnel and students used PDAs in patient care with varied frequency. Most of the users were physicians. There is some evidence that the use of a PDA in health care settings might improve decision-making, reduce the numbers of medical errors, and enhance learning for both students and professionals, but the evidence is not strong, with most studies being descriptive, and only 6 randomized controlled trials. Several special software programs have been created and tested for PDAs, and a wide range of situations for their use have been reported for different patient groups. Drug and medical information were commonly accessed by PDA users, and the PDA was often viewed as the preferred tool when compared to paper-based documents. Some users regarded the PDA easy to operate, while others found it difficult in the beginning.

    CONCLUSIONS: This overview of the use of PDAs revealed a positive attitude towards the PDA, which was regarded as a feasible and convenient tool. The possibility of immediate access to medical information has the potential to improve patient care. The PDA seems to be a valuable tool for personnel and students in health care, but there is a need for further intervention studies, randomized controlled trials, action research, and studies with various health care groups in order to identify its appropriate functions and software applications.

  • 49. Lukumay, Gift G.
    et al.
    Ndile, Menti L.
    Outwater, Anne H.
    Mkoka, Dickson A.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Backteman-Erlandsson, Susann
    Umeå University, Faculty of Medicine, Department of Nursing.
    Provision of post-crash first aid by traffic police in Dar es Salaam, Tanzania: a cross-sectional survey2018In: BMC Emergency Medicine, ISSN 1471-227X, E-ISSN 1471-227X, Vol. 18, article id 45Article in journal (Refereed)
    Abstract [en]

    Background: The availability of prehospital trauma care is an important means of reducing serious injuries and fatalities associated with road traffic injuries (RTIs). Lay responders such as traffic police play an important role in the provision of prehospital trauma care to RTI victims, especially where there is no established prehospital care system. Therefore, the objective of the present study was to investigate knowledge, self-reported practice, and attitudes toward post-crash first aid among traffic police officers in Tanzania.

    Method: A cross-sectional survey was conducted in Dar es Salaam, Tanzania between July-September 2017 to investigate knowledge, self-reported practice and attitude among traffic police officers during provision of post-crash care. We used simple random technique to recruit 340 traffic police officers, self -administered questionnaires were used to collect data. The researchers used descriptive statistics and Pearson's chi-square tests to analyze the data.

    Results: A total of 340 traffic police officers were surveyed. Nearly two thirds (65.3%) reported having had post-crash first aid on-the job training; a slightly larger proportion (70.9%) reported that they had cared for RTI victims in the previous year. The survey responses showed that, generally, traffic police officers' level of knowledge about post-crash first aid to RTI victims was low-about 3% of the surveyed officers possessed knowledge at a level considered good. Also, there was a statistically significant correlation between higher educational attainment and greater knowledgeability (p = 0.015). Almost all of the officers (96%) had a positive attitude toward providing post-crash first aid to RTI victims.

    Conclusions: Improved training of Tanzania traffic police officers, by means of an updated post-crash first aid curriculum and updated resources is recommended. Also, user-friendly post-crash first aid leaflets should be provided to traffic police for their reference.

  • 50.
    Lämås, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jacobsson, Catrine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Östlund, Ulrika
    Possibilities for evaluating cost-effectiveness of family system nursing: an example based on Family Health Conversations with families in which a middle-aged family member had suffered stroke2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 38, no 2, p. 74-81Article in journal (Refereed)
    Abstract [en]

    Family Health Conversations (FamHC) increase health and well-being, but knowledge about their cost-effectiveness, and how to best calculate this, is lacking. In this feasibility study we evaluated the cost-effectiveness of using FamHC with families in which a middle-aged family member had suffered stroke. Seven families participated in a FamHC intervention and seven families received ordinary care. Health-related quality of life (HRQoL) was estimated with SF-6D and EQ-5D over a six-month period. The costeffectiveness of the intervention was calculated. Families receiving FamHC intervention had significantly increased HRQoL at follow up. Cost per quality adjusted life year differed depending on the instrument and analysis method used in the calculation. However, all calculations showed that FamHC were cost-effective. We conclude that FamHC significantly increase HRQoL and suggest that they are cost-effective. Both instruments seemed to be able to capture changes. Considering the participants’ experience of answering the two instruments, we advocate the use of EQ-5D.

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