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  • 101.
    Axelsson, Ann-Sofie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mässing, Carolina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Föräldrars upplevelser av att få ett kroniskt svårt sjukt barn - inriktning på primär immunbrist2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Varje år föds ett till två barn med svår primär immunbrist i Sverige. Studier på föräldrar till barn med andra kroniska sjukdomar visar på att kontakten med olika vårdinstanser var en viktig faktor för deras förmåga att hantera situationen. Föräldrarna beskrev hur den både kunde hindra och stödja deras vårdande roll. Syftet med denna studie är att belysa föräldrars upplevelser av att få ett kroniskt svårt sjukt barn med primär immunbrist och deras kontakt med vården.Metod/Analys. Tio informanter medverkade, en fader och nio mödrar. Intervjustudien genomfördes med narrativ ansats och analyserades med kvalitativ innehållsanalys. Resultat. I resultatet framkom upplevelsen av en kamp för att bli tagna på allvar när det gällde oron över sitt barns symptom och att få rätt vård. Ofta har de stött på okunskap inom vården. Diagnosen var för många en vändpunkt då de upplevde att de fick den vård de länge sökt efter. Informanterna har upplevt vårdens positiva och negativa sidor, vilket resulterade i att de kunde ge önskemål på förbättringsområden inom vården. Konklusion. Resultatet visade att majoriteten av föräldrarna kastats mellan hopp och förtvivlan i sin kamp för att bli tagna på allvar och få sitt barn under rätt vård. Detta visar på att det finns förbättringsområden inom svensk sjukvård som skulle kunna underlätta dessa föräldrars upplevelse. Att få en engagerad omvårdnadsansvarig sjuksköterska som fungerade som spindeln i nätet, möta rätt kunskap ochkontinuitet, få psykosocialt stöd, bra information samt tidig diagnos var faktorer som hjälpte informanterna att hantera situationen.

  • 102.
    Axelsson, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eating problems and nutritional status after stroke1988Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Eating problems and nutritional status were studied in a consecutive series of 104 stroke patients admitted to emergency hospital care. During their stay in hospital eating problems were observed in 46 patients. Certain common types of eating problems were identified: aberrant eating behaviour as regards chewing,lokalization or swallowing, eating small amounts, hoarding of food in the mouth, leakage of food from the mouth and unawareness of eating problems. Poor nutritional status occurred in 16 % of the patients on admission and in 22 % on discharge from the stroke unit.

    A subgroup of 32 patients hospitalized for 21 days or longer was studied for three weeks. On at least one occasion during these three weeks a poor nutritional status was observed in 18 patients, of whom 17 had eating problems.

    All subjects who had eating problems during their hospital stay, plus those patients without eating problems but with neurological deficits and those living in a nursing home one year after the stroke (n=36) were selected for a longitudinal study 18 months after the onset of stroke. Eating problems were identified in 23 of these patients during their hospital stay while 21 had such problems when they were followed up.

    Two patients who could not eat due to severe dysphagia (after a stroke) for three years and 18 months respectively, were successfully trained to eat normally. One patient exhibited impaired oral and hypopharyngeal function and the other impaired hypo- pharyngeal function and a spastic crico-pharyngeal muscle. In both patients training in swallowing was the main remedical measure and one of them also had a myotomy of the spastic muscle.

  • 103.
    Axelsson, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Persson, Emelie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Operationssjuksköterskors erfarenheter av att handleda operationssjuksköterskestudenter2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Preceptoring is about to improve the theoretical knowledge through practical exercise, to make the student familiar with the practical work and be able to create an exchange of knowledge and a need to learn more. The healthcare environment in an operating department is high-tech and complex. Studies show that preceptors often experience a lack of time and operating theatre nurses’ experience that teaching in an operating department takes place in a pressurized environment.Motive: There is no major study that focuses exclusively on preceptoring of operating theatre nurse students; hence it is important to highlight the importance of the preceptor’s role and its experiences of precepting operating theatre nurse students.Aim: To illustrate operating theatre nurses’ experiences of preceptoring operating theatre nurse students. Methods: An interview study with qualitative design and inductive approach. Nine operating theatre nurses were interviewed with semi-structured questions. Qualitative content analysis has been used to analyse the interview text.Results: The analysis resulted in two categories that were referred as ‘Prerequisites for good precepting’ with five sub-categories and ‘Obstacles to good precepting’ with four sub-categories.Discussion: In the discussion, the results are deepened with the support of the Tveitens model for professional guidance. Preceptoring operating theatre nurse students can develop their own professional practice, partly through self-reflection but also by learning together and by the student. If the preceptor and the student have different focus, insecurity can be created for both preceptor and student, which does not benefit the student’s learning.Conclusion: Preceptoring can be seen as a mutual learning where the foundation is based on a safe and permissive environment. Obstacles in preceptoring can make mutual learning more difficult.

  • 104.
    Backlund, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lilja, Felicia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Livspartnerns upplevelse av att leva med en partner med demenssjukdom2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In Sweden, eight percent of all people by the age of 65 years or older have a dementia disease. The healthy spouse received or unconsciously took the role as caregiver in the home which could cause psychological and physical stress. Therefore it is important that nurses have good understanding of how the healthy spouses experience their life situation.

    Aim: The aim of this study was to describe spouses´experiences of living with a partner with dementia disease.

    Methods: This literature study was performed with a qualitative method. Nine scientific articles have been quality checked and analyzed with inspiration from Friberg´s way of thinking. The databases Cinahl and PubMed were used.

    Results: The literature study resulted in the construction of five categories followed by 13 subcategories. The result of the literature study shows that the healthy spouses are affected physically and mentally by living with a partner with dementia disease. A change in the life situation, which entails that the healthy spouse must adapt and change everyday life for the dementia suffering partner's abilities and skills. Conclusion: Living with a partner with dementia disease means a strain for the healthy spouses. It is important for nurses to pay attention to the healthy spouses´well-being. By this study the nurses hopefully understand that it is important to focus on both partners´ needs.

  • 105.
    Backman, Annica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Leadership: person-centred care and the work situation of staff in Swedish nursing homes2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Swedish nursing home managers, who constitute the empirical focus of this thesis, hold overall operational responsibility for the nursing homes, which includes the care of residents, direct care staff and work environment. Aged care organisations are also expected to provide person-centred care. Working towards a person-centred approach poses new demands and leads to challenges for leaders, and there is currently limited knowledge of what characterises leadership that promotes a person-centred approach. In addition, an ongoing demographic shift in the aged care workforce entails further challenges, as the proportion of professional workers is decreasing. Leading a healthy work environment is therefore important for ensuring and protecting staff health. Based on this, it is important to explore nursing home managers’ leadership in relation to person-centred care and the work situation of staff.

    Aim: The overall aim was to explore leadership in relation to person-centred care and the work situation of staff in Swedish nursing homes.

    Methods: This thesis is based on data from two data collections. First, it includes cross-sectional baseline data from a national inventory of health and care in Swedish nursing homes (SWENIS) collected in 2013-2014. The SWENIS dataset consists of a sample of staff n=3605 from 169 nursing homes in 35 municipalities, and nursing home managers n=191. The second data collection consists of 11 semi-structured interviews with 12 nursing home managers in highly person-centred nursing homes that already participated in SWENIS. Data were explored via descriptive statistics, simple and multiple regression analyses, and qualitative content analysis.

    Results: Leadership was positively associated with person-centred care and psychosocial climate. Highly rated leadership behaviors’ among nursing homes managers was characterized by experimenting with new ideas, controlling work closely, relying on his/her subordinates, coaching and giving direct feedback, and handling conflicts constructively. Leading person-centred care can be outlined by four leadership processes: embodying person-centred being and doing; promoting a person-centred atmosphere; maximizing person-centred team potential and optimising person-centred support structures. Leadership was also positively associated with social support and negatively associated with job strain. Further, the variation in leadership was to a very small extent explained by the nursing home managers’ educational qualification, operational form of the nursing home and the number of employees in a unit.

    Conclusions: All findings point in the same direction: that leadership, as it is characterized and measured in this thesis, is significantly associated with person-centred care provision as well as with the work situation of staff. This suggests that nursing managers have a central leadership role in developing and supporting person-centred care practices, and also in creating a healthy work environment. The results also highlight five specific leadership behaviours that are most characteristic of highly rated leadership, thereby adding concrete descriptions of behaviours to the literature on existing leadership theories. The findings also include four central processes for leading towards person-centred care in nursing homes. Taken together, it seems important for managers to translate the person-centred philosophy into actions and to promote an atmosphere pervaded by innovation and trust, in which cultural change is enhanced by positive cultural bearers. Utilizing the overall knowledge and competencies among staff and potentiating care teams was also considered important for leading person-centred care, along with optimising supportive structures for supporting and maintaining person-centred care. If aged care organisations are to be committed to person-centred care, an important implication seems to be to organise nursing homes in a way that allows nursing home managers to be close and present in clinical practice and actively lead towards person-centred care. The findings of this thesis contribute to our understanding of leadership in relation to person-centre care and the work situation of staff. These findings can be used in leadership educations and nursing curriculum. Longitudinal studies would be valuable for following leadership, person-centred care and the work situation of staff over time.

  • 106.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ahnlund, Petra
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    McGilton, Katherine S.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia .
    Leading towards person-centred care – Nursing home managers' experiences of leading person-centred care in highly person-centred Swedish nursing homesManuscript (preprint) (Other academic)
    Abstract [en]

    Background:Although a growing body of research knowledge exists highlighting the importance of leadership for person-centred care, studies focused on nursing home managers’ own descriptions of leading their staff to provide person-centred care is lacking. This study aims to explore the process of nursing home managers’ leading person-centred care in Swedish nursing homes.

    Methods:The methods of the study consisted of semi-structured interviews with 12 nursing home managers within 11 highly person-centred nursing homes purposively selected from a national wide survey of nursing homes in Sweden. A qualitative content analysis was performed for data analyses.

    Results:The study revealed that the leading person-centred care in nursing homes can be outlined as comprising four processes: Embodying person-centred being and doing; promoting a person-centred atmosphere; maximizing person-centred team potential; and finally, optimizing person-centred support structures.

    Conclusion:This study contributes to the literature by providing concrete descriptions of how person-centred care can be operationalised and supported in everyday practice by the leadership of nursing home managers. The study is significant in that it provides evidence on how the provision of person centred care can be facilitated by managers and the important role they play in developing and maintaining this philosophy of care within nursing homes.

  • 107.
    Backman, Annica C.
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. La Trobe Univ, Melbourne, Vic, Australia.
    Leadership behavior in relation to person-centeredness and person-centered climate - a cross-sectional study in residential aged care in Sweden2015In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 55, p. 806-807Article in journal (Other academic)
  • 108.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Characteristics of highly rated leadership in nursing homes using item response theory2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2903-2913Article in journal (Refereed)
    Abstract [en]

    Aim: To identify characteristics of highly rated leadership in nursing homes. Background: An ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care. Design: Cross-sectional. Method: From 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct-care staff employed in 169 Swedish nursing homes. The staff assessed their managers' (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 - September 2014, and the study was completed in November 2016. A two-parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership. Results: Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings. Conclusion: This study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings.

  • 109.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifer y, La Trobe University, Melbourne, VIC, Australia.
    Towards person-centredness in aged-care: exploring the impact of leadership2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 6, p. 766-774Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the association between leadership behaviours among managers in aged care, and person‐centredness of care and the psychosocial climate.

    Background: Theory suggests that leadership is important for improving person‐centredness in aged care, however, empirical evidence is lacking.

    Methods: A cross‐sectional design was used to collect data from Swedish aged care staff (= 3661). Valid and reliable questionnaires assessing leadership behaviours, person‐centeredness of care and the psychosocial climate were used. Data were analysed using multiple linear regression including interaction terms.

    Results: Leadership behaviours were significantly related to the person‐centredness of care and the psychosocial climate. The level of person‐centredness of care moderated the impact of leadership on the psychosocial climate.

    Conclusions and implications for nursing management: The leadership behaviour of managers significantly impacts person‐centred care practice and contributes to the psychosocial climate for both staff and residents in aged care. This study is the first empirically to confirm that middle managers have a central leadership role in developing and supporting person‐centred care practice, thereby creating a positive psychosocial climate and high quality care.

  • 110.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.
    Job strain in nursing homes: exploring the impact of leadership2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. 1552-1560Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore the association between nursing home managers' leadership, job strain and social support as perceived by direct care staff in nursing homes.

    Background: It is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Leadership styles have been associated with job strain in the literature; however, the impact of perceived leadership on staff job strain and social support has not been clarified within nursing home contexts.

    Design: This study had a cross‐sectional design.

    Methods: Participating staff (n = 3,605) completed surveys which included questions about staff characteristics, valid and reliable measures of nursing home managers' leadership, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted.

    Results: Nursing home managers' leadership were significantly associated with lower level of job strain and higher level of social support among direct care staff. A multiple regression analysis including an interaction term indicated individual and joint effects of nursing home managers' leadership and social support on job strain.

    Conclusions: Nursing home managers' leadership and social support were both individually and in combination associated with staff perception of lesser job strain. Thus, nursing home managers' leadership are beneficial for the working situation and strain of staff.

    Relevance to clinical practice: Promoting a supporting work environment through leadership is an important implication for nursing home managers as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers can buffer adverse health effects among staff.

  • 111.
    Backman, Sandra
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Skystedt, Mathilda
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att förändras över en natt: Erfarenheter av att ha genomgått obesitaskirurgi- En litteraturstudie.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Att förändras över en natt, erfarenheter av att ha genomgått obesitaskirurgi – En litteraturstudie.Bakgrund: Övervikt och fetma är ett allvarligt hälsoproblem som kan förebyggas genom samhälleliga insatser och livsstilsförändringar. Det har visat sig att för de som är kraftigt överviktiga kan obesitaskirurgi vara ett alternativ. Studier visar att obesitaskirurgi resulterar i både positiva och negativa följder.Syfte: Denna litteraturstudies syfte var att belysa ungdomars och vuxnas erfarenheter av att ha genomgått obesitaskirurgi.Metod: En litteraturstudie genomfördes med elva kvalitativa artiklar. Artiklarna granskades och deras resultat analyserades och sammanställdes.Resultat: Erfarenheterna beskrivs i tre kategorier och sju underkategorier, personerna som genomgått obesitaskirurgi fick ett förändrat förhållande till mat, en förändrad relation till omgivningen samt fysiska och psykiska konsekvenser såsom viktnedgång och förbättrad självkänsla.Slutsats: Obesitaskirurgi medför förändrad kroppsbild och det krävs stora ansträngningar och stark vilja för att inte återfå övervikten som många tappar efter operationen. Kunskapen om erfarenheter av att genomgå obesitaskirurgi är viktigt för sjuksköterskor, för att kunna stötta ungdomar och vuxna att finna sin inre motivation, hitta meningsfullhet samt att coacha dessa individer när de ställs inför den förändrade kroppsbilden.

  • 112.
    Backström, Johanna
    Umeå University, Faculty of Medicine, Department of Nursing.
    ATT ÅLDRAS MED HIV: Erfarenheter och kunskapsbehov hos distriktssköterskor inom hemsjukvården2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    ABSTRAKT

    Titel: ATT ÅLDRAS MED HIV. Erfarenheter och kunskapsbehov hos distriktssköterskor inom hemsjukvården.

    Bakgrund: I Sverige lever drygt 6500 personer med HIV. Effektiv behandling gör att antalet äldre som lever med HIV ökar. Idag betraktas HIV som en kronisk sjukdom, vilket ställer krav på kunskap om de åldersrelaterade problem det kan medföra för den äldre. Tidigare studier visar att sjuksköterskor och distriktssköterskor till viss del saknar grundläggande kunskap om HIV, smittsamhet och smittvägar. Brist på erfarenhet och kunskap kan påverka bemötandet och kvalitén på vård av äldre som lever med HIV.

    Syfte: Att belysa erfarenheter och kunskapsbehov hos distriktssköterskor inom hemsjukvården beträffande äldre som lever med HIV.

    Design: Kvalitativ design med induktiv ansats.

    Metod: Studien bygger på semistrukturerade intervjuer med sju distriktssköterskor och två sjuksköterskor inom kommunal hemsjukvård i ett län i norra Sverige. Intervjuerna spelades in, transkriberades och analyserades med hjälp av kvalitativ innehållsanalys.

    Resultat: Analysen resulterade i tre huvudkategorier, Medvetandegöra okunskap, Önskan om fortbildning och Önskan om tydliga riktlinjer och sju subkategorier. Resultatet belyses med citat från intervjuerna.

    Slutsats: För att säkerställa en god vård och ett bemötande utan rädsla och fördomar krävs uppdaterad grundläggande kunskap om HIV. Det finns också ett behov av tydliga rutiner som är lätta att hitta och behov av stöd från personal med mer erfarenhet. Vård av äldre som lever med HIV bör präglas av ett personcentrerat förhållningssätt där brukarens erfarenheter och kunskap tas tillvara.

    Nyckelord: distriktssköterska, erfarenhet, HIV, hemsjukvård, kunskap, personcentrerad, åldrande, äldre

  • 113.
    Backteman-Erlanson, Susann
    Umeå University, Faculty of Medicine, Department of Nursing.
    Burnout, work, stress of conscience and coping among female and male patrolling police officers2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background. Police work is a stressful occupation with frequent exposure to traumatic events and psychological strain from work might increase the risk of burnout. This thesis focuses on patrolling police officers (PPO), who work most of their time in the community and have daily contact with the public. Since police work traditionally is a male coded occupation we assume that there are differences between women and men in burnout as well as experiences from psychosocial work environment.

    Aim. The overall aim of this thesis is to explore burnout, psychosocial and physical work environment, coping strategies, and stress of conscience when taking gender into consideration among patrolling police officers.

    Methods. This thesis employs both qualitative and quantitative methods. In Paper I a qualitative approach with narrative interviews was used where male PPO described experiences of traumatic situations when caring for victims of traffic accidents. A convenience sample of nine male PPO from a mid-sized police authority was recruited. Interviews were analyzed using qualitative content analysis. Papers II, III, and IV were based on a cross-sectional survey from a randomly selected sample stratified for gender from all 21 local police authorities in Sweden. In the final sample, 1554 PPOs were invited (778 women, 776 men), response rate was 55% (n=856) in total, 56% for women (n=437) and 53% for men (n=419). The survey included a self-administered questionnaire based on instruments measuring burnout, stress of conscience, psychosocial and physical work environment, and coping.

    Results. Findings from Paper I were presented in three themes; “being secure with the support system,” “being confident about prior successful actions,” and “being burdened with uncertainty.” Results from Paper II showed high levels of emotional exhaustion (EE), 30% for female PPOs and 26% for male PPOs. High levels of depersonalization (DP) were reported for 52 % of female PPO, corresponding proportions for male were 60%. Multiple logistic regression showed that stress of conscience (SCQ-A), high demand, and organizational climate increased the risk of EE for female PPO. For male PPO stress of conscience (SCQ-A), low control and high demand increased the risk of EE. Independent of gender, stress of conscience (SCQ-A) increased the risk of DP. Psychometric properties of the WOCQ were investigated with exploratory factor analysis and confirmatory factor analysis, a six-factor solution was confirmed. DIF analysis was detected for a third of the items in relation to gender. In Paper IV a block wise hierarchical multiple regression analysis was performed investigating the predictive impact of psychological demand, decision latitude, social support, coping strategies, and stress of conscience on EE as well as DP. Findings revealed that, regardless of gender, risk of EE and DP increased with a troubled conscience amongst the PPO.

    Conclusion. “Being burdened with uncertainty” in this male-dominated context indicate that the PPO did not feel confident talking about traumatic situations, which might influence their coping strategies when arriving to a similar situation. This finding can be related to Paper II and IV showing that stress of conscience increased the risk of both EE and DP. The associations between troubled conscience and the risk of experiencing both emotional exhaustion and depersonalization indicate that stress of conscience should be considered when studying the influence of the psychosocial work environment on burnout. Results from this study show that the psychosocial work environment is not satisfying and needs improvement for patrolling police officers in Sweden. Further studies including both qualitative and quantitative (longitudinal) methods should be used to improve knowledge in this area to increase conditions for preventive and rehabilitative actions.

  • 114.
    Backteman-Erlanson, Susann
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jacobsson, Ann
    Umeå University, Faculty of Medicine, Department of Nursing.
    Öster, Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Caring for traffic accident victims: the stories of nine male police officers2011In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 19, no 2, p. 90-95Article in journal (Refereed)
    Abstract [en]

    Psychological strain due to the work environment is common, especially in those occupations which involve working in critical situations. Working as a police officer seems to increase the risk of psychological problems such as symptoms of stress and post traumatic stress disorders. The aim of this study was to describe male police officers’ experiences of traumatic situations when caring for victims of traffic accidents, and to reflect the results through the perspective of gender theories. Nine police officers were asked to narrate and reflect upon their experiences in taking care of people who had been severely injured in traffic accidents. The interviews were analysed with qualitative content analysis. The findings are presented in three themes: “being secure with the support system”, “being confident about prior successful actions, and “being burdened with uncertainty”. The officers’ descriptions showed that most of them had strategies that they used when they were first responders, developed on the basis of their own knowledge and actions and the support systems in their organization which enabled them to act in traumatic situations. When support systems, knowledge, and actions were insufficient, they sometimes felt insecure and “burdened with uncertainty”. In this male-dominated context, there was a risk that the officers may not talk enough about traumatic situations, thus influencing their ability to cope successfully.

  • 115.
    Backteman-Erlanson, Susann
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Öster, Inger
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brulin, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Padyab, Mojgan
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Exploration of the WOCQ tool in relation to gender and psychometric properties among Swedish patrolling police officersManuscript (preprint) (Other academic)
    Abstract [en]

    Police work is a stressful occupation with frequent exposure to traumatic events. In Sweden knowledge about coping strategies among police personnel is absent probably due to lack of validated measurements. Aim of this study was to explore psychometric properties of the Ways of Coping Questionnaire (WOCQ) among Swedish police personnel, including testing differential item functioning (DIF) for gender. The WOCQ was sent out to 1554 randomly selected patrolling police officers in Sweden. Exploratory factor analysis and confirmatory factor analysis were used. A six factor solution was confirmed with differences and similarities compared to the original eight factor solution. DIF analysis showed similarities and differences in relation to gender. We suggest that the WOCQ can be used when investigating coping strategies in a Swedish police context.

     

  • 116.
    Bagger, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Svensson, Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anestesisjuksköterskans bemötande av patienter med preoperativ oro: - En litteraturstudie kring preoperativ oro och metoder att lindra denna2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 117.
    Bahamon, Alejandra
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Granvik, Gabriella
    Umeå University, Faculty of Medicine, Department of Nursing.
    "Hör du mig": En litteraturstudie om närståendes upplevelse av kommunikation med omvårdspersonal i palliativ vård2019Independent thesis Basic level (university diploma), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Background: Palliative care is when the care goes from curative to only relieving. The aim of this approach is to facilitate better quality of life for both the patient and the relatives. Relatives are an important part of palliative care, however they can experience the situation hard and difficult emotionally. Healthcare professionals have an important role to play in alleviating suffering and conveying important information. There may be different barriers that affect communication, such as lack of understanding and knowledge of healthcare professionals and relatives.

    Aim: The purpose of the literature study was to investigate the relatives experience of communication with healthcare professionals in palliative care.

    Method: This literature study included 10 qualitative articles analyzed with content analysis.

    Result: The results of the study are presented in four main categories: 1) information, 2) conversation, 3) the approach of healthcare professional, 4) relatives' need for communication & information and six subcategories; 1) good information, 2) lack of information, 3) positive experiences of conversations, 4) negative experiences of conversation, 5) the positive influence of the healthcare professionals, 6) the negative influence of the healthcare professionals.

    Conclusion: Relatives had different experiences of communication in palliative care. It became clear that the healthcare professionals acting had an important part in the experience of communication for the relatives. In order to contribute to better communication, healthcare professionals need more education in conversation art.

  • 118.
    Bang, Isabell
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Allanius Koskenniemi, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Anestesisjuksköterskors erfarenheter av att söva barn.2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The majority of the children who undergo surgery experience severe anxiety prior to surgery. Preoperative anxiety should be avoided to reduce the psychological trauma. The nurse anesthetist should create a good contact and help the family cope with the frightening situation. There are both pharmacological and non-pharmacological ways to reduce anxiety.

    Aims: The purpose of the study is to describe the anesthetic nurses' experiences of anesthetizing children.

    Method: The study is based on interviews with twelve nurse anesthetists, operating at three of the sections on surgery center at one of Sweden's regional hospital. The interviews were based on semi-structured questions and analyzed using qualitative content analysis.

    Findings: Six categories emerged: parents, profession and compliance to different situations, the important meeting, premedication and external factors.

    Conclusion: An optimized premedication was highlighted as the most important factor for a successful anesthetic induction of children. If the child already had an intravenous line upon arrival at the surgical department it simplified the induction significantly. How well the parents handled the situation was also important for how the situation turned out.

  • 119.
    Baradaran, Nadja
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundgren, Sofie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att vårda under rädsla: - En litteraturstudie om vårdpersonals upplevelser av hot och våld inom psykiatrisk vård.2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: Working under fear- a literature review about nursing staff’s experiences of threat and violence in psychiatric care.

    Background: Reports show that threat and violence is a common phenomenon in healthcare. It appears in every part of healthcare, but some units are at more risk than others, for example psychiatric care. The verbal and physical violence creates an insecure work environment and can cause serious consequences for both personnel and patients.

    Aim: To describe psychiatric nursing staff’s perceptions of threat and violence in psychiatric care. Methods: A literature review based on eight qualitative articles. These articles were examined, analyzed and compiled.

    Results: Threat and violence caused strong emotional reactions, like fear and anger, among nursing staff that influenced the work and their private life. The unsafe work environment composed a threat to the nursing staff’s professional role and self image. It was percieved that violence were unavoidable, and that nursing staff were expected to accept violence as a part of the job. Violence were handled and prevented with different strategies, while manegement support were lacking.

    Conclusion: Violence against nursing staff in psychiatric care are a relatively unexplored subject in need of more research. Nursing staff are suffering both physical and psychological damage due to violence in the workplace, which also effects the care given to patients and the nursing staff’s own health. To improve the work situation the nursing staff need more education in handling violence.

    Keywords: Nursing staff, Psychiatry, Threat and violence, Workrelated violence

  • 120. Barremo, Ann-Sofi
    et al.
    Bruce, Elisabeth
    Västernorrlands läns landsting, Örnsköldsvik (Västernorrland County Council).
    Salander, Monica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sundin, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Personers upplevelse av att leva med kronisk hjärtsvikt: Systematisk litteraturstudie2008In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 28, no 3, p. 34-38Article in journal (Refereed)
    Abstract [en]

    Background: Heart failure is a clinical syndrome where the heart is no longer able to maintain adequate blood circulation to the tissue. Many suffer from symptoms difficult to handle such as dyspnoea, fatigue, and physical weakness.

    Aim: The purpose of the study was to investigate peoples’ experiences of living with congestive heart failure.

    Method: A systematic literature review was used. Relevant articles were found in the Medline and Cinahl databases. The articles were examined, classified and critically appraised. Twenty articles were included. A qualitative content analysis was used to organize the results.

    Results: The results are described in three main categories: losses, protecting independences and readjustment. The category ‘losses’ details physical, emotional and social changes that people experience as losses caused by the debilitating symptoms of heart failure. The category ‘protecting independences’ shows the different ways in which people try to keep control over their lives. The category ‘readjustment’ presents how people try to seek a new ‘wholeness’ in life after the changes heart failure have caused by using acceptance, adaptation and finding new meanings.

    Conclusion: Living with congestive heart failure can be experienced as a synopsis of the «suffering human being» on a continuum, a time axle; from falling ill to seeking a new meaning in life.

  • 121.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Commentary on: Sullivan and Willis (2018). Towards Changing the Long-Term Care (LTC) Paradigm: Explicating the Concept of Thriving in Older Adults Living in LTC2019In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 7, p. 639-640Article in journal (Refereed)
  • 122.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence: A quasi-experimental study2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 65, p. 156-161Article in journal (Refereed)
    Abstract [en]

    Background: Postgraduate education is said to support the development of nurses' professional competence and confidence, essential to the delivery of safe and effective care. However, there is a shortness of empirical evidence to demonstrate an increase to nurses' self-reported confidence and competence on completion of critical care postgraduate certificate-level education.

    Objectives: To explore the impact of a critical care postgraduate certificate course on nurses' self-reported competence and confidence. To explore the psychometric properties and performance of the Critical Care Competence and Confidence Questionnaire.

    Design: A quasi-experimental pre/post-test design.

    Participants: A total population sample of nurses completing a critical care postgraduate certificate course at an Australian University.

    Methods: The Critical Care Competence and Confidence Questionnaire was developed for this study to measure nurses' self-reported competence and confidence at baseline and follow up. Descriptive and inferential statistics were used to explore sample characteristics and changes between baseline and follow-up. Reliability of the questionnaire was explored using Cronbach's Alpha and item-total correlations.

    Results: There was a statistically significant increase in competence and confidence between baseline and follow-up across all questionnaire domains. Satisfactory reliability estimates were found for the questionnaire.

    Conclusions: Completion of a critical care postgraduate certificate course significantly increased nurses' perceived competence and confidence. The Critical Care Competence and Confidence Questionnaire was found to be psychometrically sound for measuring nurses' self-reported competence and confidence.

  • 123.
    Baxter, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Sustainable Health.
    Sköldunger, Anders
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden.
    Bergland, Ådel
    Winblad, Bengt
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing & Midwifery, La Trobe University, Melbourne, Australia.
    The Thriving of Older People Assessment Scale: Psychometric evaluation and short‐form development2019In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    Aim: To evaluate the psychometric properties and performance of the 32‐item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short‐form.

    Background: The 32‐item TOPAS has been used in studies of place‐related well‐being as a positive measure in long‐term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.

    Design: Cross‐sectional.

    Method: Staff members completed the 32‐item TOPAS as proxy‐raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 and September 2014. Reliability analysis, exploratory factor analysis and item response theory‐based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.

    Results: Psychometric properties of the 32‐item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short‐form TOPAS exhibited a high level of internal consistency (α=0.90) and strong correlation (r=0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.

    Conclusion: The 32‐item and short‐form TOPAS' indicated sound validity and reliability to measure resident thriving in the nursing home context.

    Impact: There is a lack of positive life‐world measures for use in nursing homes. The short‐form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health promoting purposes in nursing homes.

  • 124.
    Bay, Annika
    Umeå University, Faculty of Medicine, Department of Nursing.
    Being physically active as an adult with congenital heart disease2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Due to advances in medical and surgical care adults with congenital heart disease (CHD) is a growing and aging population, that now outnumbers the children with CHD. In general, adults with CHD have reduced aerobic exercise capacity and nearly half of the patients do not reach current recommendations on physical activity. It is known that a low level of physical activity is associated with an increased risk for acquired cardiovascular disease. Studies has shown that adults with CHD are at the same, or even higher risk as the general population, for developing acquired cardiovascular disease.

    Aim: The overall aim was to explore physical activity in adults with CHD with respect to associated factors, exercise self-efficacy and their own experiences.

    Methods: This thesis is based on four papers. Paper I included 471 adults with CHD from three tertiary care centres in Sweden. The participants completed questionnaires measuring patient reported outcomes (e.g. SF-12) including physical activity level. Paper II was based on data from 79 adults with CHD from two tertiary care centers in Sweden and 42 matched controls. All participants completed questionnaires on exercise self-efficacy and quality of life, wore an activity monitor during four consecutive days and performed muscle endurance tests. Paper I and II were of cross-sectional design and analyses were done using logistic regression. In paper III and IV data were collected through structured interviews for 14 participants. They were asked about their experiences of being physically active (paper III), what they considered as physical activities, and their experiences of enablers and barriers to physical activity (paper IV). Qualitative content analysis was used in papers III and IV.

    Results: Physical activity level (paper I) and exercise self-efficacy (paper II) were strongly associated with age where those over 40 years had a lower level of physical activity and lower exercise self-efficacy. Further, in paper I, it appeared that patient reported outcomes from SF-12 were strongly associated with physical activity level. In paper II, exercise self-efficacy was associated with performance in a muscle endurance tests. Paper III revealed an overall theme – It´s like balancing on a slackline that illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four themes: (1) Being an adventurer – enjoying the challenges of physical activity; (2) Being a realist – adapting to physical ability; (3) Being a non-doer – lacking prerequisites for physical activity and (4) Being an outsider – feeling excluded depending on physical ability. In paper IV, the analysis revealed a description of what adults with CHD consider to be physical activity and considered as enablers and barriers for physical activity. Four categories appeared; physical aspects, psychological aspects, psychosocial aspects and environmental aspects. In the psychosocial aspect, social support and encouragement in childhood to be physically active and no restrictions from e.g. parents, teachers and health care increased physical activity in adulthood.

    Conclusions: Age, social support and accepting physical limitations seem to have an important impact regarding physical activity level and exercise self-efficacy. In contrast, the complexity of CHD and other medical factors appear to be of less importance for adults with CHD in relation to physical activity. In order to support adults with CHD to increase their physical activity and reach their full potential, it is important to explore and consider the various aspects that may affect physical activity in this population.

  • 125.
    Bay, Annika
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Fysiskt aktiv som vuxen med medfött hjärtfel: ”Som att balansera på slak lina”2018Conference paper (Other academic)
  • 126.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Berghammer, Malin
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Facilitators and barriers for physical activity in adults with congenital heart disease2018In: European Heart Journal: ESC Congress 2018 25 - 29 August Munich, Germany, Oxford University Press, 2018, Vol. 39, article id P5433Conference paper (Refereed)
  • 127.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Dellborg, Mikael
    Berghammer, Malin
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Engström, Gunnar
    Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Surgery.
    Moons, Philip
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Patient reported outcomes are associated with physical activity level in adults with congenital heart disease2017In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 243, p. 174-179Article in journal (Refereed)
    Abstract [en]

    Background: In general, adults with congenital heart disease (CHD) have impaired exercise capacity, and approximately 50% do not reach current recommendations on physical activity. Herein we analysed factors associated with physical activity level (PAL) in adults with CHD by using patient-reported outcomes (PRO). Methods: Patients with CHD (n = 471) were randomly selected from the national register on CHD and categorized according to complexity of lesions -simple (n = 172, 39.1 +/- 14.6 years), moderate (n = 212, 39 +/- 14.1 years), and severe (n = 87, 31.7 +/- 10.7 years). Participants completed a standardized questionnaire measuring PRO-domains including PAL. Variables associated with PAL were tested in multivariate logistic regression. Results: PAL was categorized into high (>= 3 METs = 2.5 h/week, n = 192) and low (>= 3 METs <2.5 h/week, n = 279). Patients with low PAL were older (42.6 vs. 35.8 years, p = 0.001), had more prescribed medications (51% vs. 39%, p = 0.009), more symptoms (25% vs. 16%, p = 0.02) and comorbidity (45% vs. 34% p= 0.02). Patients with low PAL rated a lower quality of life (76.6 vs. 83.4, p < 0.001), satisfaction with life (25.6 vs. 27.3, p = 0.003), a lower Physical Component Summary score (PCS) (78.1 vs. 90.5, p < 0.001) andMental Component Summary score (MCS) (73.5 vs. 79.5, p < 0.001). Complexity of heart lesion was not associated with PAL. The included PROs-separately tested in the model, together with age were associated with PAL. Conclusions: PCS and MCS are stronger associated with PAL than age and medical factors. The use of these PROs could therefore provide valuable information of benefit for individualized advice regarding physical activity to patients with CHD.

  • 128.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lämås, Kristina
    Berghammer, Malin
    Sandberg, Camilla
    Johansson, Bengt
    Enablers and barriers for being physically active: experiences from adults with congenital heart diseaseManuscript (preprint) (Other academic)
  • 129.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Berghammer, Malin
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Enablers and barriers for physical activity in adults with congenital heart disease2019Conference paper (Refereed)
  • 130.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Berghammer, Malin
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    It ́s like balancing on a slackline: A description from adults living with congenital heart disease2018In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 28, no Suppl. S1, p. S37-S37Article in journal (Refereed)
    Abstract [en]

    Introduction: Several studies have shown that adults with congenital heart disease have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of great importance to investigate how this population experiences physical activity. The aim of the study is to illuminate how adults with congenital heart disease describes themselves in relation to physical activity.

    Methods: Semi-structured interviews with fourteen adults with complex congenital heart disease were performed. Patients were recruited from the clinic waiting list, based on their scheduled follow up and diagnosis. Interviews were analysed by qualitative content analysis.

    Results: The overall theme It´s like balancing on a slackline illustrates how adults with congenital heart disease described themselves in relation to physical activity. The overall theme consists of four themes: Being an adventurer- enjoying the challenges of physical activity, Being a realist- adapting to physical ability, Beinga non-doer- lacking prerequisites for physical activity and Being an outsider- feeling excluded depending on physical ability.

    Conclusions: The descriptions on themselves as a physically active were not constant or one-dimensional and the descriptions varied during the interviews, related to different time periods in life. It meant that they could described themselves as being an adventurer liking tough challenges, but at the same time describing themselves as being a non-doer with uncertainty over their physical strength. The findings point out specific factors for adults with CHD that might constitute as obstacles, but also possibilities for being physically active.

  • 131.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Lämås, Kristina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Berghammer, Malin
    Sandberg, Camilla
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    It's like balancing on a slackline: a description of how adults with congenital heart disease describe themselves in relation to physical activity2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 15-16, p. 3131-3138Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To illuminate how adults with CHD describe themselves in relation to physical activity.

    BACKGROUND: Several studies have shown that adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of immense importance to investigate how this population experiences physical activity.

    DESIGN: Qualitative study with semi-structured interviews analysed with qualitative content analysis.

    METHODS: Semi-structured interviews were individually performed with fourteen adults (women=7, age 19-68 years) with complex CHD. Patients were purposively recruited from the clinic waiting list, based on a scheduled follow-up and diagnosis.

    RESULTS: The overall theme, It's like balancing on a slackline, illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four subthemes: (1) Being an adventurer- enjoying the challenges of physical activity; (2) Being a realist- adapting to physical ability; (3) Being a non-doer- lacking prerequisites for physical activity; and (4) Being an outsider- feeling excluded depending on physical ability.

    CONCLUSIONS: Adults with CHD seem to have a diverse relationship to physical activity and it involves various aspects throughout the lifespan. The findings point out factors that might constitute as obstacles for being physically active, specific for people with chronic conditions like CHD. This highlights the importance of further exploring the hindering and facilitating factors for being physically active in order to get a deeper understanding of how to support adults with CHD to be physically active.

    RELEVANCE TO CLINICAL PRACTICE: Given the diverse relationship to physical activity, nurses have to further investigate the patients' relationship to physical activity, in order to support a healthy lifestyle. Nurses and allied health professionals should offer individualized exercise prescriptions and education about suitable physical activities in relation to physical ability. This article is protected by copyright. All rights reserved.

  • 132.
    Bay, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Sandberg, Camilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Thilén, Ulf
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Johansson, Bengt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.
    Exercise self-efficacy in adults with congenital heart disease2018In: International Journal of Cardiology: Heart and vasculature, E-ISSN 2352-9067, Vol. 18, p. 7-11Article in journal (Refereed)
    Abstract [en]

    Background: Physical activity improves health, exercise tolerance and quality of life in adults with congenital heart disease (CHD), and exercise training is in most patients a high-benefit low risk intervention. However, factors that influence the confidence to perform exercise training, i.e. exercise self-efficacy (ESE), in CHD patients are virtually unknown. We aimed to identify factors related to low ESE in adults with CHD, and potential strategies for being physically active.

    Methods: Seventy-nine adults with CHD; 38 with simple lesions (16 women) and 41 with complex lesions (17 women) with mean age 36.7 ± 14.6 years and 42 matched controls were recruited. All participants completed questionnaires on ESE and quality of life, carried an activity monitor (Actiheart) during four consecutive days and performed muscle endurance tests.

    Results: ESE in patients was categorised into low, based on the lowest quartile within controls, (≤ 29 points, n = 34) and high (> 29 points, n = 45). Patients with low ESE were older (42.9 ± 15.1 vs. 32.0 ± 12.4 years, p = 0.001), had more complex lesions (65% vs. 42%, p = 0.05) more often had New York Heart Association functional class III (24% vs. 4%, p = 0.01) and performed fewer shoulder flexions (32.5 ± 15.5 vs. 47.7 ± 25.0, p = 0.001) compared with those with high ESE. In a logistic multivariate model age (OR; 1.06, 95% CI 1.02-1.10), and number of shoulder flexions (OR; 0.96, 95% CI 0.93-0.99) were associated with ESE.

    Conclusion: In this study we show that many adults with CHD have low ESE. Age is an important predictor of low ESE and should, therefore, be considered in counselling patients with CHD. In addition, muscle endurance training may improve ESE, and thus enhance the potential for being physically active in this population.

  • 133.
    Beckman, Emelie
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Larsson, Anna-Maja
    Umeå University, Faculty of Medicine, Department of Nursing.
    Känslor av utsatthet: En litteraturstudie om erfarenheter av mötet med sjukvårdspersonal för kvinnor utsatta för partnerrelaterat våld2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Intimate partner violence is a public health problem and women are more exposed. Women suffering from intimate partner violence are visiting the health care twice as much compared to other women. The health care workers often fails to identify and help the women.

    Aim: The aim of the study is to illuminate the experience of encounters with health care professionals for women exposed to intimate partner violence.

    Methods: Literature study with qualitative approach. Twelve scientific qualitative studies have been analyzed with content analysis. Three categories with eight subcategories were compiled into a result.

    Findings: The women wanted to be asked about intimate partner violence by health care professional. Many women found it difficult disclosing violence. Many women stated that they had not got the help or the information they needed.  Women who had positive experiences described the importance of relevant information and an emphatic approach.

    Conclusion: The women had mostly negative experiences of the encounters with the health care professionals. The health care professionals needs more education to be able to give a good health care. 

  • 134.
    Belander, Elina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nordlund, Felicia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Föräldrars erfarenheter av att leva med ett barn som har typ 1 diabetes: -En litteraturstudie2017Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Title: Parents' experiences of living with a child with type 1 diabetes

    Background: Type 1 diabetes is a disease that mainly affects children and adolescents, it requires a lifelong treatment. This means a change in daily life and in the parenthood for the parents. The parents may have a need for support from the nurse and the diabetes team.

    Aim: To illuminate parents' experiences of living with a child with type 1 diabetes.

    Method: A literature study was conducted. Database search was performed in CINAHL, SCOPUS and PubMed. The results of eight qualitative studies were reviewed, analyzed and compiled.

    Result: The result was compiled into three categories: Becoming a parent to a child with type 1 diabetes, facing challenges in everyday life and to receive/not receive support from the environment.

    Conclusion: Parents of a child with type 1 diabetes may experience a change in their role as a parent after the child has received the diagnosis. Family-focused care includes parental involvement which can, if the nurse if being responsive, enchance their ability to perform care of their child with type 1 diabetes.

  • 135. Bellelli, Giuseppe
    et al.
    Mazzola, Paolo
    Morandi, Alessandro
    Bruni, Adriana
    Carnevali, Lucio
    Corsi, Maurizio
    Zatti, Giovanni
    Zambon, Antonella
    Corrao, Giovanni
    Olofsson, Birgitta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Annoni, Giorgio
    Duration of Postoperative Delirium Is an Independent Predictor of 6-Month Mortality in Older Adults After Hip Fracture2014In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 62, no 7, p. 1335-1340Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate the association between number of days with delirium and 6-month mortality in elderly adults after hip fracture surgery. DESIGN: Prospective cohort study with 6-month follow-up. SETTING: Orthogeriatric Unit (OGU). PARTICIPANTS: Individuals (mean age = 84.3 +/- 6.4) admitted to the OGU between October 2011 and April 2013 with hip fracture (N = 199). MEASUREMENTS: Postoperative delirium (POD) was assessed daily using the Confusion Assessment Method algorithm and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria. Multivariable Cox regression models were used to evaluate the association between POD of and 6-month mortality after surgery, after adjustment for covariates including age, prefracture residence, Katz activity of daily living score, New Mobility score, diagnosis of prefracture dementia, American Society of Anesthesiologists score, albumin serum levels, Charlson Comorbidity Index, and length of OGU stay. RESULTS: Fifty-seven participants (28.6%) developed POD. In the 6-month period after surgery, 35 (17.6%) participants died: 16 of 57 (28.1%) with POD and 19 / of 142 (13.4%) with no POD. The average duration of POD was 2.0 +/- 3.2 days for participants who died and 0.7 +/- 1.8 days for those who survived (P < .001). After adjusting for covariates, each day of POD in the OGU increased the hazard of dying at 6 months by 17% (hazard ratio = 1.17, 95% confidence interval = 1.07-1.28). CONCLUSION: In older adults undergoing hip fracture surgery, duration of POD is an important prognostic factor for 6-month mortality. Efforts to reduce duration of POD are therefore crucial for these individuals.

  • 136. Benedetti, Franzisca Domeisen
    et al.
    Ostgathe, Christoph
    Clark, Jean
    Costantini, Massimo
    Daud, Maria Laura
    Grossenbacher-Gschwend, Barbara
    Latten, Richard
    Lindqvist, Olav
    Umeå University, Faculty of Medicine, Department of Nursing.
    Peternelj, Andreja
    Schuler, Stefanie
    Tal, Kali
    van der Heide, Agnes
    Eychmueller, Steffen
    International palliative care experts' view on phenomena indicating the last hours and days of life2013In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 21, no 6, p. 1509-1517Article in journal (Refereed)
    Abstract [en]

    Providing the highest quality care for dying patients should be a core clinical proficiency and an integral part of comprehensive management, as fundamental as diagnosis and treatment. The aim of this study was to provide expert consensus on phenomena for identification and prediction of the last hours or days of a patient's life. This study is part of the OPCARE9 project, funded by the European Commission's Seventh Framework Programme. The phenomena associated with approaching death were generated using Delphi technique. The Delphi process was set up in three cycles to collate a set of useful and relevant phenomena that identify and predict the last hours and days of life. Each cycle included: (1) development of the questionnaire, (2) distribution of the Delphi questionnaire and (3) review and synthesis of findings. The first Delphi cycle of 252 participants (health care professionals, volunteers, public) generated 194 different phenomena, perceptions and observations. In the second cycle, these phenomena were checked for their specific ability to diagnose the last hours/days of life. Fifty-eight phenomena achieved more than 80 % expert consensus and were grouped into nine categories. In the third cycle, these 58 phenomena were ranked by a group of palliative care experts (78 professionals, including physicians, nurses, psycho-social-spiritual support; response rate 72 %, see Table 1) in terms of clinical relevance to the prediction that a person will die within the next few hours/days. Twenty-one phenomena were determined to have "high relevance" by more than 50 % of the experts. Based on these findings, the changes in the following categories (each consisting of up to three phenomena) were considered highly relevant to clinicians in identifying and predicting a patient's last hours/days of life: "breathing", "general deterioration", "consciousness/cognition", "skin", "intake of fluid, food, others", "emotional state" and "non-observations/expressed opinions/other". Experts from different professional backgrounds identified a set of categories describing a structure within which clinical phenomena can be clinically assessed, in order to more accurately predict whether someone will die within the next days or hours. However, these phenomena need further specification for clinical use.

  • 137.
    Bentorp, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Palmcrantz, Josefin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Faktorer av betydelse för uppkomst av arbetsrelaterad stress2018Independent thesis Advanced level (degree of Master (One Year)), 40 credits / 60 HE creditsStudent thesis
    Abstract [en]

    Background: Stress is a physiological response to external and internal requirements. Work-related stress has increased and contributes to an increased risk of physical and mental illness. IT employees run a higher risk of suffering from, for example, heart disease caused by work-related stress compared to the general population.

    Motive: A large part of research in the subject of stress is mainly from Asia, but further studies on work-related stress in the IT industry in Sweden are needed to gain in-depth knowledge.

    Aim: The aim of this study was to survey factors contributing to work-related stress and compare these to the level of stress among employees of an IT company in the northern part of Sweden.

    Method: This study had a quantitative design and was carried out using a web site questionnaire. The result has been analyzed using the SIMCA statistics program. Result: The result showed strongest correlation between recuperation, workload and reported degree of stress. Demographic data showed no correlation with stress.

    Conclusion: Good recuperation and a reasonable workload reduced the risk of stress and fatigue. It is important for companies and employers to comply with current laws and regulations regarding the working environment, which the business nurse can contribute to.

  • 138. 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)
  • 139. 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)
  • 140. 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.

  • 141.
    Berg, Katarina
    et al.
    Inst för Omvårdnad, Hälsouniversitetet i Linköping.
    Idvall, Ewa
    Inst för Omvårdnad, Hälsouniversitetet Linköping.
    Nilsson, Ulrica
    Department of Anesthesia and Intensive Care/Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Franzén Årestedt, Kristofer
    Inst för Omvårdnad, Hälsouniversitetet Linköping.
    Unosson, Mitra
    Inst för Omvårdnad, Hälsouniversitetet Linköping.
    Psychometric evaluation of the post-discharge surgical recovery scale2010In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 16, no 4, p. 794-801Article in journal (Refereed)
    Abstract [en]

    Rationale, aim and objectives  Day surgery patients are discharged after a short period of postoperative surveillance, and reliable and valid instruments for assessment at home are needed. The aim of this study was to evaluate the psychometric properties of a Swedish version of the post-discharge surgical recovery (PSR) scale, an instrument to monitor the patient's recovery after day surgery, in terms of data quality, internal consistency, dimensionality and responsiveness.

    Methods  Data were collected on postoperative days 1 and 14 and included 525 patients. Data quality and internal consistency were evaluated using descriptive statistics, correlation analyses and Cronbach's α. The dimensionality of the scale was determined through an exploratory factor analysis. Responsiveness was evaluated using the standardized response mean and the area under the receiver operating characteristics curve (AUC). The correlation between change score in PSR and change score in self-rated health was assessed using Pearson's correlation coefficient. Patients' ability to work and their self-rated health on postoperative day 14 were used as external indicators of change.

    Results  Six items showed floor or ceiling effects. Cronbach's coefficient α was 0.90 and the average inter-item correlation coefficient was 0.44 after the deletion of two items. The items were closely related to each other, and a one-factor solution was decided on. A robust ability to detect changes in recovery (standardized response mean = 1.14) was shown. The AUC for the entire scale was 0.60. When initial PSR scores were categorized into three intervals, the ability to detect improved and non-improved patients varied (AUC 0.58–0.81). There was a strong correlation between change scores in PSR and health (0.63).

    Conclusions  The Swedish version of the PSR scale demonstrates acceptable psychometric properties of data quality, internal consistency, dimensionality and responsiveness. In addition to previous findings, these results strengthen the PSR scale as a potential instrument of recovery at home.

  • 142. Berg, Katarina
    et al.
    Idvall, Ewa
    Nilsson, Ulrica
    Umeå University, Faculty of Medicine, Department of Nursing.
    Unosson, Mitra
    Postoperative recovery after different orthopedic day surgical procedures2011In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 15, no 4, p. 165-175Article in journal (Refereed)
    Abstract [en]

    Orthopedic day surgery is common. Postoperative recovery may differ according to surgical procedures and personal factors. We studied postoperative recovery up to 2 weeks after different orthopedic day surgical procedures and tried to identify possible predictors associated with recovery. Three-hundred and fifty eight patients who had undergone knee arthroscopy or surgery to the hand/arm, foot/leg or shoulder were included. Data were collected on postoperative days 1, 7 and 14 using the Swedish Post-discharge Surgery Recovery scale, the emotional state, physical comfort and physical independence dimensions in the Quality of Recovery-23 and a general health question. Multiple linear regression was used to explore predictors of recovery. The shoulder patients experienced significantly lower postoperative recovery and general health 1 and 2 weeks after surgery compared to the other patient groups (p < 0.001). Significant predictors of recovery were age, perceived health and emotional status on the first postoperative day and type of surgery. Postoperative recovery after common orthopedic day surgical procedures varies and factors influencing it need to be further explored. The impact of a patient’s emotional state on recovery after day surgery can be of particular interest in this work. Post-discharge planning needs to be tailored to the surgical procedure.

  • 143.
    Berg, Linda
    et al.
    Umeå University, Faculty of Arts, Ethnology. Umeå University, Faculty of Medicine, Department of Nursing.
    Hernborg, Emma
    Umeå University, Faculty of Arts, Ethnology. Umeå University, Faculty of Medicine, Department of Nursing.
    Mot nya gränser: Kulturanalytiska perspektiv på sjuksköterskeyrket2001Report (Other academic)
  • 144.
    Berg, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Paulsson, Katte
    Umeå University, Faculty of Medicine, Department of Nursing.
    En kvalitativ litteraturstudie av sjuksköterskans erfarenhet av stress inom vården2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Stress-related health problems among nurses resulted in an increased number of sick leaves which resulted in large societal costs. Work-related stress have a negative impact on the patient safety and the quality of care. Because of the consequenses from the work-related stress, both newly qualified and experienced nurses considered leaving the profession.

     

    Aim: The aime was to describe nurses’ experiences of work-related stress.

     

    Method/design: A qualitative literature review. A database search was conducted using PubMed, PsycINFO and Cinahl. This resulted in eight articles which were analysed with inspiration from qualitative content analysis.

     

    Result: Eight subcategories and three categories were presented. These showed that understaffing, time pressure, powerlessness, poor relationships and lack of support had a negative impact on patient safety, nurses’ health, and the nurses’ private life.

     

    Conclusion: Most of the stressors are caused by the structure of the organisation. By improving nurses’ working conditions and work environment, patient safety can be secured and the nursing profession can become a more attractive choice of career. Which thereby could counteract the shortage of nurses that today is a global issue.

  • 145.
    Berg Marklund, Erik
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jonsson, Tony
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ambulanspersonals perspektiv och upplevelser av skadehändelser i underjordsgruvor2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka ambulanspersonals perspektiv och upplevelser av skadehändelser i underjordisk gruvmiljö.

    Metod: En kvalitativ intervjustudie med 13 deltagare på fem ambulansstationer runt om i Sverige med underjordsgruvor inom sitt upptagningsområde. Innehållet analyserades därefter utifrån en kvalitativ innehållsanalys.

    Resultat: Tre kategorier framkom, när larmet går om en skadehändelse i gruva. Ambulanspersonalen ser ett larm som en sällanhändelse och det kan upplevas laddat att åka dit. Bristande information initialt skapade en ovisshet och minskade möjligheten att överblicka situationen. Stora skadehändelser beskrivs vara problematiskt ur resurssynpunkt. Gruvkontext och egna erfarenheter påverkar händelseutfallet. Trots att gruvan beskrivs som en extrem miljö upplever ambulanspersonalen ingen skillnad i omhändertagandet när de kommer åt patienten. Den största skillnaden beskrivs förutom den extrema miljön vara tidsaspekten. Den tredje kategorin är sjukvårdsarbetet på plats i gruvan – ett sätt att lära för framtiden. Den personliga säkerheten prioriteras först och samarbetet på plats grundar sig i en tillit mellan ambulanspersonal, räddningstjänst och gruvans personal. Att gruvans personal följer med ner i gruvan upplever ambulanspersonal är viktigt då de inte vet hur de bör agera nere i gruvan. Många ambulansstationer hade inte någon aktiv utbildning kring gruvor. Studiebesök, utbildning och samövning med andra aktörer skulle göra dem bättre förberedda och känna en större känsla av kontroll av händelsen än vad de gör i dagsläget.

    Slutsats: Studien belyser flera upplevelser hos ambulanspersonal som kan komma att påverka deras förmåga att utföra en god vård och omvårdnad negativt. Några av de upplevda svårigheterna skulle, enligt resultatet, möjligen kunna lösas genom bland annat studiebesök, förtydligande av riktlinjer och gemensamma träffar för att diskutera larmplaner. Lösningarna bör vara av stort intresse för samtliga aktörer som kan bli involverade i en skadehändelse i en gruva.

  • 146.
    Berg, Therese
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bladh, Frida
    Umeå University, Faculty of Medicine, Department of Nursing.
    Förekomst av stressrelaterad ohälsa och stöd hos anställda på ett IT-företag2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stress can arise from many circumstances, often exacerbated when employees experiencelow support from management and colleagues and lack of control at work. Costs of mental illness at workincrease both nationally and internationally. Psychiatric diagnoses are the largest diagnostic group forongoing illnesses for both genders, and mental illness is increasing among the working population inSweden.

    Aim: The purpose of the study was to survey the prevalence of stress-related illness and supportamong employees at an IT company.

    Method: Quantitative cross-sectional study, web-based questionnairewith three validated instruments (s-UMS, PSS-10 and QPSNordic). The study population included 43employees at a smaller, international IT company with headquarters in Sweden. Analysis was performedwith Spearman's rank correlation, Chi2-test and descriptive statistics.

    Result: Most participants reportedlow levels of stress and high levels of support witho risk of developing exhaustion according to s-ED. Almosta third of the participants had moderate or pronounced exhaustion syndrome according to s-ED.Relationship could be demonstrated between levels of stress, exhaustion and support. No significantdifferences could be detected in levels of stress, risk of exhaustion and support based on age and workexperience.

    Conclusion: Experience support from colleagues and managers reduces the perceived stressand risk of exhaustion.

  • 147.
    Bergfors, Christine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Könsspecifika skillnader vid BPSD bland personer med kognitiv nedsättning i särskilt boende.2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Of all people with dementia, it is estimated that 90 percent sometime in the course of the disease, suffer from BPSD - behavioral and psychological symptoms of dementia. People with BPSD often have the need to receive care in nursing homes. The symptoms in some behavioral and psychological disorders differ between the sexes and that may be of importance when caring for these people. Some of the symptoms in BPSD differ between women and men. The aim of this study was to compare prevalence of BPSD between women and men among people with cognitive impairment in nursing homes. Design: This study is a quantitative descriptive cross-sectional study. The analysis was a secondary analysis. Method: A total sample of 836 people with cognitive impairment (582 women and 254 men), living in a nursing home located in two bigger cities in the county of Västerbotten was included. To evaluate their symptoms a questionnaire with individual questions based on the Multi-Dimensional Dementia Assessment Scale (MDDAS) was used. Comparisons between the groups were done by means of Pearson χ2 test. Result: The result showed significant differences between how BPSD is exposed in women and men.  Women were more prone to cry, be anxious, roll table cloths, be suspicious, having hearing hallucinations and to hide things. Men were more prone to urinate in inappropriate places and to stack things. Conclusion: This study have shown differences in specific BPSD symptoms between gender. These behaviors could be interpreted as attempts to communicate. This knowledge is estimated to be used in quality development in geriatric care settings and other places where people with dementia is caredfor. This could have the effect to improve quality of life for people with dementia.

  • 148.
    Bergfors, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nygren, Martina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att ha tid, kunskap och att våga känna: En litteraturstudie om sjuksköterskors upplevelse av att möta kvinnor utsatta för våld i en nära relation2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    To have time, knowledge and dare to feel: a literature study concerning nurses’ experiences of encountering women exposed to intimate partner violence

     

    Abstract

    Aim: To describe nurses’ experiences of encountering women exposed to intimate partner violence

    Background: IPV (intimate partner violence) is a large social problem and the exposed women have difficulties in asking for help. Nurses have an unique opportunity to make these women visible, but describes barriers preventing them from doing so.

    Method: An overall literature study of nine qualitative studies. Articles from CINAHL, PubMed and PsychInfo was audited, analyzed and compiled.

    Findings: Main themes that emerged was Knowledge, a key to intervene, Time constraint as a barrier and The emotional work. Nurses described that lack of knowledge complicated their work with the abused and requested education. They highlighted that time constraint could lead to less adequate care. Meeting abused women can have an emotional lasting effect on nurses whereupon they need support.

    Conclusion: Nurses need education in order to become more confident in identifying and responding to abused women. It is needed to highlight the effect of time constraint in the meeting with the abused. Further research concerning nurses´ emotional needs and their knowledge and stereotype perception towards IPV is needed. And this should form the base to implement improvement in the care of women exposed to IPV.

     

    Key words: Nurses, intimate partner violence, respond

  • 149.
    Berggren, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nilsson, Eira
    Umeå University, Faculty of Medicine, Department of Nursing.
    Föräldrars upplevelse av att ha barn med typ 1-diabetes2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Det är vanligt att föräldrar till barn med diabetes upplever en psykisk påfrestning, både kring diagnostillfället men även flera år efter. När ett barn drabbas av diabetes faller det största ansvaret för egenvården på föräldrarna. Sjuksköterskan har en central roll när det gäller att stödja och vägleda föräldrarna och barnet.

    Syfte: Syftet med den här litteraturstudien är att belysa föräldrars upplevelse av att ha barn med typ 1-diabetes.

    Metod: Åtta empiriska studier med kvalitativ ansats har granskats och analyserats. En analysmetod som påminner om beskrivande metasyntestänkande har använts.

    Resultat: Sjukdomens oförutsägbarhet, den ständiga planering och den konstanta vaksamheten den kräver upplevdes som psykiskt påfrestande för föräldrarna. Det upplevdes som värdefullt att samarbeta kring diabetesvården, känna tillit och få emotionellt stöd. Föräldrarna kände oro för långtidskomplikationer och barnens övergång till tonåren. Att lära sig hantera ett liv med diabetes är en process som inleds med självklander och övergår i acceptans.

    Slutsats: Utifrån resultatet är det påfrestande att ha barn med diabetes. På vägen till att finna acceptans har sjuksköterskan en central roll. Det är av betydelse för sjuksköterskan att vara medveten om föräldrarnas upplevelse för att kunna ge professionell vård, ett gott bemötande och ta hänsyn till familjens alla behov.

  • 150.
    Berggren, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hjalmar Andersson, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Psykisk ohälsa i somatisk slutenvård. Att vårda patienter med psykisk ohälsa på medicin- och kirurgavdelning2014Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte. Syftet med studien är att belysa viktiga aspekter i mötet mellan sjuksköterskan och patienter med psykisk ohälsa inom den somatiska slutenvården.

    Bakgrund. Patienter som lider av psykisk ohälsa vårdas frekvent i den somatiska slutenvården. Sjuksköterskor på medicin och kirurgavdelningar möter och vårdar dessa patienter tillsammans med undersköterskor och läkare, men är de som har omvårdnadsansvaret för patienterna.

    Design. Kvalitativ intervjustudie.

    Metod. Åtta legitimerade sjuksköterskor vid kirurg och medicinavdelning med olika långa anställningstid, intervjuades individuellt. Alla sjuksköterskor utom en intervjuades på sin arbetsplats inom arbetstid. Intervjuerna analyserades genom kvalitativ innehållsanalys och analysen resulterade i två kategorier och sju underkategorier.

    Resultat. Kategorier som formades från det analyserade materialet var; Erfarenheter, reflektioner och information är grundelement för det goda mötet och; Kunskap och samordning underlättar vårdarbete. Resultatet visar att sjuksköterskor i den somatiska slutenvården upplever att de har en önskan och en vilja att bemöta och vårda patienter med psykisk ohälsa på ett bra sätt.

    Sjuksköterskorna beskriver i stor utsträckning att tidsbrist hos sjuksköterskan och bristen på möjlighet till sekretess mellan patienter med psykisk ohälsa och sjuksköterska är faktorer som påverkar bemötande, vårdkvalitet och arbetsmiljö negativt.

    Vidare upplever sjuksköterskorna att kunskapsbrist om psykisk ohälsa, stressig vårdmiljö och begränsad möjlighet till konsultation är faktorer som påverkar vården av patienter med psykisk ohälsa.

    Slutsats. Sjuksköterskorna upplever att tidsbrist påverkar vårdkvalitet och arbetsmiljö negativt. Sjuksköterskorna önskar kompetensutveckling i området psykisk ohälsa och ett utvecklat samarbete kring personer med psykisk ohälsa. Både med yrkesgrupper på avdelning och med psykiatrisk klinik, för ökad vårdkvalitet för personer med psykisk ohälsa.

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