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  • 151.
    Berggren, Monica
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Stenvall, Michael
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Englund, Undis
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    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.
    Co-morbidities, complications and causes of death among people with femoral neck fracture: a three-year follow-up study2016In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 120Article in journal (Refereed)
    Abstract [en]

    Background: The poor outcome after a hip fracture is not fully understood. The aim of the study was to describe the prevalence of co-morbidities, complications and causes of death and to investigate factors that are able to predict mortality in old people with femoral neck fracture. Methods: Data was obtained from a randomized, controlled trial with a 3-year follow-up at Umea University Hospital, Sweden, which included 199 consecutive patients with femoral neck fracture, aged >= 70 years. The participants were assessed during hospitalization and in their homes 4, 12 and 36 months after surgery. Medical records and death certificates were analysed. Results: Multivariate analysis revealed that cancer, dependence in P-ADL (Personal Activities of Daily Living), cardiovascular disease, dementia at baseline or pulmonary emboli or cardiac failure during hospitalization were all independent predictors of 3-year mortality. Seventy-nine out of 199 participants (40 %) died within 3 years. Cardiovascular events (24 %), dementia (23 %), hip-fracture (19 %) and cancer (13 %) were the most common primary causes of death. In total, 136 participants suffered at least one urinary tract infection; 114 suffered 542 falls and 37 sustained 56 new fractures, including 13 hip fractures, during follow-up. Conclusion: Old people with femoral neck fracture have multiple co-morbidities and suffer numerous complications. Thus randomized intervention studies should focus on prevention of complications that might be avoidable such as infections, heart diseases, falls and fractures.

  • 152.
    Berggren, Rebecca
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rönnqvist, Elina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Självskadebeteende: Sjuksköterskans upplevelse2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 153.
    Bergh, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rydberg, Claes
    Umeå University, Faculty of Medicine, Department of Nursing.
    Egenvårdsråd vid cytostatikabehandling: En jämförande studie mellan öppenvård och slutenvård2017Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Att undersöka i vilken utsträckning personer med cancersjukdom har erhållit egenvårdsråd i samband med cytostatikabehandling - en jämförande studie mellan öppen- och slutenvård. Bakgrund: Personer med cancersjukdom som genomgår cytostatikabehandling skall erhålla information om eventuella biverkningar och hur dessa kan lindras och förebyggas dvs. egenvårdsråd. Egenvård är ett aktuellt ämne och forskning visar på vikten av välinformerade patienter då detta bidrar till ökad delaktighet och trygghet i sin sjukdomssituation. Få studier har undersökt förekomsten av givna egenvårdsråd samt jämfört skillnader mellan öppen-och slutenvård. Design: Deskriptiv tvärsnittsstudie med kvantitativ design. Metod: Data samlades in via enkäter på 41 studiedeltagare på en onkologisk klinik våren 2017. Enkäten bestod av 12 flervalsfrågor utformade av författarna. Resultat: Analysen visade inte på några signifikanta skillnader i givna egenvårdsråd mellan öppen-och slutenvård. Överlag hade deltagarna erhållit egenvårdsråd gällande få symtom/biverkningar. Resultatet visade på att deltagare var mycket nöjda med erhållna egenvårdsråd & trygga med att hantera biverkningar. Muntlig & skriftlig information gavs i större utsträckning inom öppenvården, men denna skillnad var ej statistiskt signifikant. Slutsats: Studien visar att vissa patienter erhållit egenvårdsråd i större utsträckning jämfört med andra patienter samtidigt som det var vanligare att deltagare erhållit egenvårdsråd gällande vissa specifika symtom/biverkningar. I denna studie kunde inga eller mycket små skillnader ses mellan öppenvård och slutenvård. Sjuksköterskor var en viktig källa till egenvårdsråd samtidigt som läkare och i vissa fall undersköterskor var en informationskälla. Studien visar att deltagarna generellt sätt var mycket nöjda.

  • 154. Bergland, Adel
    et al.
    Hofoss, Dag
    Kirkevold, Marit
    Vassbo, Tove
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Person-centred ward climate as experienced by mentally lucid residents in long-term care facilities2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 3-4, p. 406-414Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. To assess the content validity and reliability of the Person-centred Climate Questionnaire-Patient version in long-term care facilities, to describe residents' perceptions of the extent to which their ward climate was person-centred and to explore whether person-centredness was associated with facility and resident characteristics, such as facility and ward size, having a sensory garden and having a primary caregiver.

    Background. The importance of the physical environment to persons with dementia has been investigated. However, research is lacking regarding the extent to which mentally lucid residents experience their physical and psycho-social ward climate as person-centred and the factors influencing their experience.

    Design. Cross-sectional survey design.

    Methods. The Person-centred Climate Questionnaire-Patient version was translated into Norwegian with forward and backward translation. The content validity index for scales was assessed. The Person-centred Climate Questionnaire-Patient version was completed by 145 mentally lucid residents in 17 Norwegian long-term care facilities. Reliability was assessed by Cronbach's alpha and item-total correlations. Test-retest reliability was assessed by paired samples t-test and Spearman's correlation. To explore differences based on facility and resident characteristics, independent-samples t-test and one-way ANOVA were used.

    Results. The content validity index for scales was satisfactory. The Person-centred Climate Questionnaire-Patient version was internally consistent and had satisfactory test-retest reliability. The climate was experienced as highly person-centred. No significant differences were found, except that residents in larger facilities experienced the climate as more person-centred in relation to everyday activities (subscale 2) than residents in smaller facilities.

    Conclusion. The Norwegian version of the Person-centred Climate Questionnaire-Patient version can be regarded as reliable in a long-term care facility context. Perceived degree of person-centredness was not associated with facility or resident characteristics, such as the number of residents, having a sensory garden or knowing that one has a primary caregiver.

    Relevance to clinical practice. A person-centred climate can be attained in different kinds of long-term care facilities.

  • 155. Bergland, Adel
    et al.
    Kirkevold, Marit
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Psychometric properties of the Norwegian Person-centred Climate Questionnaire from a nursing home context2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 4, p. 820-828Article in journal (Refereed)
    Abstract [en]

    Background: The physical and psychosocial environments in nursing homes influence the residents everyday life as well as their well-being and thriving. The staffs perceptions of and relationships with the residents are crucially important to quality care. Quality care is described often as person-centred. Few measurement tools exist that focus on person-centred care in nursing homes.

    Objective: The aim of this study was to evaluate the psychometric properties of the Norwegian version of the Person-centred Climate QuestionnaireStaff version (PCQ-S).

    Design: This study had a cross-sectional survey design.

    Participants and Settings: Two hundred and nine healthcare and support staff in five nursing homes in the eastern part of Norway.

    Methods: The Swedish PCQ-S was translated into Norwegian with forward and backward translation. The relevance of the items included in the questionnaire was assessed by an expert panel of 10 nursing home care staff, because the questionnaire has not been used in this context previously. A psychometric evaluation using statistical estimates of validity and reliability was performed. The discriminatory capacity of the questionnaire was also tested.

    Results: The content validity index was satisfactory (0.78). The PCQ-S showed high internal consistency reliability in that Cronbachs a was satisfactory for the total scale (0.92) and the three subscales (0.81, 0.89 and 0.87). The testretest reliability was also satisfactory as evident from a Spearmans correlation coefficient of 0.76 (p < 0.01) between the total PCQ scores at test and retest. The Norwegian version retained the original factor structure of the Swedish version.

    Conclusion: As the psychometric evaluation showed satisfactory validity and reliability scores, this study supports the Norwegian version of the PCQ-S when applied to a sample of nursing home staff.

  • 156. Bergland, Adel
    et al.
    Kirkevold, Marit
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hofoss, Dag
    Vassbo, Tove
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.
    Thriving in long-term care facilities: instrument development, correspondence between proxy and residents' self-ratings and internal consistency in the Norwegian version2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 7, p. 1672-1681Article in journal (Refereed)
    Abstract [en]

    Aims. To develop an instrument for measuring thriving among residents in long-term care facilities, to assess the correspondence between proxy ratings and self-report and the internal consistency of the Norwegian version. Background. The instrument was developed from the life-world concept of thriving and thereby has a different theoretical basis than existing 'dementia related' quality-of-life instruments. Thriving relates the experience of older persons to the place where they live. Proxy instruments need to be developed for residents in long-term care facilities who are not able to report their subjective experiences. Design. Instrument development using cross-sectional survey design. Methods. The instrument was developed in three versions (resident, family and staff) from a theory on thriving. Forty-eight triads consisting of a resident, family member and primary nurse from 12 Norwegian nursing homes participated. Data collection took place between March-December 2011. Inter-rater agreement between the groups was assessed by Cohen's kappa coefficient (weighted). Internal consistency was evaluated by Cronbach's alpha. Homogeneity was explored through item-total correlations. Results. Agreement between residents, family members and staff was poor or fair (<0.41) in six of 38 items. These items were excluded. The 32-items instrument had satisfactory Cronbach's alpha values in each of the three samples and satisfactory homogeneity as item-total correlations was substantial without being excessive and thus indicated that items were measuring the same construct. Conclusion. The instrument appears to have internal consistency and enable reliable proxy measures of the thriving construct. Further psychometric assessment including checking for possible item redundancy is needed.

  • 157. Bergland, Ådel
    et al.
    Kirkevold, Marit
    Sandman, Per-Olof
    Umeå University, Faculty of Medicine, Department of Nursing. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.
    Hofoss, Dag
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
    The thriving of older people assessment scale: validity and reliability assessments2015In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 71, no 4, p. 942-951Article in journal (Refereed)
    Abstract [en]

    AimTo explore construct validity and reliability of the Thriving of Older People Assessment Scale. BackgroundThe concept of thriving emphasizes person-environment interaction in relation to well-being. The Thriving of Older People Assessment Scale has been developed and evaluated as a self-report and proxy scale based on the theory of thriving. DesignCross-sectional survey design. MethodThe Thriving of Older People Assessment Scale was completed by a sample of 259 residents, 146 family members and 52 staff from 13 long-term care facilities in Norway and Sweden. Data were collected between April 2010-December 2011. Exploratory factor analysis was applied to explore construct validity in terms of factor structure and dimensionality of the 32-item scale in relation to the thriving theory. Reliability was explored through internal consistency estimation using Cronbach's alpha and through homogeneity evaluation using corrected item-total correlations. ResultsExploratory factor analysis resulted in five factors (subscales) that corresponded meaningfully with the thriving theory and were labelled 1: Resident' attitudes towards being in long-term care; 2: Quality of care and caregivers; 3: Resident engagement and peer relationships; 4: Keeping in touch with people and places; and 5: Quality of the physical environment. The scale had satisfactory internal consistency and homogeneity estimates. ConclusionThe 32-item Thriving of Older People Assessment Scale can be regarded as construct valid and reliable. Its factor structure corresponded logically to the thriving theory and its factors showed satisfactory internal consistency and homogeneity. Nevertheless, the TOPAS would benefit from further testing in other populations and contexts.

  • 158.
    Berglund, Ann-Sofi
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bransell-Kantoniemi, Maria
    Umeå University, Faculty of Medicine, Department of Nursing.
    BVC-sjuksköterskors erfarenheter av att arbeta med övervikt och fetma bland barn under 5 1/2 år2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Övervikt och fetma är ett ökande problem bland barn i tidig ålder. Syftet var att belysa BVC-sjuksköterskorserfarenheter av att arbeta med övervikt och fetma bland barn under 5 ½ år. Nio BVC-sjuksköterskor intervjuades. Texten analyserades med kvalitativ innehållsanalys. Resultatet visade att BVC-sjuksköterskorna inte beskriver fetma och övervikt som ett stort problem. Resultatet visade på kulturella skillnader. I det dagliga arbetet använder de sig av stödjande och motiverande samtal utan att kritisera eller skuldbelägga föräldrarna. I arbetet med övervikt och fetma är det viktigt att se arbetet långsiktigt ur ett familjeperspektiv.

  • 159.
    Berglund, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Gahlin, Emilié
    Umeå University, Faculty of Medicine, Department of Nursing.
    Utmanande möten: Distriktssköterskor erfarenheter av stressfyllda arbetssituationers inverkan på patientbemötandet2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The need for care of the Swedish population is increasing, the number of district nurses decreases and primary care is not sufficiently developed based on current needs. In this organization, healthcare professionals are exposed to a higher level of workrelated stress while satisfying a patient's basic care needs in a professional manner. For patients it is important to be listened to and experience being treated as an individual.

    Motive: An increased understanding of how work-related stress affects patient attendance is of great importance for improving the district nurse's work environment and increasing patient safety. 

    Aim: To highlight district nurses' experiences of how work-related stress affects patient response at health care center. 

    Methods: The study was conducted through a qualitative method. The data was collected through nine semistructured interviews from district nurses residing in either Västerbotten, Västernorrland or Uppsala County. The interviews were analyzed with qualitative content analysis and finally formed eight subcategories, three categories and one theme.

     Result: The district nurses' experiences of how work-related stress affects patient attendance is described under the theme "Difficulties to Afford Professional" and the categories "Non-focused Treatment", "Unresponsive Treatment," and "Care-Centered Treatment." 

    Conclusion: District nurses experience that work-related stress makes them streamline patient meetings. The consequence of this approach is that they often exhibit an attitude that is not related to how they associate professionalism.   

  • 160.
    Berglund, Sara
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hot och våld bygger en mur i vårdrelationen: Omvårdnadspersonals erfarenheter av hot och våld i omvårdnadsarbetet inom slutenpsykiatrisk vård2015Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hot och våld saknar generellt accepterade definitioner och är ett känt fenomen inom slutenpsykiatrisk vård. Förekomsten av hot och våld är svår att fastställa på grund av underrapportering och definitionssvårigheter. Konsekvenser av hot och våld har emotionella, fysiska, professionella, organisatoriska samt ekonomiska konsekvenser. Psykiatrisk vård berör relationer mellan omvårdnadspersonal och patient som är en central del i omvårdnadsarbetet. Omvårdnadspersonal inom slutenpsykiatrisk vård kommer i kontakt med hotfulla och våldsamma patienter där hantering och prevention är en uppgift för omvårdnadspersonal. Det finns begränsat med vetenskaplig forskning kring omvårdnadspersonals erfarenheter av hot och våld fokuserat på omvårdnadsarbetet. Syfte: Syftet med studien var att beskriva omvårdnadspersonals erfarenheter av hot och våld i omvårdnadsarbetet inom slutenpsykiatrisk vård. Design: Kvalitativ design med semistrukturerade intervjuer. Metod: Ändamålsenligt urval med åtta deltagare. Datainsamling genomfördes våren och sommaren 2015 och analyserades med kvalitativ innehållsanalys. Resultat: Resultatet består av tre kategorier och nio subkategorier. Resultatet presenteras under kategorierna: ́Hot och våld sätter en osynlig vägg i mötet med patienten ́, ́Hot och våld skapar ett tomrum i omvårdnadsarbetet ́ och ́Hot och våld fjärmar omvårdnadspersonal och patient från varandra ́. Slutsats: Hot och våld skapar svårigheter i omvårdnadsarbetet kring utförande av omvårdnadsåtgärder, tillgodose omvårdnadsbehov och kan bygga en mur i vårdrelationen till patienten.

  • 161.
    Berglund, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Eriksson, Beatrice
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kvinnors erfarenheter av att leva med urininkontinens: En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract

    Background: Urinary incontinence defines as unintentional passing of urine and also counts as a hidden scourge. Women are overrepresented but men are affected as well. The illness has large impact on the economy for the society. Estimated annually cost is 2% of Sweden's healthcare. Urinary incontinence causes daily life disturbances for those who are affected.

    Aim: The aim of this literature study was to describe women's experiences of living with urinary incontinence.

    Method: In this literature study eleven qualitative research articles were compiled and analyzed by content analysis method. A content analysis was accomplished with categories and subcategories. Articles were searched for in two databases; Cinahl and PubMed.

    Results: The analysis resulted in three categories and eight subcategories; Experience of shame: Taboo subject, Scared getting caught. Impact on daily life: Routine behavior, Limit yourself, Changed self-image, Impacts on relations. Reception from health professionals: Thoughts of not being taken seriously, The importance of communication.

    Conclusion: Urinary incontinence is a subject filled with shame and therefore difficult to talk about.

  • 162.
    Berglund, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindgren, Britt-Marie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Patients' Experiences After Attempted Suicide: A Literature Review2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 10, p. 715-726Article, review/survey (Refereed)
    Abstract [en]

    The aim of this study has been to synthesize research on suicidal patients' experiences of the suicide process. A literature search was performed in CINAHL, PubMed, and PsycINFO, and the analysis of the 15 articles covered was based on meta-synthesis. Patients experience a wide variety of feelings regarding their situation during the suicide process, and these exist on two levels: they relate to the different aspects of care that the patients receive and the patients' need to communicate with others and regain hope. The patients in this study described the struggle to maintain hope when life became too difficult and their suffering despite a sense of security, and they sought to achieve emotional balance. A good understanding of how suicidal individuals live with and manage suicidal ideation, while maintaining hope is important for planning effective nursing care. Further research from the patient perspective is needed to further develop psychiatric care for people at risk of suicide.

  • 163.
    Bergman, Birgit
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlström, Elisabeth
    Umeå University, Faculty of Medicine, Department of Nursing.
    Effekter av hund i omvårdnaden av äldre personer med demenssjukdom2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 164.
    Bergman, Caroline
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Johansson, Sofie
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjuksköterskors erfarenheter av att arbeta med telefonrådgivning: -En intervjustudie2017Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The purpose of having telephone triage is to decrease the number of doctor appointments and to increase the availability by getting the patient to the right level of care from the start. The nurses working with telephone triage should make adequate and informed decisions based on the patient's health problem. They should also give the patient a sense of security. Telephone triage is an independent and challenging work task that requires the nurse to be competent.  

    Purpose: To illustrate how nurses experience working with telephone triage

    Method: Eight nurses working with telephone triage were interviewed using semi-structured questions. A qualitative analysis was performed to review and interpret the results.  

    Results: By performing the qualitative analysis five categories and some subcategories were found to be important. The five categories are; To give good service, The need of recovery, To be challenged, To be professional and To develop at work.

    Conclusion: This study has given light to the complexity of working with telephone triage to people with various symptoms in all ages. The job requires extensive experience, competence and the ability to work independently. The study has shown that the nurses have a positive experience of working with telephone triage and shows that it requires clear strategies for it to be performed without risking the patient safety.  

  • 165.
    Bergman, Julia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bjelkefelt, Ida
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att balansera privatliv och arbetsliv: Hur skiftarbetande sjuksköterskor med barn i förskoleåldern upplever balans mellan arbetsliv och privatliv2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research shows that shift work can cause social stress as it affects private life and can complicate social relations. Statistics show that three out of ten employees who work shift find it difficult to combine work and leisure.

    Motive: Since only a few studies have been found about how shift-working nurses with children in preschool age experience a balance between working life and private life, this study intends to add more knowledge within the subject.

    Aim: The aim of the study is to describe the experience of balance between private life and working life among shift-working nurses with children in preschool age.

    Methods: Qualitative method with inductive approach. Ten shift-working nurses with children in preschool age were interviewed based on an interview guide with semistructured questions. The interviews were then transcribed and analyzed using qualitative content analysis with inductive approaches. 

    Result: The nurses described that their irregular working hours often lead to a lack of recovery. The participants also stated that they experienced bad conscience towards their family because they worked shifts. Furthermore, it was described that their irregular working hours affected them in such a way that they missed social activities. The nurses also highlighted that support from their partner was important related to their working hours. All participants saw advantages of shift work in their current life situation.

    Discussion: The result shows both negative and positive aspects of working shifts with young children. Both the lack of recovery and the experience of missing out on social activities is revealed in the result, yet the nurses nevertheless described that the benefits of their irregular working hours outweighed the disadvantages. The shift

    work made it possible for the children to spend a shorter time at the preschool, which was an aspect that made the nurses not want to switch to a job that was placed only during the daytime.

    Conclusion: In order for shift-working nurses with children in preschool age to be able to find a balance between working life and private life, it is important that the employer has a holistic perspective.

  • 166.
    Bergman, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Danielsson, Mia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonals följsamhet till handhygienrutiner inom hälso. och sjukvården: En litteraturstudie om faktorer som främjar eller hindrar2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Utövande av handhygienrutiner är en av de viktigaste åtgärderna inom vården för att förhindra vårdrelaterade infektioner. Årligen orsakar vårdrelaterade infektioner stort lidande för patienter och kan leda till bestående skador och döden. All personal inom hälso- och sjukvården är enligt lag ålagda att följa de regler kring basala hygienrutiner som fastställts av Socialstyrelsen.

    Syfte: Syftet med litteraturstudien var att belysa vad som främjar eller hindrar vårdpersonalens följsamhet till handhygienrutiner inom hälso- och sjukvården, samt äldrevården.

    Metod: Inklusionskriterierna för litteraturstudien var all vårdpersonal och studenter på sjukhus och äldreboenden. Nio artiklar valdes för att belysa vårdpersonalens upplevelser, perspektiv och erfarenheter. Artiklarna skulle vara skrivna på engelska och peer reviewed samt etiskt granskade. I litteraturstudien har de nio kvalitativa artiklarna kvalitetsbedömts efter SBU:s modell. Artikelsökningarna har gjorts på databaserna: Cinahl, Scopus och PubMed. Exklusionkriterierna var all personal inom tandvården. Analysmetoden innebar att texten kondenserades ned utan att innehållet förlorades. Tio underkategorier framkom i analysen som sedan delades in i två huvudkategorier.

    Resultat: Resultatet visar att organisatoriska och individuella faktorer har betydelse för utövandet av god handhygien. Information och utbildning höjde följsamheten tillfälligt. Att ha bra förebilder inom yrkesområdet sågs som viktigt och höjde vårdpersonalens benägenhet till att utföra hygienrutiner.

    Slutsats: Denna litteraturstudie visar att utförande av handhygien är beroende både av organisatoriska- och individuella faktorer. Det finns många metoder för att öka följsamheten, men författarna har inte funnit någon metod som gör att bra rutiner bibehålls. Orsaker som nämnts är bland annat tidsbrist och attityd till att utföra handhygienrutiner.

  • 167.
    Bergman, Magdalena
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sahlström, Ida
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dansande skelett, smurfarna och trollerisalva: Sjuksköterskans upplevelse av lustgas i kombination med avledning och kompletterande preparat i samband med smärtrelaterade procedurer hos barn.2012Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 168.
    Bergström, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Persson, Margareta
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology. Umeå University, Faculty of Medicine, Department of Nursing.
    Mogren, Ingrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynecology.
    Psychosocial and behavioural characteristics in women with pregnancy-related lumbopelvic pain 12 years postpartum2019In: Chiropractic and Manual Therapies, ISSN 2045-709X, E-ISSN 2045-709X, Vol. 27, no 1, article id 34Article in journal (Refereed)
    Abstract [en]

    Background: There is insufficient evidence regarding psychosocial factors and its long-term association with persistent pregnancy-related lumbopelvic pain. The overall aim of this study was to investigate women with persistent pregnancy-related lumbopelvic pain 12 years postpartum based on psychosocial and behavioural characteristics using the Swedish version of the Multidimensional Pain Inventory (MPI-S) classification system.

    Material and methods: This is a cross-sectional study based on a previous cohort. Data collection took place through a questionnaire. A total of 295 women from the initial cohort (n = 639) responded to the questionnaire giving a response rate of 47.3%. To determine the relative risk (RR) of reporting pain 12 years postpartum, a robust modified Poisson regression was used. This is the first study using the MPI-S as a predictive variable on women with persistent pregnancy-related lumbopelvic pain.

    Results: The MPI-S classification procedure was carried out on a total of n = 226 women, where 53 women were classified as interpersonally distressed (ID), 82 as dysfunctional (DYS), and 91 as adaptive copers (AC). Women in the ID and DYS subgroups had a relative risk (RR) of reporting persistent pregnancy-related lumbopelvic pain 12 years postpartum that was more than twice as high compared to the AC subgroup (95% confidence interval (CI) in parenthesis): RR 2.57 (CI 1.76 - 3.75), p<0.0001 and RR 2.23 (CI 1.53 - 3.25), p<0.0001 respectively. Women in the DYS subgroup had more than 5 times increased risk of reporting sick leave the past 12 months compared to the AC subgroup (RR 5.44; CI 1.70 - 17.38, p=0.004).

    Conclusions: The present study demonstrates that it is possible to classify women with persistent pregnancy-related lumbopelvic pain 12 years postpartum into relevant clinical subgroups based on psychosocial and behavioural characteristics using the MPI-S questionnaire.

  • 169.
    Bergström, Cecilia
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Persson, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mogren, Ingrid
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Obstetrics and Gynaecology.
    Sick leave and healthcare utilisation in women reporting pregnancy related low back pain and/or pelvic girdle pain at 14 months postpartum2016In: Chiropractic and Manual Therapies, ISSN 2045-709X, E-ISSN 2045-709X, Vol. 24, article id 7Article in journal (Refereed)
    Abstract [en]

    Background: Pregnancy related low back pain (PLBP) and pelvic girdle pain (PGP) are considered common complications of pregnancy. The long-term consequences for women with persistent PLBP/PGP postpartum are under-investigated. The main objective was to investigate the prevalence, pattern and degree of sick leave as well as healthcare utilisation and its perceived effect in women with persistent PLBP/PGP at 12 months postpartum.

    Method: This is a follow-up study of a cohort involving of a sample of women, who delivered from January 1st 2002 to April 30th in 2002 at Umea University Hospital and Sunderby Hospital, and who reported PLBP/PGP during pregnancy. A total of 639 women were followed-up by a second questionnaire (Q2) at approximately 6 months postpartum. Women with persistent PLBP/PGP at the second questionnaire (N = 200) were sent a third questionnaire (Q3) at approximately 12 months postpartum.

    Results: The final study sample consisted of 176 women reporting PLBP/PGP postpartum where N = 34 (19.3 %) reported 'no' pain, N = 115 (65.3 %) 'recurrent' pain, and N = 27 (15.3 %) 'continuous' pain. The vast majority (92.4 %) of women reported that they had neither been on sick leave nor sought any healthcare services (64.1 %) during the past 6 months at Q3. Women with 'continuous' pain at Q3 reported a higher extent of sick leave and healthcare seeking behaviour compared to women with 'recurrent' pain at Q3. Most women with persistent PLBP/PGP had been on sick leave on a full-time basis. The most commonly sought healthcare was physiotherapy, followed by consultation with a medical doctor, acupuncture and chiropractic.

    Conclusion: Most women did not report any sick leave or sought any healthcare due to PLBP/PGP the past 6 months at Q3. However, women with 'continuous' PLBP/PGP 14 months postpartum did report a higher prevalence and degree of sick leave and sought healthcare to a higher extent compared to women with 'recurrent' PLBP/PGP at Q3. Women with more pronounced symptoms might constitute a specific subgroup of patients with a less favourable long-term outcome, thus PLBP/PGP needs to be addressed early in pregnancy to reduce both individual suffering and the risk of transition into chronicity.

  • 170.
    Bergström, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundberg, Johnna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Upplevelsen av hälsa bland renskötande samer i Sverige: En intervjustudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Idag lever cirka 20 000 samer i Sverige varav cirka 2500 har sin

    huvudsakliga inkomst från renskötsel. Livet som renskötare beskrivs som fritt men

    samtidigt präglat av konstant oro och stress inför framtiden. Diskriminering och

    bristande stöd hör till vardagen och senare forskning visar att ohälsan ökar bland

    renskötare. De flesta hälsoproblemen bland renskötande samer grundar sig i

    marginalisering och kunskapsbrist hos allmänheten gällande renskötsel och samisk

    kultur.

    Syfte: Att belysa upplevelser av hälsa bland renskötande samer i en sameby i

    Sverige.

    Metod: Semistrukturerade intervjuer med intervjuguide och följdfrågor kring

    upplevelsen av hälsa användes. Totalt 27 personer tillfrågades om deltagande och

    elva personer medgav samtycke. Intervjuerna spelades in, transkriberades och

    analyserades enligt kvalitativ innehållsanalys. Intervjuerna genomfördes under

    januari och februari månad 2016.

    Resultat: Tre kategorier och elva underkategorier identifierades utifrån

    informanternas upplevelser. Kategorierna som identifierades var; förutsättningar för

    en god hälsa, hinder för en god hälsa samt hälsa i framtiden. Resultatet visar på att

    renskötarna saknar stöd och förståelse från myndigheter samt ortsbefolkning och att

    det råder informationsbrist gällande den samiska kulturen. Dagens ökade

    exploatering och klimatförändringar skapar svårigheter i arbetet med renskötsel och

    det är en bidragande orsak till renskötarnas upplevelse av ohälsa.

    Slutsats: Resultatet av studien visar att det finns fortsatt behov av forskning inom

    området då renskötarna befinner sig i en utsatt situation vilket påverkar deras hälsa

    på ett negativt sätt. Resultatet ses som användbart till det fortsatta arbetet inom

    svensk hälso- och sjukvård samt aktörer såsom myndigheter och övriga befolkningen.

  • 171.
    Bergström, Olesia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rudberg, Staffan
    Umeå University, Faculty of Medicine, Department of Nursing.
    Operationssal, en spännande miljö där kommunikation ochsamspel utmanar operationsprofessioner: - en studie om kommunikation och samarbete ur ett genusperspektiv2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: In a room for surgery there are several different participants that together forma team consisting of; surgeon, surgeon nurse, anaesthesiologist, nurse of anaesthesia and anoperational assistant. For the team to function optional it is essential that communication betweenthe team members uphold. Earlier studies show the many surgeon nurses describestheir professional role subordinate in relation to the other roles in the team. There are storiestold about different occasions where surgeon nurses have experienced bad collegial behaviorincluding stories told of direct insult of surgeon nurses from surgeons in their team. This wasour main focus in this study, to see how gender affects communication. Aim: The surgeonnurse experience of the communication between the surgeon and the nurse from a gender perspective.Method: Qualitative method with analysis of the content from semi structured interviewsincluding five surgeon nurses. Result: Experiences of communication has proven to bedifferent between males and females in this study. The study shows that the surgeon nursesability to read the surgeons temper, and adapt to that, was frequently occuring. Surgeon nurses,of both gender, considered themselves to be important as mediators between the differentsurgeon actors in order to solve conflicts. All interviewed perceived that age, experience, ethnicity,and personal characteristics affected communication cooperation. Opinions from surgeonnurses that professionalism doesn´t have a gender was expressed. Discussion: Gendercultural norms contrahend gender cultural communicative expectations on females and males.This expectation inflects communication between genders, and thus can inflect individualskills and limit the individuals’ potential of progress. Essential is to explore all possible differencesin communication between man and woman to avoid misunderstandings, conflictsand be able to work professionally.

  • 172.
    Bergström, Peter
    et al.
    Umeå University, Faculty of Social Sciences, Department of applied educational science.
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Developing the role of Swedish advanced practice nurse (APN) through a blended learning master's program: consequences of knowledge organisation2018In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 28, p. 196-201Article in journal (Refereed)
    Abstract [en]

    This paper reports on a research study conducted with a group of nurses in Sweden enrolled in a newly developed blended learning master's programme to become advanced practice nurses (APNs). As background, the paper presents the regional needs the programme is intended to address and describes how the programme was designed. The aim was to understand how, from students' perspective, the nurse master's programme structured knowledge for their future position as APNs. The research question focuses on how the master's programme prepares students by meeting their diverse needs for knowledge. Empirical material was collected at two times during the students' first and second years of study through semi-structured qualitative interviews. The findings highlight the process in which these master's students gained a more advanced identity of becoming APNs. This process demonstrates how students perceive their current position as nurses based on a discourse of knowledge in relation to the practical and theoretical knowledge they encounter in the master's programme. This article concludes by recommending that attention should be paid to developing APN role models in the current Swedish healthcare system.

  • 173.
    Berleen Danå, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Valfridsson, Linn
    Umeå University, Faculty of Medicine, Department of Nursing.
    Salutogent perspektiv på hälsa och arbete bland vårdpersonal - en kvantitativ tvärsnittsstudie2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syftet med denna studie var att beskriva vårdpersonals upplevelse av arbete och självskattad hälsa utifrån ett salutogent perspektiv.

    Bakgrund. Arbetsmiljön har stor betydelse för upplevelsen av hälsa och hur vi mår. Det finns därför ett behov av att utforska samband mellan upplevelse av arbete och hälsa, särkilt bland vårdpersonal som ofta utsätts för höga krav i arbetet. Genom att utgå från ett salutogent perspektiv kan hälsofrämjande faktorer i arbetsmiljön beskrivas vilket är av värde vid hälsofrämjande arbete.

    Design. Studien genomfördes i form av en kvantitativ tvärsnittssstudie under april-maj månad 2013,bland vårdpersonal med patientnära arbete i Stockholms och Uppsala län.

    Metod. Data samlades in genom pappersenkäter som delades ut till 100 sjuksköterskor,undersköterskor och läkare (svarsfrekvensen var 68%). För att mäta vårdpersonalens upplevelse av arbete och självskattad hälsa, användes mätinsinstrumenten Salutogenic Health Indicator Scale(SHIS) och Work Experience Measurement Scale (WEMS). Bearbetning och analys av datainsamlingen gjordes med SPSS 20.0.Resultat. Det fanns ett signifikant samband mellan självskattad hälsa och upplevelse av arbete ocharbetsplats. Ingen signifikant skillnad sågs i upplevelse av hälsa och arbete i förhållande till kön,sysselsättningsgrad, anställningsform eller yrke/utbildningsnivå. De respondenter som tillhörde den äldre åldersgruppen hade en signifikant högre skattad hälsa och högre medelvärden i WEMS.

    Slutsats. Vårdpersonal som trivs och mår bra på arbetet skattar även sin hälsa högre. Genom att öka förståelsen för sambanden mellan arbete och hälsa och vilka faktorer som bidrar till att vi trivs och mår bra på arbetet kan en värdefull utgångspunkt för hälsofrämjande arbete på arbetsplatsen skapas.

  • 174.
    Bernbäck, Katarina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Olsson, Caroline
    Umeå University, Faculty of Medicine, Department of Nursing.
    Emotionella upplevelser hos kvinnor efter avslutad bröstcancerbehandling: En litteraturstudie2015Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
  • 175.
    Berndes, Melinda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jonsson, Julia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kvinnors erfarenheter av att leva med endometrios2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Endometriosis is a chronic disease, and it is estimated to affect 10% ofall women in reproductive age. Up to 80% of these women suffer from chronic pain.The pain can affect the woman’s life and perceived health.Aim: The aim of this study was to describe women’s experience of living withendometriosis.Method: A literature study was made based on nine qualitative articles. Thedatabases CINHAL, PubMed and Medline have been used during the literaturesearches. The results from selected articles was quality-reviewed, then analyzed andcompiled.Results: The results are presented in four maincategories: physical and mentalimpact, limitations in every day life, experiences of healthcare, to deal with thedisease and nine subcategories.Conclusion: Endometriosis turned out to affect the life of the woman in a variety ofways. Women's experiences can be related to different dimensions of suffering;disease causing, caused by life changes and healthcare. Suffering may be related topain because of the disease and treatment. The woman can experience mental andphysical suffering, which in turn limits women's opportunities for work andeducation, but also in relationships with others. Furthermore, suffering can be shownin the meeting with healthcare, where the path to diagnosis was described as long andthe women were met by ignorance and nonchalance. The importance of healthcareprofessionals having appropriate knowledge and meeting women with respect isfundamental in order to avoid unnecessary suffering. Some women, on the otherhand, had positive experiences of care, and the disease had led more women into ahealthier lifestyle.

  • 176.
    Bernroth, Benjamin
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ekman, Jakob
    Umeå University, Faculty of Medicine, Department of Nursing.
    Är det någonsin för sent?: Betydelsen av fysisk aktivitet relaterat till den kognitiva funktionsförmågan hos personer med demenssjukdom2012Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 177.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Consequences of stroke: aspects of impairments, disabilities and life satisfaction : with special emphasis on perception and on occupational therapy1987Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Perceptual and motor functions and self-care ability after stroke were assessed within two weeks (n:109; mean age 69±10) and 4-6 years (n:75;70±9) after admission to a non-intensive care stroke unit. Sixty-two of the long-term stroke survivors reported on their life satisfaction (7 items) as experienced (in retrospect) before the stroke and at the time of the investigation. Perceptual functions and actual levels of life satisfaction were registered in 60 clinically healthy subjects aged about 60 or about 80 years.

    Both early on and late after stroke the 16 items of perceptual function were clearly grouped into two factors, which neatly fitted an ecological perceptual concept. One factor characterized low-order and the other higher-order perception. Impairments of low-order perception occurred for about 10% of the patients, whether investigated early or late after stroke. No one among the reference populations had such impairments. Higher-order perceptual impairments prevailed in 60% early on and in 57% late after stroke and were often more pronounced than those occurring in the reference populations, among whom 35% of the 60 year olds and significantly more - 77% - of the 80 year olds had such impairments. Hence, perceptual impairments are common after stroke, but slight age-dependent reductions should be considered when higher-order perceptual function is assessed and treated after stroke.

    Together with motor function, which was impaired in 52% of the early and 36% of the late stroke samples, higher-order perceptual function and to a limited extent low-order perception could predict the level of self-care ability in 70% and 62% of the early and late samples, respectively.

    Whereas levels of global and of domain specific variables of life satisfaction were similar in the two reference populations, the stroke had lead to a reduction in life satisfaction for 61% of the long-term survivors. Reductions were particularly pronounced for global life satisfaction and for satisfaction with leisure and sexuality. Although significantly associated with motor impairment and self-care disability, these reductions could not be attributed only to impairments and disability.

    The findings are discussed with particular reference to assessment and treatment in occupational therapy.

  • 178.
    Berntsson, Sandra
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brandén Persson, Caroline
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonalens hanteringsstrategier vid arbetsrelaterad stress2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background - Stress affects the body both physically and mentally, to avoid negative effects of stress, it’s important with recovery. Occupational stress is common especially in health care personal and can occur when there are high work demands on the individual. To avoid occupational stress affect on the individual the use of various forms of coping strategies, it can vary from problemsolving- to emotional coping strategies. Purpose - To describe healthcare personnel management of occupationalstress. Method - A Literaturereview with eleven qualitative studies were included, these were analyzed by Forsberg and Wengströms, inspired by the method of content analysis. Results - The authors' results demonstrated in two categories, "problemsolving coping strategies" and "emotional coping strategies" and eight subcategories, "to seek, give and receive support", "to prioritize and plan work", "to perform activities", "reflection and breaks","use of humor", "anger and avoidance", "substance use" and "spirituality and faith". Conclusion – The nursing profession is a demanding area where stress is inevitable, therefore it is important to manage the stress that arises in the workplace in order to maintain focus. More research on effective strategies for stress management is required. 

  • 179.
    Berntsson, Sandra
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brandén Persson, Caroline
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonalens hanteringsstrategier vid arbetsrelaterad stress2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background - Stress affects the body both physically and mentally, to avoid negative effects of stress, it’s important with recovery. Occupational stress is common especially in health care personal and can occur when there are high work demands on the individual. To avoid occupational stress affect on the individual the use of various forms of coping strategies, it can vary from problemsolving- to emotional coping strategies. Purpose - To describe healthcare personnel management of occupationalstress. Method - A Literaturereview with eleven qualitative studies were included, these were analyzed by Forsberg and Wengströms, inspired by the method of content analysis. Results - The authors' results demonstrated in two categories, "problemsolving coping strategies" and "emotional coping strategies" and eight subcategories, "to seek, give and receive support", "to prioritize and plan work", "to perform activities", "reflection and breaks","use of humor", "anger and avoidance", "substance use" and "spirituality and faith". Conclusion – The nursing profession is a demanding area where stress is inevitable, therefore it is important to manage the stress that arises in the workplace in order to maintain focus. More research on effective strategies for stress management is required.

  • 180.
    Bertelson, Sara
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hedberg, Linda
    Umeå University, Faculty of Medicine, Department of Nursing.
    Kvinnors upplevelser efter abort: En litteraturstudie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: There are about 46 million induced abortion in the world every year. According to the Swedish abortion law that came year 1974, women have a right to an induced abortion up to the 18th week of pregnancy and with a permission from the health authorities women have a right to an induced abortion up to 21th week. Aim: The purpose of the study was to describe women’s experiences after an induced abortion. Method: A literature-based study including eight qualitative, empirical articles where the result has analyzed with a content analysis. Result: For many women the abortion was a hard and difficult process, emotions like grief, guilt, shame, worry and regret was shown. For some women the abortion process was easier and the only emotion that appeared was relief. The women’s emotions lead to two main categories: satisfied with the abortion and suffering. Conclusion: Women who have had an induced abortion are often affected emotionally. How they are affected is individual for each woman. It is therefore important that the nurse provides a person-centered care to provide the right help for emotional adjustment.

  • 181.
    Bexelius, Moa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lundberg, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mastektomi till följd av bröstcancer: inte bara förlust av ett bröst2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Almost 20 women are diagnosed with breast cancer daily. It is most common among middle aged women and older. Mastectomy is recommended as a treatment for extensive breast cancer. The whole breast or a part of the breast is surgically removed. A mastectomy can affect your self image and gender identity. Aim: The aim of this study was to describe women’s experiences of undergoing a mastectomy following breast cancer. Method: This literature study is based on qualitative articles. Inclusion criterias were women from 18 years and older, should have had a mastectomy, they were allowed to wear a prosthesis and articles with high or medium quality post quality review. The articles were analysed with content analysis with inspiration of Febe Friberg. Result: Three main categories were identified. A traumatic change in women’s life, mastectomy effects femininity and how women manage life after the mastectomy. To strengthen the categories, ten subcategories were identified. Conclusion: To undergo a mastectomy was life changing. The women lost their femininity and self esteem. However the priority lies in survival rather than appearance. Older women were less bothered by their appearance than younger women. Nonetheless they were all required to cope with new limitations in their everyday life.

  • 182.
    Bjarte, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bergqvist, Sofia
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hysterektomi: En litteraturstudie om kvinnors upplevelser av att ha genomgått hysterektomi2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hysterektomi definieras som avlägsnande av livmodern via kirurgi. Hysterektomi är en av de vanligaste gynekologiska operationerna. I Sverige utförs operationen på i genomsnitt 1 av 10 kvinnor. De vanligaste orsakerna till att utföra hysterektomi är cancer eller för att lindra långvariga sjukdomar som onormal uterin blödning eller bäckensmärta. Hysterektomi leder till att kvinnan förlorar sin fertilitet.

    Syfte: Syftet med denna litteraturstudie var att beskriva kvinnors upplevelser av att ha genomgått hysterektomi.

    Metod: I litteraturstudien har 10 kvalitativa empiriska studier granskats och analyserats med inspiration av metasyntes. Artikelsökning gjordes i databaserna CINAHL, PubMed och Medline.

    Resultat: Analysen resulterade i två teman; Bemötandets olika ansikten samt Förändrad men ändå kvinna. Varje tema understöddes av två subteman.

    Slutsats: Litteraturstudiens resultat visar att kvinnors upplevelser av hysterektomi är varierande och komplex. För att kvinnor i denna situation ska uppleva god omvårdnad krävs att sjuksköterskan individanpassar omvårdnaden utifrån patientens behov.

     

    Nyckelord: Hysterektomi, kvinnor, upplevelse, stöd, omvårdnad.

  • 183.
    Björk, Hanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Forssman, Anna-Maria
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att medverka vid tvångsåtgärder: en litteraturstudie om vårdpersonals erfarenhet2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Background: The care in Sweden is ruled by different laws and guidlines. One of them is Health and Medical Services Act, which is volontary. When a person gets mentally ill, up to the point when they can no longer care for them selves they can be treated under The Compulsory Mental Care Act. In the swedish closed psychiatric wards approximatly twenty percent of all patients are being treated under The Compulsory Mental Care Act. Sometimes the nursing staff needs to use coercive measures against the patients will. This puts great emotional, physical and psychcolgical pressure on the nursing staff. Aim: To describe nursing staffs’ experience of participating in coercions. Method: Literature study based on eight scientific articles with a qualitative approach. Findings: Coercions induced negative emotions like fear, discomfort, helplessness and powerlessness and it also resulted in feelings of guilt and bad conscience. It also had a negative effect in the daily work and there were a need for enhanced knowledge and experience. The personal approach could either ease or aggravate the percieved experience during coercions. The nursing staff also stated that a good relation with doctors, cheifs and patients was important. Conclusion: The physical and the emotional stress could decrease if the staff received therapeutic counselling and education which could result in fewer people quitting their jobs and fewer sick-leaves. It may also have a positive effect on patient care because the nursing staff would have recieved tools for managing their own and their patients emotions. Importance of care: By describing nursing staffs’ experience of participating in coercions it could be possible to identify confounding factors and then arrange interventions to prevent physical and psychological illness among the nursing staff who are working at closed psychiatric wards.

    Keywords: qualitative literature study, coercions, nursing staff, experience

  • 184.
    Björk, Sabine
    Umeå University, Faculty of Medicine, Department of Nursing.
    Exploring resident thriving in Swedish nursing homes: the Umeå Ageing and Health Research Programme (U-Age) Thesis I2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

    The population living in nursing homes is generally characterized by high age and female sex, as well as by physical and cognitive impairments. Also, negative symptoms such as pain and neuropsychiatric symptoms are reportedly common. Care in Swedish nursing homes is regulated by law and national guidelines implying that care is to be tailored to resident preferences and needs in order to facilitate their well-being. However, there is no national data source on the characteristics of nursing home residents or on measures of their well-being. Thriving and not merely surviving in nursing homes has been described as a subjective experience of place-related well-being resulting from interaction between residents and the nursing home environment in terms of the quality of care and caregivers, as well as from the physical and psychosocial environment. However, there is a gap in knowledge of whether and, if so, to what extent resident characteristics and factors in the nursing home environment are associated with resident thriving in nursing homes.

    Aim

    The overall aim of this thesis is to explore resident thriving in Swedish nursing homes, and the extent to which resident characteristics, neuropsychiatric symptoms, activities, and environmental factors are associated with resident thriving.

    Methods

    This thesis is based on cross-sectional baseline data from a national inventory of health and care in Swedish nursing homes collected in 2013–2014. The resident sample covered 4831 residents in 548 units from 172 nursing homes in 35 Swedish municipalities. The data were explored using descriptive statistics, as well as simple and multiple linear regression analyses and multilevel linear regression analyses. Resident characteristics and symptom prevalence as well as their associations with thriving; and engagement in everyday activities and their associations with thriving were explored in a sample comprising 4831 nursing home residents from 172 nursing homes. Associations between resident thriving and resident living conditions, nursing home facility and unit characteristics, and the psychosocial climate of units were explored in a sample comprising 4205 residents from 147 nursing homes.

    Results

    Engagement in everyday activities was positively associated with resident thriving, the strongest associations being found for engagement in an activity programme, dressing nicely, and spending time with someone the resident likes. 

    Environmental factors associated with thriving were a positive psychosocial climate at the unit, having access to newspapers, residing in a special care unit, and residing in a facility that was unlocked during the day. Cognitive functioning was strongly associated with resident thriving. Aggressive and depressive symptoms were found to be negatively associated with resident thriving regardless of levels of cognitive functioning.

    Conclusions

    Engagement in everyday activities can support thriving and can be conceptualized and implemented as nursing interventions to facilitate thriving in nursing homes. Factors in the nursing home environment can support resident thriving; in particular, the psychosocial climate of units seems to have a great influence. Aggressive and depressive symptoms were associated with lower levels of thriving. Targeting these symptoms would therefore seem to be a priority in nursing homes. The population living in Swedish nursing homes has a high prevalence of neuropsychiatric symptoms and cognitive impairment. Residents with cognitive impairment also commonly resided in general units. As all data were cross-sectional, longitudinal studies would be valuable to further explore causality. As resident data were based on proxy ratings, future research exploring residents’ perspectives on thriving would be valuable. The present findings contribute to our understanding of nursing home residents’ complex care needs and identify factors that could have an impact on their well-being. These findings can provide benchmark estimates for further research, quality assessment activities, as well as further clinical development work. 

  • 185.
    Björk, Sabine
    et al.
    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, Geriatric Medicine.
    Bergland, Ådel
    Wimo, Anders
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Exploring resident thriving in relation to the nursing home environment: A cross‐sectional study2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 12, p. 2820-2830Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the extent to which environmental factors are associated with resident thriving. Background: Thriving is a concept that denotes experiences of well-being in relation to the living environment. Although there is a substantial body of research into quality of life in nursing homes, less is known about what contributes to thriving among residents. Recent research on resident thriving has focused mainly on resident characteristics and activities associated with thriving. Less attention has been given to explore associations with the physical and psychosocial environment of the nursing home. This study explores facility- and unit-level factors associated with resident thriving. Design: A cross-sectional national survey. Methods: Data on 4,205 residents, 3,509 staff, and environment of 147 nursing home facilities collected in 2013–2014 were analysed using descriptive statistics, multilevel simple, and multiple linear regression to explore resident thriving in relation to environmental factors. Results: Multilevel analysis revealed that residents’ thriving varied significantly across nursing home units. Several environmental factors were associated with thriving in univariate analyses. However, a positive psychosocial climate of units, having access to newspapers, living in a special care unit, and living in an unlocked facility showed significant positive associations with resident thriving when controlling for resident characteristics. The psychosocial climate showed the strongest association of the environment variables with resident thriving. Conclusions: Nursing home environments may have an impact on residents’ thriving. A positive psychosocial climate of units seems to have an important role in facilitating thriving in nursing home residents.

  • 186.
    Björk, Sabine
    et al.
    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.
    Wimo, Anders
    Juthberg, Christina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bergland, Ådel
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Residents' engagement in everyday activities and its association with thriving in nursing homes2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 8, p. 1884-1895Article in journal (Refereed)
    Abstract [en]

    Aim: To describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving.

    Background: Research into residents’ engagement in everyday activities in nursing homes has focused primarily on associations with quality of life and prevention and management of neuropsychiatric symptoms. However, the mere absence of symptoms does not necessarily guarantee experiences of well-being. The concept of thriving encapsulates and explores experiences of well-being in relation to the place where a person lives.

    Design: A cross-sectional survey.

    Method: A national survey of 172 Swedish nursing homes (2013–2014). Resident (= 4831) symptoms, activities and thriving were assessed by staff using a study survey based on established questionnaires. Descriptive statistics, simple and multiple linear regression, and linear stepwise multiple regression were performed.

    Results: The most commonly occurring everyday activities were receiving hugs and physical touch, talking to relatives/friends and receiving visitors, having conversation with staff not related to care and grooming. The least commonly occurring everyday activities were going to the cinema, participating in an educational program, visiting a restaurant and doing everyday chores. Positive associations were found between activity engagement and thriving, where engagement in an activity program, dressing nicely and spending time with someone the resident likes had the strongest positive association with resident thriving.

    Conclusions: Engagement in everyday activities can support personhood and thriving and can be conceptualized and implemented as nursing interventions to enable residents to thrive in nursing homes.

  • 187.
    Björk, Sabine
    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.
    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.
    Wimo, Anders
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Thriving in relation to cognitive impairment and neuropsychiatric symptoms in Swedish nursing home residents2018In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 33, no 1, p. E49-E57Article in journal (Refereed)
    Abstract [en]

    Objectives: The purpose of this study was to explore relations among thriving, cognitive function, and neuropsychiatric symptoms (NPS) in nursing home residents.

    Methods: A national, cross-sectional, randomized study of Swedish nursing home residents (N = 4831) was conducted between November 2013 and September 2014. Activities of daily life functioning, cognitive functioning, NPS, and thriving were assessed with the Katz activities of daily living, Gottfries' Cognitive Scale, Nursing Home version of the Neuropsychiatric Inventory, and Thriving of Older People Scale, respectively. Individual NPS were explored in relation to cognitive function. Simple linear and multiple regression models were used to explore thriving in relation to resident characteristics.

    Results: Aggression and depressive symptoms were identified as negatively associated with thriving regardless of resident cognitive functioning. At higher levels of cognitive functioning, several factors showed associations with thriving; however, at lower levels of cognitive functioning, only the degree of cognitive impairment and the NPS was associated with thriving. Most of the individual NPS formed nonlinear relationships with cognitive functioning with higher symptom scores in the middle stages of cognitive functioning. Exceptions were elation/euphoria and apathy, which increased linearly with severity of cognitive impairment.

    Conclusions: The lower the cognitive functioning was, the fewer factors were associated with thriving. Aggression and depressive symptoms may indicate lower levels of thriving; thus, targeting these symptoms should be a priority in nursing homes.

  • 188.
    Björklund, Kristian
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Persson, Stefan
    Umeå University, Faculty of Medicine, Department of Nursing.
    Riskfaktorer för kontrastmedelsreaktioner vid användningen av icke-joniska kontrastmedel2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    ABSTRAKT

    Riskfaktorer för kontrastmedelsreaktioner vid användningen av icke-joniska kontrastmedel

    Bakgrund: Risken för att utveckla kontrastmedelsreaktioner är låg. Frekvensen av kontrastmedelsreaktioner är olika för kön, åldersgrupper, patienter med tidigare kontrastmedelsreaktion, astma/allergi och andra sjukdomar.

    Syfte: Syftet med denna litteraturstudie var att beskriva riskfaktorer för och förekomst av akuta kontrastmedelsreaktioner vid administrering av icke-joniska kontrastmedel.

    Metod: Sammanställning av åtta kvantitativa studiers resultat avseende kön, ålder och tidigare kontrastmedelsreaktioner, allergi/astma och andra sjukdomar. Analysprocessen utgick från Fribergs trestegsmodell.

    Resultat: Kvinnligt kön hade ett statistiskt signifikant samband med högre frekvens av kontrastmedelsreaktioner kontra manligt kön. Högre ålder kan i vissa fall innebära lägre frekvenser av kontrastmedelsreaktioner hos patientgrupper. Tidigare kontrastmedelsreaktioner, astma/allergier och andra sjukdomar kan innebära högre risk för att utveckla en kontrastmedelsreaktion.

    Konklusion: Kontrastmedelsreaktioner av icke-joniska kontrastmedel är ovanliga. Denna litteraturstudie bidrar med att ge röntgensjuksköterskor en övergripande bild av frekvensen i de tre kategorier av riskfaktorer. Förhoppningsvis bidrar denna litteraturstudie till en ökad handlingsberedskap. Vidare forskning behövs för att öka förståelsen för orsakerna till kontrastmedelsreaktioner.

  • 189.
    Björklund, Kristoffer
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brask, Sara
    Umeå University, Faculty of Medicine, Department of Nursing.
    Föräldrars erfarenheter relaterat till sitt barns självskadebeteende: En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract 

    Background: Mental illness is an increasing problem in children and adolescents, which can cause self-harm. Self-harm does not only affect the individual committing the act, but also persons that are closely related. From a family-centered perspective, it is important to take the parents’ experiences into account in order to offer the right support, so that the parents can support their children in the long run.

    Aim: The aim of the study was to describe parents experiences related to their child's self-harm. 

    Method: A literature study with nine qualitative articles. The results from all of the articles was quality-reviewed, analyzed and compiled. PubMed, CINAHL and PsycINFO were the databases which were used in the literature study. 

    Results: The result was categorized into three main categories and eight subcategories. The main categories comprises of: reactions to the child and its self-harm, social consequences and support

    Conclusion: For parents with children who self-harm, reactions appear that are similar to those related to crisis. Many parts of their life are affected by the child’s self-harm and the proper support is not always available. Healthcare professionals can, with the right knowledge and measures, facilitate the situation for the parents. The importance of family-centered care measures, such as interventions, could be assessed by further studies. 

  • 190.
    Björkén Burman, Maria
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Friström, Jenny
    Umeå University, Faculty of Medicine, Department of Nursing.
    Föräldrars upplevelser i samband med deras barns död på en intensivvårdsavdelning2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Death during childhood in Sweden is uncommon. Approximatley 98% of all children cared for in the intensivecareunit survive into adulthood. This means that the public health care system does not acquire much experience in taking care of parents of a child who has died. A child’s death leads to strong emotional experiences for parents. They can experience hopelessness, grieving, shock, guilt, and depression. Through family centered care, the health care system can support parents during the difficult period with end-of-life health care for a child. Aim: The aims of this literature review was to examine parental experiences in connection with the death of their child in an intensive care unit setting. Method: A systematic literature search was conducted. Articles were searched in the databases CIHNAL, PubMed and PsycINFO. Manual search was also conducted. Nine articles were included. Relevant articles were analyzed for categories. Result: The analysis resulted in five main categories, and twelve sub categories. The main categories included the following: interplay between parents and personnel, parental trust in the dying child’s health care management, the impact of the surroundings on the parents, the ability for the parents to maintain a parental role and various forms of support. Conclusion: Through better knowledge and understanding of parental experience when a child dies in an intensive care unit, personnel can better manage the parents grief and meet their needs.

  • 191.
    Björnram, Gabriella
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ek, Sara
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ut i det okända: En intervjustudie om sjuksköterskestudenters föreställningar inför det kommande arbetslivet2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Previous research reveal an increasing number of nurses leave their new profession after a short time working. Studies show that many newly graduated do not feel prepared and that the work does not meet the expectations.

     

    Motive: Since there are only a small number of studies that describe nursing student’s thoughts about their coming profession to be found, this study aims to contribute with research on the subject.

     

    Aim: The aim of the study is to describe nursing student’s conceptions about their coming profession.

     

    Methods: A qualitative method with an inductive approach was used for the study. Eight nursing students was interviewed individually with an interview guide built up with semi-structured questions. The interviews were analysed by a qualitative content analysis with an inductive approach.

     

    Result: The students describe that workplace training was important to feel prepared for the upcoming working life. The students of the study did feel prepared to start working and were looking forward to becoming independent. They also had an apprehension that they were going to feel insufficient in their coming profession. There was a concern about not having enough support as a newly graduated nurse and about not being able to master their new profession. Among the participants, there was also a fear of falling into bad health as an effect of their work.

     

    Discussion: The result shows both positive and negative feelings about the coming profession. The work training was of importance to feel prepared and gave a feeling of assurance. The concerns were especially connected to the working environment and its components, there was a fear of being affected by bad health. A big part of the concern was also to not have enough knowledge. A long introduction time and satisfactory support in the beginning of the working life was considered to be important.

     

    Conclusion: To get more nurses to stay in the profession, a good start is important. The aim of the study was to describe nursing student’s conceptions about their coming profession, and to simplify for employers to meet the needs of newly graduates.

  • 192.
    Blaschke, Sarah
    et al.
    Dept of Cancer Experiences Research, Univ of Melbourne.
    O'Callaghan, Clare
    Dept of Cancer Experiences Research, Univ of Melbourne.
    Schofield, Penelope
    Dept of Cancer Experiences Research, Univ of Melbourne.
    Salander, Pär
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Cancer patients' experiences with nature: Normalizing dichotomous realities2017In: Social Science and Medicine, ISSN 0277-9536, E-ISSN 1873-5347, Vol. 172, p. 107-114Article in journal (Refereed)
    Abstract [en]

    Aims: To explore cancer patients' subjective experiences with nature in order to examine the relevance of nature-based care opportunities in cancer care contexts. The rationale was to describe the underlying mechanisms of this interaction and produce translatable knowledge. Methods: Qualitative research design informed by grounded theory. Sampling was initially convenience and then theoretical. Competent adults with any cancer diagnosis were eligible to participate in a semi structured interview exploring views about the role of nature in their lives. Audio-recorded and transcribed interviews were analyzed using inductive, cyclic, and constant comparative analysis. Results: Twenty cancer patients (9 female) reported detailed description about their experiences with nature from which a typology of five common nature interactions emerged. A theory model was generated constituting a core category and two inter-related themes explaining a normalization process in which patients negotiate their shifting realities (Core Category). Nature functioned as a support structure and nurtured patients' inner and outer capacities to respond and connect more effectively (Theme A). Once enabled and comforted, patients could engage survival and reconstructive maneuvers and explore the consequences of cancer (Theme B). A dynamic relationship was evident between moving away while, simultaneously, advancing towards the cancer reality in order to accept a shifting normality. From a place of comfort and safety, patients felt supported to deal differently and more creatively with the threat and demands of cancer diagnosis, treatment and outlook. Conclusions: New understanding about nature's role in cancer patients' lives calls attention to recognizing additional forms of psychosocial care that encourage patients' own coping and creative processes to deal with their strain and, in some cases, reconstruct everyday lives. Further research is required to determine how nature opportunities can be feasibly delivered in the cancer care setting.

  • 193.
    Blixt, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjöli, Linnéa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Attityder hos operationssjuksköterskor och operatörer kan påverka risken för intraoperativa stick- och skärskador2015Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim. To illustrate the attitudes of the operating theatre personnel and the risk of intraoperative sharp injuries.

    Background. There are several ways to manage sharp instruments such as various techniques and safety products to minimize the risk of sharps injuries. There are many studies about working practices to minimize the risk of sharps injuries but only a few that illustrate the importance of attitudes towards techniques and safety products as well as follow up and reporting incidents.

    Method. The design of the study is an empirical interview study with a qualitative approach. Semi-structured interviews were conducted with seven theatre nurses and four surgeons at two hospitals in Sweden. Data collected October-December 2015.

    Findings. The findings show that there exists different attitudes of the operating theatre personnel that could affect the risk of sharps injuries. The finding is presented in four themes: To have a safe working environment; To protect oneself, co-worker and patient; To be compliant to guidelines and working practices and To be non-compliant to guidelines and working practices.

    Conclusions. The risk of sharp injuries can’t be eliminated since there is always a risk of sharp injuries which the operating theatre personnel must pay attention to. There are a lot of knowledge about safety products and techniques for minimizing the risk of sharps injuries but when the attitude of the user come into play the safety product may not be used correctly, if used at all. In this study a indication appears that the attitudes of the operating theatre personnel may be affecting the risk of intraoperative sharp injuries.

  • 194.
    Blohm Engström, Amanda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Grimstedt, Ronja
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjuksköterskestudenters syn på den professionella rollen relaterat till våld mot kvinnor: En kvalitativ studie på en sjuksköterskeutbildning i Bangalore2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Våld mot kvinnor är ett brott mot mänskliga rättigheter. Globalt sett har 35% av alla kvinnor utsatts för fysiskt eller sexuellt våld. Våldet har kortsiktiga och långsiktiga konsekvenser för kvinnan och kvinnor som utsatts för våld använder i högre grad sjukvården. De avslöjar dock inte alltid vad de upplevt och vårdpersonal undviker att uppmärksamma våldet. Sjuksköterskor efterfrågar mer kunskap och riktlinjer i omvårdnaden av våldsutsatta kvinnor. Sjuksköterskestudenter saknar också kunskap och kan bära på förmodar, därför är ytterligare utbildning inom ämnet nödvändig.

    Syfte: Att beskriva sjuksköterskestudenters syn på det professionella ansvaret i mötet med våldsutsatta kvinnor samt förekomst av ämnet i utbildningen

    Metod: Kvalitativ studie i form av fokusgruppsdiskussioner analyserat med kvalitativ innehållsanalys. Två grupper med sex deltagare i vardera med sjuksköterskestudenter från St. Martha’s College of Nursing, Bangalore.

    Resultat: Studenterna reflekterade över samhällets och individens inverkan på kvinnor utsatta för våld och hur det påverkar avslöjande av våldet, samt hur sjuksköterskan kan arbeta i denna miljö. De beskrev egenskaper hos sjuksköterskan som är viktiga i vården av dessa kvinnor och vikten av att etablera en trygg och pålitlig relation. Studenterna uttryckte en önskan om mer utbildning kring de psykologiska aspekterna av vården för dessa patienter, såväl som alternativa lärosätt.

    Konklusion: Sjuksköterskeutbildningen kan skapa möjligheter för studenter att få praktisk övning och reflektion i mötet med våldsutsatta kvinnor genom simuleringsövningar. Utbildningen bör också lyfta emotionella aspekter kring mötet med särskilt utsatta patienter.

    Nyckelord: Våld mot kvinnor, sjuksköterskestudenter, professionellt ansvar, utbildning, Indien

  • 195.
    Blomdal, Jessica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    von Ahn, Karoline
    Umeå University, Faculty of Medicine, Department of Nursing.
    Att leva med långvarig smärta: En litteraturstudie2016Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Titel: Att leva med långvarig smärta

    Bakgrund: En av de vanligaste orsakerna till att människor söker sjukvård är smärta. Smärta är en komplex subjektiv känsla och har upplevts av de flesta. Långvarig smärta påverkar en person fysisk, psykiskt och socialt. I Sverige beräknas 18 % av befolkningen lida av långvarig smärta.

    Syfte: Syftet med litteraturstudien är att beskriva erfarenheter av att leva med långvarig smärta.

    Metod: En litteraturstudie som baserats på åtta kvalitativa artiklar har analyserats, granskats och sammanställts. Databassökningarna gjordes i CinAhl och PubMed.

    Resultat: Studiens resultat presenterades i en huvudkategori “”När smärtan dominerar livet” och fem subkategorier “Smärtans uttryck”, “Kroppslig begränsning”, ”Förluster av relationer och roller”, “Att känna sig misstrodd och ifrågasatt” och “Acceptans och framtid”. Resultatet redogör hur den ständigt närvarande smärtan gavs i uttryck och de konsekvenser som tillkom i det dagliga livet och tillvaron.

    Konklusion: Erfarenheter av långvarig smärta är alltid subjektiv, men beskrivs av många på liknande sätt. Smärtan påverkar hela individen med en rad konsekvenser där den psykiska påfrestningen är mest påtaglig. I mötet med dessa personer är det viktigt att sjuksköterskan tror, lyssnar, visar förståelse och bekräftar deras smärtupplevelser. 

  • 196.
    Bokne, Kajsa
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Sjöström, Malin
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Unit of Research, Education and Development – Östersund.
    Samuelsson, Eva
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Self-management of stress urinary incontinence: effectiveness of two treatment programmes focused on pelvic floor muscle training, one booklet and one Internet-based2019In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724Article in journal (Refereed)
    Abstract [en]

    Objectives: In a previous study, self-management of stress urinary incontinence (SUI), via an Internet-based programme or a booklet improved symptoms and quality of life. We wanted to evaluate the effectiveness of these programmes when implemented for free use, as well as to characterize the users.

    Design: Pragmatic prospective cohort study.

    Setting and subjects: Information about the Internet programme and the booklet was provided at www.tät.nu and by nurse midwives. Both programmes included a three-month pelvic floor muscle training (PFMT) programme. Questionnaires were used at the start and after three months.

    Main outcome measures: Characteristics of the participants regarding age and education. Reductions in symptom severity was measured using the validated ICIQ-UI SF.

    Results: 109 women using the booklet, and 166 women using the Internet-based programme responded to the pre-treatment questionnaire. Of these, 53 (48.6%) in the booklet group and 27 (16.3%) in the Internet group responded to the follow-up. The mean age of booklet users was higher, 59.4 years vs. 54.5 years (p = .005). The proportion of women with post-secondary education was high, 59% in the booklet group and 67% in the Internet group. The mean reduction in the symptom score was 2.6 points (SD 3.4) in the booklet group, and 3.4 (SD 2.9) in the Internet group. These reductions were significant within both groups, with no difference between the groups, and in the same order of magnitude as in the previous randomised controlled study.

    Conclusion: Two self-management programmes for SUI, one provided as a booklet and one as an Internet-based programme, also rendered clinically relevant improvements when made freely available.

    Key points:

    • Female stress urinary incontinence can be treated using self-management programmes focused on pelvic floor muscle training. This study evaluates the effect of two different programmes, one provided as a booklet and one Internet-based, when made freely available to the public.
    • Both programmes rendered clinically relevant improvements, in the same order of magnitude as in the previous randomised controlled study.
    • Self-management of stress urinary incontinence should be recommended to women that request treatment.
  • 197.
    Bolyki, Jenny
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Malm, Lovisa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonalens upplevelser av att möta suicidnära patienter2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Health care professional’s experiences of meeting suicidal patients

    Background: Suicide is when a person with intention ends his life. Suicide counts as an endemic disease and about 1000 person commit suicide in Sweden every year. A negative attitude in the health care professionals can make them perceived as judging and abrupt.

    Aim: The aim with this literature study was to describe health care professional’s experiences of meeting patients with suicidal behavior.

    Method: A qualitative literature study was performed. Nine quality- and ethic assessed studies was picked. The analysis was conducted with help from Friberg’s five step model.

    Results: The result present in three categories: emotional reactions, the character of the meeting and the obstacle and opportunity in the caring, described in nine subcategories.

    Conclusion: Health care professionals fight with a large amount of emotional reactions in the meeting with suicidal patients. They describe obstacles and opportunities and strives to create a caring meeting where the suicidal patients are viewed as individuals, listened to and meet in a respectful way. The health care professionals can create possibilities for a change through providing security, confirmation, and helping and supporting the patient to move on in life as a person and not as a patient. 

     

    Keywords: Suicide, health care professionals and experience.

     

     

     

  • 198.
    Boman, Erika
    Umeå University, Faculty of Medicine, Department of Nursing.
    Inner strength as a health resource among older women2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background Long life does not inevitably mean more healthy years; older women have an increased risk of disabilities, diseases and adverse life events. Nevertheless, many older women experience health. This may be explained by possessing resources that promote health, despite adversities. Inner strength is seen as a resource as such. In this thesis inner strength is interpreted according to a theoretical model where inner strength comprises four interrelated and interacting dimensions: connectedness, creativity, flexibility and firmness, and being rated by the Inner Strength Scale (ISS).

    Aim and methods The overall purpose of this thesis was to explore inner strength as a health resource among older women. In study I six focus group interviews were performed with older women (66-84 years; n = 29) and the interviews were analysed by a concept driven approach and by means of qualitative content analysis. Studies II–IV had a quantitative, cross-sectional design. A questionnaire was sent to all older women (65 years and older) living in Åland, an autonomous island community in the Baltic Sea, and 1555 (57%) women responded. The data was analysed using descriptive and inferential statistics.

    Results In study I, exploring how inner strength and its dimensions can be identified in narratives of older women, connectedness was interpreted as a striving to be in communion, creativity as the ability to make the best of the situation, firmness as having a spirit of determination – “it is all up to you”, and flexibility as a balancing act. The results of study II showed that strong inner strength was associated with better mental health, but not physical health. In exploring factors associated with health-related quality of life, fewer symptoms of depressive disorders was the strongest explanatory variable, and together with not feeling lonely associated with better both physical health and mental health. Better physical health was also explained by not having a diagnosed disease, being of lower age and the opportunity to engage in meaningful leisure activities. Better mental health was additionally explained by having enough money for personal needs. In study III the result showed that non-depressed women were likely to have a strong inner strength, as well as never or seldom feeling lonely, taking fewer prescribed drugs, feeling needed and having the opportunity to engage in meaningful leisure activities. In study IV poorer mental health was associated with weaker inner strength in total, and in all four dimensions of inner strength. Symptoms of depressive disorders and feeling lonely were related to lower scores in three of the dimensions (except firmness and creativity, respectively) and poorer physical health was associated with lower scores in two of the dimensions (firmness and flexibility). Some other health threats were significantly associated with only one of the dimensions (connectedness or creativity), and others were not significantly associated at all.

    Conclusion The results add nuance to the notion of inner strength and deepen empirical knowledge about the phenomenon. It is elucidated that the ISS can be used not only to rate inner strength but also to offer guidance as to the areas (i.e. dimensions) in which interventions may be profitable. It is further shown that inner strengths can be identified in narratives of older women. Mental ill health has shown to have overall the strongest association with weakened inner strength among community-dwelling older women. The causality can, though, not be studied due to the cross-sectional design; therefore, longitudinal studies are recommended. Notwithstanding that limitation, the findings can be used as a knowledge base in further research within this field.

  • 199.
    Boman, Erika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Faculty of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.
    Gustafson, Yngve
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Häggblom, Anette
    Faculty of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.
    Santamäki Fischer, Regina
    Umeå University, Faculty of Medicine, Department of Nursing. Faculty of Nursing, Åland University of Applied Sciences, Mariehamn, Finland.
    Nygren, Björn
    Umeå University, Faculty of Medicine, Department of Nursing.
    Inner strength: associated with reduced prevalence of depression among older women2015In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 12, p. 1078-1083Article in journal (Refereed)
    Abstract [en]

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

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

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

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

  • 200.
    Boman, Erika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Åland University of Applied Sciences, Mariehamn, Finland.
    Haggblom, Anette
    Lundman, Berit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nygren, Björn
    Umeå University, Faculty of Medicine, Department of Nursing.
    Santamäki Fischer, Regina
    Umeå University, Faculty of Medicine, Department of Nursing. Åland University of Applied Sciences, Mariehamn, Finland.
    Inner Strength as Identified in Narratives of Elderly Women A Focus Group Interview Study2015In: Advances in Nursing Science, ISSN 0161-9268, E-ISSN 1550-5014, Vol. 38, no 1, p. 7-19Article in journal (Refereed)
    Abstract [en]

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

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