umu.sePublications
Change search
Refine search result
4344454647 2251 - 2300 of 2313
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 2251.
    Åkerlind, Johanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Stål, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Barns erfareneter av att leva med en förälder som lider av psykisk ohälsa.: En litteratur studie.2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: Having a parent with mental illness often means increasedresponsibility for the child, for example helping out at home or taking care of siblingsare common tasks. A constant feeling of having to be available in case anythinghappens makes it very unpredictable wich is described stressful by children. In themajority of science the children often falls behind.AIM: To describe a childs experience of living with a parent who suffer from mentalillness.METHOD: The literature consists of 8 articles with qualitative design of wich theresult has been quality examined, analysed and compiled. Searches were made in thedatabases of CINAHL, Pubmed and Scopus.RESULTS: The research emerged three clear categories in the result: Anxiety aboutthe parents mental illness, otherness of the family life and the need of support andinformation. Feelings like sadness, worries, fear, anger and envy was described inmany studies, while the love of the parent was strong despite the illness.CONCLUSION: A child to a parent with mental illness often tend to be neglected.To be able to deal with life and the consequenses of mental illness everyone in thefamily will need support in different ways. Parents and health professionals need tobe better informing the child about the illness, what it does and how it shows.

  • 2252.
    Åkerlund, Britt Mari
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Nursing.
    Dementia care in an ethical perspective: an exploratory study of caregivers' experiences of ethical conflicts when feeding severely demented patients1990Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this study was to explore how caregivers caring for severely demented patients experience ethical conflict situations. Feeding patients in a late state of dementia was chosen as focus. Special attention was paid to analyses of the caregivers' experiences with regard to their feelings, use of force, interpretations of the patients' behaviour and their ethical reasoning.

    The study was carried out in five separate parts, presented as five papers. A phenomenological - hermeneutic approach was consistent. Personal interviews, a projective defence mechanism test, the Meta Contrast Technique and an analysis of patient/caregiver behaviour as shown in video taped feeding sessions were the methods used.

    Study participants were forty-one caregivers in psychogeriatric care, registered nurses, licensed practical nurses and nurses' assistants.

    The result indicated that, when facing ethical decisions the caregivers were caught in a double bind conflict due to the contradicting ethical demands "Keep the patient alive!" and "Don't cause the patient suffering!". The difficulty to interpret what the patients experienced and the impossibility to know for sure what actions would be right or wrong were sources of anxiety. They defined force feeding individually, yet a pattern was found. Some caregivers defined force feeding according to the amount of persuasiveness or violence they had to perform. Some regarded force feeding from a patient wish perspective. A majority combined the two dimensions.

    The caregivers' ethical reasoning showed that their decision making was to be regarded as a process grounded on ethical rules. Interdependence in the relation caregiver/patient made them develop their reasoning in a direction of existential reasoning.

  • 2253.
    Åkerman, Lisa
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Holmström, Malin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Vårdpersonals erfarenheter av hot och våld inom psykiatrin: En litteraturstudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT Title: Healthcare professionals experience of threats and violence within the psychiatric care: A literature review Background: During 2014, 78 percent of Swedish nurses in psychiatric care reported that they had been exposed to work-related violence. Systematic overview studies where health professionals 'experiences of threats and violence in psychiatric care have been investigated are missing and can contribute to an increased understanding of the healthcare professionals' experience and can improve nursing work with patients who have demonstrated this behavior. Aim: The aim of the study is to describe health professionals' experiences of threats and violence in psychiatric care. Methods: Nine qualitative articles were examined, analyzed and compiled in a literature review. Searches for relevant studies were done in Cinahl, PubMed and PsycINFO. Results: The analysis resulted in three categories "Emotional distress adversely affect nursing, the individual and personal life", "Need for coping and management strategies" and "Need for organizational and personal support". Conclusions: Results showed that threats and violence lead to negative feelings in healthcare professionals who adversely affect nursing work, privacy and self-esteem. Results showed that healthcare personnel normalize violence and develop strategies for managing and preventing violence. Results showed that healthcare staff experienced insufficient support from managers and colleagues and highlighted the importance of support for recovery. Healthcare professionals could, with increased support and person-centered care, possibly contribute to the prevention of threats and violence and for it to be easier to manage, but more studies are needed.

  • 2254.
    Åkerström, Victoria
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Brodersen, Thomas
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjuksköterskans attityder och förhållningssätt gentemot personer med benign långvarig smärta.2014Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 2255.
    Ålander, Linda
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rubensson, Ulrika
    Umeå University, Faculty of Medicine, Department of Nursing.
    Krav, kontroll och socialt stöd i arbetet hos lärare: En enkätstudie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Denna uppsats undersökte den psykosociala arbetsmiljön för lärare i en kommun i mellersta Norrland, Sverige, med hjälp av mätinstrumentet, The Swedish Demand Control Support Questionnaire (DCSQ). Metod: En kvantitativ studie som omfattade 56 grundskollärare. DCSQ är en enkät med 17 frågor som behandlar upplevelser av krav, kontroll och socialt stöd på arbetsplatsen. Resultat: Inga signifikanta skillnader kunde påvisas mellan lärare i låg- och mellanstadiet och högstadiet. Dock indikerade siffrorna att lärare i låg- och mellanstadiet upplever högre krav än sina kollegor i högstadiet. Slutsats: Då deltagarantalet var relativt lågt (45,2%), är det svårt att dra slutsatser av resultatet som kan appliceras på hela populationen (124 lärare). Författarna föreslår vidare kvantitativ och kvalitativ forskning med större studiepopulation som även inkluderar frågor kring krav, kontroll och socialt stöd på fritiden. 

  • 2256.
    Ångqvist, Tobias
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Edblom, Eveline
    Umeå University, Faculty of Medicine, Department of Nursing.
    Personalens utsatthet för våldsamt och aggressivt beteende inom psykiatrisk öppenvård: En tvärsnittsstudie2015Independent thesis Advanced level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Abstract Background. Aggressive behavior is common in health care, with consequences such as impaired job satisfaction and burnout. The aim of the study is to investigate the relationship between self-rated exposure to aggressive and violent behavior, and job satisfaction, burnout and sick-leave in psychiatric outpatient care. Design. Cross-sectional study with a quantitative approach. Method. Analysis of data collected in autumn 2014 from a total of 129 respondents was performed in SPSS. The result shows that 20.6% of respondents are often exposed to aggressive behavior and 7.3% are often exposed to violent behavior. No association between being exposed and its impact on job satisfaction and burnout. In contrast the results show significance difference in terms of exposure between studied cities. Conclusion The examined groups are rarely exposed to violent behavior, however, there is a high incidence of aggressive behavior. The job satisfaction were estimated high despite the exposure. Keywords:Aggressive behavior, violent behavior, job satisfaction, burnout, psychiatric outpatient.

  • 2257.
    Ångstrom-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Engvall, G.
    Mullaney, T.
    Nilsson, K.
    Wickart-Johansson, G.
    Svärd, A. M.
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Facilitating Radiotherapy for Children: Technique, Design and Professional Care in Synergy, a Multicenter Intervention Study2016In: Pediatric Blood & Cancer, ISSN 1545-5009, E-ISSN 1545-5017, Vol. 63, p. S213-S213Article in journal (Other academic)
  • 2258.
    Ångström Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Descriptions of comfort in the social networks surrounding a dying child2014In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 34, no 113, p. 4-8Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe how comforters of one dying child were comforted, described by the child's mother and nurse.

    Background: The death of a child is one of the greatest losses parents can sustain and a stressful experience for nurses. Those who provide comfort may also need comfort, yet little is known about how comforters are comforted.

    Method: The interviews with mother and nurse were analysed using content analysis. Persons and activities mentioned as comforting were outlined in a sociogram.

    Findings: The findings show that the mother received comfort from her child and family, the nurse, extended family and others close to the family. She found comfort in being involved in the care and sharing worries with the nurse and in self-comfort. She described that siblings found comfort in each other, in living everyday life, in music and in expressing their feelings in drawings. The nurse gained comfort from sharing hardships with colleagues and a relative and from making a difference to the child.

    Conclusion: The findings provide a picture of interacting comforting social networks surrounding one dying child.

  • 2259.
    Ångström-Brännström, Charlotte
    Umeå University, Faculty of Medicine, Department of Nursing.
    Långvarigt sjuka barn och tröst2013In: Palliativ vård: begrepp & perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkansson, Lund: Studentlitteratur, 2013, 1, p. 313-320Chapter in book (Other (popular science, discussion, etc.))
  • 2260.
    Ångström-Brännström, Charlotte
    Umeå University, Faculty of Medicine, Department of Nursing.
    TRÖST: beskriven av långvarigt sjuka barn, föräldrar och en sjuksköterska2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the thesis was to describe experiences of comfort for children with chronic illnesses, and who and what comforted children, parents and one nurse. The thesis comprises four studies and is based on interviews with sick children, parents and one nurse. The children also made drawings.

    In study I the aim was to examine how children with chronic illnesses narrate their experiences of being comforted in the hospital. Seven children 4-10 years old described in interviews their experiences of comfort and made drawings. Thematic content analysis revealed four themes: being physically close to one’s family, feeling safe and secure, staff being there for the children, and children being there for parents and siblings. The findings suggest that trusting the staff’s knowledge and professional skills is a prerequisite for children to feel "at home", and safe in hospital. Being close to one’s family was essential for feeling comforted.

    In study II the aim was to describe what parents narrate as comforting them when their child was suffering from cancer. Interviews were performed with nine parents, eight mothers and one father, of children aged 3-9 years, who were admitted to a pediatric oncology ward and had undergone their first treatment. Content analysis revealed five themes: experiencing comfort from being close to the child, deriving comfort from the child’s strength, from feeling at home on the ward, from being a family and being at home, and deriving comfort from support of social networks. In communion with the child and others, the parents built a new normality perceived as being at home in life, despite all their difficulties. Within the frame of communion the parents experienced moments of hope.

    In study III the aim was to describe what comforted a seriously ill and finally dying child, as revealed by the child, his mother and his nurse. Field notes, drawings and interviews were analyzed using content analysis that revealed four themes: expressing feelings and becoming ready for comfort, being in communion, shifting perspective and finding comfort in feeling at home. Based on the findings, comfort for an ill and finally dying child was interpreted as being about having opportunities to express feelings in the way the child chooses, the family being close and involved in care, and achieving feelings of being at home and having a trustful relationship with a special nurse.

    In study IV the aim was to describe who and what comforted the comforters of a seriously ill and ultimately dying child as described by the child’s mother and nurse. Interviews with a mother and a nurse from study III were analyzed by content analysis and a sociogram was outlined. The findings provided a picture of interacting social networks that can exist around a seriously ill child. The difficult situation meant that the child’s family carried a heavy burden. However, surrounded by a comforting network with which they could share both suffering and responsibility, they were able to find comfort and comfort each other.

    The findings from this thesis show that chronically ill children and parents found comfort from sharing suffering with one another. The parents and the nurse found comfort in sharing suffering and responsibility with persons in their social networks. The model of consolation (Norberg et al, 2001) could be used to give structure to the discussion.

  • 2261.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Ersta Sköndal University College.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing. Ersta Sköndal University College.
    Victor and the Dragon.: A Young Child's Experiences of Discomfort and Comfort, From Diagnosis Until Death2013In: Journal of Hospice and Palliative Nursing, ISSN 1522-2179, E-ISSN 1539-0705, Vol. 15, no 8, p. 464-470Article in journal (Refereed)
    Abstract [en]

    Children with progressive cancer often suffer during treatment and at the end of their life, and they need comfort. This study's aim was to describe a child's experiences of being cared for until death, with a focus on discomfort and comfort. Conversations, field notes, drawings, and interviews with the child and his mother and nurse were content analyzed. The themes enduring unbearable situations, expressing emotional suffering, and finding comfort were constructed. The children's parents and other family members are often a significant source of help for the children to endure discomfort and find comfort. Emotional suffering can be expressed in drawing and crying, but sometimes, a child is inconsolable and must endure discomfort. Comfort for a dying child is enhanced by having the family close, experiencing normal daily activities such as drawing and playing, and feeling at home in life despite approaching death.

  • 2262.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Engvall, Gunn
    Mullaney, Tara
    Umeå University, Faculty of Science and Technology, Umeå Institute of Design.
    Nilsson, Kristina
    Wickart-Johansson, Gun
    Svärd, Anna-Maja
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Children Undergoing Radiotherapy: Swedish Parents' Experiences and Suggestions for Improvement2015In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 10, article id e0141086Article in journal (Refereed)
    Abstract [en]

    Approximately 300 children, from 0 to 18 years old, are diagnosed with cancer in Sweden every year. Of these children, 80-90 of them undergo radiotherapy treatment for their cancer. Although radiotherapy is an encounter with advanced technology, few studies have investigated the child's and the parent's view of the procedure. As part of an ongoing multi-center study aimed to improve patient preparation and the care environment in pediatric radiotherapy, this article reports the findings from interviews with parents at baseline. The aim of the present study was twofold: to describe parents' experience when their child undergoes radiotherapy treatment, and to report parents' suggestions for improvements during radiotherapy for their children. Sixteen mothers and sixteen fathers of children between 2-16 years old with various cancer diagnoses were interviewed. Data were analyzed using content analysis. The findings showed that cancer and treatment turns people's lives upside down, affecting the entire family. Further, the parents experience the child's suffering and must cope with intense feelings. Radiotherapy treatment includes preparation by skilled and empathetic staff. The parents gradually find that they can deal with the process; and lastly, parents have suggestions for improvements during the radiotherapy treatment. An overarching theme emerged: that despair gradually turns to a sense of security, with a sustained focus on and close interaction with the child. In conclusion, an extreme burden was experienced around the start of radiotherapy, though parents gradually coped with the process.

  • 2263.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Mullaney, Tara
    Nilsson, Kristina
    Wickart-Johansson, Gun
    Svärd, Anna-Maja
    Nyholm, Tufve
    Lindh, Jack
    Engvall, Gunn
    Parents’ experiences and responses to an intervention for psychological preparation of children and families during the child’s radiotherapy2018In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 35, no 2, p. 132-148Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate parents’ experiences and responses to a systematic intervention for psychological preparation of children and families during the child’s radiotherapy (RT) treatment. In this case-control study at 3 pediatric RT centers, an intervention with a preparatory kit, including age-adjusted information on tablets, gift of a stuffed toy or a pair of headphones, a parent booklet, and toy models of the computed tomography and RT machines was implemented. For evaluation, a mixed methods data collection was conducted. A total of 113 parents of children undergoing RT were included—n = 59 in the baseline group and n = 54 in the intervention group. Health-related quality of life was rated low, but parents in the intervention group expressed less anxiety after the RT compared with the baseline group. They found information suitable for their young children, siblings, and friends were involved and the toy models were used for play. Parents expressed positive feelings due to close interaction with staff and each other within the family. The solutions developed within a human-centered design approach and shaped as a systematic family-centered strategy contributed to parents understanding and coping with the child’s RT.

  • 2264.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Viveca
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nyholm, Tufve
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Engvall, Gunn
    Staff's Experiences of Preparing and Caring for Children With Cancer and Their Families During the Child's Radiotherapy2018In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Approximately one-third of children diagnosed with cancer are treated with radiotherapy (RT). Staff experiences of preparing and distracting the children and their families during a child's RT are sparsely described.

    OBJECTIVE: The aim of this study was to describe staff experiences of preparing and caring for children with cancer and their families during the child's RT.

    INTERVENTION/METHODS: Semistructured interviews with staff were performed at 3 Swedish RT centers. The interviews were analyzed using inductive qualitative content analysis.

    RESULTS: The analysis revealed 5 categories summarizing the staff members' experiences. These include the following: experiences of various emotions; care for the child and the child's family; commitments before, during, and after RT; organizational issues; and experiences of the intervention and suggestions for improvement.

    CONCLUSIONS: The preparatory intervention facilitated the ability of staff members to conduct their work, although the intervention should be specifically tailored to each child. Meeting children and their families and providing care to both during RT were challenging. The staff strived to provide optimal care for each child and family. Interdisciplinary teamwork and organizational acceptance for the importance of preparation and distraction were essential.

    IMPLICATIONS FOR PRACTICE: A future challenge will be to provide opportunities for all staff involved in the treatment of children with cancer to develop their skills continuously in order to provide high-quality preparation and distraction to all children undergoing RT, regardless of the geographical location of the RT center.

  • 2265.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing. Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden.
    Comforting measures described by staff working in paediatric units2017In: Nursing children and young people, ISSN 2046-2336, Vol. 29, no 4, p. 24-30Article in journal (Refereed)
    Abstract [en]

    Aim: Children with cancer identify staff members, who work with them in paediatric units, as their most important comforters. This study aimed to shed light on how those staff members deliver this comfort.

    Methods: Semi-structured interviews were performed and the content then analysed. Nine families (n=9) and eight staff members (n=8) participated in the study.

    Findings: The staff described caring for the children and the whole family. They implemented certain comforting measures with the child, and described how they provided support to parents. Staff described how they felt comforted by relating to the children they were caring for.

    Conclusion: Staff working in paediatric units develop good relationships with children and parents and comfort them using methods described in the literature. The quality of the staff's positive relationships with the children marked all their actions.

  • 2266.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Umeå University, Faculty of Medicine, Department of Nursing.
    Victor's story: a seriously ill child's experiences of discomfort and comfort from being diagnosed with cancer to dyingManuscript (preprint) (Other academic)
    Abstract [en]

    In this case study, the aim was to describe what comforted a seriously ill and finally dying child, here called Victor, as revealed by the child, his mother and his nurse. Content analysis was performed of analyses of conversations, field notes, drawings, interviews and comments on drawings. In the data comfort was often expressed as releasing extreme discomfort Victor experienced and accordingly four themes describing both discomfort and comfort were formulated in the analysis: Expressing feelings and becoming ready for comfort, Being in communion, Shifting perspective and Finding comfort in feeling at home. By expressing feelings through body language, crying and drawings Victor became ready for comfort and found it through feeling close to loved ones while sharing with them whatever was happening; through experiencing a trustful relationship with his nurse, transforming pressure into play, making plans for the future and maintaining his interests in nature; and through being at home, surrounded by his family’s love and concern. Based on these findings comfort for an ill and finally dying child is interpreted as being about providing the child with opportunities to express feelings in the way the child chooses, enabling the family to be close and involved in care, and supporting feelings of being at home and having a trustful relationship with a special nurse.

  • 2267.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jansson, Lilian
    Umeå University, Faculty of Medicine, Department of Nursing.
    Narratives of children with chronic illness about being comforted2008In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 23, no 4, p. 310-316Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to examine how children with chronic illnesses narrate their experience of being comforted in hospital. During interviews, seven children, 4-10 years old described their experiences and made drawings. Thematic content analysis revealed following themes: being physically close to one's family , feeling safe and secure, staff being there for the children, and children being there for the parents and siblings. Mother was identified as the most important comforter. The findings suggest that trusting in the staff's knowledge and professional skills is a prerequisite for the children to feel "at home", and safe in hospital. Being close to one's family is even more important.

  • 2268.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Umeå University, Faculty of Medicine, Department of Nursing.
    Comforting the comforters: descriptions of comfort in the social networks surrrounding a seriously ill and ultimately dying childManuscript (preprint) (Other academic)
    Abstract [en]

    The death of a child is considered to be one of the greatest losses a parent can sustain and an extremely stressful experience for nurses. Those who provide comfort, i.e. the comforters, may also need comfort in this difficult situation yet little is known about who and what comforts comforters. The aim of this study was to describe who and what comforted the comforters of a seriously ill and ultimately dying child, as narrated by the child’s mother and nurse. The interviews with mother and nurse were analysed using content analysis. Persons and activities who comforted were outlined in a sociogram (Figure 1). The findings showed that the mother received comfort from her child and family, the nurse, the extended family and others close to the family. She found comfort in being involved in the care and sharing worries with the nurse and other hospital staff and in self-comfort. Siblings found comfort in each other, in living everyday life and in music and making drawings. The nurse gained comfort from sharing hardships with colleagues and a relative and from making a difference to the child. The findings provide a picture of interacting comforting networks that can surround a seriously ill child.

  • 2269.
    Ångström-Brännström, Charlotte
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Strandberg, Gunilla
    Umeå University, Faculty of Medicine, Department of Nursing.
    Söderberg, Anna
    Umeå University, Faculty of Medicine, Department of Nursing.
    Dahlqvist, Vera
    Umeå University, Faculty of Medicine, Department of Nursing.
    Parents' experiences of what comforts them when their child is suffering from cancer2010In: Journal of Pediatric Oncology Nursing, ISSN 1043-4542, E-ISSN 1532-8457, Vol. 27, no 5, p. 266-275Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to describe parents' narratives concerning what they find comforting when they have a child suffering from cancer. Interviews were conducted with 9 parents--8 mothers and 1 father--of children aged 3 to 9 years who were admitted to a pediatric oncology ward and had undergone their first treatment. The findings showed that the parents derived comfort from being close to their child, perceiving the child's strength, feeling at home in the ward, being a family and being at home, and receiving support from their social network. Comfort experienced in communion with the child and others became important and helped the parents build a new normality perceived as being at home in life despite all their difficulties. Within the frame of communion, the parents seemed to experience moments of hope for their child's recovery and survival.

  • 2270. Årestedt, K.
    et al.
    Alvariza, A.
    Håkansson, C.
    Ohlen, J.
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Goliath, I.
    Furst, C-J
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Symptom relief and palliative care during the last week of life among patients with heart failure2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, p. S58-S59Article in journal (Refereed)
  • 2271. Årestedt, Kristofer
    et al.
    Alvariza, Anette
    Boman, Kurt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine. Research Unit, Medicine-Geriatric, Skellefteå, Sweden.
    Öhlén, Joakim
    Goliath, Ida
    Håkanson, Cecilia
    Fürst, Carl Johan
    Brännström, Margareta
    Umeå University, Faculty of Medicine, Department of Nursing.
    Symptom Relief and Palliative Care during the Last Week of Life among Patients with Heart Failure: a National Register Study2018In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 21, no 3, p. 361-367Article in journal (Refereed)
    Abstract [en]

    Background: Heart failure is a disease with high morbidity, mortality, and physical and psychological burden. More knowledge about the care provided for patients with heart failure close to death is needed.

    Objective: The aim was to describe key aspects of palliative care during the last week of life in patients with heart failure, as reported by healthcare professionals.

    Design: This is a national register study.

    Setting/Subjects: The study included 3981 patients with diagnosed heart failure as the underlying cause of death.

    Measurements: Data were obtained from the Swedish Register of Palliative Care, a national quality register that focuses on patients’ last week of life, independent of diagnosis or care setting. The register includes information about care interventions connected with key aspects of palliative care. Data are reported retrospectively by a nurse or physician at the healthcare unit where the patient dies.

    Results: Only 4.2% of patients with heart failure received specialized palliative care. In their last week of life, symptom prevalence was high, validated scales were seldom used, and symptoms were unsatisfactorily relieved. Around one-fifth (17%) of the patients in the study died alone. Less than half of family members had been offered bereavement support (45%). Moreover, one-third (28%) of the patients and more than half (61%) of the family members were reported to have had end-of-life discussions with a physician during the illness trajectory.

    Conclusion: The results indicate inadequate palliative care for patients with heart failure during their last week of life.

  • 2272.
    Åström, Gunilla
    Umeå University, Faculty of Medicine, Department of Nursing.
    The meaning of caring as narrated, lived, moral experience1995Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The purpose of this research was to understand the meaning of caring as narrated, lived, moral experience. Forty-five good nurses experienced in the care of patients in surgical, medical and geriatric wards were interviewed. They described their experience of; caring, caring abilities, the worthwhile of caring, the strength related to caring and narrated situations (n=88) in which they had experienced that their caring had made a difference to the patient. Surgical nurses described care and cure as an integrated whole, medical nurses described care as integrated with the patients' social context and geriatric nurses described care as enhancing the autonomy of patients (I). The nurses' narrated, lived, experiences of caring situations revealed ways of intervening and interacting with the patient including caring actions (II).

    Eighteen good nurses experienced in the care of cancer patients were also interviewed. Their narrated, lived experiences of morally difficult care situations i.e. situations where it had been hard to know what was the right and good thing to do for the patient (n=60), revealed that relationships with their co-workers were very important for their possibility to act according to their moral reasoning and feelings(III). The situations for the nurses were either disclosed as overwhelming or possible to grasp. When narrating about these situations the nurses used different terms about themselves and their co-workers (One, They, I and We). The nurses viewed the patients either as a task to be accomplished or as a valuable unique person. In the latter situations ethical demands were interpreted, judged and acted upon (IV). Interpretations of these nurses' skills in managing morally difficult care situations disclosed two levels; one group of nurses who described positive paradigm cases, liberating maxims and disclosed open minds, while the other group described negative paradigm cases, restrictive maxims and revealed closed minds. The latter nurses were mostly the nurses who disclosed in Paper III that they used the term "one" about themselves and "they" about their co-workers (V).en patients recently cared for at surgical and medical wards were interviewed(IV). They narrated lived experiences of receiving/not receiving the help they needed or wanted when suffering from pain and anxiety/fear. The patients revealed that the most important thing for them to feel cared for in these situations was to be listened to, taken seriously and trusted, if they were not treated in this way the patients revealed that they felt they were in the hands of somebody who was uncaring.

    The findings are interpreted within the framework of Paul Tillich's philosophy concerning love, power, justice and courage, thereby showing the tension between these phenomena in the narrated, lived, moral experience. Light is also thrown on the dynamics of openness, vulnerability, fallibility, forgiveness, affirmation as well as powerlessness, meaninglessness, insufficiency, dissociation and exclusion. Reflections are made concerning practical wisdom.

  • 2273.
    Åström, Sanna
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lind, Diana
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nutritionens betydelse: Näringskomponenternas positiva inverkan på sårläkningsprocessen vid trycksår hos äldre2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: En stor andel inneliggande äldre patienter är i riskzonen för att drabbas av trycksår, detta orsakat av en kombination av undernäring samt bristande kunskaper hos sjuksköterskor gällande patienters näringsintag. Trycksår orsakar inte bara ett stort lidande hos den enskilde individen utan är även en stor hälsoekonomisk kostnad. Kunskap om nutritionens betydelse samt dess olika näringskomponenter behövs vid upprättade av individuella behandlingsplaner hos äldre.

    Syfte: Att beskriva näringskomponenternas positiva inverkan på sårläkningsprocessen vid trycksår hos äldre. 

    Metod: Tolv kvantitativa empiriska studier har i litteraturstudien granskats, analyserats och sammanställts. Artikelsökningen genomfördes i databaserna Cinahl, PubMed och Medline och analysprocessen utgick från beskrivande syntes.

    Resultat: I de tolv granskade artiklarna, påvisades vikten av makro- och mikronäringsämnen, så som protein, protein i kombination med kolhydrater och fett, arginin och arginin i kombination med vitamin C och zink samt övriga aminosyrors positiva inverkan på trycksårsläkningen hos äldre.Slutsats: Litteraturstudiens resultat visade att näringskomponenter har en positiv inverkan på trycksårsläkningen. För att inkludera nutrition som en omvårdnadsåtgärd krävs ökad kunskap hos sjuksköterskor gällande betydelsen av rätt nutritionsbehandling och kunskapen att identifiera personer som kan bli hjälpta av den behandlingen, samt vidare forskning inom ämnet.

  • 2274.
    Åström, Sofia
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindberg, Karolina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Föräldrars upplevelse av intrauterin fosterdöd: en litteraturstudie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 2275.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Nursing. Department of Geriatric Medicine, Karolinska Institute, Huddinge Hospital, Huddinge, Sweden.
    Attitudes, empathy and burnout among staff in geriatric and psychogeriatric care1990Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This study concerned assessments of attitudes towards demented patients among students and nursing staff as well as attitudes towards active euthanasia, wish to transfer to other jobs, ability of empathy and experience of burnout among nursing staff. The study aimed also to relate experience of burnout to attitudes towards demented patients, ability of empathy and experience of work with demented patients. The study was performed by use of questionnaires, scales measuring attitudes towards demented patients, experience of burnout and ability of empathy. Tape-recorded interviews were also included aiming to explore the staffs experience at work.

    The results showed that a majority of the students and staff held positive attitudes towards demented patients. A small proportion intended to work solely with demented patients. Staff working in psychogeriatric care and somatic long-term care held more positive attitudes than staff working in acute medical care. Proportions of staff with positive attitudes varied depending on age, duration of employment, education and place of work. A larger proportion of staff in geriatric care than in acute care reported a wish to transfer to another job. LPN’s in nursing homes to the largest proportion stated this wish to transfer.

    A majority of both students and staff expressed negative attitudes towards active euthanasia to severely demented patients in the finale stage of life. However, most favourable attitudes towards active euthanasia were found among students with shorter health care education and among nurse's aides and LPN’s.

    The staffs empathy was judged as moderately high and there were no differences found in relation to sex, staff category or place of work.

    Experience of burnout /tedium varied with the place of work and category of staff. Largest proportions at risk to develop burnout were found among those working in somatic long-term care and psychogeriatric care. RN’s showed lower burnout scores than nurse's aides and LPN’s.

    Experience of burnout was correlated to attitudes towards demented patients, indicating that the lower burnout score the staff have the more positive are the attitudes. Burnout was also related to the staffs ability of empathy i.e. the lower degree of burnout the higher is the empathie ability. Regression analysis showed that "Experience of feed-back at work” and "Time spent at present place of work" were the most important factors for the staffs experience of burnout.

  • 2276.
    Åström, Sture
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Karlsson, Stig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Sandvide, Asa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Eisemann, Martin
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Saveman, Britt-Inger
    Staff's experience of and the management of violent incidents in elderly care.2004In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, Vol. 18, no 4, p. 410-6Article in journal (Refereed)
  • 2277.
    Öberg, Ulrika
    Umeå University, Faculty of Medicine, Department of Nursing.
    Finding a common ground: a pilot implementation of digital self-managment support in Swedish primary health care2019Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: Due to an ageing, multi-diseased population, type 2 diabetes (T2D) and other chronic conditions pose a challenge for primary healthcare. To meet such challenges, primary healthcare nurses must adapt to new roles and acquire new skills regarding self-management support. eHealth and digital solutions are suggested to facilitate the increasing need for care in chronic conditions. However, how these solutions are experienced among users has not yet been sufficiently explored. To successful implement new working methods in primary healthcare, it is important to identify prerequisites and barriers that exists.

    Aim: The overall aim of this thesis was to explore perceptions among primary healthcare nurses and patients about digital self-management support in T2D and also to develop and evaluate a digital screening instrument assessing individual needs for self-management support. This thesis is based on four papers. Papers I and II aimed to describe perceptions among primary healthcare nurses and persons with T2D of using eHealth services for self-management support. Paper III aimed to develop and psychometrically test a screening instrument for person-centred guidance and self-management support. Paper IV aimed to describe diabetes specialist nurses’ experiences of a pilot implementation of the instrument labelled the Self-Management Assessment Scale (SMASc) as a basis for person-centred digital self-management support.

    Methods: A combined approach was used to collect and analyse data. Data in the qualitative studies were collected by means of focus group interviews (I) and individual interviews (II, IV) as well as participant observations (IV) were analysed using qualitative content analysis (I, II, IV). Quantitative data in study III were psychometrically tested. The participants in the respective studies were in Paper I primary healthcare nurses (n = 24), in Papers II and III persons with T2D (n = 11; n = 104) and in Paper IV diabetes specialist nurses (n = 5) and persons with T2D (n = 14). All data were collected in a county in northern Sweden.

    Results: The overall results constituted a web of mixed experiences and feelings towards using digital self-management support. Primary healthcare nurses pronounced their ambivalence towards the digital development in healthcare (I). Patients as well had mixed feelings, but they also pronounced benefits and potentials leading to increased involvement and empowerment (II). The psychometric assessment of the screening instrument, SMASc, demonstrated high potential and promising results for clinical assessments on factors affecting self-management behaviours (III). Preliminary results suggest that the SMASc instrument is considered suitable for screening of patients’ needs for self-management support (IV). 

    Conclusion: The results of this thesis suggest that digitalization needs stepwise implementation. Digital tools such as the SMASc instrument can be useful in facilitating identification of patients in need of targeted interventions. However, primary healthcare nurses must be open to discussing patients’ emotional adaptation to the disease as well as the knowledge, sometimes not evidence based, the patients may have obtained from Internet sources. Targeted self-management support including person-centred guidance is suggested to be an effective way to achieve patient.

  • 2278.
    Öberg, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    The Self‐Management Assessment Scale: development and psychometric testing of a screening instrument for person‐centred guidance and self‐management support2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, p. 504-513Article in journal (Refereed)
    Abstract [en]

    Aim: To develop and psychometrically test the Self‐Management Assessment Scale (SMASc), a screening instrument for person‐centred guidance and self‐management support of persons with type 2 diabetes (T2D).

    Background: T2D is a common and globally increasing chronic condition. Improved self‐management is a vital and integral component of diabetes care to prevent complications from poorly managed diabetes. For diabetes nurses to better understand persons with diabetes experienced challenges and needs regarding self‐management and further for persons with T2D to take an active role in managing their condition, an instrument measuring this is needed.

    Design: Instrument development and psychometric testing of the content and construct validity, factor structure and reliability.

    Method: The SMASc was psychometric tested on a sample of participants (September 2017–November 2017) with a confirmed diagnosis of T2D (N = 104).

    Results: Psychometric findings were satisfactory and supported the scale´s reliability. Cronbach's alpha, CVI and goodness‐of‐fit were acceptable.

    Conclusion: Self‐Management Assessment Scale is a short validated screening instrument, which can indicate possible barriers for self‐management that ought to be approached during the conversation between the person with T2D and the primary healthcare nurses. Therefore, it is a promising instrument to be used to facilitate person‐centred guidance and to improve self‐management of people living with T2D.

  • 2279.
    Öberg, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Jutterström, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Orre, Carl-Johan
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Perceptions of Persons With Type 2 Diabetes Treated in Swedish Primary Health Care: Qualitative Study on Using eHealth Services for Self-Management Support2018In: JMIR Diabetes, ISSN 2371-4379, Vol. 3, no 1, article id e7Article in journal (Refereed)
    Abstract [en]

    Background: Digital health services are increasing rapidly worldwide. Strategies to involve patients in self-monitoring of type 2 diabetes (T2D) on a daily basis is of crucial importance, and there is a need to optimize the delivery of care such as self-management support. Digitalized solutions have the potential to modify and personalize the way in which people use primary health services, both by increasing access to information and providing other forms of support at a distance. It is a challenge to integrate core values of person-centered care into digitalized health care services.

    Objective: The objective of this study was to describe perceptions of using electronic health (eHealth) services and related technologies for self-management support among people with T2D treated in Swedish primary health care.

    Methods: This is a qualitative study based on interviews analyzed using qualitative content analysis conducted among people diagnosed with T2D.

    Results: Findings suggest that the participants had mixed feelings regarding the use of digital health services for self-management support. They experienced potentials such as increased involvement, empowerment, and security, as well as concerns such as ambivalence and uncertainty.

    Conclusions: Digital health services for self-management are easily accessible and have the potential to reach a wide population. However, targeted training to increase digital skills is required, and personalized devices must be adapted and become more person-centered to improve patients’ involvement in their own care.

  • 2280.
    Öberg, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jutterström, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Orre, Carljohan
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Person-Centered Interactive Self-Management Support in Primary Health Care for People with Type 2 Diabetes: Protocol for a Randomized Controlled Trial2019In: JMIR Research Protocols, ISSN 1929-0748, E-ISSN 1929-0748, Vol. 8, no 4, article id e10250Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Type 2 diabetes (T2D) is increasing as the population ages. The development of new medical treatments is promising and important, but the basic treatment remains self-management, even if adherence to lifestyle advice is low. Electronic health (eHealth) or mHealth interventions can increase empowerment among people living with T2D and may compensate for the lack of professional resources and geographical distances. The interactive self-management support (iSMS) project aims at including digital tools to support people living with T2D in their self-management and facilitating their interaction with diabetes specialist nurses (DSNs). This protocol outlines a study with the purpose of developing and evaluating an intervention where people living with T2D can increase self-efficacy and empowerment through digital self-monitoring and interaction with DSNs.

    OBJECTIVE: To develop and evaluate a person-centered iSMS intervention in primary health care for people with T2D in addition to their usual diabetes care.

    METHODS: This study is a 12-month, 3-armed, nonblinded randomized controlled trial (RCT), which will be conducted in 6 primary health care centers (HCCs) in northern Sweden. Eligible participants will be randomized to either an intervention group (n=46), a control group (n=46), or an external group (n=46) for comparison. The intervention group will receive the mobile app, and the control group will receive a minimal intervention (diabetes brochure) and the usual standard of care. Changes in glycated hemoglobin (HbA1c) will be the primary outcome measure.

    RESULTS: This trial is currently open for recruitment. The first results are expected to be submitted for publication in Autumn 2019.

    CONCLUSIONS: This study, with its focus on iSMS, will provide insights regarding suitable ways to promote and develop a person-centered intervention. If successful, the intervention has the potential to become a model for the provision of self-management support to people with T2D.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/10250.

  • 2281.
    Öberg, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Arctic Research Centre at Umeå University.
    Orre, Carl Johan
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jutterström, Lena
    Umeå University, Faculty of Medicine, Department of Nursing.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Using the Self‐Management Assessment Scale (SMASc) as an instrument for screening self-management support needs in type 2 diabetes: experiences from nurse-led digital self-management support in Swedish primary health careManuscript (preprint) (Other academic)
  • 2282.
    Öberg, Ulrika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Orre, Carl-Johan
    Umeå University, Faculty of Social Sciences, Department of Informatics. Department of Computer Science and Media Technology, Malmö University, Malmö, Sweden.
    Isaksson, Ulf
    Umeå University, Faculty of Medicine, Department of Nursing.
    Schimmer, Robyn
    Umeå University, Faculty of Social Sciences, Department of Informatics.
    Larsson, Håkan
    Hörnsten, Åsa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Swedish primary healthcare nurses' perceptions of using digital eHealth services in support of patient self-management2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 961-970Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nurses have expressed doubts about the ongoing digitalisation of Swedish primary health care. Given the potential role of eHealth in primary health care, including supporting interactive self-management for people with chronic conditions, it is important to highlight nurses' experiences. This study is part of a larger project aimed at implementing person-centred interactive self-management support (iSMS) in primary health care.

    AIM: The aim of this study was to describe Swedish primary healthcare nurses' perceptions of using digital eHealth systems and services to support patient self-management.

    METHODS: Focus group interviews were conducted with primary healthcare nurses (n = 20). The interview transcriptions were analysed using qualitative content analysis.

    RESULTS: Three themes emerged from the content analysis: caregiving in the midst of digital chaos; a lack of overview and control in daily work; and mixed feelings towards digitalisation. Each theme was subdivided into three subthemes.

    CONCLUSION AND RELEVANCE TO CLINICAL PRACTICE: The results of this study provide insight into a number of concerns that stand in the way of success when it comes to the implementation and use of digital technology. If nurses are to adapt to the new policies and practices that accompany the current digitalised development in Swedish primary health care, the concept of a nurse's traditional work role needs to be amended in terms of the scope of work tasks and established views of traditional nursing. The study also highlights the need for more research to enable eHealth systems/services to be designed to fulfil multiple requirements. The digitised systems should be a tool for achieving good quality self-management support as well as giving the primary healthcare nurses adequate resources to support patients' self-management while still maintaining the values associated with person-centred care.

  • 2283.
    Ödling, Annika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Seijsing, Louise
    Umeå University, Faculty of Medicine, Department of Nursing.
    Naturpromenaders påverkan på personer med mental ohälsa: En litteraturstudie2015Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
  • 2284.
    Ödling, Evelina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Engström, Lovisa
    Umeå University, Faculty of Medicine, Department of Nursing.
    Erfarenheter av stigmatisering i hälso- och sjukvården bland personer som drabbats av HIV.: -en litteraturstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Title: Experiences of stigma in health care among people affected by HIV- A literature review Background: HIV (Human Immunodeficiency Virus) has been associated with stigmatization for a long time because of ignorance and uncertainty still exists regarding the transmission routes and infectivity. Aim: The aim for the study was to highlight experiences of stigma in health care among people affected by HIV. Method: A literature study was conducted with ten qualitative articles from eight different countries. The articles were examined, analyzed and compiled. Results: The result generated two categories and five subcategories. The categories are: To be treated with a lack of care actions and experiences of integrity violation. The sub-categories are: excessive security measures, ignorant attitudes, lack of secrecy, offensive body language and abusive verbal communication.                                                                   Conclusion: Lack of knowledge about HIV can be seen internationally seen as a contributing factor to the patients still experiencing varying stigmatized treatment by health professionals. To counteract the stigma requires research that can generate knowledge on how health professionals can provide better treatment and that this information is disseminated to the medical staff. Keywords: HIV, stigmatization, patient-experience, discrimination.

  • 2285.
    Ödling, Gunvor
    Umeå University, Faculty of Medicine, Department of Nursing.
    Professional caregivers’ experiences of caring for women with breast cancer on a surgical ward2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of the thesis was to describe caregivers’ experiences of caring for women with breast cancer on a surgical ward. The study was based on interviews with narrative parts and tape-recorded clinical supervision sessions. The interviews and clinical supervision sessions were transcribed verbatim, and analysed by content analysis.

    Nurses (n=10) described life for women with breast cancer as either having freedom or not having freedom, with both physical and existential suffering. Dying occurred either naturally in patients’ own home or unnaturally in hospital. The nurses felt that it is possible to alleviate suffering during dying through providing adequate pain relief but also, through listening, providing information and changing the caring atmosphere (I).

    Breast cancer as an illness was described from a dark point of view by caregivers (n=37). The descriptions focused on loss of breasts and control, progression of the illness and annihilation. The illness seemed, in the caregivers’ mind, to often end with a painful death. Caregivers who had the opportunity to follow the total care process described a lighter viewpoint (II).

    According to nurses (=31) the most important needs among women, their relatives and nurses themselves were the needs to talk and receive information. There was a discrepancy between what was described as important needs and the descriptions of how these needs were provided for. Nurses, whose own needs for support were sometimes unsatisfactorily met (III), seemed almost to be unaware of the needs among women and their relatives.

    In the clinical supervision sessions caregivers reflected on difficult care situations related to women’s, relatives’, and most often caregivers’ feelings (n=38). The care situations were described as evoking feelings of discomfort, powerlessness and reduced self-esteem. These feelings were described by caregivers as arising in connection with caring for especially women with advanced breast cancer in a changing organisation (IV).

    Caregivers’ descriptions of caring for women with breast cancer show a lot of negative experiences of powerlessness and frustration. They met women and their relatives who suffered in various ways and had considerable need for support. Caregivers often found themselves unable to meet these needs due to organisational obstacles e.g. lack of time and lack of knowledge about other caregivers’ responsibility in the care.

  • 2286.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Danielson, E
    Christensen, SB
    Norberg, A
    Living with breast cancer: care givers’ perceptions in a surgical ward1998In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 21, no 3, p. 187-195Article in journal (Refereed)
  • 2287.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Danielson, E
    Jansson, L
    Caregivers’ descriptions of patients with advanced breast cancer in connection with supervision sessions in a surgical ward2001In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 24, no 1, p. 28-34Article in journal (Refereed)
  • 2288.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, A
    Life, suffering and dying as narrated by nurses in a surgical wardArticle in journal (Refereed)
  • 2289.
    Ödling, Gunvor
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Norberg, A
    Danielson, E
    Care of women with breast cancer on a surgical ward: nurses’ opinions of needs for support for women, relatives and themselves2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 39, no 1, p. 77-86Article in journal (Refereed)
  • 2290.
    Ölund, Erika
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Olofsson, Lina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Andlighet inom palliativ vård2013Independent thesis Basic level (professional degree), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Inom hälso- och sjukvården finns ett ökat intresse för andlig vård, vilket har resulterat i mer forskning kring ämnet andlighet. Det finns dock lite forskning som visar hur sjuksköterskan definierar och ger andlig vård. Andlighet är något som bör integreras inom den palliativa vården enligt de internationella och nationella riktlinjer som finns för sjuksköterskans arbete. Syftet med denna litteraturstudie var att beskriva hur sjuksköterskor såg på andlighet och hur de tillgodosåg andlig vård. I studien analyserades och sammanställdes nio artiklar om hur sjuksköterskorna såg på andlighet och gav andlig vård. Artiklarna söktes fram i databaser Pubmed, CINAHL, Scopus och Medline. Även manuell sökning genomfördes. Analysen resulterade i att tre huvudteman framkom: (1) sjuksköterskans syn på begreppet andlighet, (2) befrämjande för andlig vård och (3) hinder för att tillgodose andliga behov, subteman presenterades under huvudtema 2 och 3. Vid vårdandet av döende patienter är det viktigt att sjuksköterskan tillgodoser fysiska, sociala, emotionella och andliga behov. Förmedla livsmening, hopp, tröst, att beröra och följa med patienten på resan mot döden är viktigt när sjuksköterskan ger andlig vård. Tidsbrist, stress, hög arbetsbelastning och bristande kunskap kring andlig vård är faktorer som leder till brister inom den andliga vården av döende patienter

  • 2291.
    Öresland, Stina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses go visiting: ethics and gender in home-based nursing care2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis is to explore how nursing is constructed in home-based nursing care from the viewpoint of patients and nurses who are receiving or giving care. Since nursing both constructs and is in turn constructed by the context in which it serves, language plays a central part in those constructions and in this thesis. The thesis has been guided by social constructionism, meaning that the positions the patients and the nurses inhabits have been considered as social phenomenon constructed in discursive processes.

    There are two ideas that guided this thesis. One idea was that home-based nursing care promotes the association of caring abilities in relation to nursing, women and the private sphere. Another idea was that the place where the care was carried out has ethical implications.

    Data was collected from interviews with 10 home-based nurses (study I) working in community in the western part of Sweden and 10 patients cared for in their home by these nurses (study II). Nurses and patients were interviewed about their experiences of giving respectively receiving home-based nursing care. The interviews were transcribed verbatim and analyzed with a discourse analytic method in study I and II. The findings in study I show that the nurses described their subject positions as "guests" and "professionals" and that they have to make a choice between these positions, as it is impossible to perform both positions at the same time. Dependent on the situation, both an ethics of care and an ethics of justice were applied by the nurses, that is, to perform according to the subject positions of "guest" or "professional."

    In study II, the patients describe their own subject position as "safeguard" and the nurses‟ positions as "substitutes". These subject positions provided the opportunities, and the obstacles, for the patients‟ possibilities to receive care in their home which included which kind of strategies, habits and activities the patients described and what tasks and how they considered or expected the nurses to perform. These findings are discussed within a theoretical framework, i.e. a gendered dichotomy of the private spheres versus the public spheres. Inherent in this framework is a discussion of the findings related to the habits that are essential in the nurses‟ and the patients‟ constructions of subject positions.

    In study III, metaphors used by home-based nurses‟ were explored as a means to discover values and norms held by nurses working in home-based nursing care. Ten interviews with nurses working in home-based nursing care (the same interviews as in study I) were analyzed and interpreted with a metaphor analytic method. In the analysis metaphoric linguistic expressions (MLE) were explored and patterns of MLEs formed two entailments. After exploring MLEs and entailments on an explicit surface level the analysis went to a broader underlying dimension of conceptual metaphors identifying the overall metaphor: "Home-based nursing care is an endless journey". The metaphor "Home-based nursing care is an endless journey" exposed home-based nursing care in constant motion, thereby requiring nurses to adjust to circumstances. This adjustment required ethical maturity based on experience, knowledge, and creativity. The study III focuses on the importance of further developing reflections over experiences related to everyday ethical issues.

    In study IV, the findings from study I were the starting point for a philosophical exploration of the concept "guest" and its relation to other adjacent concepts such as hosts and hospitality. The question to be answered was as follows: In what ways can home-based nurses‟ description of being "guests" in patients‟ home be understood? The exploration was based on Derrida‟s philosophy of unconditional and conditional hospitality, Levinas‟ philosophy of "face" and "the Other" and Arendt‟s philosophy of "go visiting". The findings indicated that the concept "guest" was not appropriate for the nurses to use when describing their position in home-based nursing care, since the concept was problematic for the content and the complexity of home-based nursing care. The findings also showed that exposing concepts as binaries is fruitful since they show relationship between concepts. Just illuminating the concept "guest" did not reveal the power relationship between the "guest" and the "host" and their relationship to hospitality.

    The distinction between diverse ethical perspectives could be seen as problematic or as an opportunity. According to this study, the nurses used a plurality of different ethical ideas, such as an ethics of care, an ethics of justice, an ethics of virtue and an "everyday ethics." A possible interpretation could be that this was a sign of a difficulty to maintain distinction between ethical theories in clinical practice. 

    Ethical issues in the private sphere are less commonly explored compared to ethical issues in the public sphere, for example in hospital care. As showed in this thesis, the distinction between the private and the public spheres was problematic. It does not describe two spatially separate spheres, but rather it describes functionally dependent activities, interests and relations, such as diverse areas of ethical ideas and "feminine" and "masculine" positions.

    Home-based nursing care is a complex area and discourse analysis of the relation between home-based nursing care, subject positions, ethics and gender is more or less lacking. Exploring home-based nursing care outgoing from discourse analytic perspectives and methods is rewarding for nurses‟ practice, education and research as it opens up new perspectives of home-based nursing care.

  • 2292. Öresland, Stina
    et al.
    Lutzen, Kim
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rasmussen, Birgit
    Umeå University, Faculty of Medicine, Department of Nursing.
    Maatta, Sylvia
    Nurses as 'guests' - a study of a concept in light of Jacques Derrida's philosophy of hospitality2013In: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 14, no 2, p. 117-126Article in journal (Refereed)
    Abstract [en]

    As revealed in previous empirical research, nurses describe their position in home-based nursing care (HBNC) as that of guests' in the patient's home. Such a description is problematic as guests' might not be considered to belong to the realm of professionalism. As Jacques Derrida's work on hospitality has received wide publicity, sparking theoretical and philosophical discussion about host and guest, the aim of this study was to explore how the concept guests' can be understood in the light of Derrida's philosophy of hospitality. The study revealed that (a) guest must be considered a binary concept; and (b) hospitality should be regarded as an exchange of giving and receiving between a host and a guest. The present study demonstrated that it is important to reflect on the meaning of the concepts used by nurses in HBNC. Further theoretical and empirical exploration of the concept hospitality' would be fruitful, i.e. what is patients' understanding of hospitality' and hostility' related to nurses' descriptions of themselves as guests' in the patient's home.

  • 2293.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lützén, Kim
    Institutionen för Neurobiologi, Vårdvetenskap och Samhälle (NVS), Sektionen för Omvårdnad, Huddinge, Karolinska Institutet.
    Määttä, Sylvia
    Institutionen för vårdvetenskap och hälsa, Göteborgs universitet.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Rasmussen, Birgit H
    Umeå University, Faculty of Medicine, Department of Nursing.
    Nurses go visitingManuscript (preprint) (Other academic)
  • 2294.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Määttä, Sylvia
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Jörgensen, Marianne Winther
    Umeå University, Faculty of Social Sciences, Umeå Centre for Gender Studies (UCGS).
    Lützén, Kim
    Nurses as guests or professionals in home health care2008In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, no 3, p. 371-383Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: ;guest' and ;professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm.

  • 2295.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Määttä, Sylvia
    Institutionen för vårdvetenskap och hälsa, Göteborgs universitet.
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lützén, Kim
    Institutionen för Neurobiologi, Vårdvetenskap och Samhälle (NVS), Sektionen för Omvårdnad, Huddinge, Karolinska Institutet.
    Home-based nursing: an endless journey2011In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 18, no 3, p. 408-417Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore metaphors for discovering values and norms held by nurses in home-based nursing care. Ten interviews were analysed and interpreted in accordance with a metaphor analytical method. In the analysis, metaphoric linguistic expressions and two entailments emerged, grounded in the conceptual metaphor ‘home-based nursing care is an endless journey’, which were created in a cross-domain mapping between the two conceptual domains of home-based nursing care and travel. The metaphor exposed home-based nursing care as being in constant motion, thereby requiring nurses to adjust to circumstances that demand ethical maturity. The study focuses on the importance of developing further theories supporting nurses’ expressions of their experiences of everyday ethical issues.

  • 2296.
    Öresland, Stina
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Määttä, Sylvia
    Norberg, Astrid
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lützén, Kim
    Patients as 'safeguard' and nurses as 'substitute' in home health care2009In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, no 2, p. 219-230Article in journal (Refereed)
    Abstract [en]

    One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as 'safeguard', and the nurses' subject position as 'substitute' for themselves. These subject positions provided the opportunities, and the obstacles, for the patients' possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.

  • 2297.
    Öster, Inger
    Umeå University, Faculty of Medicine, Omvårdnad.
    Bildterapi vid bröstcancer: Kvinnors berättelser i ord och bild2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aims of this thesis are to describe women’s experiences of breast cancer from a gender perspective, describe women’s experiences of an art therapy intervention and the effects of an art therapy intervention on self-rated coping resources and quality of life. The thesis presents results from a study with 42 women with primary breast cancer without distance metastasis who participated in a randomized intervention study with art therapy carried out between 2001 and 2004. All women were recruited as they were referred to the Department of Oncology at Umeå University Hospital in northern Sweden for postoperative radiotherapy. They were randomized to an intervention group (n = 20) with individual art therapy for 1 hour/week during postoperative radiotherapy, or to a control group (n = 22). The women were between 37–69 years old and had a range of educational and socioeconomic backgrounds. All 42 women completed questionnaires in connection with three interview occasions during six months: at baseline (start of radiotherapy), two and six months later. The questionnaires assessed coping resources, quality of life, symptoms, and self-image. In addition, all women were interviewed about their experiences, and were asked to write a weekly diary about their experiences of breast cancer during the six months of participation. All women signed a written consent form in which they were assured voluntariness and that ending their participation would not affect the care or medical treatment in any way. The study protocol was approved by the Umeå University Ethical Committee at the Medical Faculty (archive number 99-386). In this thesis, part of results from the study is reported.

    The results presented in the first study show an overall increase in coping resources as measured by the Coping Resources Inventory (CRI) among women with breast cancer after taking part in the art therapy intervention. Significant differences were seen between the study group and the control group in the total score on the second occasion and in the social domain on the second and third occasions.

    The second study reports results of the art therapy intervention, with regard to quality of life aspects as measured by the instruments WHOQOL-BREF and EORTC QLQ-BR23, at baseline (start of radiotherapy) and two and six months later. Significant increases in total health, total quality of life, physical health and psychological health were found in the art therapy group compared to the control group. A significant positive difference was also found within the intervention group, concerning future perspectives, body image and systemic therapy side effects.

    The third study builds on previous quantitative results, drawing on gender theories and, taking a discursive approach in analyzing the women’s use of interpretative repertoires in diaries and interviews. The results show a connection between participation in art therapy, talking about protecting one’s own boundaries, and scoring higher on the CRI compared to the control group. A connection between the control group, repertoire conflicts, and lower scores on the CRI was also found.

    The fourth study presents further knowledge about women’s trajectories, in art therapy, towards helpful management of restraining boundaries. We were inspired by discursive psychology and the analytic concept of subject position. The result shows that art therapy helped women to get access to subject positions that enabled them to protect and strengthen their boundaries and put forward their own needs.

    Taken together, the results from all four studies support art therapy as a valuable complement in oncology care and rehabilitation of women with primary breast cancer in similar contexts.

  • 2298.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Hedestig, Oliver
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Johansson, Mona
    Umeå University, Faculty of Medicine, Department of Nursing.
    Klingstedt, Nina
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
    Sharing experiences in a support group: men's talk during the radiotherapy period for prostate cancer2013In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 11, no 4, p. 331-339Article in journal (Refereed)
    Abstract [en]

    Objective: Prostate cancer, one of the most common cancers in men, is often treated with radiotherapy, which strains both physical and mental health. This study aimed to describe the experiences of men living with prostate cancer shared within conversational support groups during a course of radiotherapy. Method: Nine men participated in one of two groups that met six or seven times, led by a professional nurse. Qualitative content analysis was used to identify themes and subthemes in the recorded group conversations. Results: The analysis resulted in six themes: living with a changing body, being in the hands of others, learning to live with the disease, the importance of knowledge, everyday life support, and meeting in the support group. The men discussed a wide variety of bodily experiences and described support from healthcare professionals, relatives, friends, and the support group as crucial to their recovery. Significance of results: Meeting men in a similar situation, sharing experiences of living with the disease, and feeling allied to each other were important to the men in our study. The conversational support group provided the patient with prostate cancer a forum where sharing was made possible.

  • 2299.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Omvårdnad.
    Magnusson, E
    Thyme, K E
    Lindh, J
    Åström, Sture
    Umeå University, Faculty of Medicine, Omvårdnad.
    Erratum to "Art therapy for women with breast cancer: The therapeutic consequences of boundary strengthening" [Arts Psychother. 34 (2007) 277-288] (DOI:10.1016/j.aip.2007.04.003)2008In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 35, no 3, p. 242-Article in journal (Other (popular science, discussion, etc.))
  • 2300.
    Öster, Inger
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Magnusson, Eva
    Umeå University, Faculty of Social Sciences, Centre for Women's Studies.
    Egberg Thyme, Karin
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Lindh, Jack
    Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Åström, Sture
    Umeå University, Faculty of Medicine, Department of Nursing.
    Art therapy for women with breast cancer: the therapeutic concequences of boundary strenghtening2007In: The arts in psychotherapy, ISSN 0197-4556, E-ISSN 1873-5878, Vol. 34, no 3, p. 277-288Article in journal (Refereed)
    Abstract [en]

    Between 2001 and 2004, 42 women with breast cancer (20 women in the study group and 22 women in the control group) participated in an intervention study involving art therapy. This article elaborates on previous quantitative results, taking a discursive approach and drawing on gender theories in analyzing the women's use of interpretative repertoires in interviews and diaries and their answers on single items of the Coping Resources Inventory (CRI). The aim was to inquire into whether and, if so, how and with what consequences women with breast cancer who participated in art therapy improved their access to beneficial cultural interpretative repertoires, compared to a control group. The results showed a connection between participation in art therapy, talking about protecting one's own boundaries, and scoring higher on the CRI compared to the control group. There was also a connection between the control group, repertoire conflicts, and lower scores on the CRI. Our interpretation is that art therapy became a tool the women could use to distinguish cultural understandings about boundaries and, through image making and reflections, to give higher legitimacy to their own interpretations and experience.

4344454647 2251 - 2300 of 2313
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf