Umeå University's logo

umu.sePublications
Change search
Link to record
Permanent link

Direct link
Publications (10 of 42) Show all publications
Åkerström Wenneberg, L., Olsson, C., Eklund, A. J., Larsson, M. & Ringnér, A. (2026). Contact nurses’ experiences of using the BETTER model to address sexuality issues with cancer patients: a study based on the normalization process theory. European Journal of Oncology Nursing, 81, Article ID 103148.
Open this publication in new window or tab >>Contact nurses’ experiences of using the BETTER model to address sexuality issues with cancer patients: a study based on the normalization process theory
Show others...
2026 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 81, article id 103148Article in journal (Refereed) Published
Abstract [en]

Background Contact Nurses in Cancer Care (CNCCs) are well-positioned to address patients’ concerns regarding sexual health, but many lack the tools and confidence to initiate such conversations. Aim To explore how CNCCs perceive the use of the BETTER model as a new practice for integrating discussions of sexuality into cancer care. Methods Data were collected from 37 CNCCs through video-recorded educational seminars, written reflections, and focus group interviews. A directed qualitative content analysis was conducted, guided by the four constructs of the Normalization Process Theory: coherence, cognitive participation, collective action, and reflexive monitoring. Results The BETTER model was perceived as a valuable tool for initiating conversations about sexuality. The CNCCs highlighted the importance of personal reflection, peer support, and managerial backing. Time constraints and structural barriers were identified as key challenges to implementation. Many CNCCs viewed themselves as clinical champions, advocating for the sustained integration of the model into practice. Conclusion Communication tools such as the BETTER model can enhance CNCCs' confidence and competence in addressing sexual health. Successful implementation requires organizational support and recognition of CNCCs’ roles as facilitators of change. The Normalization Process Theory proved useful in understanding the implementation process, even across diverse clinical settings.

Place, publisher, year, edition, pages
Elsevier, 2026
Keywords
BETTER model, Cancer nursing, Contact nurse in cancer care, Implementation, Normalization process theory, Person-centered care, Sexual health
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-249927 (URN)10.1016/j.ejon.2026.103148 (DOI)2-s2.0-105029699978 (Scopus ID)
Funder
Knut and Alice Wallenberg FoundationSwedish Research Council, 2022-01024Umeå UniversityThe Swedish Brain FoundationRegion VästerbottenThe Kempe FoundationsMärta Lundqvists FoundationFredrik och Ingrid Thurings StiftelseStiftelsen Sigurd och Elsa Goljes minne
Available from: 2026-02-19 Created: 2026-02-19 Last updated: 2026-02-19Bibliographically approved
Winblad von Walter, A., Lundberg, V., Sonnemo, S. & Ringnér, A. (2026). Nurses' experiences of caring for children on long‐term mechanical ventilation. Nursing in Critical Care, 31(1), Article ID e70330.
Open this publication in new window or tab >>Nurses' experiences of caring for children on long‐term mechanical ventilation
2026 (English)In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 31, no 1, article id e70330Article in journal (Refereed) Published
Abstract [en]

Background:  The number of children with long-term home mechanical ventilation (LTV) is increasing globally. Parents become experts on their children's needs and sometimes know more about LTV treatment than non-specialist healthcare professionals. Nurses caring for LTV-dependent children in intensive care settings adjust to a collaborative caregiving role; however, this interaction has not been described in general paediatric wards.

Aim:  To describe nurses' experiences of caring for children and adolescents with established LTV at general paediatric wards.

Study design:  We conducted individual semi-structured interviews with 15 participants and analysed the data using qualitative content analysis.

Findings:  The study resulted in three categories: 'Building a relationship', 'Working hand in hand with the family', and 'Doing one's best despite the LTV', interpreted into the theme 'Working for reciprocal trust despite frail confidence', which can be seen as foundational to nursing both the child and the family.

Conclusions and relevance to clinical practice:  Reciprocal trust between families, nurses and the respiratory team could and should be established swiftly after admission with a discussion of each party's immediate responsibilities and back-up roles.

Place, publisher, year, edition, pages
John Wiley & Sons, 2026
Keywords
children, long‐term home mechanical ventilation, paediatric nursing, parent–nurse relationship.
National Category
Nursing
Research subject
caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-248715 (URN)10.1111/nicc.70330 (DOI)001661705600001 ()41536128 (PubMedID)2-s2.0-105027478699 (Scopus ID)
Available from: 2026-01-19 Created: 2026-01-19 Last updated: 2026-02-08Bibliographically approved
Ringnér, A., Ljung, M. & Rullander, A.-C. (2025). Parents' and nurses' experiences when children undergo limb lengthening treatment. International Journal of Orthopaedic and Trauma Nursing, 57, Article ID 101176.
Open this publication in new window or tab >>Parents' and nurses' experiences when children undergo limb lengthening treatment
2025 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 57, article id 101176Article in journal (Refereed) Published
Abstract [en]

Introduction: The aim of this study was to describe parents' and nurses’ experiences when children undergo limb lengthening procedures. Anisomelia (difference in limb length) great enough to need treatment is relatively rare in children. In Sweden the mean number of limb lengthening operations per year is 22 (National Board of Social Affairs and Health, 2025).

Nurses at these orthopaedic clinics are responsible to provide information to the child and caregivers about what to expect pre- and postoperatively. Treatment is lengthy and often painful. The actual lengthening process starts at the hospital and then proceeds at home for several months. The parents of most children treated for anisomelia are responsible for the day-to-day handling of the limb lengthening instrument, and this could put a large strain on them.

Place, publisher, year, edition, pages
Elsevier, 2025
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-237137 (URN)10.1016/j.ijotn.2025.101176 (DOI)001459393100001 ()40147364 (PubMedID)2-s2.0-105000659938 (Scopus ID)
Available from: 2025-04-15 Created: 2025-04-15 Last updated: 2025-04-15Bibliographically approved
Olsson, C., Larsson, M., Josse Eklund, A. & Ringnér, A. (2024). Associations between sexuality, body image and health-related quality of life in patients treated for diffuse large B-cell lymphoma: A cross-sectional study. European Journal of Oncology Nursing, 73, Article ID 102729.
Open this publication in new window or tab >>Associations between sexuality, body image and health-related quality of life in patients treated for diffuse large B-cell lymphoma: A cross-sectional study
2024 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 73, article id 102729Article in journal (Refereed) Published
Abstract [en]

Purpose: Sexuality and body image are closely related to health-related quality of life (HRQoL), but these factors are less investigated in patients treated for lymphoma.Therefore, the aim of this study was to describe and explore the associations between sexuality, body image, comorbidities and HRQoL in patients treated for diffuse large B-cell lymphoma.

Methods: A cross-sectional study with 257 patients (25% response rate) was conducted in 2019 using measures for sexuality, HRQoL and body image and data from the Swedish National Quality Registry for Leukemia–Subregistry for Lymphoma.

Results: The participants had a mean HRQoL of 69.75 on a 1 to 100 scale, and the functional scales ranged from 68.50 for Role to 80.82 for Social functioning. The symptoms ranged from 5.56 for nausea and vomiting to 37.73 for fatigue. Regarding body image, the participants scored a total of 14.47 (reference values 10–40). The total score for Sexual adjustment was 3.02 (fair), and for the subscales Sexual Interest 2.63 (low), Sexual Relation 2.72 (low), Sexual Function 3.62 (high) and Sexual Satisfaction 3.50 (high). HRQoL was positively associated with Sexual Relation; however, negative body image and comorbidities showed negative associations. The model explains 39.6% of the variation in HRQoL.

Conclusion: The positive impact of sexual relationships on HRQoL was highlighted, which emphasised the unfavourable effect of negative body image and comorbidities on HRQoL for lymphoma patients. Cancer nurses should address these topics with patients to improve their long-term well-being.

Place, publisher, year, edition, pages
Elsevier, 2024
National Category
Nursing
Research subject
caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-232217 (URN)10.1016/j.ejon.2024.102729 (DOI)001357406200001 ()39536378 (PubMedID)2-s2.0-85208573704 (Scopus ID)
Available from: 2024-11-27 Created: 2024-11-27 Last updated: 2024-11-27Bibliographically approved
Ringnér, A. & Rullander, A.-C. (2024). Barnortopedi (1ed.). In: Katarina Patriksson; Helena Wigert (Ed.), Omvårdnad för barn och unga - på avancerad nivå: (pp. 403-420). Lund: Studentlitteratur AB
Open this publication in new window or tab >>Barnortopedi
2024 (Swedish)In: Omvårdnad för barn och unga - på avancerad nivå / [ed] Katarina Patriksson; Helena Wigert, Lund: Studentlitteratur AB, 2024, 1, p. 403-420Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2024 Edition: 1
National Category
Nursing Pediatrics
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-220722 (URN)9789144156057 (ISBN)
Available from: 2024-02-09 Created: 2024-02-09 Last updated: 2024-02-15Bibliographically approved
Ringnér, A., Björk, M. & Olsson, C. (2023). Effects of person-centered information for parents of children with cancer (the PIFBO study): a randomized controlled trial. Journal of Pediatric Hematology/Oncology Nursing, 40(6), 400-410
Open this publication in new window or tab >>Effects of person-centered information for parents of children with cancer (the PIFBO study): a randomized controlled trial
2023 (English)In: Journal of Pediatric Hematology/Oncology Nursing, ISSN 2752-7530, E-ISSN 2752-7549, Vol. 40, no 6, p. 400-410Article in journal (Refereed) Published
Abstract [en]

Background: Conveying information to parents is a core part of pediatric oncology nursing; however, most published interventions do not tailor information to individual parental needs. Objective: To evaluate the effect on parental illness-related stress of person-centered information provided to parents of children with cancer.

Methods: A multicenter, unblinded randomized controlled trial with two parallel arms recruiting parents of children diagnosed within the past two months from two tertiary children's cancer centers in Sweden. Parents were randomized using sealed envelopes prepared and opened by an independent person. Parents in the intervention arm met four times with experienced nurses trained in the intervention, whereas controls received standard care. The effect of the intervention was measured five times regarding parents’ illness-related stress. Secondary outcomes were psychosocial states, experiences with healthcare providers, and received information. Further, we collected process data on the intervention's content and fidelity.

Results: Of the 32 parents included and analyzed in the study, 16 were randomized to the intervention, which addressed a broad variety of topics. The intervention increased parents’ knowledge about the biophysiological and functional aspects of their child's illness, but it had no measurable effect on their distress.

Discussion: Although fidelity to the intervention protocol was sufficient, the study was flawed by recruitment difficulties, primarily due to organizational factors, which may have prevented us from observing any possible effects on psychosocial distress. Having a person-centered perspective could be promising for future studies aimed at parents of children with cancer.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
parents, person-centered information, questionnaires, randomized controlled study
National Category
Nursing
Research subject
caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-204389 (URN)10.1177/27527530221115860 (DOI)000921986100001 ()36731493 (PubMedID)2-s2.0-85147513006 (Scopus ID)
Funder
Swedish Childhood Cancer Foundation, PR20130086
Available from: 2023-02-03 Created: 2023-02-03 Last updated: 2023-12-20Bibliographically approved
Ringnér, A., Björk, M. & Olsson, C. (2023). What was on the parents' minds?: Changes over time in topics of person-centred information for mothers and fathers of children with cancer. Comprehensive Child and Adolescent Nursing, 46(2), 114-125
Open this publication in new window or tab >>What was on the parents' minds?: Changes over time in topics of person-centred information for mothers and fathers of children with cancer
2023 (English)In: Comprehensive Child and Adolescent Nursing, ISSN 2469-4207, E-ISSN 2469-4193, Vol. 46, no 2, p. 114-125Article in journal (Refereed) Published
Abstract [en]

Acquiring information about one's child's cancer diagnosis is a complex and ever-changing process, and parents' needs change over time. As yet, we know little about what information parents require at different stages of their child's illness. This paper is part of a larger randomized control trial studying the parent-centered information given to mothers and fathers. The aim of this paper was to describe the topics addressed in person-centered meetings between nurses and parents of children with cancer and how those changed over time. Using qualitative content analysis, we analyzed nurses' written summaries of 56 meetings with 16 parents and then computed for each topic the percentage of parents who brought it up at any time during the intervention. The main categories were Child's disease and treatment (addressed by 100% of parents), Consequences of treatment (88%), Emotional management for the child (75%), Emotional management for the parent (100%), Social life of the child (63%), and Social life of the parent (100%). Different topics were addressed at different points in time, and fathers raised more concerns about the child's emotional management and the consequences of treatment than mothers. This paper suggests that parental information demands change over time and differ between fathers and mothers, implying that information should be person-centered. Registered at Clinicaltrials.gov (NCT02332226).

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
childhood cancer, Parents, person-centered information, process evaluation
National Category
Nursing Pediatrics Cancer and Oncology
Identifiers
urn:nbn:se:umu:diva-205346 (URN)10.1080/24694193.2023.2168790 (DOI)000935248300001 ()36811905 (PubMedID)2-s2.0-85148661261 (Scopus ID)
Funder
Swedish Childhood Cancer Foundation, PR2013-0068
Available from: 2023-04-03 Created: 2023-04-03 Last updated: 2023-08-17Bibliographically approved
Neyra Marklund, I., Rullander, A.-C., Lindberg, K. & Ringnér, A. (2022). Initial education for families with children diagnosed with type 1 diabetes: Consensus from experts in a Delphi study. Comprehensive Child and Adolescent Nursing, 45(3), 310-319
Open this publication in new window or tab >>Initial education for families with children diagnosed with type 1 diabetes: Consensus from experts in a Delphi study
2022 (English)In: Comprehensive Child and Adolescent Nursing, ISSN 2469-4207, E-ISSN 2469-4193, Vol. 45, no 3, p. 310-319Article in journal (Refereed) Published
Abstract [en]

A child’s diagnosis of type 1 diabetes can create major challenges for the family, and early education about the disease is crucial. The aim of this study was to identify and reach expert consensus about the priority of topics for the two initial weeks of education of families with a child diagnosed with type 1 diabetes. Specialist nurses (n = 15) working with children and adolescents with diabetes at Swedish pediatric clinics participated in a Delphi study. We sent these experts three rounds of a web survey and analyzed their answers using qualitative content analysis and descriptive statistics. The results show the experts’ consensus on the most important educational topics for families of a child diagnosed with type 1 diabetes. The highest priority topics were actions for hypo-/hyperglycemia, blood-glucose monitoring, symptoms of hypo-/hyperglycemia and adjustment of insulin. The experts’ top-ranked educational topics were in line with the International Society for Pediatric and Adolescent Diabetes guidelines for educating children with type 1 diabetes and also considered important by children and their families. The topics identified here can help nurses educate children with type 1 diabetes, contribute to further research into type 1 diabetes education, and inform the development of national guidelines.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
children, Delphi study, education, nursing, parents, Type 1 diabetes
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-192959 (URN)10.1080/24694193.2022.2033351 (DOI)000755009200001 ()2-s2.0-85125218526 (Scopus ID)
Funder
Region Västerbotten, VLL-582751
Available from: 2022-03-07 Created: 2022-03-07 Last updated: 2023-08-17Bibliographically approved
Ringnér, A., Olsson, C., Eriksson, E., From, I. & Björk, M. (2021). A moment just for me: Parents’ experiences of an intervention for person-centred information in paediatric oncology. European Journal of Oncology Nursing, 51, Article ID 101923.
Open this publication in new window or tab >>A moment just for me: Parents’ experiences of an intervention for person-centred information in paediatric oncology
Show others...
2021 (English)In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 51, article id 101923Article in journal (Refereed) Published
Abstract [en]

Purpose: Information can help parents of children with cancer by reducing uncertainty and giving them a sense of control in a chaotic situation. Although providing information to parents is a core activity of paediatric oncology nursing, few studies focus on interventions for informing parents. Thus, the aim of this study is to evaluate parents’ experiences after participating in a person-centred information intervention for parents of children with cancer.

Method: This study is part of a process evaluation of a person-centred informational intervention in paediatric oncology for patients’ parents. Qualitative semi-structured interviews with 13 parents who had taken part in the intervention were analysed using qualitative content analysis.

Results: An opening for healing emerged as the overarching theme, consisting of three categories. Gaining a deeper understanding of the entire situation describes how parents benefitted from processing current topics and moving forward by learning. Caring reflections in a safe space describes how parents appreciated having a moment just for themselves and feeling better by venting their feelings. Meeting a competent and compassionate nurse describes how parents experienced trust and being listened to.

Conclusion: Having individual information meetings integrated as a primary nursing responsibility, mediated by competent and compassionate nurses also responsible for the care of the child, could enhance person-centred care and individualise parental education.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Intervention, Nursing, Paediatric oncology, Parental experience, Person-centred information, Qualitative content analysis, Semi-structured interview
National Category
Nursing
Research subject
caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-180615 (URN)10.1016/j.ejon.2021.101923 (DOI)000634179100001 ()2-s2.0-85101074419 (Scopus ID)
Funder
Swedish Childhood Cancer Foundation
Available from: 2021-02-19 Created: 2021-02-19 Last updated: 2023-09-05Bibliographically approved
Ringnér, A. & Tiberg, I. (2021). När barnet insjuknar under uppväxten (1ed.). In: Carina Sparud Lundin; Ewa-Lena Bratt (Ed.), Övergångar i hälso- och sjukvård: ett livsloppsperspektiv och organisatoriska aspekter (pp. 123-139). Lund: Studentlitteratur AB
Open this publication in new window or tab >>När barnet insjuknar under uppväxten
2021 (Swedish)In: Övergångar i hälso- och sjukvård: ett livsloppsperspektiv och organisatoriska aspekter / [ed] Carina Sparud Lundin; Ewa-Lena Bratt, Lund: Studentlitteratur AB, 2021, 1, p. 123-139Chapter in book (Other academic)
Place, publisher, year, edition, pages
Lund: Studentlitteratur AB, 2021 Edition: 1
Keywords
transitioner, övergångar, cancer, diabetes, barn, föräldrar, tonåringar
National Category
Nursing
Research subject
caring sciences in social sciences
Identifiers
urn:nbn:se:umu:diva-189504 (URN)9789144138855 (ISBN)
Available from: 2021-11-12 Created: 2021-11-12 Last updated: 2023-07-03Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-8801-5423

Search in DiVA

Show all publications