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Ericsson, Elisabeth
Publications (10 of 43) Show all publications
Gimbler Berglund, I., Ericsson, E., Proczkowska-Björklund, M. & Fridlund, B. (2013). Nurse anaesthetists' experiences with pre-operative anxiety. Nursing Children and Young People, 25(1), 28-34
Open this publication in new window or tab >>Nurse anaesthetists' experiences with pre-operative anxiety
2013 (English)In: Nursing Children and Young People, ISSN 2046-2336, Vol. 25, no 1, p. 28-34Article in journal (Refereed) Published
Abstract [en]

Aims To explore nurse anaesthetists’ experiences and actions when administering and caring for children requiring anaesthesia.

Method A qualitative design employing critical incident technique was used. Interviews were carried out with a purposeful sample of nurse anaesthetists (n=32). The nurse anaesthetists’ experiences were grouped into two main areas: organisation focused and interrelational focused. Actions were grouped into two main areas: optimising the situation and creating interpersonal interaction.

Findings The categories and subcategories of the nurses’ experiences appeared to influence the outcome for the child. The nurse anaesthetists’ first priority was to create an optimal environment and increase sensitivity in their interactions with the child.

Conclusion Sensitivity to the child and flexibility in altering actions are key strategies to avoid physical restraint.

Keywords
Anaesthesia, children’s surgery, nurse anaesthetists, pre-operative anxiety, peri-operative nursing
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-22671 (URN)10.7748/ncyp2013.02.25.1.28.s9537 (DOI)23520951 (PubMedID)2-s2.0-84879189317 (Scopus ID)
Available from: 2013-12-12 Created: 2013-12-12 Last updated: 2018-11-19Bibliographically approved
Lundeborg, I., Hultcrantz, E., Ericsson, E. & McAllister, A. (2012). Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy-effects of surgery. Journal of Voice, 26(4), 480-487
Open this publication in new window or tab >>Acoustic and perceptual aspects of vocal function in children with adenotonsillar hypertrophy-effects of surgery
2012 (English)In: Journal of Voice, ISSN 0892-1997, E-ISSN 1873-4588, Vol. 26, no 4, p. 480-487Article in journal (Refereed) Published
Abstract [en]

Objective

To evaluate outcome of two types of tonsil surgery (tonsillectomy [TE] + adenoidectomy or tonsillotomy [TT] + adenoidectomy) on vocal function perceptually and acoustically.

Study Design

Sixty-seven children, aged 50–65 months, on waiting list for tonsil surgery were randomized to TE (n = 33) or TT (n = 34). Fifty-seven age- and gender-matched healthy preschool children were controls. Twenty-eight of them, aged 48–59 months, served as control group before surgery, and 29, aged 60–71 months, served as control group after surgery.

Methods

Before surgery and 6 months postoperatively, the children were recorded producing three sustained vowels (/ɑ/, /u/, and /i/) and 14 words. The control groups were recorded only once. Three trained speech and language pathologists performed the perceptual analysis using visual analog scale for eight voice quality parameters. Acoustic analysis from sustained vowels included average fundamental frequency, jitter percent, shimmer percent, noise-to-harmonic ratio, and the center frequencies of formants 1–3.

Results

Before surgery, the children were rated to have more hyponasality and compressed/throaty voice (P < 0.05) and lower mean pitch (P < 0.01) in comparison to the control group. They also had higher perturbation measures and lower frequencies of the second and third formants. After surgery, there were no differences perceptually. Perturbation measures decreased but were still higher compared with those of control group (P < 0.05). Differences in formant frequencies for /i/ and /u/ remained. No differences were found between the two surgical methods.

Conclusion

Voice quality is affected perceptually and acoustically by adenotonsillar hypertrophy. After surgery, the voice is perceptually normalized but acoustic differences remain. Outcome was equal for both surgical methods.

Keywords
Voice quality, Children, Perceptual and acoustic analyses, Tonsil surgery
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-12975 (URN)10.1016/j.jvoice.2010.11.003 (DOI)
Available from: 2010-08-27 Created: 2010-08-27 Last updated: 2017-12-12Bibliographically approved
Proczkowska-Björklund, M., Gimbler Berglund, I. & Ericsson, E. (2012). Reliability and validity of the Swedish version of the modified Yale Preoperative Anxiety Scale. Acta Anaesthesiologica Scandinavica, 56(4), 491-497
Open this publication in new window or tab >>Reliability and validity of the Swedish version of the modified Yale Preoperative Anxiety Scale
2012 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 56, no 4, p. 491-497Article in journal (Refereed) Published
Abstract [en]

Background:

The modified Yale Preoperative Anxiety Scale (m-YPAS) is an observational behavioral checklist that has been widely used as an indicator of pre-operative anxiety in children. The present study describes the translation process of m-YPAS into Swedish and the testing of its reliability and validity when used with Swedish children.

Methods:

The questionnaire was translated using standard forward-back-forward translation technique. The validation process was divided into two phases: a pilot study with 61 children as a first version and a test of a final version with 102 children.

Results:

The reliability tested with Cronbach's alpha was acceptable to good. Interrater reliability analyzed with weighted kappa was acceptable to good with Students Registered Nurse Anesthetists and Certified Registered Nurse Anesthetist (CRNA) as evaluators (phase 1) and good to excellent with CRNA's very experienced in child anesthesia (phase 2). Both concurrent and constructed validity could be demonstrated.

Conclusion:

This validation study of the Swedish version of the m-YPAS shows good consistency, interrater validity, and construct validity when used by experienced assessors.

National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-19525 (URN)10.1111/j.1399-6576.2011.02587.x (DOI)
Available from: 2012-09-25 Created: 2012-09-25 Last updated: 2018-11-19Bibliographically approved
Lundeborg, I., Ericsson, E., Hutltcrantz, E. & McAllister, A. M. (2011). Influence of adenotonsillar hypertrophy on s-articulation in children: Effects of surgery. Logopedics, Phoniatrics, Vocology, 36(3), 100-108
Open this publication in new window or tab >>Influence of adenotonsillar hypertrophy on s-articulation in children: Effects of surgery
2011 (English)In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 36, no 3, p. 100-108Article in journal (Refereed) Published
Abstract [en]

Tonsillar hypertrophy is common in young children and affects several aspects of the speech such as distortions of the dento-alveolar consonants. The study objective was to assess /s/-articulation, perceptually and acoustically, in children with tonsillar hypertrophy and compare effects of two types of surgery, total tonsillectomy and tonsillotomy. Sixty-seven children, aged 50-65 months, on the waiting list for surgery, were randomized to tonsillectomy or tonsillotomy. The speech material was collected preoperatively and 6 months postoperatively. Two groups of age-matched children were controls. /S/-articulation was affected acoustically with lower spectral peak locations and perceptually with less distinct /s/-production before surgery, in comparison to controls. After surgery /s/-articulation was normalized perceptually, but acoustic differences remained. No significant differences between surgical methods were found.

Keywords
Adenotonsillar hypertrophy, child, perceptual and acoustic evaluations, /s/-articulation
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-12980 (URN)10.3109/14015439.2010.531047 (DOI)21133642 (PubMedID)
Available from: 2010-08-27 Created: 2010-08-27 Last updated: 2017-12-12Bibliographically approved
Ericsson, E. (2010). Bemötande av barn inför anestesi. Paper presented at Riksföreningen för anestesi och intensivvård konferens 2010 27-28 maj.
Open this publication in new window or tab >>Bemötande av barn inför anestesi
2010 (Swedish)Conference paper, Published paper (Other (popular science, discussion, etc.))
Abstract [sv]

Barn upplever anestesiinduktionen som mycket ångestfylld och stressad situation. Stark preoperativ oro visar sig hos 50-60% av de barn som skall genomgå anestesi och operation. Oro hos barn före och i samband med anestesiinduktionen kan resultera i, sämre medverkan vid anestesiinduktionen, ett agiterat uppvaknade, ökad postoperativ smärta/ analgetikabehov samt negativa beteendeförändringar i det postoperativa skedet. Presentationen kommer att belysa resultat från egna och andras forskning angående beteende, kommunikation, information/förberedelser, skattning av barns oro, föräldramedverkan och premedicinering.

National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-12964 (URN)
Conference
Riksföreningen för anestesi och intensivvård konferens 2010 27-28 maj
Available from: 2010-08-26 Created: 2010-08-26
Stahlfors, J., Ericsson, E., Hemlin, C., Hultcrantz, E., Månsson, I., Roos, K. & Hessen-Söderman, A.-C. (2010). Symptom relief after tonsil surgery, comparison between tonsillectomy andtonsillotomy Results from the National Tonsil Surgery Register in SwedenAuthors. Paper presented at 10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010.
Open this publication in new window or tab >>Symptom relief after tonsil surgery, comparison between tonsillectomy andtonsillotomy Results from the National Tonsil Surgery Register in SwedenAuthors
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2010 (English)Conference paper, Published paper (Refereed)
Abstract [en]

OBJECTIVES

To compare tonsillotomy (TT)

and tonsillectomy (TE) with regard to relief of symptoms six months

postoperatively.

METHODS

Register study and analysis of data from the National Tonsil Surgery Register in Sweden covering the

period 1997-2008. A total of 54 696 tonsil surgery procedures were registered whereof 23 339 (42.7%) were performed on children (1-15 years) due to obstructive symptoms and tonsil hypertrophy. Data were collected from patients six months postoperatively from questionnaires.

RESULTS

17 903 children were operated with TE and 5 436 with TT. The ratio TT/TE was increasing after 2004.

More than 96 % reported total or partial symptom relief six months

CONCLUSIONS

Both TT and TE are highly effective in relieving obstructive symptoms in children.short

Identifiers
urn:nbn:se:hj:diva-13015 (URN)
Conference
10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010
Available from: 2010-09-02 Created: 2010-09-02
Ericsson, E., Hemlin, C., Hessen-Söderman, A.-C., Hultcrantz, E., Månsson, I., Roos, K. & Stahlfors, J. (2010). The role of information and instruction to children and parents in homemanagement after tonsil surgery - what is it helpful for them to know?. Paper presented at 10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010.
Open this publication in new window or tab >>The role of information and instruction to children and parents in homemanagement after tonsil surgery - what is it helpful for them to know?
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2010 (English)Conference paper, Published paper (Refereed)
Abstract [en]

OBJECTIVES

To create national recommendations for information after tonsil surgery to improve the management ofchildren.

METHODS

1. A search of Medline addressing evidence on expectations and advice about medication and nonpharamacological techniques to relieve pain after tonsil surgery and 2. A questionnaire focusing on the routines for information before and after tonsil surgery was administrated to all ENT-clinics in Sweden with 99% response rate.

RESULTS

There is evidence that information has an empowering effect upon parents to feel more control over their child’s care. Lack of information leads to anxiety and increased perception of pain in the child. Children and parents who were given specific information related to pain and morbidity, reported less pain and were less anxious than those with no or insufficient information. Constructive information should be given gradually, starting preoperatively, to parents and children. A leaflet should contain sufficient information about what happens before, during and is to be expected after surgery, the risks and possible complications, and advice and recommendation of medication and non-pharmacological techniques. Results from the national enquiry (N=48) showed the provision of a variety of different written information from the various clinics, often insufficient. Based on these findings, an information leaflet for patients and a checklist based on the literature for the staff to use at discharge were developed (both will be available).

CONCLUSIONS

A checklist for the staff insures that parents and children get consistent advice. A leaflet provided before surgery helps children and parents with methods to relieve pain. This could decrease the number of complications and later consultations and give shorter recovery.

National Category
Pedagogy Nursing Nursing Otorhinolaryngology
Identifiers
urn:nbn:se:hj:diva-13013 (URN)
Conference
10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010
Available from: 2010-09-02 Created: 2010-09-02
Hultcrantz, E., Ericsson, E., Hemlin, C., Hessen Soderman, A.-C., Roos, K. & Stahlfors, J. (2010). Tonsillectomy or Tonsillotomy - Is a change of paradigm on-going? Data out of a new National Tonsil Surgery Register in Sweden. In: : . Paper presented at 10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010.
Open this publication in new window or tab >>Tonsillectomy or Tonsillotomy - Is a change of paradigm on-going? Data out of a new National Tonsil Surgery Register in Sweden
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2010 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

OBJECTIVES

To study the current prevalence of different tonsil surgery techniques in children with obstructive symptoms in Sweden and the rates of primary and secondary bleeding as a function of the procedure and technique used.

METHODS

The new National Tonsil Surgery Register in Sweden was used; this registry was opened in March 2009.The data for patients aged 1–15 years operated for obstruction was analyzed. To the registry, age, sex,indication for surgery, surgical procedure and techniques is recorded prospectively, as is primary bleedings occurring during hospital stay. 30 days after surgery, complications such as secondary bleedings,uncontrolled pain and nosocomial infections are reported by parents in questionnaires collected using asecure internet-page.

RESULTS

A total of 3980 patients between 1–15 years were operated during the period covered, of whom 3172 for obstructive symptoms. Of the 1876 that have thus far answered the 30 day post-operative questionnaire 511 were operated with adenotonsillectomy (A+TE) and 943 with adenotonsillotomy (A+TT), 246 were operated with tonsillectomy (TE) and 174 with tonsillotomy (TT). Primary bleedings were reported in 55/3172 patients: 2.4% after A+TE, 1.8% after A+TT, 1.9% after TE and 0.35% after TT. Secondary bleedings were noted in 36/1876 patients: 3.3% after A+TE, 0.85% after A+TT, 4.1% after TE and 0.6% after TT. The used surgical techniques (TE/TT) were cold steel (455/17), radiofrequency (72/864), diathermy (39/2), ultracision (23/24) or laser (3/22).

CONCLUSIONS

TT for the indication, “obstruction” has become more common than TE. TT results in fewer both primary and secondary postoperative bleedings. Further analyzes

National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:hj:diva-12978 (URN)
Conference
10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010
Available from: 2010-08-27 Created: 2010-08-27 Last updated: 2014-03-06
Graf, J., Ericsson, E., Lundeborg, I. & Hultcrantz, E. (2010). Tonsillotomy with RF on young children with obstructive sleep disorder in ashort and long term perspective. Does the risk for recurrence balance the gain ofless surgical trauma and morbidity?.
Open this publication in new window or tab >>Tonsillotomy with RF on young children with obstructive sleep disorder in ashort and long term perspective. Does the risk for recurrence balance the gain ofless surgical trauma and morbidity?
2010 (English)Conference paper, Published paper (Refereed)
Abstract [en]

OBJECTIVES

To compare two methods of tonsil surgery with respect to long term effect in a group of pre-school children

METHODS

67 pre-school children, age 4-5 with symptoms of tonsillar hyperplasia were randomized to conventional tonsillectomy,TE,(n: 32) or tonsillotomy using radio frequency technique,TT(n:35).

28 TT patients and 25 TE patients underwent adenoidectomy at the same occasion. 5 TT and 1 TE had

already undergone an adenoidectomy. Six months and two years after surgery all children were evaluated through questionnaires including the

OSA-18 quality of life survey and two years after surgery they were again evaluated by an ENT-specialist, speech therapist and dentist.

RESULTS

The TT-children experienced less pain from the first day after surgery and were free from pain three days earlier than the TE-children. Six months after surgery there was no difference between the groups

concerning snoring and frequency and severity of upper airway infections. After two years, three of the 35 TT-children and one of the TE children had been reoperated due to recurring obstructive problems, the TEchild and one of the TT-children with adenoidectomy, two TT-children with tonsillectomy. The otherchildren did not snore and no increased tendency towards infections was noted in any child. Evaluation with VAS before/two years after surgery was 8,4/1,3 for TE and 8,5/1,6 for TT.(Median). The total OSA-18 score and the scores for all domains within OSA 18 showed significant improvement after surgery for both groups of children(p<.0001) in short- and long term scores. Three of the TT-children had some tonsillar tissue protruding from the tonsillar cleft and half of the TEchildren had small tonsillar remains in the tonsillar clefts.

CONCLUSIONS

Young children in an age with rapid immunological development have a six percent risk of recurrence of tonsil hyperplasia-related obstructive symptoms within two years after tonsillectomy, and may need to be reoperated. This risk should be weighed against the much lower postoperative morbidity of tonsillotomy as compared to tonsillectomy.ral

National Category
Otorhinolaryngology
Identifiers
urn:nbn:se:hj:diva-13016 (URN)
Available from: 2010-09-02 Created: 2010-09-02 Last updated: 2011-05-10
Hemlin, C., Stahlfors, J., Ericsson, E., Hultcrantz, E., Roos, K., Hessen-Söderman, A.-C. & Månsson, I. (2010). What factors are discriminating for tonsil surgery decision?. Paper presented at 10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010.
Open this publication in new window or tab >>What factors are discriminating for tonsil surgery decision?
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2010 (English)Conference paper, Published paper (Refereed)
Abstract [en]

OBJECTIVES

To evaluate decisive factors related to indications for tonsillar surgery among ENT surgeons.

METHODS

Webbased questionnaire presenting a number of representative cases to Swedish ENT surgeons with threealternatives: Recommend surgery, recommend further examinations or recommend no surgery. By changingone factor in the case description a value regarding the importance of each single factor could be estimated.

RESULTS

328 of 728 known ENT surgeons answered the questionnaire. An analysis of the answering population

compared to the total population of Swedish ENT surgeons showed them to be representative. The

proportion of Swedish ENT surgeons recommending surgery was 48 % higher for cases with recurrent StrepA tonsillitis compared to non Strep A tonsillitis and 53 % higher when tonsillar frequency was at least 4 episodes/year compared to 2 episodes/year.

CONCLUSIONS

Case presentations to practicing ENT surgeons can be used to achieve information on the national

perception of best practice. This information was used in the development of a national consensus documenton indications for tonsillar surgery. An iterated use of the questionnaire can furthermore give valuable information on the changes in practice over time, e.g. to evaluate the impact of new recommendations.

RESULTS

Fourteen RCT’’s (2712 children) were evaluated; most were too heterogeneous to pool into a meta-analysis.Loss to follow-up varied from 0% to 63% after 2 years.

Adenoidectomy in combination with a unilateral tympanostomy tube (n=3 trials) has a beneficial effect on the resolution of OME: risk difference 22% (95% CI 12% to 32%) and 29% (95% CI 19% to 39%) for the non-operated ear at 6 and 12 months, respectively. The effect of adenoidectomy on hearing is very small:<5dB compared to a unilateral tympanostomy tube only.

Regarding AOM (n=8 trials), adenoidectomy appears to have no significant beneficial effect.

CONCLUSIONS

Our review shows a significant effect of adenoidectomy as far as the resolution of middle ear effusion inchildren with OME is concerned. However, the benefit to hearing is small. The risks of operating should beweighed against these potential benefits. The absence of a significant effect on AOM suggests that routine surgery for this indication is not warranted.

Identifiers
urn:nbn:se:hj:diva-13014 (URN)
Conference
10th International Congress of the European Sociaty of Pediatric Otorhinolaryngology Pamplona, 5-8 June, 2010
Available from: 2010-09-02 Created: 2010-09-02
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