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  • 1.
    Ahlström, Gerd
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Sjödén, Per-Olow
    Assessment of coping with muscular dystrophy: a methodological evaluation.1994In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 20, no 2, p. 314-323Article in journal (Refereed)
    Abstract [en]

    There is no published research on coping with muscular dystrophy among adults. In the present study, two questionnaires, the Reaction to the Diagnosis of Cancer Questionnaire (RDCQ) and the Mental Adjustment to Cancer scale (MAC), were modified in order to measure coping with muscular dystrophy (MD). A total of 60 people (16-64 years) with diagnosed MD answered the questionnaires in two interviews including semi-structured questions. The replies to these questions were analysed by two independent judges on the basis of the RDCQ and MAC categories for coping. The purpose was twofold: to investigate if cancer-coping categories could be used for the classification of interview answers concerning coping with MD, and to gain knowledge about specific coping with MD. Analysis indicated that 82% of replies to semi-structured questions concerned with emotion/appraisal-focused coping with MD can be described by means of RDCQ and MAC categories. Eight new categories were developed to classify the remaining 18%: Anticipation, Creation of new life values, Minimization, Establishment of control over everyday life, Secretiveness, Fear, Social comparison and Coping with heredity. In addition, 997 replies were classified to represent problem-focused coping. The judges reached good agreement with respect to the proportions of replies in the respective coping categories. However, kappa (kappa) values were within the range of fair to good agreement.

  • 2. Andersson, I
    et al.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Case studies of food shopping, cooking and eating habits in older women with Parkinson's disease.2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 35, no 1, p. 69-78Article in journal (Refereed)
  • 3.
    Arvidsson, Susann
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Bergman, Stefan
    FoU-centrum Spenshult.
    Arvidsson, Barbro
    Högskolan i Halmstad.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Bengtsson Tops, Anita
    Växjö universitet.
    Experiences of health-promoting self-care in people living with rheumatic diseases2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 6, p. 1264-1272Article in journal (Refereed)
    Abstract [en]

    Aim This paper is a report of a study which explores and describes the meaning of the phenomenon health-promoting self-care as experienced by people living with rheumatic diseases.

    Background People with rheumatic diseases estimate health status as low and health belief and health status influence the self-care behaviours. Several self-care behaviours are used in the efforts to mitigate the diseases.

    Method The study had a descriptive phenomenological approach based on a reflective life-world perspective. Data were gathered in 2007 by unstructured open-ended interviews with 12 individuals living with rheumatic diseases.

    Findings The meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care takes place against a background of continual hope and belief to influence health in positive ways. Self-care was a way of life and implied being ready to understand and respond to signals from the body. Three inter-related constituents elucidated the experiences: dialogue, power struggle and choice. Self-care was experienced as dialogues within the body and with the immediate environment. In order to respond to signals from the body, power struggles were required to be entered when fighting the diseases. Choices were required to be made and things that were beneficial for the body were prioritized.

    Conclusion In this study, the meaning of health-promoting self-care as experienced by people living with rheumatic diseases was that self-care was a way of life. This meant to be ready to understand and respond to signals from the body. Self-care required dialogues, power struggles and choices.

  • 4.
    Arvidsson, Susanne
    et al.
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Arvidsson, Barbro
    Research and Development Centre, Spenshult Hospital for Rheumatic Diseases, Oskarström, Sweden.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Tingström, Pia
    The Faculty of Health Sciences, Linköping University, Sweden.
    Effects of a self-care promoting problem-based learning programme in people with rheumatic diseases: a randomized controlled study2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 7, p. 1500-1514Article in journal (Refereed)
    Abstract [en]

    Aim

    To evaluate the effects of a self-care promoting problem-based learning programme for people with rheumatic diseases in terms of health-related quality of life, empowerment, and self-care ability.

    Background

    Individuals with rheumatoid arthritis express a great need for education and support in adapting to the disease, but the average qualities of studies about patient education interventions are not high. There is no evidence of long-term benefits of patient education.

    Design

    Randomized controlled trial.

    Methods

    A randomized controlled design was selected with test at baseline, 1-week and 6-month post-interventions after completed the 1-year programme. The tests consisted of validity and reliability tested instruments. The participants were randomly assigned in spring 2009 to either the experimental group (n = 54) or the control group (n = 148). The programme was running alongside the standard care the participants received at a rheumatology unit. Parametric and non-parametric tests were used in the analyses.

    Results

    The participants in the experimental group had statistically significant stronger empowerment after participation in the self-care promoting problem-based learning programme compared with the control group, at the 6-month post-intervention. Approximately, two-thirds of the participants in the experimental group stated that they had implemented lifestyle changes due to the programme.

    Conclusion

    The self-care promoting problem-based learning programme enabled people with rheumatic diseases to improve their empowerment compared with the control group. It is important to continue to develop problem-based learning in patient education to find the very best way to use this pedagogical method in rheumatology care.

  • 5. Boström, B
    et al.
    Sandh, M
    Lundberg, D
    Fridlund, Bengt
    Lunds universitet.
    Cancer-related pain in palliative care: patients' perceptions of pain management2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 45, no 4, p. 410-419Article in journal (Refereed)
  • 6. Broström, A
    et al.
    Strömberg, A
    Dahlström, U
    Fridlund, Bengt
    Högskolan i Halmstad.
    Patients with congestive heart failure and their conceptions of their sleep situation2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 34, no 4, p. 520-529Article in journal (Refereed)
  • 7. Broström, Anders
    et al.
    Johansson, Peter
    Strömberg, Anna
    Albers, Jan
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Svanborg, Eva
    Obstructive sleep apnoea syndrome: patients' perceptions of their sleep and its effects on their life situation.2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 57, no 3, p. 318-327Article in journal (Refereed)
  • 8. Button, Lori
    et al.
    Green, Barbara
    Tengnah, Cassam
    Johansson, Inez
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Baker, Christine
    The impact of international placements on nurses´personal and professional lives: literature review2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 50, no 3, p. 315-324Article in journal (Refereed)
    Abstract [en]

    Aim. This paper presents a critical review of research literature on the impact of international placements on the lives and practice of nurses.

    Background. Health care institutions are progressively more aware of the need to respond to diverse patient populations and cultivate leaders to enrich the nursing profession, both locally and globally. One response has been to establish international exchange programmes for nursing students to give them experience of different cultures and health care systems.

    Methods. A search of the literature from 1980 to 2003 using electronic databases was undertaken using the databases CINAHL, ERIC, British Nursing Index, Web of Science, the BIDS Social Science Citation Index and Medline. The keywords used were 'international exchange experience', 'international studies', 'international education', 'international placement(s)', 'exchange programme(s)', combined with 'nurses/nursing', combined with 'evaluation', 'practice', 'education' and/or 'policy'. The papers retrieved used both qualitative and quantitative approaches and were scrutinized for recurring themes.

    Findings. Nurses reported significant changes in their personal development, perspectives on nursing practice and critical appraisal of health care systems. They also indicated an increased appreciation and sensitivity towards cultural issues and cross-cultural care. Moreover, differences in placement programmes, such as duration, preparation and debriefing were found to have affected the reported overall international placement experience. However, the primary effects of international placements were identified as personal development and transcultural adaptation.

    Conclusion. Students should be exposed to a variety of nursing experiences within the host country. This would give them a broad spectrum for comparisons between cultures, nursing practice and health care delivery in those cultures. Therefore, educational institutions are strongly encouraged to provide opportunities for students to participate in nursing care and education in another

  • 9. Engström, B L
    et al.
    Fridlund, Bengt
    Högskolan i Halmstad.
    Women's views of counselling received in connection with breast-feeding after reduction mammoplasty2000In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 32, no 5, p. 1143-1151Article in journal (Refereed)
  • 10.
    Eriksson, Kerstin
    et al.
    Jönköping University, School of Health and Welfare.
    Wikström, Lotta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Anaesthesia and IntensiveCare, Ryhov County Hospital, Jönköping, Sweden.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Årestedt, Kristofer
    School of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Association of pain ratings with the prediction of early physical recovery after general and orthopaedic surgery - A quantitative study with repeated measures2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 11, p. 2664-2675Article in journal (Refereed)
    Abstract [en]

    Aim: To compare different levels of self-rated pain and determine if they predict anticipated early physical recovery in patients undergoing general and orthopaedic surgery.

    Background: Previous research has indicated that average self-rated pain reflects patients' ability to recover the same day. However, there is a knowledge gap about the feasibility of using average pain ratings to predict patients' physical recovery for the next day.

    Design: Descriptive, quantitative repeated measures.

    Methods: General and orthopaedic inpatients (n = 479) completed a questionnaire (October 2012-January 2015) about pain and recovery. Average pain intensity at rest and during activity was based on the Numeric Rating Scale and divided into three levels (0-3, 4-6, 7-10). Three out of five dimensions from the tool "Postoperative Recovery Profile" were used. Because few suffered severe pain, general and orthopaedic patients were analysed together.

    Results: Binary logistic regression analysis showed that average pain intensity postoperative day 1 significantly predicted the impact on recovery day 2, except nausea, gastrointestinal function and bladder function when pain at rest and also nausea, appetite changes, and bladder function when pain during activity. High pain ratings (NRS 7-10) demonstrated to be a better predictor for recovery compared with moderate ratings (NRS 4-6), day 2, as it significantly predicted more items in recovery.

    Conclusion: Pain intensity reflected general and orthopaedic patients' physical recovery postoperative day 1 and predicted recovery for day 2. By monitoring patients' pain and impact on recovery, patients' need for support becomes visible which is valuable during hospital stays.

  • 11.
    Eriksson, Kerstin
    et al.
    Jönköping University, School of Health and Welfare. Department of Anaesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Årestedt, Kristofer
    Faculty of Health and Life Caring Sciences, Linnaeus University, Kalmar, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Clinical Neurophysiology, University Hospital, Linköping, Sweden.
    Wikström, Lotta
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Anaesthesia and Intensive Care, Ryhov County Hospital, Jönköping, Sweden.
    Nausea intensity as a reflector of early physical recovery after surgery2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    Aim: To compare different levels of self-rated average nausea intensity with early physical recovery and determine if nausea can reflect recovery in patients undergoing general or orthopaedic surgery.

    Background: Nausea has been found to influence postoperative physical recovery. Despite the incidence of nausea in postoperative care, there is a knowledge gap about the possibility of using average nausea intensity to reflect recovery, motivating further investigation.

    Design: An observational design with repeated measures.

    Methods: General and orthopaedic patients answered a questionnaire (October 2012–January 2015) about nausea and impact on recovery on postoperative days 1 (N = 479) and 2 (N = 441). Questions about average nausea intensity at rest and during activity were answered based on the Numeric Rating Scale (NRS) (0–10). Impact on recovery was evaluated using three dimensions from the postoperative recovery profile tool.

    Results: About one-fifth of the patients reported nausea intensity as moderate to severe on days 1 and 2. Nausea intensity was associated with eight of nine aspects of recovery on postoperative day 1. Nausea intensity on day 1 also reflected four of nine aspects of recovery on day 2. About reflecting physical recovery, the association was strongest between nausea intensity and appetite changes.

    Conclusions: As postoperative nausea is common, regular assessments by healthcare professionals are needed. Assessment of nausea is of importance since it reflects physical recovery. This also shows the importance of treating nausea without delay. Using the NRS to measure nausea intensity is a simple method that is easy to use in clinic. 

  • 12. Frank, C
    et al.
    Asp, M
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ. ADULT.
    Baigi, A
    Questionnaire for patient participation in emergency departments: development and psychometric testing2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 3, p. 643-651Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of the study was to develop and test the psychometric properties of a patient participation questionnaire in emergency departments.

    Background. Patient participation is an important indicator of the quality of healthcare. International and national healthcare policy guidelines promote patient participation. While patients cared for in emergency departments generally express dissatisfaction with their care, a review of the literature fails to reveal any scientifically tested instruments for assessing patient participation from the perspective of patients.

    Methods. A methodological study was conducted involving a convenience sample of 356 patients recently cared for in emergency departments in Sweden. Data were collected in 2008 and analysed for construct and criterion validity, also homogeneity and stability reliability.

    Results. A 17-item questionnaire was developed. Two separate factor analyses revealed a distinct 4-factor solution which was labelled: Fight for participation, Requirement for participation, Mutual participation and Participating in getting basic needs satisfied. Criterion validity testing showed 9 out of 20 correlations above 0·30 and, of these, three were moderate correlations of 0·62, 0·63 and 0·70. Cronbach’s alpha coefficient ranged from 0·63 to 0·84 and test–retest varied between 0·59 and 0·93.

    Conclusion. The results signify evidence of acceptable validity and reliability, and the questionnaire makes it possible to evaluate patient participation in emergency department caring situations. In addition, it produces data which are usable by a diverse range of healthcare professionals.

  • 13. Frank, C
    et al.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ. ADULT.
    Baigi, A
    Asp, M
    Patient participation in the emergency department: an evaluation using a specific instrument to measure patient participation (PPED)2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 4, p. 728-735Article in journal (Refereed)
    Abstract [en]

    Aim. This study aimed at evaluating patient participation from the perspective of patients who received care in emergency departments, with a separate examination of the relationship between participation and age, gender, education and priority level.

    Background. International and national guidelines encourage patient participation. High patient participation is required to ensure a high quality of care. No studies evaluating patient participation at an emergency department have been published.

    Methods. An evaluating study, with the Patient Participation Emergency Department questionnaire, was conducted at emergency departments in Sweden. A consecutive sample of 356 patients participated. Data were collected in 2008: participants were 49% women and with an average age of 56 years. The statistical methods used were Student’s t-test, one-way anova and Spearman correlation.

    Results. The results revealed that patients experienced good requirement for participation such as time and information. Mutual participation demonstrated a reasonable level, but patient participation is low in two dimensions (Fight for participation, Participation in getting basic needs satisfied). Young and well-educated patients fought more to participate in their care and gained less attention for basic needs than older and less well-educated patients.

    Conclusions. Patient participation in a mutual care situation between patients and healthcare professionals requires further improvement to ensure that patients are satisfied and do not have to struggle and fight to participate in their care.

  • 14. Gustafsson, K
    et al.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Food-related health perceptions and food habits among older women2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 39, no 2, p. 164-173Article in journal (Refereed)
  • 15. Hildingh, C
    et al.
    Fridlund, Bengt
    Högskolan i Halmstad.
    Segesten, K
    Cardiac nurses preparedness to use self-help groups as a support strategy1995In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 22, no 5, p. 921-928Article in journal (Refereed)
  • 16. Hultsjö, Sally
    et al.
    Berterö, Carina
    Hjelm, Katarina
    Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.2007In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 60, no 3, p. 279-88Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.

    BACKGROUND: Research from different countries reports a high-incidence of psychosis among migrants. The risk-factors discussed are social disadvantages in the new country. To understand and meet the needs of people from different countries, their perspective of psychiatric care must be illuminated and taken into consideration.

    METHOD: A phenomenographic study was conducted in 2005-2006 using semi-structured interviews with a convenience sample of 12 foreign-born people and 10 Swedish-born people with psychosis.

    FINDINGS: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born people differed from Swedish-born people in that they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and had religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.

    CONCLUSION: It is important to identify individual perceptions and needs, which may be influenced by cultural origins, when caring for patients with psychosis. Previous experience of care, different ways of relating to staff, and individual needs should be identified and met with respect. Social needs should not be medicalized but taken into consideration when planning care, which illustrates the importance of multi-professional co-operation.

  • 17. Jacobsson, Anna
    et al.
    Pihl, Emma
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Emotions, the meaning of food and heart failure: a grounded theory study.2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 46, no 5, p. 514-22Article in journal (Refereed)
  • 18. Johansson, Ingrid
    et al.
    Hildingh, Cathrine
    Wenneberg, Stig
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Theoretical model of coping among relatives of patients in intensive care units: a simultaneous concept analysis.2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 5, p. 463-471Article in journal (Refereed)
    Abstract [en]

    This paper reports the development of a theoretical model of relatives' coping approaches during the patient's intensive care unit stay and subsequent recovery at home by performing an analysis of concepts generated from two empirically grounded, theoretical studies in this area. BACKGROUND: When supporting relatives of intensive care unit patients, it is important that nurses have access to evidence-based knowledge of relatives' coping approaches during the period of illness and recovery. METHOD: Simultaneous concept analysis was used to refine and combine multiple coping concepts into a theoretical model of coping. The concepts were generated in two previous empirical studies of relatives' coping approaches during mechanically ventilated patients' intensive care unit stays and recovery at home. FINDINGS: The theoretical model was developed in 2004-2005 and illustrates the effectiveness of different coping approaches in relation to each other and to social support. Definitions summarizing each coping approach and containing the knowledge gained through the simultaneous concept analysis method were also formulated. CONCLUSION: This middle-range theory of relatives' coping approaches may make a valuable contribution to international intensive care unit nursing practice, especially as it is based on empirical studies and may therefore serve as a basis for the development of future clinical guidelines. However, the theoretical model needs to be empirically validated before it can be used.

  • 19.
    Knutsson, Susanne E M
    et al.
    The Sahlgrenska Academy at Göteborg University, Institute of Health and Care Sciences, Göteborg, Sweden.
    Samuelsson, Ingrid Pramling
    Hellström, Anna-Lena
    Bergbom, Ingegerd
    Children's experiences of visiting a seriously ill/injured relative on an adult intensive care unit2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 61, no 2, p. 154-62Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study of children's experiences of visiting a seriously ill/injured relative in an intensive care unit.

    BACKGROUND: Little attention has been paid to children's experiences and needs when visiting a relative being cared for at a high technological adult intensive care unit. Instead, the focus has been on adult's experiences and needs.

    METHOD: In 2004, 28 children (14 girls, 14 boys) aged 4-17 years who had visited an adult relative were interviewed 3 months after the visit. A hermeneutic approach was used when interpreting and analysing the text.

    FINDINGS: Four themes were generated from the data: It meant waiting, It was strange, It was white and It was good. Waiting was experienced as difficult, increasing the feeling of uncertainty, exclusion and separation, which in turn led to tension and concern. 'It was strange' was perceived as unfamiliar but also with interest and curiosity. The experience of the intensive care unit was that it was white. Everything in the patient's room was experienced as white and gloomy. It lacked joy. 'It was good' was stated about the outcome of the visit because through this they were given the opportunity to meet and see the relative by themselves. This evoked feelings of relief and joy. The visit did not seem to frighten the child; instead it generated feelings of release and relief.

    CONCLUSION: Children's experiences of visiting an adult intensive care unit seem to support theories that emphasize the involvement and participation of children in family matters.

  • 20.
    Knutsson, Susanne
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Engberg, I B
    An evaluation of patients' quality of life before, 6 weeks and 6 months after total hip replacement surgery.1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, no 6, p. 1349-59Article in journal (Refereed)
    Abstract [en]

    Annually, throughout the world, more than 800,000 primary total hip replacement surgery procedures are performed on patients suffering from hip joint arthrosis. Since 1991, approximately 11,000 of these procedures are performed annually in Sweden. This study aimed to investigate any changes in the patients' life quality 6 weeks and 6 months after their total hip replacement surgery had been performed, compared to that immediately prior to the operation. It also aimed to examine the reason for surgery, the types of prostheses used, postoperative pain, complications and the actual usage of ambulation support. The Sickness Impact Profile self-appraisal instrument, together with personal patient interviews have been used as the basis of the research. A total of 51 patients responded to the quality of life instrument prior to their operation, 47 of these participated 6 weeks after the operation, and 40 patients 6 months after the operation. Significant differences in patients' total, physical and psychosocial quality of life 6 months postoperatively compared to the situation prior to the operation were found, but not between the situation before and 6 weeks after the total hip replacement surgery. The majority of patients were of the opinion that it was more important that the pain had disappeared or decreased, than any overall increase in the quality of life. Postoperative complications occurred within 6 weeks, and even after 6 months some patients still suffered from these.

  • 21.
    Kullén Engström, Agneta
    et al.
    Nordic School of Public Health, Göteborg, Sweden.
    Rosengren, Kristina
    Nordic School of Public Health, Göteborg, Sweden.
    Hallberg, Lillemor
    Nordic School of Public Health, Göteborg, Sweden.
    Balancing involvement: employees' expereinces of merging hospitals in Sweden2002In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 38, no 1, p. 11-18Article in journal (Refereed)
  • 22.
    Kvarnström, Susanne
    et al.
    Hälsouniversitetet, avd för socialmedicin och folkhälsovetenskap.
    Cedersund, Elisabet
    Jönköping University, School of Health Science, HHJ, Dep. of Behavioural Science and Social Work.
    Discursive Patterns in multiprofessional healthcare teams2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 53, no 2, p. 244-252Article in journal (Refereed)
    Abstract [en]

    Background. In recent decades there has been an increasing demand in Western countries to change care organisations and to coordinate resources and professional competencies to better meet the needs of the patient/service user. Since society promotes this kind of work, it may be valuable to explore the self-presentations of a multi-professional health care team.

    Aim. The aim of this paper is to report a study conducted to explore how members of multi-professional health care teams talk about their team. Specifically, the team members' talk was analysed to explore the discursive patterns that emerged and their functions.

    Methods. A discourse analysis was carried out on existing empirical data from focus group interviews with a member-identified category sample comprising 32 health care professionals in six authentic multi-professional teams in south-east Sweden. The analysis focused on the participants’ discursive constructions of multi-professional teamwork, on the way they talked about their group, and, in particular, on their use of the pronouns we, they and I.

    Findings. The constructions of we by multi-professional health care teams showed discursive patterns that are here referred to as knowledge synergy and trusting support, which included factors such as cross-learning and personal chemistry. The pronoun we was also used as a flexible resource to manage expertise, power and leadership within the teams, and it might also function to ease the pressure for consensus.

    Conclusions. The mentioned discursive patterns provide powerful rhetorical resources for the team members, both to affirm their choice of membership and to claim superiority in relations with the surrounding community (“the others”) by linking to a societal discourse that promotes collaboration.

  • 23.
    Larsson, Ingrid
    et al.
    Jönköping University, School of Health and Welfare.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Arvidsson, Barbro
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Teleman, Anncia
    Spenshult Hospital for Rheumatic diseases, Spenshult Hospital, Oskarström, Sweden.
    Bergman, Stefan
    Research and Development Centre, Spenshult Hospital, Oskarström, Sweden.
    Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 1, p. 164-175Article in journal (Refereed)
    Abstract [en]

    Aim

    To compare and evaluate the treatment outcomes of a nurse-led rheumatology clinic and a rheumatologist-led clinic in patients with low disease activity or in remission who are undergoing biological therapy.

    Background

    Patients with chronic inflammatory arthritis treated with biological therapy are usually monitored by rheumatologists. Nurse-led rheumatology clinics have been proposed in patients with low disease activity or in remission.

    Design

    Randomized controlled trial.

    Methods

    A 12-month follow-up trial was conducted between October 2009 and August 2011, where 107 patients were randomized into two groups with a 6-month follow-up to a nurse-led rheumatology clinic based on person-centred care (intervention group; = 53) or to a rheumatologist-led clinic (control group; = 54). The hypothesis was that the nurse-led clinic outcomes would not be inferior to those obtained from a rheumatologist-led clinic at the 12-month follow-up. The primary outcome was disease activity measured by Disease Activity Score 28.

    Results

    A total of 47 patients in the intervention group and 50 in the control group completed the 12-month trial. The trial revealed no statistically significant differences between groups in mean change of Disease Activity Score 28, Visual Analogue Scales for pain, the Health Assessment Questionnaire, satisfaction with or confidence in obtaining rheumatology care.

    Conclusion

    Patients with stable chronic inflammatory arthritis undergoing biological therapy could be monitored by a nurse-led rheumatology clinic without difference in outcome as measured by the Disease Activity Score 28.

  • 24.
    Lundh, Ulla
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Sandberg, Jonas
    Nolan, Mike
    ‘I don’t have any other choice’: Spouses’ experiences of placing a partner in accommodation for older people in Sweden2000In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 32, no 5, p. 1178-1186Article in journal (Refereed)
    Abstract [en]

    The main aim of this paper is to consider the experiences of Swedish spouses who have placed a partner in a care home for older people. Data were gathered from semi-structural interviews with 14 spouses (11 wives and 3 husbands) who had been involved in a care home placement within the previous 6 months. The results reported here are from the first component of a larger grounded theory study, the aim of which is to explore, describe and understand the experience of care home placement from a variety of perspectives and to identify the implications for policy and practice in Sweden. The focus here is on the experience of spouses, relating to the decision-making process, the move into care and subsequent contact with the care home. Four themes emerged from the data – making the decision, making the move, adjusting to the move and reorientation. The results show a lack of planning for the elder person’s entry to a care home, and professional dominance of this stage of the process. The largely ambivalent emotional responses to the move that spouses experience and the difficulties in initiating and sustaining relationships with staff in the home are discussed in the light of previous research.

  • 25.
    Munck, Berit
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Next-of-kin caregivers in palliative home care: from control to loss of control2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 64, no 6, p. 578-586Article in journal (Refereed)
    Abstract [en]

    AIM: This paper is a report of a study to describe situations influencing next-of-kin caregivers' ability to manage palliative care in the home.

    BACKGROUND: Palliative home care often involves major resources from next-of-kin, municipal and county personnel. Next-of-kin caregivers' situation is depicted as so demanding and exhausting that it can affect their mental health and limit their ability to continue as a caregiver.

    METHODS: A qualitative study using the Critical Incident Technique was conducted. Nine next-of-kin caregivers from palliative home care were strategically chosen and data were collected using audiotaped interviews in 2005.

    FINDINGS: The analysis resulted in two main areas: 'Maintaining control' and 'Losing control'. Next-of-kin caregivers wanted to maintain control over their lives by being continuously available 24 hours a day and by supporting and taking complete responsibility for all of the patient's needs. They lost this control when professional assistance was lacking and they described feelings of inadequacy when their physical energy or time was insufficient. They felt incapable as the patient's physical or mental persona metamorphosed or as serious symptoms developed that they could not control.

    CONCLUSION: Next-of-kin caregivers and the patients must feel free to choose where palliative home care will be provided and that their choice at any time can be re-evaluated, due to insecurity or workload changes. When planning for palliative care, they should be informed that having only one caregiver reduces the chances of completing palliative care in the home.

  • 26.
    Mårtensson, Jan
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Karlsson, Jan-Erik
    Fridlund, Bengt
    Högskolan i Halmstad.
    Female patients with congestive heart failure: how they conceive their life situation.1998In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 28, no 6, p. 1216-1224Article in journal (Refereed)
  • 27.
    Mårtensson, Jan
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Karlsson, Jan-Erik
    Fridlund, Bengt
    Högskolan i Halmstad.
    Male patients with congestive heart failure and their conception of the life situation.1997In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 25, no 3, p. 579-586Article in journal (Other academic)
  • 28.
    Nilsson, Stefan
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Hallqvist, Carina
    CITIZYS Research Group, Department of Information Technology and Media, Mid Sweden University, Sundsvall.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Children's experiences of procedural pain management in conjunction with trauma wound dressings2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 7, p. 1449-1457Article in journal (Refereed)
    Abstract [en]

    Aim.  This paper is a report of the experiences of children (5–10 years) of procedural pain when they underwent a trauma wound care session.

    Background.  Procedural pain in conjunction with trauma wound care often induces anxiety and distress in children. Children need to alleviate pain and avoid the development of fear in conjunction with examinations and treatments. The nurse could help children to reach this goal by using the comfort theory, which describes holistic nursing in four contexts: physical, psychospiritual, environmental and sociocultural. Few studies have focused on children’s experiences of comforting activities in conjunction with trauma wound dressings.

    Methods.  This study was conducted between May 2008 and January 2010. Thirty-nine participants aged 5–10 were consecutively included in this study. The wound care session was standardized for all the participants, and semi-structured qualitative interviews with open-ended questions were conducted with all the children in conjunction with the procedure. All the interviews were transcribed verbatim and analysed with qualitative content analysis.

    Findings.  Four themes were identified: clinical competence, distraction, participation and security. The children were helped to reach comforting activities to enhance pain management.

    Conclusion.  Children require more than just analgesics in wound care. They also need to experience security and participation in this context. When children feel clinical competence in wound care, they trust the nurse to carry out the wound dressing and instead can focus on the distraction that increases their positive outcomes.

  • 29. Nordgren, S
    et al.
    Fridlund, Bengt
    Högskolan i Halmstad.
    Patients' perceptions of self-determination as expressed in the context of care2001In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 35, no 1, p. 117-125Article in journal (Refereed)
  • 30. Nätterlund, Birgitta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Experience of social support in rehabilitation: a phenomenological study.1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, no 6, p. 1332-1340Article in journal (Refereed)
    Abstract [en]

    The progressive muscular weakness brought on by muscular dystrophy causes the sufferer many problems in everyday life. Earlier studies in Sweden have shown that adults with hereditary muscular dystrophy often have difficulty in gaining access to rehabilitation. For this reason a special rehabilitation programme was drawn up and carried out, extending over a period of 18 months. The purpose of the study is to describe the participants' experience of social support in connection with the programme. Thirty-seven participants (21 women and 16 men) were interviewed. The analytical method was phenomenological, incorporating validation by independent judges. Nine overall themes emerged from the interviews: psychosocial support, meeting other people with muscular dystrophy, knowledge and learning, adjustment in daily life, coping with illness-related problems, adjustment at work, management of physical disability, medical examination and treatment, and involvement of relatives. The results indicate that the participants encountered staff with a sense of commitment and felt themselves to be 'seen and confirmed'. From the discussions and the contact with others in the same situation there arises a sense of affinity and a better understanding of one's own situation. There was appreciation of the education about the disease, its hereditary aspect, technical aids, grants and physical training. Hardly any of the participants spoke of knowing such things before. In conclusion there was approval of the received support, and recognition that persons with muscular dystrophy should be given access to recurrent rehabilitation.

  • 31. Oléni, M
    et al.
    Johansson, P
    Fridlund, Bengt
    Högskolan i Halmstad.
    Nursing care at night: an evalutation using the Night Nursing Care Instrument2004In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 47, no 1, p. 25-32Article in journal (Refereed)
  • 32.
    Oterhals, Kjersti
    et al.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Fridlund, Bengt
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Nordrehaug, Jan-Erik
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Haaverstad, Rune
    Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Norekvål, Tone M.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Adapting to living with a mechanical aortic heart valve: a phenomenographic study2013In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 69, no 9, p. 2088-2098Article in journal (Refereed)
    Abstract [en]

    Aim

    To describe how patients adapt to living with a mechanical aortic heart valve.

    Background

    Aortic valve replacement with a mechanical prosthesis is preferred for patients with life expectancy of more than 10 years as they are more durable than bioprosthetic valves. Mechanical valves have some disadvantages, such as higher risk of thrombosis and embolism, increased risk of bleeding related to lifelong oral anticoagulation treatment and noise from the valve.

    Design

    An explorative design with a phenomenographic approach was employed.

    Methods

    An explorative design with a phenomenographic approach was applied. Interviews were conducted over 4 months during 2010–2011 with 20 strategically sampled patients, aged 24–74 years having undergone aortic valve replacement with mechanical prosthesis during the last 10 years.

    Findings

    Patients adapted to living with a mechanical aortic heart valve in four ways: ‘The competent patient’ wanted to stay in control of his/her life. ‘The adjusted patient’ considered the implications of having a mechanical aortic valve as part of his/her daily life. ‘The unaware patient’ was not aware of warfarin–diet–medication interactions. ‘The worried patient’ was bothered with the oral anticoagulation and annoyed by the sound of the valve. Patients moved between the different ways of adapting.

    Conclusions

    The oral anticoagulation therapy was considered the most troublesome consequence, but also the sound of the valve was difficult to accept. Patient counselling and adequate follow-up can make patients with mechanical aortic heart valves more confident and competent to manage their own health. We recommend that patients should participate in a rehabilitation programme following cardiac surgery.

  • 33. Persson, Eva K
    et al.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Kvist, Linda J
    Dykes, Anna-Karin
    Mothers' sense of security in the first postnatal week: interview study2010In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 1, p. 105-116Article in journal (Refereed)
  • 34.
    Persson, Kerstin
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Svensson, PG
    Ek, AC
    Breast self-examination: an analysis of self-reported practice.1997In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 25, no 5, p. 886-892Article in journal (Refereed)
  • 35.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Meal procedures in institutions for elderly people: a theoretical interpretation.1999In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 30, no 2, p. 319-328Article in journal (Refereed)
  • 36.
    Sidenvall, Birgitta
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Ek, AC
    Long-term care patients and their dietary intake related to eating ability and nutritional needs: nursing staff interventions1993In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 18, no 4, p. 565-573Article in journal (Refereed)
  • 37.
    Sidenvall, Birgitta
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Fjellström, C
    Ek, AC
    The meal situation in geriatric care: intentions and experiences1994In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 20, no 4, p. 613-621Article in journal (Refereed)
  • 38.
    Wallin, Anne-Marie
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Cross-cultural interview studies using interpreters: systematic literature review.2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 55, no 6, p. 723-735Article in journal (Refereed)
    Abstract [en]

    AIM: This paper reviews how the interpreter's role is described in empirically based, qualitative cross-cultural interview studies and how trustworthiness is determined. BACKGROUND: Increased immigration during the past decades has created a multiethnic society in many countries. This development poses a challenge to healthcare staff, in that they need to understand how people from different cultures experience health and illness. One way to assess immigrants' experiences is through cross-cultural interview studies, involving an interpreter. Thorough knowledge of the interpreter's role is needed in order to increase the trustworthiness of this kind of nursing research. METHOD: Literature searches were conducted from October to November 2004 using PubMed, CINAHL, Psycinfo, Sociological abstract, Your Journals@ovid, and Eric databases. Qualitative interview studies written in English and performed with an interpreter were included. The Matrix Method was used to review the literature. FINDINGS: In almost all of the 13 relevant papers found, the role of the interpreter(s) in the research process was only sparsely described. In addition, all studies except one employed different techniques to established trustworthiness. The most common techniques were prolonged engagement, member check or triangulation, the latter performed either on the data, investigators or methods. CONCLUSION: Methodological issues with respect to interpreters have received only limited attention in cross-cultural interview studies. Researchers in the field of nursing need to consider (1) the interpreter's role/involvement in the research process; (2) the interpreter's competence and the style of interpreting; (3) the interpreter's impact on the findings. This information is a prerequisite when trying to determine the trustworthiness of a cross-cultural study.

  • 39. Wenneberg, Stig
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Illness narratives of persons with post-polio syndrome.2000In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 31, no 2, p. 354-361Article in journal (Refereed)
    Abstract [en]

    This qualitative study investigated the lifetime illness experience of individuals with the 'late effects' of polio or post-polio syndrome. Fifteen individuals were interviewed twice about their illness experience and the interviews were transcribed verbatim. The empirical material first underwent a categorization process. The preliminary categories generated through this analysis were then condensed into broader categories which in the final analysis gave rise to the following temporal pattern or stages of the illness experience: (1) the acute phase of polio and subsequent treatment and care; (2) rehabilitation and care at institutions for the disabled; (3) adaptation to a new life; (4) living with the post-polio syndrome today, and finally, (5) memories of the past and apprehensions concerning the future. In spite of the difficult experiences of falling ill and slowly recovering from a life-threatening disease, these individuals have had a good life and accomplished most of their ambitions in the areas of work and family life. Their present psychosocial situation is complicated by the symptoms of the post-polio syndrome which make them more vulnerable to stress, but they are able to handle this burden except when any added strain makes it overwhelming. This potential vulnerability may sometimes express itself as a sudden flashback to traumatic polio experiences and it is therefore important that nurses are aware of the illness history of this patient group.

  • 40. Widar, Marita
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Experiences and consequences of pain in persons with post-polio syndrome.1998In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 28, no 3, p. 606-613Article in journal (Refereed)
    Abstract [en]

    This study describes the meaning of pain and its implications for everyday life in 35 persons with symptoms of post-polio syndrome. The mean age of the study group is 65 years and the sex ratio of men to women is 1.5:1. The study persons were interviewed on two occasions in their homes and answered a pain questionnaire. The result shows that everyday vocabulary is used to express pain experiences. The study persons normally answered that it hurt, although the interviewers used pain in their questions. The results show that the lower back is the most common location of pain. Joint pains are most common in the upper extremities. The pain is worst in the evening and at night, and tangibly affects the daily rhythm. Physical strain and climatic factors commonly provoke pain, whereas rest and heat give relief. The study show that interviews and pain questionnaire should be supplemented with questions on activities so as to gain a comprehensive view of the difficulties experienced in everyday life.

  • 41.
    Widäng, Ingrid
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Self-respect, dignity and confidence: Conceptions of integrity among male patients2003In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 42, no 1, p. 47-56Article in journal (Refereed)
    Abstract [en]

    A mapping of fatigue crack growth rates in thick plates of a high strength aluminium alloy has been done. The plate thicknesses investigated was 100, 150 and 200 mm. In this work, material from near edge at near surface and mid-thickness has been investigated.

    Measurements of crack length has been performed using DC potential drop. Cyclic condensation is used in order to reveal crack growth behaviour for stage I and the earlier part of stage II crack growth.

    Influence of crack closure, crack branching and slow growing side cracks on fatigue crack growth rate of S-L and L-T oriented specimens are discussed. Variation of difference in growth rate in the upper part of the stage II growth between near surface and mid thickness positioned L-T specimens are found to vary with plate thickness.

  • 42.
    Widäng, Ingrid
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Mårtensson, Jan
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Women patients' conceptions of integrity within health care: a phenomenographic study2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 61, no 5, p. 540-548Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe how female patients conceive integrity within health care. A phenomenographic approach was chosen to focus on women’s conceptions. The participants were 15 strategically-chosen female patients who were interviewed after discharge from a hospital in Sweden. Three description categories were identified: ‘maintaining the self’, which represented the patient’s relationship to herself; ‘dignity’, which characterized the professional caregivers’ relationship to the patient; and ‘confidence’, which was associated with the relationship between patient and professional caregivers. Integrity implied having courage to set boundaries and have control of the private sphere, but also if necessary changing the boundaries of integrity. It is essential that professional caregivers are knowledgeable about all aspects of integrity and the importance of interactions with patients being characterized by dignity and confidentiality. Professional caregivers should take part in reflective discussions to identify situations in health care with an inherent risk of threatening or violating patients’ integrity, and how best to preserve it. Integrity is an abstract and complex concept that is not well-defined, and further research is needed to clarify its connection with other concepts.

  • 43.
    Williamsson, Anna
    et al.
    Department of Biomedical Engineering and Health Systems, KTH - Royal Institute of Technology, Stockholm, Sweden.
    Dellve, Lotta
    Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.
    Karltun, Anette
    Jönköping University, School of Engineering, JTH, Supply Chain and Operations Management.
    Nurses' use of visual management in hospitals: A longitudinal, quantitative study on its implications on systems performance and working conditions2018In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to examine potential benefits provided by daily visual management tool use and explore its association with systems performance and working conditions among hospital nurses.

    BACKGROUND: Visual management tools used in everyday work and improvement work in health care theoretically contribute to shared understanding of complex work systems and provide certain user benefits. Cognitive load, miscommunication within and between professional groups, and pressure to engage in care process redesign add to nurses' strained working conditions.

    DESIGN: Quantitative longitudinal.

    METHODS: Questionnaires were distributed at T0, (N = 948, 66% response rate), T1 (N = 900, 70% response rate), and T2 (N = 621, 72% response rate) to nurses at five hospitals. Three groups of users (daily users, start users, and non-daily users) were compared by means T1-T2 (significance tested with Wilcoxon signed rank test) and by mixed model repeated measures T0, T1, T2.

    RESULTS: Daily use associated to better overview of work, collaboration, social capital, and clinical engagement. Job resources were rated higher by daily users. Mental stress increased and development opportunities decreased over time among non-daily users. There were associations between use and perceptions of systems performance, though the differences between groups were small.

    CONCLUSION: This study specifically explores visual management tool use in the hospital setting, which contributes to research by broadening the understanding of cognitive, social, and emotional benefits provided by visual management tool use. Daily use was associated to positive working conditions, small but positive differences in systems performance, and indicated a buffering effect on nurses' mental stress.

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