Endre søk
Begrens søket
2345678 201 - 250 of 4731
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Treff pr side
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
  • Standard (Relevans)
  • Forfatter A-Ø
  • Forfatter Ø-A
  • Tittel A-Ø
  • Tittel Ø-A
  • Type publikasjon A-Ø
  • Type publikasjon Ø-A
  • Eldste først
  • Nyeste først
  • Skapad (Eldste først)
  • Skapad (Nyeste først)
  • Senast uppdaterad (Eldste først)
  • Senast uppdaterad (Nyeste først)
  • Disputationsdatum (tidligste først)
  • Disputationsdatum (siste først)
Merk
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 201.
    Almborg, Ann-Helene
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Perceived Participation in Discharge Planning and Health Related Quality of Life after Stroke2008Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    The overall aim of this thesis was to investigate the patients’ and their relatives’ perceived participation in discharge planning after stroke and the patients’ health-related quality of life, depressive symptoms, performance of personal daily activities and social activities in connection with discharge. Another aim was to evaluate the psychometric assumptions of the SF-36 for Swedish stroke patients.

    Prospective, descriptive and cross-sectional designs were used to study all patients with stroke admitted to the stroke unit at a hospital in southern Sweden from October 1, 2003 to November 30, 2005 each with one close relative. The total sample consisted of 188 patients (mean age=74.0 years) and 152 relatives (mean age=60.1 years). Data were collected during interviews, 2-3 weeks after discharge.

    The results showed that less depressive symptoms, more outdoor activities and performance of interests are important variables that related to higher HRQoL. SF-36 functions well as a measure of health related quality of life in Swedish stroke patients, but the two summary scales have shortcomings. Compared to a Swedish normal population, scores on all scales/components of the SF-36 were lower among stroke patients especially in the middle-aged group. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal setting. The relatives perceived that they need more information and they perceived low participation in goal setting and needs assessment. The professionals seem to lack effective practices for involving patients and their relatives to perceive participation in discharge planning. It is essential to develop and to implement methods for discharge planning, including sharing information, needs assessment with goal setting that facilitate patients’ and relatives’ perceived participation. The results suggest that ICF can be used in goal setting and needs assessment in discharge planning after acute stroke.

  • 202.
    Almborg, Ann-Helene
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Ulander, Kerstin
    Thulin, Anders
    Berg, Stig
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Discharged after stroke - important factors for health-related quality of life.2010Inngår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, nr 15-16, s. 2196-2206Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIMS: This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke.

    BACKGROUND: HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge.

    DESIGN: Cross-sectional study.

    METHODS: The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL.

    RESULTS: Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL.

    CONCLUSIONS: Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests.

    RELEVANCE TO CLINICAL PRACTICE: These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.

  • 203.
    Almborg, Ann-Helene
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Natl Board Hlth & Welf, Nord Ctr Classificat Hlth, S-16030 Stockholm, Sweden.
    Welmer, Anna-Karin
    ARC, Karolinska Inst, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden.
    Use of the International Classification of Functioning, Disability and Health (ICF) in social services for elderly in Sweden2012Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, nr 11, s. 959-964Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: To examine the content of health information in acts of social services of elderly people in relation to the International Classification of Functioning, Disability and Health (ICF) and to describe the health information in the different parts of the acts according to the ICF. Method: Health information of 25 acts from four municipalities was analysed and the concepts were linked to ICF codes, using the established coding rules. Results: The health information consisted of 372 concepts, which were linked to 122 specific ICF codes. The concepts in the acts were mostly linked to the ICF component Activities and Participation, except for the current functioning concepts where the ICF component Body functions was the most frequent. The 3rd level was most frequent in Activities and Participation and in Environmental factors, and the 2nd level was most frequent in Body functions. Conclusions: The ICF covers the concepts and terms contained in the acts to a large extent. Furthermore, the results show that the ICF codes differ in the different parts of the acts. The ICF provides a coherent and structured documentation, which contributes to a legally secure assessment of assistance. The selection of ICF codes can be used in development of "code sets" for social services for elderly.

  • 204. Almerud, S
    et al.
    Alapack, RJ
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Ekebergh, M
    Caught in an artificial split: a phenomenological study of being a caregiver in the technologically intense environment.2008Inngår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, nr 2, s. 130-136Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle 'moments' of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs

  • 205. Almerud, S
    et al.
    Alapack, RJ
    Fridlund, Bengt
    Växjö universitet.
    Ekebergh, M
    Of vigilance and invisibility: beeing a patient in technologically intense environments2007Inngår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 12, nr 3, s. 151-158Artikkel i tidsskrift (Fagfellevurdert)
  • 206. Almerud, S
    et al.
    Baigi, A
    Hildingh, C
    Jogre, J
    Lyrström, L
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Acute coronary syndrome: social support and coping ability on admittance.2008Inngår i: British Journal of Nursing, ISSN 0966-0461, Vol. 17, nr 8, s. 527-531Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To compare social support and coping ability in acute coronary syndrome patients at the time of the cardiac event with a healthy community-based sample, with regard to age, sex, education and marital status. Method: The study comprised 241 patients and 316 healthy controls. The participants answered a self-administered questionnaire that included three well-established scales. Multiple logistic regression was used in the analysis to compare the health situation between the patients and controls. Results: Persons suffering from acute coronary syndrome rated emotional support significantly lower than the healthy controls. However, there were no differences between the two groups in terms of socio-demographic variables. Conclusion: This study indicates that social support may be a predictor of acute coronary syndrome.

  • 207. Almerud, Sofia
    et al.
    Alapack, Richard J
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Ekebergh, Margaretha
    Beleaguered by technology: care in technologically intense environments.2008Inngår i: Nursing Philosophy, ISSN 1466-7681, E-ISSN 1466-769X, Vol. 9, nr 1, s. 55-61Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients' lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.

  • 208. Almerud Österberg, S
    et al.
    Baigi, A
    Bering, C
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Knowledge of heart disease risk in patients declining rehabilitation2010Inngår i: British Journal of Nursing, Vol. 19, nr 5, s. 288-293Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background:

    Participation in cardiac rehabilitation programmes (CRPs) allows patients to increase their knowledge of the importance of established risk factors to help them maintain healthy lifestyle changes after coronary heart disease (CHD).

    Aim: To explore perceived importance and knowledge of known risk factors for CHD among non-attendees in CRPs.

    Method: Consecutive non-attendees in CRPs (n=106) answered a questionnaire focusing on patients' attitudes towards risk factors and cardiac rehabilitation.

    Results: The non-attendees lacked knowledge of non-physical characteristics such as depression and social isolation. They also had poor knowledge about biological causes and hereditary factors. However, those who said they knew enough about CHD to prevent recurrent illness did have sufficient knowledge about the established risk factors.

    Conclusion: There is a lack of knowledge about social isolation and depression and their importance in the development of CHD among the non-attendees. They show greater knowledge about biological risk factors than the importance of companionship, joy and happiness. CHD and loneliness are intimately correlated, so creating a sense of belonging must not be underestimated as a measure to prevent CHD.

  • 209.
    Almgren, Malin
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Olsson, Jenny
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Aktivitetsbalans hos gymnasieungdomar2017Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Ungdomar spenderar stor del av sin tid i skolan och upplever en minskad tid till fritid på grund av skolarbete. Tiden utanför skoltid är viktig för återhämtning och för att upprätthålla aktivitetsbalansen samt motverka stressrelaterad ohälsa. Syftet med studien är att beskriva aktivitetsbalans i relation till den tid eleven spenderar på skolarbete utanför skoltid och stress. Studien har en kvantitativ design, 46 deltagare rekryterades genom ett icke-slumpmässigt bekvämlighetsurval. Deltagarna besvarade påståenden kring aktivitetsbalans med Occupational Balance Questionnaire (OBQ) och kompletterande frågor om tid spenderad på skolarbete utanför skoltid och stress. Deskriptiv statistik, Spearman´s rank correlation och Mann-Whitney U-Test användes för att sammanställa data. Resultatet visar att deltagargruppen uppnår generellt låga totalpoäng i OBQ. Kvinnor skattar betydligt lägre aktivitetsbalans än män. Generellt anger hela deltagargruppen många studietimmar/vecka, och kvinnor anger fler studietimmar/veckan än män. Majoriteten av deltagarna upplever stress. Deltagare som inte upplever stress anger alla höga poäng på påståendet balans mellan vila, återhämtning och sömn. Slutsatsen för studien är att flertalet av deltagarna upplever låg aktivitetsbalans. Det är inte troligt att det finns en relation mellan skolarbete utanför skoltid och ungdomars aktivitetsbalans. 

  • 210.
    Almqvist, Lena
    et al.
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD. Mälardalens högskola.
    Sjöman, Madeleine
    Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Golsäter, Marie
    Högskolan i Jönköping, Hälsohögskolan.
    Granlund, Mats
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Högskolan i Jönköping, Högskolan för lärande och kommunikation, HLK, CHILD.
    Children’s behavior difficulties and staff-implemented special support in Swedish preschools: Emotional and behavioral difficultiesManuskript (preprint) (Annet vitenskapelig)
  • 211. Alm-Roijer, C
    et al.
    Fridlund, Bengt
    Växjö universitet.
    Stagmo, M
    Erhardt, L
    Knowing your risk factors for coronary heart disease improves adherence to advice on lifestyle changes and medication2006Inngår i: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 21, nr 5, s. E24-E31Artikkel i tidsskrift (Fagfellevurdert)
  • 212. Alm-Roijer, C
    et al.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Stagmo, M
    Erhardt, L
    Pivotal factors for successful implementation of secondary prevention actions in patients with coronary heart diseaseInngår i: AAMA. E-pubArtikkel i tidsskrift (Fagfellevurdert)
  • 213.
    Alnervik, Anitha
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Linddahl, Iréne
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Sätt värde på arbetsterapi: En studiecirkel i evidensbasering av arbetsterapi2006Annet (Annet vitenskapelig)
  • 214.
    Alnervik, Anitha
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Linddahl, Iréne
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Value of occupational therapy - about evidence-based occupational therapy2011Annet (Annet vitenskapelig)
  • 215.
    Alrawi, Sura
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Biomedicinsk plattform.
    Younan, Manar
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Biomedicinsk plattform.
    High Molecular Weight (HMW) snabbtypning av Clostridium difficile med MALDI-TOF MS: Genom två metoder direkt och proteinextraktion2016Independent thesis Basic level (university diploma), 10 poäng / 15 hpOppgave
  • 216.
    Altevid, Karin
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Ljung, Sabine
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Upplevelsen av att vara närstående till person med långvarig smärta.2013Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Upplevelsen av att vara närstående till en person som lever med långvarig smärta är vanlig då det berör ca 20 % av Sveriges befolkning. Eftersom familjen kan ses som en helhet kan detta innebära både sociala och psykologiska konsekvenser även hos de närstående som då löper ökad risk att drabbas av ohälsa. Syfte: Att beskriva upplevelsen av att vara närstående till en person som lever med långvarig smärta. Metod: Litteraturöversikt sammanställd av kvalitativa artiklar och analyserad enligt Friberg. Resultat: Vardagen för de närstående förändras och begränsas genom att de känner att de måste anpassa sig, det sociala nätverket minskar, rollerna och relationerna förändras. Närstående upplever stora känslomässiga bördor såsom psykiskt illabefinnande, de känner sig misstrodda, känner oro för framtiden och brist på information och kunskap gör att de känner sig åsidosatta.

    Slutsats: Närstående till en person som lever med långvarig smärta påverkas starkt men på andra sätt än den direkt smärtdrabbade. Det är av vikt att sjuksköterskan uppmärksammar de närstående och deras situation för att förebygga ohälsa.

  • 217.
    Altonchi, Iasmine
    et al.
    Högskolan i Jönköping, Hälsohögskolan.
    Ahmad, Sara
    Högskolan i Jönköping, Hälsohögskolan.
    Att leva med diabetes mellitus typ II2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Diabetes mellitus typ II (DMT2) är en kronisk sjukdom som ökar i antal både i Sverige och runtom i världen. Att få diagnosen DMT2 innebär att personen får ett ansvar för egenvård och att utföra livsstilsförändringar. Om personen inte följer sin behandling och ändrar sin livsstil kan det medföra flertals komplikationer så som hjärt- och kärlproblematik.Syfte: Var att beskriva personers upplevelse av att leva med DMT2.Metod: Litteraturöversikt med 14 artiklar med kvalitativ ansats.Resultat: Resultatet har huvudkategorierna psykisk, fysisk och social påverkan i vardagslivet samt synen på livsstilsförändringar med respektive underkategorier. Personer som lever med DMT2 upplevde blandade känslor och blev olika påverkade. Att ha DMT2 krävde livsstilsförändringar som kunde ses som en möjlighet eller svårighet. Personer beskrev vikten av stöd och vad sjuksköterskans roll innebär för hanterbarheten av sjukdomen.Slutsats: Litteraturöversikten bidrog med förståelse och kunskap om hur personer som lever med DMT2 upplever sitt liv och sjukdomen. Kunskapen från litteraturöversikten gav även en förståelse för varför personer inte följer deras rekommendationer, deras behov av omvårdnad och stöd.

  • 218.
    Altoumaimi, Ahmed
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Isvatten för en bättre bildkvalité vid myokardscintigrafi2015Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Myokardscintigrafi är en nuklearmedicinsk undersökning där hjärtat bedöms utifrån perfusionen i hjärtmuskeln, främst i vänsterkammaren. Detta görs för att diagnosticera patienter med misstanke om kärlkramp eller inför ett kirurgiskt ingrepp såsom ballongdilatation. Ibland kan det uppstå högt tarmupptag som gör att det bli svårt att utvärdera bilderna på hjärtat.

     

    Flera metoder har används tidigare för att minska tarmupptaget såsom dricka mjölk eller äta en stor måltid innan bildtagningen. Syftet med denna randomiserade studie är att se om det kan bli mindre upptag i tarmarna och en bra effekt på bildkvalité om patienten dricker ett glas isvatten precis innan stress bildtagningen.  39 randomiserade patienter ingick totalt i studien som delades i två kvoter, med och utan isvatten. Datainsamling gick ut på att räkna antal pulser på tre ställen på stressbilder med hjälp av ROI. ROI 1 som återspeglade hjärtat jämfördes med ROI 2 samt ROI 3 som är bakgrundsaktivitet för att se hur bakgrundsaktivitet förhåller sig till hjärtat. Resultaten som gjordes genom att jämföra kvot 1 utan isvatten och kvot 2 med isvatten talar om att isvatten hade bättre verkan på ROI2 (lateralt under hjärtat) än ROI3(medialt under hjärtat) där metoden utan isvatten visade sig bättre.

  • 219.
    Ameryoun, Ahmad
    et al.
    Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
    Pakpour, Amir H.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Qazvin University of Medical Sciences, Qazvin, Iran.
    Nikoobakht, Mehdi
    Department of Neurosurgery, Iran University of Medical Sciences, Tehran, Iran.
    Saffari, Mohsen
    Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
    Yaseri, Mahdi
    Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
    O'Garo, Keisha-Gaye N.
    Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
    Koenig, Harold G.
    Duke University Medical Center, Durham, North Carolina.
    Effectiveness of an In-Service Education Program to Improve Patient Safety Directed at Surgical Residents: A Randomized Controlled Trial2019Inngår i: Journal of Surgical Education, ISSN 1931-7204, E-ISSN 1878-7452, Vol. 76, nr 5, s. 1309-1318Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Patient safety is a critical issue in healthcare services particularly in surgical units and operation rooms because of the high prevalence and risk of medical errors in such settings. This study was conducted to determine whether a 1-day educational intervention can change the attitude and behavior of surgical residents regarding patient safety.

    Methods: A total of 90 surgical residents were recruited from 6 university hospitals located in Tehran and Qazvin, Iran, and were randomized to either the intervention or a control group. Those in the intervention group participated in a 1-day workshop on patient safety, whereas the control group received no intervention. Both groups were followed for 3 months after the intervention was completed. The Safety Attitude Questionnaire and Oxford Non-Technical Skills scale were administered at 3 points in time (baseline, 1 month after the intervention, and 3 month later). The data were analyzed using repeated measures analysis of variance.

    Results: Total score on the Safety Attitude Questionnaire improved from 54.5 (SD = 14.4) at baseline to 58.3 (SD = 13.8) 3 months after the intervention in the intervention group; all dimensions, with the exception of working condition, showed significant changes. In addition, the Oxford Non-Technical Skills scale – as assessed by attending surgeons – improved significantly in all domains (p < 0.05). More than 60% of participants in the intervention group scored in the positive range for items assessing safety and teamwork climate.

    Conclusions: A 1-day interactive educational workshop may be effective in changing the attitude and practice of surgical residents regarding patient safety. Further assessment of this intervention in other healthcare settings involving health professionals from various specialties and use of an objective measure such as number of reported medical errors are needed to corroborate these findings. 

  • 220.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Eide, L. S. P. E.
    Bergen University College, Institute of Nursing, Bergen, Norway.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Haaverstad, R. H.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Hufthammer, K. O. H.
    Haukeland University Hospital, Centre for Clinical research, Bergen, Norway.
    Kuiper, K. K. J. K.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Schjott, J. S.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Ranhoff, A. H. R.
    University of Bergen, Department of Clinical Science, Faculty of Medicine and Dentistry, Bergen, Norway.
    Norekval, T. M. N.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Factors affecting in-hospital sleep-wake pattern in octogenarians during the early postoperative phase after transcutaneous aortic valve replacement2017Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S53-S53Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Octogenarian patients are an increasing group admitted for advanced cardiac treatment. Little is known about factors disturbing their sleep-wake pattern in the early postoperative phase after transcutaneous aortic valve replacement (TAVI), as current knowledge is based upon studies on younger age groups treated for surgical aortic valve replacement.

    Aim: To determine factors affecting the in-hospital sleep wake pattern in octogenarian patients after TAVI.

    Methods: This is a prospective cohort study in a tertiary university hospital. Inclusion criteria were age > 80 years with severe aortic stenosis accepted for TAVI. Actigraphy was used to identify sleep-wake pattern (sleep time night and sleep time day), and the Minimal Insomnia Symptom Scale (MISS) to measure self-reported insomnia daily during the first five postoperative days. Charlson`s comorbidity index was used as a measure of comorbidities and the Visual Analog Scale (VAS) to rate pain severity. Information regarding duration of anesthesia, blood transfusion and parenteral administration of morphine equivalents were derived from the patients’ medical journals. Multiple regression analysis was used to test associations between variables.

    Results: In all, 65 patients (41 women) were included. Mean age was 85 years (SD 2.8). No significant associations were found between age, comorbidities, blood transfusion and morphine equivalents and sleep. Gender was significantly associated with sleep time night and sleep efficiency as men had shortest duration of sleep from the third to the fifth postoperative night (p < .001, and adjusted R2=.230 to .283). Duration of anesthesia had a significant association with sleep time night and sleep efficiency from the third to the fifth postoperative night (p=.013 to p < .001, and adjusted R2=.230 to .283), where longer duration gave less total sleep and lower sleep efficiency. VAS score correlated with wake time night the third night, where a higher VAS score gave more wake time (p=.006 and adjusted R2 .236).

    Conclusion: Male gender, longer duration of perioperative anesthesia and postoperative pain were associated with disturbances in the postoperative sleep-wake pattern in octogenarian patients in the early postoperative phase after TAVI. This knowledge is important and relevant and should have implications in improving patient care.

  • 221.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Eide, L. S. P. E.
    Bergen University College, Institute of Nursing, Faculty of Health and Social Science, Bergen, Norway.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Haaverstad, R. H.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Hufthammer, K. O. H.
    Haukeland University Hospital, Centre for Clinical research, Bergen, Norway.
    Kuiper, K. K. J. K.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Schjott, J. S.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Ranhoff, A. H. R.
    University of Bergen, Department of Clinical Science, Faculty of Medicine and Dentistry, Bergen, Norway.
    Norekval, T. M. N.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway .
    Factors associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after surgical aortic valve replacement2017Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, nr Suppl. 1, s. S63-S64Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Disturbances of the sleep-wake pattern are known phenomenon in the postoperative phase after aortic valve replacement (SAVR) that have negative impact on the morbidity, quality of life and mortality. Octogenarian patients are an increasing group admitted for cardiac surgery, however knowledge is based on younger patients.

    Aims: To determine factors associated with disturbances in postoperative sleep-wake pattern in octogenarian patients after SAVR.

    Methods: A prospective cohort study of octogenarian patients in a single center university hospital. Inclusion criteria were age > 80 years, severe aortic stenosis, accepted for SAVR. Actigraphy was used to identify the sleep-wake pattern (sleep-time, sleep efficiency and wake time night and sleep- and wake-time day) for the five first postoperative days, and the sleep questionnaires Minimal Insomnia Symptom scale (MISS) to measure the selfreported insomnia at baseline and daily for the five first postoperative days. 

    Charlsons comorbidity index was used to score comorbidities and the Visual Analog Scale (VAS), was used to rate pain severity. The patients’ medical journals were used to record duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusions and parenteral administration of morphine equivalents. Multiple regression analysis was used to test associations between variables.

    Results: In all, 78 patients were included (40 women). Mean age was 82 years (SD 2.0). For the sleep-wake pattern first to fifth postoperative night, mean sleep-time night was 330-370 minutes (SD 32-124). Mean sleep efficiency was 68-77% (SD 21-26). Mean sleep-time day was 545-712 minutes (SD 146-169). Mean insomnia score was 1,8-5,3 (SD 2,6-3,8). On the first postoperative night the pain VAS score correlated with wake time night, where a higher VAS indicated more wake time (p=.014, adjusted R2=.213). No other variable; age, gender, duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusion or morphine equivalents showed significant association with the sleep-wake pattern or insomnia.

    Conclusion: Postoperative pain was associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after SAVR. This indicates that pain management may be inadequate for patients after SAVR. More research on this issue is needed to establish data needed to improve treatment and care.

  • 222.
    Amofah, H. A.
    et al.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Haaverstad, R.
    Haukeland University Hospital, Thoracic surgical unit, Bergen, Norway.
    Instenes, I.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Kuiper, K. K. J.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Ranhoff, A. H.
    University of Bergen, Department of clinical science, faculty of medicine, Bergen, Norway.
    Schjott, J. D.
    Haukeland University Hospital, Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Bergen, Norway.
    Norekval, T. M.
    Haukeland University Hospital, Departement of Heart Disease, Bergen, Norway.
    Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy2018Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, s. 104-105Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Sleep disturbance and delirium are complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve replacement (TAVI), especially in octogenarian patients. Sedatives and z-hypnotics are medications distributed to promote sleep. However, a knowledge-gap exists on patient experiences with these medications, and sleep and delirium after the cardiac treatment.

    Aim: To explore and describe how octogenarians suffering from delirium after SAVR/TAVI experience their sleep situation related to sedatives and z-hypnotics, in a long-term perspective.

    Methods An explorative and descriptive design with a longitudinal qualitative approach was applied. Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium. Information about administration of sedatives and z-hypnotics was collected from the patients journals. The Confusion Assessment Method (CAM) was used to assess delirium, the Sleep Sufficient Index (SSI) and Minimal Insomnia Symptom Scale (MISS) were used to document self-reported sleep and insomnia. All measures were performed at baseline and daily the five first postoperative days. Ten patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were re-interviewed four years later, focusing on their sleep situation.

    Findings: For the initial interview, five men and five woman, four after TAVI and six after SAVR, mean age 83 were included. One overarching theme revealed; hours in bed represented an emotional chaos. Three sub-themes described the patients experiences with sleep and delirium, a cascade of distressful experiences, the struggle between sleep and activity and elements influencing sleep. In the category physical sleep distractions, sleep medications emerged as a sleep disturbing element but also to evoke delirium. Patients described to be offered sedatives and z-hypnotics in hospital. However, they did not have a positive experience with this as the medication did not make them sleep better. Moreover, they associated the nightmares by the sedatives Four years after the cardiac treatment, the octogenarian patients described that medication did not have a sleep promoting effect, and they did not want it.

    Conclusion: Octogenarian patients are vulnerable to complications like sleep disturbances and delirium. In preventing and treating these conditions, health-care professionals should be aware of the effect and side-effect of sedatives and z-hypnotics in the octogenarian patients. Our findings show that medications should be cautiously used within this group of patients.

  • 223.
    Amofah, Hege A.
    et al.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Broström, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Institute of Nursing, Faculty of Health and Social Science, Bergen University College, Norway.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Bjorvatn, Bjørn
    Norwegian Competence Centre for Sleep Disorders, Bergen, Norway.
    Haaverstad, Rune
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Hufthammer, Karl Ove
    Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
    Kuiper, Karel K. J.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Ranhoff, Anette H.
    Department of Clinical Science, University of Bergen, Norway.
    Norekvål, Tone M.
    Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.
    Sleep in octogenarians during the postoperative phase after transcatheter or surgical aortic valve replacement2016Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, nr 2, s. 168-177Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Octogenarians with aortic stenosis are an increasing population of patients admitted for surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI). Although adequate sleep is important after illness and surgery, it has scarcely been studied in the immediate postoperative phase.

    Aims: To determine and compare the nature of self-reported sleep and insomnia, and recorded sleep–wake patterns in octogenarians during the in-hospital postoperative phase after SAVR or TAVI.

    Methods: A prospective cohort design was used that included octogenarian patients undergoing SAVR or TAVI at a regional university hospital. Self-reports were used to document sleep and insomnia, and actigraphy was used to record sleep–wake patterns. Data were collected at baseline preoperatively, and then daily for the first five postoperative days.

    Results: SAVR patients experienced the most insomnia on postoperative nights later in recovery, while TAVI patients experienced the most insomnia on postoperative nights early in recovery. The median total sleep time, as measured by actigraphy, was 6.4 h, and the median sleep efficiency was 79% for the five postoperative nights, but no differences were found between SAVR and TAVI patients on this parameter. All patients slept more during daytime than at night, with SAVR patients having significantly more total sleep hours for all five days than TAVI patients (p < 0.01).

    Conclusion: Octogenarians with aortic stenosis had disturbed self-reported sleep, increased insomnia, and disturbed sleep–wake patterns postoperatively, resulting in more daytime sleep and inactivity. In patients undergoing SAVR or TAVI, sleep evolves differently during the in-hospital postoperative phase.

  • 224.
    Anarp, Sofia
    Högskolan i Jönköping, Hälsohögskolan.
    How Does a Swedish Nursing Student View Clinical Oncology Care in the United States?2019Inngår i: Clinical Journal of Oncology Nursing, ISSN 1092-1095, E-ISSN 1538-067X, Vol. 23, nr 2, s. 224-224Artikkel i tidsskrift (Annet vitenskapelig)
    Abstract [en]

    I have always been the type of person who wants to create the greatest good for the greatest number of people. This led me to an adventure that started in the fall of 2016 as I entered the Bachelor of Science in Nursing program at Hälsohögskolan (the School of Health Sciences) at Jönköping University in Sweden. A goal was set in the back of my mind that I wanted to study abroad in the United States and examine the similarities and differences between care provided in hospitals in the two different countries. For my independent study at the University of North Carolina (UNC) at Chapel Hill, I had the opportunity to take a deep dive into the area of nursing that interests me the most: adult oncology. Working closely with Ashley Leak Bryant, PhD, RN-BC, OCN®, my mentor in the UNC Chapel Hill School of Nursing, I was provided with several opportunities to learn about oncology nursing practice in the United States.

  • 225.
    Anarp, Sofia
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Strand, Anna
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Upplevelsen av hopp hos personer med lungcancer: - En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Bakgrund: Lungcancer är den cancerform med högst mortalitet. Att drabbas av lungcancer kan leda till att personen upplever olika känslor som rädsla, uppgivenhet och hopp vilket är viktigt för sjuksköterskor att ha kunskap och förståelse om. Sjuksköterskors uppgift är att främja den fysiska, psykiska, sociala och existentiella hälsan hos personer de vårdar genom ett personcentrerat arbetssätt. Syfte: Att beskriva upplevelsen av hopp hos personer med lungcancer. Metod: En litteraturöversikt med kvalitativ design och deduktiv ansats. Tretton artiklar inkluderades i resultatet. Polit och Becks modell användes i analysprocessen. Resultat: Analysen resulterade i två teman som beskrev upplevelsen av hopp hos personer med lungcancer. Det första temat var hälso- och sjukvårdens betydelse med tillhörande underteman att ha tilltro till medicinsk behandling och att få ett gott bemötande. Det andra temat var inneboende resurser med underteman att ha en religiös tro, att ha en meningsfull resterande tid och att tänka positivt. Slutsatser: Upplevelsen av hopp är betydelsefull hos personer med lungcancer. Det är en positiv känsla och en önskan kring vad personen vill ska ske i framtiden. Sjuksköterskor har därmed en betydande roll för att stärka hoppet hos personer med lungcancer genom sitt bemötande och förmåga till att arbeta personcentrerat.

  • 226.
    Anastassaki, Alkisti
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Magnusson, Tomas
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Patients referred to a specialist clinic because of suspected temporomandibular disorders: a survey of 3194 patients in respect of diagnoses, treatments, and treatment outcome.2004Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 62, nr 4, s. 183-192Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aims were to study the patient population at a temporomandibular disorders (TMD) specialist clinic over time, and to try to find variables of importance for treatment outcome. The material consisted of 3194 consecutive patients who were referred to the clinic and underwent a clinical examination during the period 1995-2002. A number of patient and treatment-related variables that had been collected in an electronic database were analyzed retrospectively. The age and sex distribution of the present patient material was in line with several previous investigations of TMD patients. The mean age of both men and women was 42 years, and there was a large preponderance of women. A vast majority of the patients responded positively, and in few visits, on traditional conservative treatment methods. In line with previous studies, no strong predictors for treatment outcome were found. However, the diagnoses of disk displacement without reduction, arthritis in TMJs, and myalgia in masticatory muscles were predictors for a significant improvement, while the diagnosis orofacial pain of unspecified origin predicted a poorer prognosis.

  • 227.
    Anastassaki, Alkisti
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för beteendevetenskap och socialt arbete.
    Öster, Anders
    Helkimo, Martti
    Magnusson, Tomas
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Globus pharyngeus: Litteraturöversikt och jämförande studie av två patientgrupper1996Inngår i: Tandläkartidningen, ISSN 0039-6982, Vol. 88, nr 7, s. 404-409Artikkel, forskningsoversikt (Annet vitenskapelig)
  • 228.
    Anastassaki Köhler, Alkisti
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Hugoson, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Magnusson, Tomas
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Clinical signs indicative of temporomandibular disorders in adults: time trends and associated factors2013Inngår i: Swedish Dental Journal, ISSN 0347-9994, Vol. 37, nr 1, s. 1-11Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The study aimed to examine possible time trends in the prevalence of clinical signs indicative of temporomandibular disorder (TMD) in an adult population, to analyse possible associations between TMD signs and associated factors and to estimate the need for TMD treatment. Three independent, stratified and randomly selected samples of around 100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years participated in the Jönköping studies in 1983,1993 and 2003. The study material consisted of 1,693 subjects who, after answering a questionnaire and being interviewed about the presence of TMD symptoms, were clinically examined in terms of the presence of TMD signs according to the Clinical Dysfunction Index (Di) by Helkimo. Associations between clinical signs and the Di as dependent variables and each of the independent variables of age group, gender, reported bruxism, trauma, self-perceived healthiness and the year of investigation were analysed in binary logistic regression models. Estimates of the need for TMD treatment were based on the presence of a combination of severe symptoms and clinical signs. The prevalence of severely impaired jaw movement capacity, relating to horizontal movements, had increased in 2003. The prevalence of muscle pain and temporomandibular joint pain upon posterior palpation was found to vary statistically significantly between 1993 and 2003. Gender differences were noted in these changes overtime. Female gender, advancing age, awareness of bruxism, self-perceived health impairment and the wearing of complete dentures were associated with TMD signs and a higher degree of clinical dysfunction. The estimated need for TMD treatment increased from 5% in 1983 to 8% in 2003 and was higher in women than in men. In conclusion, the results indicate that the prevalence of some TMD signs and of estimated treatment need increased during the period 1983-2003.

  • 229.
    Anastassaki Köhler, Alkisti
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Hugoson, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Magnusson, Tomas
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Prevalence of symptoms indicative of temporomandibular disorders in adults: cross-sectional epidemiological investigations covering two decades2012Inngår i: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 70, nr 3, s. 213-223Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives. The aims were (1) to study possible secular trends in the prevalence of temporomandibular disorder (TMD) symptoms in adults and (2) to analyse possible associations between TMD symptoms and background factors. Materials and methods. The investigation has a repeated cross-sectional design. Three independent, randomly selected samples of 100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years, a total of 1704 subjects, participated in the Jönköping studies in 1983, 1993 and 2003. All the subjects were evaluated using a questionnaire and a structured interview relating to the presence of TMD symptoms. Associations between symptoms and the Anamnestic Dysfunction Index (Ai) as dependent variables and each of the independent variables, age group, gender, reported bruxism, trauma (1983), self-perceived health impairment and the year of investigation were analysed in binary logistic regression models. Results. The prevalence of the separate symptoms, apart from for TMJ clicking, did not vary to any statistically significant degree between the different examination years. However, the prevalence of recurrent headache in 20-year-old subjects rose remarkably in 2003 and an increase in the Ai I and Ai II for the whole population was observed during the 20-year period. Reported bruxism, which increased during the study period, and self-perceived health impairment were associated with most of the TMD symptoms and the Ai. Conclusions. An increase in the prevalence of TMD symptoms expressed as Anamnestic Dysfunction Index I and II has been noted over a 20-year period.

  • 230.
    Anastassaki Köhler, Alkisti
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Nydell Helkimo, Anna
    Magnusson, Tomas
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Hugoson, Anders
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Prevalence of symptoms and signs indicative of temporomandibular disorders in children and adolescents: A cross-sectional epidemiological investigation covering two decades2009Inngår i: European Archives of Paediatric Dentistry, ISSN 1818-6300, Vol. 10, nr Suppl. 1, s. 16-25Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    AIM: These were to 1) estimate the prevalence of subjective symptoms and clinical signs of temporomandibular disorders (TMD) in children and adolescents in the city of Jönköping, Sweden, 2) follow possible variations in TMD signs and symptoms over a 20-year period, and 3) study possible associations between TMD symptoms and signs and factors of interest. DESIGN: About 100 individuals in the age groups of 3, 5, 10 and 15 years participated in crosssectional stratified epidemiological investigations in 1983, 1993 and 2003. METHODS: All participants were asked to fill in a questionnaire including questions on general and oral health, dental care habits and some sociodemographic issues. More specific questions recorded the presence or absence of subjective symptoms: tiredness in the jaws on awakening or during chewing; clicking sounds or crepitations from the temporomandibular joints (TMJs); locking/ catching of the mandible; luxation of the mandible; reduced jaw movement capacity; pain during jaw movements; other pain conditions in the jaws or in the TMJ regions. Subjects were examined clinically at each time period for; jaw mobility (maximum jaw opening including vertical overbite, maximum laterotrusion to the right and to the left, maximum protrusion); TMJ function (normal function, deflection on jaw opening of > 2 mm, TMJ clicking or crepitations, TMJ locking, TMJ luxation); pain on jaw movement (no pain on movements, pain on one movement, pain on more than one movement); muscle pain (no muscle pain, pain on palpation in 1-3 sites, pain on palpation in > 3 sites); TMJ pain (no joint pain, pain on lateral palpation of one or both joints, pain on posterior palpation of one or both joints). No functional examination of the masticatory system was performed in children aged 3 and 5 years. RESULTS: TMD-related symptoms were very rare in 3- and 5-year-olds. In the age groups of 10- and 15-yearolds, 5-9% of the participants reported more severe symptoms, up to 50% showed one or more TMD signs, while it was estimated that 1-2% were in need of TMD treatment. Several symptoms and signs increased with age. No gender differences, with the exception of recurrent headache, were noted. Oral parafunctions were reported by 11-47%. Apart from a few variables, no statistically significant changes in the prevalence of TMD symptoms and signs were observed over the 20-year period. Clenching/grinding of teeth and general health factors were found to be associated with TMD symptoms and signs. CONCLUSIONS: The prevalence of more severe TMD symptoms and signs in children and adolescents was generally low in all three examinations and did not change significantly during the 20-year period. Increasing age, general health factors and oral parafunctions were associated with TMD symptoms and signs in 10- and 15-year-olds.

  • 231.
    Anastassaki-Köhler, A
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Hugoson, A
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    Magnusson, Tomas
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin.
    Clinical signs indicative of temporomandibular disorders in adults: changes over time and associated factors – a preliminary report.2011Konferansepaper (Fagfellevurdert)
  • 232.
    Anastassaki-Köhler, Alkisti
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa.
    On temporomandibular disorders: Time trends, associated factors, treatment need and treatment outcome2012Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    During the last few decades, and especially during the 1990s, an increase in musculoskeletal pain conditions and stress-related ill-health has been observed in Sweden. At the same time, an improvement in the oral health of the population has been noted. The overall aim of this thesis was to acquire knowledge relating to possible time trends for the presence of temporomandibular disorders (TMD) in the population. A further objective was to study factors that possibly influence the presence of these disorders and the outcome of their treatment.

    Studies I–III are based on a series of repeated cross-sectional population-based investigations. Three independent samples of 130 individuals in the age groups of 3, 5, 10, 15, 20, 30, 40, 50, 60 and 70 years were randomly selected from the inhabitants of the city of Jonkoping, Sweden in 1983, 1993 and 2003. The total participation rate was 21%, 22% and 29% respectively. The participants were examined using a questionnaire, interview and a clinical examination of the stomatognathic system regarding the presence of symptoms and signs indicative of TMD. Study IV is a retrospective survey of a clinical sample of patients referred to and treated at the Department of Stomatognathic Physiology, The Institute for Postgraduate Dental Education, Jonkoping, in 1995–2002. The overall frequencies of symptoms and the rates for some clinical signs and consequently of an estimated treatment need in adults increased during the study period. In 2003, the prevalence of frequent headache in 20-year-olds, mainly females, had markedly increased. The reports of bruxism among adults increased from 1983 to 2003. Awareness of bruxism and self-perceived health impairment were associated with TMD symptoms and signs. A favourable treatment outcome was observed for the majority of patients with common TMD sub-diagnoses and no strong predictors of treatment outcome were found.

    In conclusion, the results suggest some time trends towards an increased prevalence in the overall symptoms and some signs indicative of TMD in the Swedish adult population during the time period 1983–2003. A profound understanding of the social determinants of health is recommended when planning public health resources.

  • 233. Andel, Ross
    et al.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    The role of midlife ocupational complexity and leisure time activity in cognitive performance later in life.2013Konferansepaper (Annet vitenskapelig)
  • 234. Andel, Ross
    et al.
    Silverstein, Merril
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Occupational and Leisure Time Engagement at Midlife and Cognitive Functioning in Advanced Old Age2012Inngår i: The 21st Nordic Congress of Gerontology, Dilemmas in Ageing Societies, Abstracts and Program, Copenhagen, Denmark, June 10th - 13th, 2012, 2012Konferansepaper (Fagfellevurdert)
  • 235.
    Andel, Ross
    et al.
    School of Aging Studies, University of South Florida, Tampa, Florida.
    Silverstein, Merril
    Sociology Department and School of Social Work, Aging Studies Institute, Syracuse University, New York.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    The role of midlife occupational complexity and leisure activity in late-life cognition2015Inngår i: The journals of gerontology. Series B, Psychological sciences and social sciences, ISSN 1079-5014, E-ISSN 1758-5368, Vol. 70, nr 2, s. 314-321Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE:

    To examine whether occupational complexity of working with data or people, and cognitive or social leisure activity at midlife predicted cognition in advanced old age.

    METHODS:

    We used 810 eligible participants from Longitudinal Study of Living Conditions of the Oldest Old, a Swedish nationally representative study of individuals aged 77+ with cognitive assessments (an abridged version of the Mini-Mental State Exam) administered in 1992 and 2002 and linked to information about their midlife occupation and leisure activities collected in 1968 and 1981. A bootstrapping technique was applied to examine the direct and interactive associations of occupational complexity and leisure activity with late-life cognition.

    RESULTS:

    Controlling for demographic and health-related factors from childhood, midlife, and late life, we found that greater work complexity, both with people and with data, and greater participation in cognitive or social leisure activities independently related to better late-life cognitive scores. The complexity-cognition link was moderated by leisure activity such that the cognitive benefit related to the complexity of work-especially complexity of working with people-was rendered insignificant when participation in leisure activities-especially social activities-was above average.

    DISCUSSION:

    Results are discussed in terms of using work complexity to compensate for lack of leisure activity as well as in terms of promoting leisure engagement to compensate for long-term cognitive disadvantage imposed by working in less challenging occupations.

  • 236.
    Anderson, Janet E.
    et al.
    Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK.
    Robert, Glenn
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King’s College London, London, UK.
    Nunes, Francisco
    Department of Human Resources and Organizational Behavior, ISCTE-IUL, Lisbon, Portugal.
    Bal, Roland
    Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Netherlands.
    Burnett, Susan
    Faculty of Medicine, Department of Surgery & Cancer, Imperial College, UK.
    Karltun, Anette
    Högskolan i Jönköping, Tekniska Högskolan, JTH, Logistik och verksamhetsledning. Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Sanne, Johan
    IVL Swedish Environmental Research Institute, Sweden.
    Aase, Karina
    SHARE—Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Norway.
    Wiig, Siri
    SHARE—Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Norway.
    Fulop, Naomi J.
    Department of Applied Health Research, University College London, UK.
    The QUASER Team, ,
    Translating research on quality improvement in five European countries into a reflective guide for hospital leaders: the ‘QUASER Hospital Guide’2019Inngår i: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objective: The aim was to translate the findings of the QUASER study into a reflective, dialogic guide to help senior hospital leaders develop an organization wide QI strategy.

    Design: The QUASER study involved in depth ethnographic research into QI work and practices in two hospitals in each of five European countries. Three translational stakeholder workshops were held to review research findings and advise on the design of the Guide. An extended iterative process involving researchers from each participant country was then used to populate the Guide.

    Setting: The research was carried out in two hospitals in each of five European countries.

    Participants: In total, 389 interviews with healthcare practitioners and 803 hours of observations.

    Intervention: None.

    Main outcome measure: None.

    Results: The QUASER Hospital Guide was designed for leadership teams to diagnose their organization’s strengths and weaknesses in the eight QI challenges. The Guide supports organizational dialogue about QI challenges, enables leaders to share perspectives, and helps teams to develop solutions to their situated problems. The Guide includes extensive examples of QI strategies drawn from the data and is published online and on paper.

    Conclusion: The QUASER Hospital Guide is empirically based, draws on a dialogical approach to Organizational Development and complexity science and can facilitate hospital leadership teams to identify the best solutions for their organization.

  • 237.
    Andersson, Adam
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Malmquist, Gabriella
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Att vara närståendevårdare i livets slutskede2017Independent thesis Advanced level (degree of Master (One Year)), 10 poäng / 15 hpOppgave
    Abstract [sv]

    Sammanfattning

     

    Bakgrund: Palliativ vård har utvecklats för att lindra lidande och främja livskvalitet i livets slutskede. Den palliativa vården delas in i främst två faser; tidig och sen fas. Symtomlindring är en av hörnstenarna i palliativ vård och ofta utförs palliativ vård i hemmen av närstående. Detta kan innebära en påfrestning för de närstående då familjestrukturer kan komma att förändras.

    Syfte: Att beskriva upplevelsen av att vara närståendevårdare till en person som vårdas palliativt i hemmet.

    Metod: En kvalitativ litteraturöversikt där teorin om KASAM har använts. Elva artiklar har analyserats utifrån Fribergs femstegsmodell.

    Resultat: Närståendevårdarna upplevde att de inte fick tillräckligt med information eller kunskap från sjukvården samt att kommunikationen med denna var bristfällig. De upplevde att detta påverkade deras känsla av kontroll i situationen och att deras delaktighet i omvårdnaden av den sjuke individen inte togs på allvar. De saknade ofta stöd från sjukvården men tog sig ändå an uppgiften som vårdare och uttryckte tacksamhet över att ha kunnat finnas där för sin sjuke familjemedlem.

    Slutsatser: Närståendevårdarna behöver ett bättre stöd från sjukvårdens sida i form av information, fysiskt och psykiskt stöd och bättre kunskap. Sjuksköterskan kommer att spela en stor roll i mötet med dessa personer och det är viktigt att inse vilken stor roll närståendevårdarna spelar i vårdandet av den sjuke individen. 

  • 238.
    Andersson, Amanda
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Rosenlund, Hanna
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Effekter av taktil beröring hos personer med smärta: -      en litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 poäng / 15 hpOppgave
    Abstract [sv]

     

    Bakgrund: Beröringsmetoder har länge använts hos människan i olika kulturer för att uppnå lugn och ro. Beröring är ett grundläggande behov för att utvecklas och ett sätt att kommunicera. Taktil beröring används många gånger som ett komplement till läkemedelsbehandling. Smärta innefattar olika dimensioner och är en komplex företeelse. Sjuksköterskan ska i sitt omvårdnadsarbete kunna uppmärksamma, möta och lindra patientens smärta genom adekvata åtgärder.

    Syfte: Syftet var att beskriva effekter av taktil beröring hos personer med smärta.

    Metod: Litteraturöversikt med totalt fjorton artiklar, varav tre kvalitativa och  elva kvantitativa. Artiklarna analyserades med hjälp av Fribergs femstegsmodell.

    Resultat: Tre teman framkom i resultatet. Psykiska effekter, fysiska effekter och existentiella effekter. Personer med smärta upplever att taktil massage lindrar smärtan både under och efter massagen.

    Slutsats: Taktil massage har flera positiva effekter på kroppen. Forskning har visat att taktil massage kan lindra smärta och också medföra andra positiva effekter.  Taktil massage kan lindra både akut och kronisk smärta och minska användandet av analgetika.

    Nyckelord: Effekter, taktil beröring, taktil massage, smärta. 

  • 239.
    Andersson, Amanda
    et al.
    Högskolan i Jönköping, Hälsohögskolan.
    Wallenborg, Jenny
    Högskolan i Jönköping, Hälsohögskolan.
    Hälsoeffekter hos MR-personal vid exponering av magnetfält: En litteraturstudie2019Independent thesis Basic level (degree of Bachelor), 180 hpOppgave
  • 240.
    Andersson, Ann-Christine
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    How to reach effective health service delivery?2017Inngår i: Journal of General Practice, ISSN 2329-9126, Vol. 5, nr 4, artikkel-id 1000320Artikkel i tidsskrift (Fagfellevurdert)
  • 241.
    Andersson, Ann-Christine
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Kvalitetsarbete inom omvårdnad – förbättringskunskap och ständiga förbättringar2018Inngår i: Kvalitetsutveckling inom omvårdnad: sjuksköterskans professionella ansvar / [ed] A. Hommel & Å. Andersson, Lund: Studentlitteratur AB, 2018, s. 45-68Kapittel i bok, del av antologi (Annet vitenskapelig)
  • 242.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Ainalem, Ingrid
    Centre for Innovation and Improvement (CII), Region Skåne, Malmö, Sweden.
    Berg, Agneta
    School of Health and Society, Kristianstad University, Sweden.
    Janlov, Ann-Christin
    School of Health and Society, Kristianstad University, Sweden.
    Challenges to improve inter-professional care and service collaboration for people living with psychiatric disabilities in ordinary housing2016Inngår i: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 25, nr 1, s. 44-52Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of this study was to describe health care- and social service professionals' experiences of a quality-improvement program implemented in the south of Sweden. The focus of the program was to develop inter-professional collaboration to improve care and service to people with psychiatric disabilities in ordinary housing. Focus group interviews and a thematic analysis were used. The result was captured as themes along steps in process. (I) Entering the quality-improvement program: Lack of information about the program, The challenge of getting started, and Approaching the resources reluctantly. (II) Doing the practice-based improvement work: Facing unprepared workplaces, and Doing twice the work. (III) Looking backevaluation over 1 year: Balancing theoretical knowledge with practical training, and Considering profound knowledge as an integral part of work. The improvement process in clinical practice was found to be both time and energy consuming, yet worth the effort. The findings also indicate that collaboration across organizational boundaries was broadened, and the care and service delivery were improved.

  • 243.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Thor, Johan
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Lenrick, Raymond
    Rapport om utvärdering av IVO:s lärande tillsyn2018Rapport (Annet vitenskapelig)
    Abstract [sv]

    Inspektionen för vård och omsorg (IVO) har i sin tillsynspolicy lagt fokus på att främja lärande för att stödja utvecklingen av god kvalitet och säkerhet i vård och omsorg. Under 2017 har IVO givit Jönköping Academy for Improvement of Health and Welfare vid Jönköping University i uppdrag att utvärdera tillämpning av lärande tillsyn. Syftet med denna studie var att belysa om, och om möjligt hur, IVO:s tillsyn kan stödja verksamhetsutveckling och förbättring i de tillsynade verksamheter. Det finns många teoribildningar kring lärande och kvalitetsutveckling. Denna rapport tar utgångspunkt i teorier om organisatoriskt lärande, samskapande och förbättringskunskap och belyser vad som kan bidra, och i så fall hur, till en ömsesidig tillit som leder till ett fördjupat lärande som grund för förbättring.

    Studien omfattar två tillsyner, där deltagarna bestod av personal från de berörda verksamheterna, samt IVO-inspektörer från de regionala IVO avdelningar. Det empiriska materialet samlades in genom intervjuer och en observation. En dokumentgenomgång av relevanta IVO dokument skapade underlag för utvecklandet av studiens intervjuguider. Intervjuerna bandades, transkriberades och analyserades med en metod inspirerad av tematisk analys, som utmynnade i fem teman: (I) Förberedelse inför tillsyn; (II) Genomförande i verksamheten; (III) Resultat i verksamheten; (IV) Förutsättningar för lärande; och (V) Önskemål för ökat lärande. Samtliga teman innehåller både förhållanden som stödjer (främjar) och som försvårar (hindrar) lärande:

    • Förberedelsearbetet ansågs inte bidra till en ökad tillit som förutsättning för lärande. Det uttrycktes en önskan om mer samskapande i förberedelsearbetet redan innan tillsynstillfället
    • Det framkom önskemål om att lärandet, som ett av målen med tillsynen, skulle lyftas tydligare i dialogen vid tillsynstillfället.
    • Det uppfattades som svårt att peka på reella resultat i verksamheterna som direkt berodde på tillsynen, men det beskrevs ändå som viktigt att tillsynen fanns.
    • Det fanns olika uppfattningar om hur IVO:s roll som tillsynsmyndighet påverkade lärandet. Ett större fokus på gemensam uppföljning skulle vara ett sätt att optimera lärandet både i verksamheterna och hos IVO:s inspektörer.
    • Ett lärande skulle gynnas av en tydlig gemensam problembeskrivning, samt fortlöpande uppföljningar och delad kunskap, exempelvis genom goda exempel och dialogkonferenser.

    Generellt fanns en stor samstämmighet mellan IVO:s inspektörer och de verksamhetsföreträdare som intervjuats, men vissa skillnader framkom också. Rapporten avslutas med några avslutande reflektioner.

  • 244.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Golsäter, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Melke, Anna
    Erfarenheter från lärandeseminarier: Barn som anhöriga: Reflektioner från följeforskning2016Rapport (Annet vitenskapelig)
    Abstract [sv]

    Under 2015 genomfördes nationella lärandeseminarier för att stärka implementeringen av den lag som ger barn rätt till information, råd och stöd när en förälder plötsligt avlider, är svårt sjuk eller skadad (HSL 2g §). Satsningen var ett förbättringsarbete som omfattade sex landsting som med hjälp av en projektledning träffades vid fyra tillfällen från januari till september. Två av träffarna skedde i Stockholm och två var digitala. Under våren 2015 knöts följeforskning till arbetet med frågeställningar om vilka resultat förbättringsarbetet gav och hur deltagarna upplevde arbetssättet. Syftet var att lyfta fram vad satsningen gav samt att lära inför framtida satsningar – är lärandeseminarier ett användbart arbetssätt för nationella implementeringssatsningar?

    Rapporten visar att lärandeseminarier tycks vara en användbar form. Teamen kan redovisa att de uppnått många av de mål som de föresatte sig under projekttiden. Det handlade om kartläggning av kunskapsläge och strukturer, kompetensutveckling samt utveckling av rutiner och material. Teamen uppskattade också att få delta i ett nationellt sammanhang som gav inspiration. Samtidigt framkom det önskemål om fortsatt och ännu mer handfast stöd i fortsatt implementering i klinisk verksamhet.

  • 245.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Golsäter, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Melke, Anna
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. The Göteborg Region Association of Local Authorities, Gothenburg, Sweden.
    Learning through networking in healthcare and welfare: The use of a breakthrough collaborative in the Swedish context2017Inngår i: International Journal of Healthcare Management, ISSN 2047-9700, E-ISSN 2047-9719Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Breakthrough Collaborative (BC) aims at learning through networking, mainly at micro level, and is used as a tool to improve care and welfare organizations. The aim of this study was to explore and illuminate the challenges when applying BC model at meso and macro level. In 2010, the Swedish Health and Medical Services Act stated the responsibility of healthcare professionals to consider children’s needs as relatives. This study uses an interactive collaborative research model. To support healthcare organizations in the implementation of the regulation, county councils/regions in Sweden were invited to take part in a BC during 2015. Six teams from different county councils/regions participated. Team members were interviewed several times during the project time. Data were analyzed with an explorative and descriptive qualitative content analysis. The result illuminates the challenges faced when applying BC at meso and macro level. Most challenges concern preparation, support structures and system connections. There are similarities with the challenges met at micro level when BC is used at meso and macro level. But it seems even more important to consider how the team is constituted at meso and macro level to make use of the learnings and achieve long-term impact in the home organization.

  • 246.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättring och ledarskap inom hälsa och välfärd.
    Idvall, Ewa
    Malmö Högskola.
    Perseius, Kent-Inge
    Röda Korsets högskola, Stockholm.
    Elg, Mattias
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Linköpings Universitet.
    Two Different Strategies to Facilitate Involvement in Healthcare Improvements: A Swedish County Council Initiative2014Inngår i: Global Advances in Health and Medicine, ISSN 2164-957X, E-ISSN 2164-9561, Vol. 3, nr 5, s. 22-28Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: From a management point of view, there are many different approaches from which to choose to engage staff members in initiatives to improve performance.

    Objective: The present study evaluated how two different types of improvement strategies facilitate and encourage involvement of different professional groups in health-care organizations.

    Methods/Design: Empirical data of two different types of strategies were collected within an improvement project in a County Council in Sweden. The data analysis was carried out through classifying the participants' profession, position, gender, and the organizational administration of which they were a part, in relation to their participation.

    Setting: An improvement project in a County Council in Sweden.

    Participants: Designed Improvement Processes consisted of n=105 teams and Intrapreneurship Projects of n=202 projects.

    Intervention: Two different types of improvement strategies, Designed Improvement Processes and Intrapreneurship Projects.

    Main Outcome Measures: How two different types of improvement strategies facilitate and encourage involvement of different professional groups in healthcare organizations.

    Results: Nurses were the largest group participating in both improvement initiatives. Physicians were also well represented, although they seemed to prefer the less structured Intrapreneurship Projects approach. Assistant nurses, being the second largest staff group, were poorly represented in both initiatives. This indicates that the benefits and support for one group may push another group aside.

    Conclusions: Managers need to give prerequisites and incentives for staff who do not participate in improvements to do so. Comparisons of different types of improvement initiatives are an underused research strategy that yields interesting and thoughtful results.

    Read More: http://www.gahmj.com/doi/abs/10.7453/gahmj.2014.040

  • 247.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Johansson, Rose-Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Ryhov County Hospital, Jönköping, Sweden.
    Elg, Mattias
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare.
    Andersson-Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Christensson, Lennart
    Ryhov County Hospital, Jönköping, Sweden.
    Using quality improvement methods to implement guidelines to decrease the proportion of urinary retention in orthopaedic care2017Inngår i: International Archives of Nursing and Health Care, ISSN 2469-5823, Vol. 3, nr 1, artikkel-id IANHC-3-065Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In patients treated with indwelling urethral catheter (IUC), complications such as catheter associated urinary tract infections are common, while underuse of IUC may cause harmful urinary retention (UR). A quality improvement (QI) program called ‘Indwelling urethral catheter (IUC) - only when needed’ was developed in Jönköping County Council, Sweden, aiming at creating a new approach: hospital staff should be able to identify and manage patients with risk of UR, prevent UR or treat UR without delay, and only use urinary IUCs on appropriate indications. The aim of this study was to describe the process of application of the quality improvement program. The Model for Improvement was used, and process coaches were appointed in the participating units. Their training was based on clinical issues and facts about UR, IUCs, guidelines, QI methods and measurements. Data were collected through prospective and retrospective patient record reviews, and differences were analyzed by inferential statistics.

    Before the intervention, only two patients out of 296 were cared for following the guidelines perfectly. During the intervention, adherence to guidelines showed a rising trend, and reached a new stable level, with an average of 67% adherence to guidelines. A systematic improvement program supported by coaches and improvement tools can increase the adherence to new guidelines and incorporate them into local practice. This study also shows that adherence to guidelines can improve patient safety, in this case a decreased risk for and incidence of UR in an orthopaedic patient population.

  • 248.
    Andersson, Ann-Christine
    et al.
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Futurum-Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Melke, Anna
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Göteborg Region Association of Local Authorities, Gothenburg, Sweden.
    Andersson Gäre, Boel
    Högskolan i Jönköping, Hälsohögskolan, The Jönköping Academy for Improvement of Health and Welfare. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping).
    Golsäter, Marie
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Futurum-Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Identification of children as relatives with a systematic approach; a prerequisite in order to offer advice and support2018Inngår i: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 27, nr 3, s. 172-177Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The purpose of this study was to elucidate conditions at all system levels in a specific health care service to develop practices for identification of children as relatives. An interactive research approach with the intention to create mutual learning between practice and research was used. The participating health care service cared for both clinic in- and outpatients with psychiatric disorders. Health care professionals from different system levels (micro, meso, macro) participated, representing different professions. At the first project meeting, it was obvious that there was no systematic approach to identify children as relatives. At the micro level, activities such as a pilot survey and an open house activity were carried out. At the meso level, it was discussed how to better support collaboration between units. At the management (macro) level, it was decided that all units should appoint at least one child agent, with the aim to increase collaboration throughout the whole health care service. To change focus, in this case from only parents to inclusion of children, is an important challenge faced by health care services when forced to incorporate new policies and regulations. The new regulations contribute to increased complexity in already complex organizations. This study highlights that such challenges are underestimated.

  • 249.
    Andersson, Bengt-Åke
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Biomedicinsk plattform. Högskolan i Jönköping, Hälsohögskolan, HHJ. Oral hälsa. Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Sayardoust, Shariel
    Department of Periodontology, Institute for Postgraduate Dental Education, Jönköping, Sweden.
    Löfgren, Sture
    Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Rutqvist, Lars Erik
    Scientific Affairs Group, Swedish Match AB, Stockholm, Sweden.
    Laytragoon-Lewin, Nongnit
    Department of Laboratory Medicine, Ryhov County Hospital, Jönköping, Sweden.
    Cigarette smoking affects microRNAs and inflammatory biomarkers in healthy individuals and an association to single nucleotide polymorphisms is indicated2018Inngår i: Biomarkers, ISSN 1354-750X, E-ISSN 1366-5804, Vol. 24, nr 2, s. 180-185Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: Cigarette smoke induces inflammation and remodels immune response. Genetic and epigenetic alterations might be involved in the pathogenesis of smoking related diseases. In this study, we investigated the effect of smoking on systemic inflammation biomarkers and epigenetic changes at microRNA (miRNA) expression level. We also examined if the levels of inflammatory biomarkers were associated with selected single nucleotide polymorphisms (SNPs).

    METHOD: From 39 smokers and 101 non-smokers, levels of total white blood cells (WBCs) and its subpopulations, plasma cytokines/chemokines/proteins and miRNAs were analysed. For three biomarkers, C-reactive protein (CRP), MCP-1 and IFN-γ that were affected by smoking, the influence of SNPs was analyzed.

    RESULT: Elevated levels of total WBCs, neutrophils, monocytes, lymphocytes, CRP, MCP-1, IFN-γ and lower levels of miR-21 were detected in smokers. The elevated levels of IFN-γ in smokers was only statistically significantly associated with rs2069705 AG/GG SNP-genotype.

    CONCLUSIONS: A lower level of oncomir miRNA-21 and a higher level of immune modelling cytokine IFN-γ detected in smokers could be a protective immune response to cigarette smoke. The higher level of IFN-γ in smokers with a specific SNP genotype also suggests that a genetic interaction with smoking might predict the pathobiology of smoking related disease.

  • 250.
    Andersson, Bodil T.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Radiographers’ Professional Competence: Development of a context-specific instrument2012Doktoravhandling, med artikler (Annet vitenskapelig)
    Abstract [en]

    Aims: The overall aim of this thesis was to explore and describe radiographers‟ professional competence based on patients‟ and radiographers‟ experiences and to develop a context-specific instrument to assess the level and frequency of use of radiographers‟ professional competence.

    Methods: The design was inductive and deductive. Both qualitative and quantitative methods were used. The data collection methods comprised interviews (Studies I-II) and questionnaires (Studies III-IV). The subjects were patients in study I and radiographers in studies II-IV. In study I, 17 patients were interviewed about their experiences of the encounter during radiographic examinations and treatment. The interviews were analysed using qualitative content analysis. In study II, 14 radiographers were interviewed to identify radiographers‟ areas of competence. The critical incident technique was chosen to analyse the interviews. Studies III and IV were based on a national cross-sectional survey of 406 randomly selected radiographers. Study III consisted of two phases; designing the Radiographer Competence Scale (RCS) and evaluation of its psychometric properties. A 42-item questionnaire was developed and validated by a pilot test (n=16) resulting in the addition of 12 items. Thus the final RCS comprised a 54-item questionnaire, which after psychometric tests was reduced to 28 items. In study IV, the 28-item questionnaire served as data. The level of competencies was rated on a 10-point scale, while their use was rated on a six-point scale.

    Results: In study I, the female patients‟ comprehensive understanding was expressed as feelings of vulnerability. The encounters were described as empowering, empathetic, mechanical and neglectful, depending on the radiographers‟ skills and attitudes. Study II revealed two main areas of professional competence, direct patient-related and indirect patient-related. The first focused on competencies in the care provided in close proximity to the patient and the second on competencies used in the activities of the surrounding environment. Each of the two main areas was divided into four categories and 31 sub-categories that either facilitated or hindered good nursing care. In study III the analysis condensed the 54-item questionnaire in two steps, firstly by removing 12 items and secondly a further 14 items, resulting in the final 28-item RCS questionnaire. Several factor analyses were performed and a two factor-solution emerged, labelled; “Nurse initiated care” and “Technical and radiographic processes”. The psychometric tests had good construct validity and homogeneity. The result of study IV demonstrated that most competencies in the RCS received high ratings both in terms of level and frequency of use. Competencies e.g. „Adequately informing the patient‟, „Adapting the examination to the patient‟s prerequisites and needs‟ and „Producing accurate and correct images‟ were rated the highest while „Identifying and encountering the patient in a state of shock‟ and „Participating in quality improvement regarding patient safety and care‟ received the lowest ratings. The total score of each of the two dimensions had a low but significant correlation with age and years in present position. The competence level correlated with age and years in present position in both dimensions but not with the use of competencies in the “Nurse initiated care” dimension.

    Conclusion: This thesis has shown that professional competence is important in the encounter between patient and radiographer. It has also demonstrated that radiographers‟ self-rated professional competence is based on nursing, technological and radiographic knowledge. From a radiographer‟s perspective, „Nurse initiated care‟ and „Technical and Radiographic processes‟ are two core dimensions of Radiographer Competence Scale. The 28-item questionnaire regarding level and frequency of use of competence is feasible to use to measure radiographers‟ professional competence.

2345678 201 - 250 of 4731
RefereraExporteraLink til resultatlisten
Permanent link
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annet format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annet språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf