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  • 4551.
    Wallin, Anne-Marie
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Löfvander, Monica
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Diabetes: a cross-cultural interview study of immigrants from Somalia.2007Ingår i: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, nr 11C, s. 305-314Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To describe how diabetic immigrants from Somalia experience everyday life in Sweden and how they manage diabetes-related problems, with inclusion of a gender perspective. Background: To treat and care for minority populations successfully, healthcare staff in Sweden must thoroughly understand the illness experiences of different ethnic groups. However, no studies have so far been reported that focus on immigrants from Somalia with diabetes. Design: Descriptive, qualitative interview study with 19 diabetic adults born in Somalia and now living in Sweden. Method: Cross-cultural interviews with the aid of an interpreter. The transcribed interviews were subjected to qualitative latent content analysis, resulting in sub-themes and themes. Results: Four themes emerged: experience of distress in everyday life; everyday life continues as before; comprehensibility gives a feeling of control; and being compliant. A major finding was the variation in how the participants managed the fasting month of Ramadan. Several participants fasted and did not see the diabetes as an obstacle, others did see it as an obstacle or indicated that fasting was not compulsory for a sick person. Conclusions: This study provides healthcare staff with information about how a minority group experience and manage diabetes. The results indicate the importance of considering cultural background, as well as religious traditions such as Ramadan, in diabetes care. They also indicate that men and women differ in their reaction to diabetes and that care should be adapted to this. Relevance for clinical practice: It is important to develop evidence-based guidelines for diabetes care in ethnic groups that are fasting during Ramadan to prevent complications and promote relevant self-care. Further, the prescribed dietary advice must be culturally appropriate.

  • 4552.
    Wallin, Anne-Marie
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Löfvander, Monica
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Living with diabetes: a interview study with immigrants from Somalia.2007Ingår i: The 7th Conference on Advances in Health Care Science Research, 2007Konferensbidrag (Refereegranskat)
  • 4553.
    Wallin, Anne-Marie
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Sidenvall, Birgitta
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Conceptions of the encounter in diabetes care on the part of patients of Somalian origin and health-care professionals: a qualitative study2009Artikel i tidskrift (Refereegranskat)
  • 4554. Wallin, Karin
    et al.
    Solomon, Alina
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi.
    Tuomilehto, Jaakko
    Soininen, Hilkka
    Kivipelto, Miia
    Midlife rheumatoid arthritis increases the risk of cognitive impairment two decades later: a population-based study2012Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 31, nr 3, s. 669-676Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Inflammation has been associated with Alzheimer's disease (AD) and dementia. The association between rheumatoid arthritis (RA) or arthritis and dementia/AD has been investigated in several case-control or hospital- and register-based studies with mixed results. This long-term population-based study investigates the association between presence of joint disorders (RA and other joint disorders) in midlife and cognitive status later in life. 1,449 participants were first evaluated in 1972, 1977, 1982, and 1987 and follow-up was performed after 21 years. A self-administered questionnaire including questions on joint disorders was used at both evaluations. Cognitive status (control, mild cognitive impairment, dementia/AD) was assessed at follow-up. The presence of any joint disorder in midlife was significantly associated with a worse cognitive status later in life: OR (95% CI) in an ordinal logistic regression analysis adjusted for age, gender, follow-up time, education, APOEε4, body mass index, smoking, drug treatment, and diabetes was 1.96 (1.17-3.28). For RA only, OR (95% CI) was 2.77 (1.26-6.10). The correlation remained significant for RA when AD was considered instead of dementia OR (95% CI) 2.49 (1.09-5.67). The presence of joint disorders, especially RA, at midlife seems to be associated with a worse cognitive status later in life. Given the chronic inflammatory component of RA, this study suggests that inflammatory mechanisms may have an important role in increasing the risk of cognitive impairment and dementia/AD.

  • 4555.
    Wallin, Kim
    et al.
    School of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
    Fridlund, Bengt
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Thorén, Ann-Britt
    School of Health Sciences, University College of Borås, Borås, Sweden.
    Prehospital emergency nursing students' experiences of learning during prehospital clinical placements2013Ingår i: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 21, nr 3, s. 197-203Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Clinical placements play an important role in learning a new profession, but students report about poor placement experiences. Standards have been laid down for improvements within clinical training in Prehospital Emergency Nursing programmes in Sweden, but no studies have been carried out in this field in a Swedish context. The purpose of this study was thus to describe the experiences of Prehospital Emergency Nursing (PEN) students of their clinical placement and the effect on their learning process. Data were collected in 28 individual interviews and analyzed in accordance with Flanagan’s Critical Incident Technique. Three main areas emerged: the professional clinical supervisor, the clinical placement setting and the learning strategy. All these areas played a significant role in the PEN students’ learning progress and development into a new professional role. The choice of clinical supervisor (CS) and clinical placement is important if PEN students’ learning is to be an effective and positive experience. The prehospital environment is unique and can have positive and negative effects on student learning depending on the support and structure given during their clinical placement. A learning strategy based on reflective dialogue, CS continuity and a learning structure based on the prehospital environment is presented.

  • 4556. Wallin, U
    et al.
    Wieslander, I
    Fridlund, Bengt
    Högskolan i Halmstad.
    Loving care in the ambulance service1995Ingår i: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 11, nr 6, s. 306-113Artikel i tidskrift (Refereegranskat)
  • 4557.
    Wallén, Sofia
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Jonasson, Jenny
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Magnusson, Lina
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform. Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Ghosh, Ritu
    Mobility India Bangalore India.
    Poliomyelitis Patients In South India – A Study Measuring Quality Of Life2013Konferensbidrag (Refereegranskat)
    Abstract [en]

    Introduction The aim of this study was to examine and compare quality of life scores for three different groups with different living situations, all with a history of poliomyelitis and explore factors affecting their scores in four different quality of life domains in India.

    Method 91 participants with poliomyelitis from three different settings were included in the study. The groups were recruited from city, rural area and urban slum. The WHOQOL-Bref questionnaire was used to measure quality of life in four domains; physical health, psychological health, social relationships and environment.

    Results Significant difference (p<0,05) were found between the groups in three of the domains. In the physical health and the social relationship domain the group from the city scored significantly higher than the group from the urban slum. In the environmental domain the group from the city and the group from the rural areas scored significantly higher than the group from the urban slum. No significant difference was found in the psychological health domain between any of the three groups.

    Discussion When treating disabled persons, it is important to not only provide a person with an orthotic device, rehabilitation and inclusion in society is also very important to work with to increase a person’s quality of life.

    Conclusion It was found that the possibility to maintain the orthopedic devices and the opportunity earn an income influenced the quality of life scores positively. The living environment and rehabilitations services did not influence the scores in the psychological health domain.

    The study was conducted in collaboration between Mobility India and School of health science, Jönköping University, Sweden.

  • 4558.
    Wambui, Michelle Wanja
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Xejang, Lydia
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Experiences of Living with Indwelling Urinary Catheters: A Literature Review2018Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Background: The urinary catheter was designed by Foley in 1937.  There are diverse types of urinary catheters. Complications are common to patients living with indwelling urinary catheters. Nurses have the responsibility to provide information about the catheter to patients.

    Aim: To describe patients’ experiences of living with an indwelling urinary catheter.

    Method: A literature review of qualitative study was carried out. 10 articles were analysed. Friberg’s analysis model was used to analyse data.

    Results: Patients had different perceptions about living with indwelling urinary catheters. Some needed to adjust to having indwelling urinary catheters as part of their life. Others experienced catheter related problems such as pain, leakage and discomfort. Patients expressed need for support from family and healthcare professionals.

    Conclusion: Patients felt that they had received inadequate information from healthcare professionals and needed information about having an indwelling urinary catheter.

  • 4559.
    Wan, Anson H.
    et al.
    Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Wong, Duo W.
    Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Ma, Christina Zong-Hao
    Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Zhang, Ming
    Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Lee, Winson C.
    Interdisciplinary Division of Biomedical Engineering, Hong Kong Polytechnic University, Hung Hom, Hong Kong.
    Wearable vibrotactile biofeedback device allowing identification of different floor conditions for lower-limb amputees2016Ingår i: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 97, nr 7, s. 1210-1213Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate a newly developed biofeedback device enabling lower-limb amputees to identify various floor conditions.

    Design: Self-control with repeated measures (with and without the biofeedback device) within the amputee group, and group control comparing between amputee and nonamputee groups.

    Setting: University locomotion laboratory.

    Participants: Five lower-limb amputees and 8 nonamputees (N=13).

    Interventions: A wearable biofeedback device, which identified different floor conditions by analyzing the force patterns under the prosthetic feet and provided vibration cues in response to different floor conditions, was provided to the amputees.

    Main Outcome Measures: The subjects stepped on a foam platform concealing a small object or no object at 1 of the 4 locations of the foot sole. Subjects were asked whether there was a small object under their feet and the location of the object if it existed. The test was repeated with 4 different object types and 4 object locations. The success rate of floor identification was evaluated.

    Results: Without the biofeedback device, nonamputee subjects (76.56%) identified floor conditions better than amputees (22.5%) significantly (P<.001). On using the biofeedback device, the amputees significantly improved (P<.01) their success rate showing no significant difference (P=.746) compared with the nonamputees. No significant differences were found among object types (P=.689).

    Conclusions: Amputees performed significantly worse than nonamputees in recognizing the different floor conditions used in this experiment. With the biofeedback device, amputees significantly improved their abilities in identifying different floor conditions. Future attempts could configure the device to allow it to provide warning signals in response to fall-inducing conditions.

  • 4560.
    Wang, Lan
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    A health coaching self-management programme for patients with Chronic Obstructive Pulmonary Disease: An explorative and interventional study2018Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Chronic Obstructive Pulmonary Disease (COPD) is a primary cause of chronic morbidity and mortality and contributes to an increased economic and social burden on patients and families. Self-management education as one non-pharmacological treatment approach is highlighted in guidelines. Although self-management programmes have shown positive effects for COPD, lack of disease-specific self-management skills, high dropout rates, and poor attendance of participants are problems which should be taken under consideration. One way to cope with the problems is to use amore motivational approach which focuses on patients’ health decisions in cooperation with healthcare practitioners, combined with systematic and structured health coaching. However, there is a lack of such studies, which are needed to explore the effects of self-management on patients with COPD by health coaching, not least in China.

    Aims: The overall aim of this thesis was to explore sociodemographic and clinical factors influencing self-management and to test and evaluate a health coaching self-management programme for patients with COPD in China.

    Methods: The study’s design was explorative, prospective, and longitudinal, with both quantitative and qualitative approaches. Specifically, a quantitative method with a cross-sectional approach was used to explore the self-management status of patients with COPD and examine the associations with socio-demographic and clinical variables (I). Furthermore, a prospective randomized controlled trial was conducted to study the longitudinal effects of the health coaching self-management programme using a repeated-measures analysis of variance model of patients with COPD (II & III). A qualitative study implementing inductive content analysis was used to describe and explore participants’ experiences of the health coaching self-management programme of patients with COPD (IV).

    Results: High physical activity, high salary, and low age affected the self-management of patients with COPD most positively (I). The health coaching programme improved lung function, physical activity, quality of life, and self-management skills, as well as psychological status in both the short and long term (II & III). Participants expressed their experiences of the health coaching self-management programme as making them more aware of the importance of knowledge of the disease and their own responsibilities, taking action to maintain a healthy lifestyle, feeling supported by the programme, and being hindered by individual and programme limitations (IV).

    Conclusions: This thesis contributes to knowledge about the self-management skills of patients with COPD, which is low in China. A health coaching self-management programme with iterative interactions between patients and healthcare professionals represented a valuable and effective intervention designed to improve health-related outcomes. Moreover, low literacy, poor physical condition, and family and economic burdens should be taken into account in the development of future self-management programmes in China.

  • 4561.
    Wang, Lan
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Nygårdh, Annette
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Zhao, Yue
    School of Nursing, Tianjin Medical University, China.
    A health coaching self-management programme to improve physical activity, lung function and quality of life in patients with Chronic Obstructive Pulmonary Disease: a randomized controlled trialManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Background: Chronic obstructive pulmonary disease (COPD) is the fourth most prevalent cause of death in the world and contributes to higher economic and social burden. Health coaching, which is an approach to support self-management, has proven to be effective in health outcomes for patients with COPD in developed countries. However, no study has evaluated a systematic and structured health-coaching COPD programme to support self-management in China.

    Objectives: To evaluate the effects of a health coaching self-management programme on lung function, physical activity and quality of life in patients with COPD

    Design: A randomised controlled trial in patients with COPD

    Methods: The participants were randomised to either an intervention group (n = 48) or a control group (n = 49) during hospitalisation. The intervention group received usual care combined with a health coaching self-management programme; the control group received only usual care. The intervention programme was performed for six months, and the effects of the intervention were assessed for FEV1%, FVC%, hand grip strength and 1-minute sit-to-stand (STS); and by the Global Physical Activity Questionnaire (GPAQ), Clinical COPD Questionnaire (CCQ) at baseline, 6th week, 6th month and 12th month follow-ups post-discharge.

    Results: Of the 97 patients, 88% completed the 12-month follow-up (94% in the intervention group and 82% in the control group). The interaction effect between time and group (control or intervention) for lung function, physical activity and quality of life showed that the intervention group improved significantly compared to the control group in all measures: FEV1% (P =0.003), FVC% (P = 0.001), GPAQ (P = 0.001), 1-minute STS (P = 0.005) and Grip strength (P<0.001), as well as the CCQ-symptom (P <0.001), CCQ-emotion (P <0.001), CCQ-activity (P<0.001) and CCQ (P <0.001).

    Conclusion: The health coaching self-management programme can improve lung function, physical activity and quality of life in patients with COPD.

  • 4562.
    Wang, Lan
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Department of Nursing, School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China.
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Zhao, Yue
    Department of Nursing, School of Nursing, Tianjin Medical University, Tianjin, People's Republic of China.
    Nygårdh, Annette
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. 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).
    Experiences of a health coaching self-management program in patients with COPD: a qualitative content analysis.2018Ingår i: The International Journal of Chronic Obstructive Pulmonary Disease, ISSN 1176-9106, E-ISSN 1178-2005, Vol. 13, s. 1527-1536Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To describe the experiences of patients with COPD participating in a health coaching self-management program.

    Patients and methods: Twenty patients who had participated in a 6-month health coaching self-management program intervention were purposefully selected for a qualitative evaluation of the program using semi-structured interviews. The interviews were analyzed using inductive qualitative content analysis.

    Results: Four categories and 13 subcategories emerged describing the participants' experiences of the program. Their experiences were expressed as gaining insight into the importance of knowledge and personal responsibilities in the management of COPD, taking action to maintain a healthy lifestyle, feeling supported by the program, and being hindered by individual and program limitations.

    Conclusion: Iterative interactions between patients and health care professionals together with the content of the program are described as important to develop skills to manage COPD. However, in future self-management programs more awareness of individual prerequisites should be considered.

  • 4563.
    Wang, Lan
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Nygårdh, Annette
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Zhao, Yue
    School of Nursing, Tianjin Medical University, China.
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Effects of a health coaching self-management programme in patients with Chronic Obstructive Pulmonary Disease on self-management skills and psychological status: a randomized controlled trialManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Objectives: To evaluate the effects of a health coaching self-management programme intended to improve self-management skills and psychological status for patients with Chronic Obstructive Pulmonary Disease.

    Design: Randomized controlled trial.

    Methods: A randomized controlled study was conducted among patients with COPD. The participants who met the inclusion criteria were randomized to either an intervention group (n=48) or a control group (n=49). The intervention group received the health coaching self-management programme, while the control group received usual care. The programme were performed during six months, and the effects of the intervention were assessed by the COPD Self-management Scale (CSMS) and Hospital anxiety and depression scale (HADS) at baseline, 6th week, 6th month and 12th month post discharge.

    Results: Of the 97 patients, 45 (94%) in the intervention group and 40 (82%) in control group, completed 12-month follow-up. The interaction effect between time and group (control or intervention) showed that the intervention group improved significantly compared to the control group for all five dimensions in self management skills, Symptom management (P<0.001), Daily life management (P<0.001), Emotion management (P<0.001), Information management (P<0.001) and Self-efficacy (P<0.001), as well as psychological status with anxiety (P<0.001) and depression (P<0.001).

    Conclusion: This trial shows that a nurse-led Health Coaching Self-management Programme has the potential to significantly improve the effects on the self management skills, as well as reducing anxiety and depression for patients with COPD.

  • 4564.
    Wang, Lan
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Nygårdh, Annette
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Zhao, Yue
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Mårtensson, Jan
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT.
    Self-management among patients with chronic obstructive pulmonary disease in China and its association with sociodemographic and clinical variables2016Ingår i: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 32, s. 61-66Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: This study aimed to examine the status of self-management in patients with COPD and its associations with sociodemographic and clinical variables.

    METHODS: This cross-sectional study included 154 patients with COPD (mean age, 73 years) at four hospitals in Tianjin, China. The COPD Self-Management Scale was used to describe the level of self-management, and its associations with sociodemographic and clinical variables were examined with multiple regression analysis.

    RESULTS: More than half of the patients with COPD had a low (30%) or moderate (27%) level of self-management. Self-management was rated highest in management of daily life and lowest in information management. Higher physical activity, higher salary, and lower age affected self-management the most positively.

    CONCLUSION: The overall burden of COPD in China is greater than that found in other countries. Healthcare professionals need to improve their understanding of the importance of self-management and specifically focus on increased physical activity targeting patients with poor literacy skills.

  • 4565.
    Wang, Yunzhang
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Robert
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Jylhävä, Juulia
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Hedman, Åsa K.
    Rheumatology Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Almqvist, Catarina
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Karlsson, Ida K.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Pedersen, Nancy L.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Almgren, Malin
    Department of Clinical Neuroscience, Centrum for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
    Hägg, Sara
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Comprehensive longitudinal study of epigenetic mutations in aging2019Ingår i: Clinical Epigenetics, E-ISSN 1868-7083, Vol. 11, artikel-id 187Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The role of DNA methylation in aging has been widely studied. However, epigenetic mutations, here defined as aberrant methylation levels compared to the distribution in a population, are less understood. Hence, we investigated longitudinal accumulation of epigenetic mutations, using 994 blood samples collected at up to five time points from 375 individuals in old ages.

    Results: We verified earlier cross-sectional evidence on the increase of epigenetic mutations with age, and identified important contributing factors including sex, CD19+ B cells, genetic background, cancer diagnosis, and technical artifacts. We further classified epigenetic mutations into High/Low Methylation Outliers (HMO/LMO) according to their changes in methylation, and specifically studied methylation sites (CpGs) that were prone to mutate (frequently mutated CpGs). We validated four epigenetically mutated CpGs using pyrosequencing in 93 samples. Furthermore, by using twins, we concluded that the age-related accumulation of epigenetic mutations was not related to genetic factors, hence driven by stochastic or environmental effects.

    Conclusions: Here we conducted a comprehensive study of epigenetic mutation and highlighted its important role in aging process and cancer development. 

  • 4566.
    Wanhainen, Anders
    et al.
    Uppsala University, Sweden.
    Mani, Kevin
    Uppsala University, Sweden.
    Vorkapic, Emina
    Linköping University, Sweden.
    De Basso, Rachel
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för naturvetenskap och biomedicin. Högskolan i Jönköping, Hälsohögskolan, HHJ. ADULT. Division of Medical Diagnostics, Department of Clinical Physiology, Region Jönköping County, Sweden.
    Björck, Martin
    Uppsala University.
    Länne, Toste
    Linköping University.
    Wågsäter, Dick
    Linköping University.
    Screening of circulating microRNA biomarkers for prevalence of abdominal aortic aneurysm and aneurysm growth2017Ingår i: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 256, s. 82-88Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and aims

    MicroRNA (miR) are important regulators of gene expression and biological processes and have recently been suggested as possible biomarkers for abdominal aortic aneurysm (AAA) disease. The aim of the present study was to assess the role of miR as biomarkers for initiation and progression of AAA disease, through evaluation of a wide range of miRs in a large population-based cohort, with AAA patients with linked clinical data regarding risk factors, AAA size and growth, as well as controls.

    Methods

    The expression of the 172 most commonly expressed miRs in plasma was analyzed by real-time PCR in samples from 169 screening-detected AAA patients and 48 age-matched controls.

    Results

    For 103 miRs, there was a significant difference in expression between AAA and controls. Of these, 20 miRs were differently expressed between fast and slow growing aneurysms. These miRs target genes known to be involved in AAA disease as well as novel genes and pathways. By combining the top altered miRs together with clinical variables, strong predictive values, determining growth of AAA, were obtained (area under curve = 0.86, p < 0.001).

    Conclusions

    This large cohort study identified several novel miRs with altered expression in AAA patients when compared to controls. Assessment of miR expression may offer an opportunity to predict disease progression and aneurysm growth.

  • 4567.
    Ward, Mari
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Swann, Annika
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Skolungdomars sömnvanor i relation till deras levnadsvanor: Sleep habits amongst school youth in relation to their lifestyle habits2016Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Ett tillgodosett sömnbehov anses vara en förutsättning för en normal utveckling hos skolungdomar. Dåliga mat- och sömnvanor är exempel på faktorer som kan påverka skolresultaten negativt. Elevhälsans distriktssköterska arbetar med ungdomar som är i utveckling kroppsligt, psy- kiskt, socialt och känslomässigt. Under denna utvecklingsperiod har ungdomarna ett ökat sömnbe- hov.

    Syfte: Syftet var att studera sömn- och levnadsvanor hos ungdomar och vidare undersöka om det föreligger skillnader mellan flickor och pojkar.

    Metod: Examensarbetet har genomförts som en tvärsnittsstudie med tidigare inhämtat material som använts. Cirka 3000 skolungdomar i årskurs 9 har besvarat Folkhälsoenkäten Ung. Ungdomarna representerar niondeklassare från samtliga kommuner i ett län i södra Sverige. Undersökningen gjordes hösten 2015. Datamaterialet exporterades från webbenkäts-verktyget esMaker NX 2.0 till SPSS där det bearbetades statistiskt.

    Resultat: En större andel pojkar hade goda sömnvanor, åt vanligtvis frukost och tränade ofta. En större andel flickor drack sällan energidryck och hade lite skärmtid. Bland de med dåliga sömnva- nor återfanns en högre andel av elever som inte åt frukost, som använde energidrycker flera gånger i veckan, var mindre fysiskt aktiva och spenderade fler antal timmar framför skärm (mobil, dator, läsplatta, TV-spel).

    Slutsats: Flickor och pojkar med goda sömnvanor hade ett större intresse av att förvalta sin hälsa jämfört med de med dåliga sömnvanor och fler pojkar hade bättre levnadsvanor och fler upplevde meningsfullhet i sina liv jämfört med flickor. 

  • 4568.
    Wass, Sofie
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    The importance of eHealth innovations: Lessons about patient accessible information2017Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Access to digital information and communication has an increasing importance in both the work of healthcare professionals and in patients’ everyday life and has transformed what we do and how we carry out activities. It changes the way in which healthcare is delivered, how information is exchanged within and between organizations and how patients and other actors access and manage information. Currently, innovation is imperative in the healthcare sector and today there is a focus on how different eHealth services can improve healthcare. With increased access to various eHealth services, there is a need to know more about the impact of eHealth innovations on healthcare.

    The aim of this thesis is to acquire more knowledge about eHealth innovations in healthcare. The focus is on prerequisites to realize innovative eHealth services and eHealth services that provide patients with access to health information. The theoretical background addresses innovation, services and business models. This thesis is a compilatory work and includes five qualitative research papers. The first study is an interview study, the second is a literature review and the remaining three are case studies. The data collection consisted of interviews, surveys, workshops and secondary data collected from documents. The interview study and the case studies were performed in the Swedish eHealth setting.

    The research contributes to our understanding of eHealth innovations with insights on prerequisites to realize eHealth innovations and knowledge on patient accessible information. The first study provides a classification of prerequisites that need to be considered to realize innovative eHealth services. When dealing with eHealth services, organizational and sematic interoperability are still a challenge, and they transcend organizational boundaries. This thesis provides knowledge on the recent trend of opening up electronic health records to patients. The knowledge derived from the studies on patient accessible electronic health records show that there is a discrepancy between the perceptions of patients and healthcare professionals. The thesis concludes that patients feel more involved and that the patient-professional relationship improves with patient access to electronic health records, whereas healthcare professionals have concerns about how patients will manage access to health information. This thesis also provides empirical insights on how business models can be represented in a public eHealth setting. By viewing public eHealth services as social innovations, the thesis contributes to the research on business models in a public healthcare setting by incorporating societal value into the representation of the business model.

    The research in this thesis contributes to research in health informatics by discussing issues related to eHealth innovations and patient accessible information. Its practical importance lies in identifying issues that are important when discussing eHealth initiatives and the implications of giving patients online access to their electronic health record.

  • 4569.
    Wass, Sofie
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Carlsson, Bertil
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Korkmaz, Seher
    E-health and Strategic IT, Public Health Care Administration, Stockholm County Council, Stockholm, Sweden.
    Shemeikka, Tero
    E-health and Strategic IT, Public Health Care Administration, Stockholm County Council, Stockholm, Sweden.
    Vég, Anikó
    Department of Healthcare Development, Stockholm County Council, Stockholm, Sweden.
    Exploring the effects of eHealth service innovation2015Ingår i: Health Systems, ISSN 2047-6965, E-ISSN 2047-6973, Vol. 4, nr 3, s. 212-223Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To analyse the impact of implementation and use of eHealth services is fraught with difficulty, and there is often a gap between expected and identified outcomes. In this paper, we identify innovation effects of an eHealth service by applying a framework that focusses on the expected coherent impacts of implementing an IT innovation and contributes to the body of knowledge on tracking innovation effects of services in eHealth. A case study examines four different care units in a government-funded health-care setting. The results show that the effects in the first two contexts of the framework, the micro level and intra-/interorganisational level, could be clearly identified with regard to the physicians and the organisation. However, effects were lacking in the virtual context when looking beyond the involvement of the stakeholders in the eHealth service. The connections between effects for societal groups and larger societal systems simply could not be made in a satisfactory manner.

  • 4570.
    Wass, Sofie
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik. Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Centre for Information Technology and Information Systems (CenITIS). Linköping University, Linköping, Sweden.
    Business models in public eHealth2016Ingår i: 24th European Conference on Information Systems, ECIS 2016, 2016Konferensbidrag (Refereegranskat)
    Abstract [en]

    Several countries develop strategies and policies to foster the use of eHealth services and stress the importance of business models to develop and implement digital services. Previous research on business models has however mostly focused on the private setting or a healthcare setting with multi-payer or market-based financial systems. In this paper, we explore the use of business models in eHealth as well as the consistency of such a model in a public healthcare setting. The study is performed through a case study of an eHealth service and to which we apply a business model framework. Data have been collected through interviews, documents and project meetings. The results show that all parts of the business model could be identified and provide an overview of the service but no clear guidance on how to reach a sustainable value in the future. It seems that, in the case of public healthcare, there is a need to add the notion of a societal value as well as issues related to future governance for the diffusion of the service to make the business model and the service sustainable.

  • 4571.
    Wass, Sofie
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik. Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Centre for Information Technology and Information Systems (CenITIS). Department of Computer Science, Linköping University, Sweden .
    Healthcare in the age of open innovation – A literature review2016Ingår i: Health Information Management Journal, ISSN 1833-3583, E-ISSN 1833-3575, Vol. 45, nr 3, s. 121-133Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: In spite of an increased interest in open innovation and strategies that call for an increased collaboration between different healthcare actors, there is a lack of open innovation research in public contexts.

    Objective: This article presents the results of a review regarding the healthcare sector’s engagement in open innovation as well as constraining factors and positive outcomes of open innovation in healthcare.

    Method: The literature search focused on papers published in English between 2003 and 2014. Based on specified inclusion criteria, 18 articles were included.

    Results: Results reveal that most studies focus on inbound open innovation where external knowledge is integrated with the internal knowledge base at an initial phase of the innovation process. Innovation primarily results in products and services through innovation networks. We also identified constraining factors for open innovation in healthcare, including the complex organizations of healthcare, the need to establish routines for capturing knowledge from patients and clinicians, regulations and healthcare data laws as well as the positive outcome patient empowerment.

    Conclusion: The healthcare sector’s engagement in open innovation is limited, and it is necessary to perform further research with a focus on how open innovation can be managed in healthcare. 

  • 4572.
    Wass, Sofie
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik. Linköping University, Sweden.
    Same, same but different: Perceptions of patients’ online access to electronic health records among healthcare professionals2019Ingår i: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 25, nr 4, s. 1538-1548Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    In this study, we explore how healthcare professionals in primary care and outpatient clinics perceive the outcomes of giving patients online access to their electronic health records. The study was carried out as a case study and included a workshop, six interviews and a survey that was answered by 146 healthcare professionals. The results indicate that professionals working in primary care perceive that an increase in information-sharing with patients can increase adherence, clarify important information to the patient and allow the patient to quality-control documented information. Professionals at outpatient clinics seem less convinced about the benefits of patient accessible electronic health records and have concerns about how patients manage the information that they are given access to. However, the patient accessible electronic health record has not led to a change in documentation procedures among the majority of the professionals. While the findings can be connected to the context of outpatient clinics and primary care units, other contextual factors might influence the results and more in-depth studies are therefore needed to clarify the concerns.

  • 4573.
    Wass, Sofie
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik. Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Centre for Information Technology and Information Systems (CenITIS). Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Computer and Information Science, Linköping University, Sweden .
    The Role of ICT in Home Care2017Ingår i: Context Sensitive Health Informatics: Redesigning Healthcare Work / [ed] Christian Nøhr, Craig E. Kuziemsky, Zoie Shui-Yee Wong, IOS Press, 2017, Vol. 241, s. 153-158Konferensbidrag (Refereegranskat)
    Abstract [en]

    With an ageing population and limited resources, ICT is often mentioned as a solution to support elderly people in maintaining an independent and healthy lifestyle. In this paper, we describe how ICT can support access to information and rationalization of work processes in a home care context. We do this by modelling the workflow and identifying the possible impact of ICT. The results show a complex process and indicate that the available resources are not used in the best possible way. The introduction of ICT could increase patient safety by reducing the risk of misplacing information about the care recipients and at the same time provide real time information about the care recipients’ needs and health at the point of care. However, to rationalize the work processes there is a need to combine ICT with a changed procedure for handling keys.

  • 4574.
    Wass, Sofie
    et al.
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik.
    Vimarlund, Vivian
    Högskolan i Jönköping, Internationella Handelshögskolan, IHH, Informatik. Högskolan i Jönköping, Hälsohögskolan, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Computer and Information Science/Human-Centered Systems, Linköping University, Sweden.
    The Role of PAEHRs in Patient Involvement2018Ingår i: Journal of medical systems, ISSN 0148-5598, E-ISSN 1573-689X, Vol. 42, nr 11, artikel-id 210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    With increased patient access to data, healthcare services are experiencing change where patients are moving away from being mere passive actors towards becoming more active and involved participants. In this paper, we explore the role of patient accessible electronic health records (PAEHRs) with respect to this increase in patient involvement. The study was performed as a case study and included nine interviews with patients and a survey that was responded to by 56 patients. Our results show that PAEHRs have a role in the enhancement of patient involvement because PAEHRs (i) foster a more balanced relationship between patients and healthcare professionals and (ii) increase access to information.

  • 4575.
    Wedin, Linnéa
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Wisberg, Linnéa
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering.
    Äldres upplevelser av möjligheter och hinder till meningsfulla aktiviteter: En kvalitativ intervjustudie2017Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Meningsfulla aktiviteter ingår i arbetsterapeutens kompetens och något som arbetsterapeuter bör grunda sina interventioner i. Syftet med examensarbetet var att beskriva upplevelse av möjlighet och hinder till meningsfulla aktiviteter hos äldre med hemtjänst i ordinärt boende. Examensarbetet hade en kvalitativ design med semistrukturerade intervjuer. Tio deltagare intervjuades. En kvalitativ innehålls-analys resulterade i faktorer som både möjliggjorde och hindrade meningsfulla aktiviteter. Tre kategorier identifierades; ”Den fysiska miljöns betydelse”, miljön kring den äldre påverkade utförandet beroende på om den var anpassad eller inte, om man hade närhet till aktivitet, om man hade möjlighet till transport samt att den varma årstiden möjliggjorde. ”Hindrande Personfaktorer”, kroppsliga begränsningar och mentala begränsningar påverkade möjlighet till utförande av meningsfulla aktiviteter. ”Organiserade sociala aktiviteter”, kyrkan möjliggjorde aktivitet, hemtjänsten stöttar till viss del och organiserade aktiviteter har lagts ned. Temat ”Det handlar inte om hur gammal man är, utan hur man är gammal” framkom. Samhällets syn på äldre samt äldres internaliserade syn på sig själva påverkar möjlighet till utförande av meningsfulla aktiviteter. Slutsatsen var att möjlighet till meningsfulla aktiviteter påverkas av omgivningsfaktorer och personfaktorer. Denna kunskap bidrar till att arbetsterapeuter kan arbeta för att äldre ska kunna utföra meningsfulla aktiviteter genom att uppmärksamma de hinder och möjligheter som den äldre upplever.

  • 4576. Weinstein, M.
    et al.
    Green, Dido
    Department of Occupational Therapy, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
    Geva, R.
    Schertz, M.
    Fattal-Valevski, A.
    Artzi, M.
    Myers, V.
    Shiran, S.
    Gordon, A. M.
    Gross-Tsur, V.
    Bashat, D. B.
    Interhemispheric and intrahemispheric connectivity and manual skills in children with unilateral cerebral palsy2014Ingår i: Brain Structure and Function, ISSN 1863-2653, E-ISSN 1863-2661, Vol. 219, nr 3, s. 1025-1040Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    This study investigated patterns of motor brain activation, white matter (WM) integrity of inter- and intrahemispheric connectivity and their associations with hand function in children with unilateral cerebral palsy (CP-U). Fourteen CP-U (mean age 10.6 ± 2.7 years) and 14 typically developing children (TDC) underwent magnetic resonance imaging. CP-U underwent extensive motor evaluation. Pattern of brain activation during a motor task was studied in 12 CP-U and six TDC, by calculating laterality index (LI) and percent activation in the sensorimotor areas (around the central sulcus), and quantifying the activation in the supplementary motor area (SMA). Diffusivity parameters were measured in CP-U and eight other TDC for the corpus callosum (CC), affected and less affected cortico-spinal tracts (CST), and posterior limb of the internal capsule (PLIC). Abnormal patterns of brain activation were detected in areas around the central sulcus in 9/12 CP-U, with bilateral activation and/or reduced percent activation. More activation in areas around the central sulcus of the affected hemisphere was associated with better hand function. CP-U demonstrated more activation in the SMA when moving the affected hand compared to the less affected hand. CP-U displayed reduced WM integrity compared to TDC, in the midbody and splenium of the CC, affected CST and affected PLIC. WM integrity in these tracts was correlated with hand function. While abnormal pattern of brain activation was detected mainly when moving the affected hand, the integrity of the CC was correlated with function of both hands and bimanual skills. This study highlights the importance of interhemispheric connectivity for hand function in CP-U, which may have clinical implications regarding prognosis and management.

  • 4577. Weinstein, M.
    et al.
    Myers, V.
    Green, Dido
    Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
    Schertz, M.
    Shiran, S. I.
    Geva, R.
    Artzi, M.
    Gordon, A. M.
    Fattal-Valevski, A.
    Ben Bashat, D.
    Brain Plasticity following Intensive Bimanual Therapy in Children with Hemiparesis: Preliminary Evidence2015Ingår i: Neural Plasticity, ISSN 2090-5904, E-ISSN 1687-5443, Vol. 2015, artikel-id 798481Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Neuroplasticity studies examining children with hemiparesis (CH) have focused predominantly on unilateral interventions. CH also have bimanual coordination impairments with bimanual interventions showing benefits. We explored neuroplasticity following hand-Arm bimanual intensive therapy (HABIT) of 60 hours in twelve CH (6 females, mean age 11 ± 3.6 y). Serial behavioral evaluations and MR imaging including diffusion tensor (DTI) and functional (fMRI) imaging were performed before, immediately after, and at 6-week follow-up. Manual skills were assessed repeatedly with the Assisting Hand Assessment, Children's Hand Experience Questionnaire, and Jebsen-Taylor Test of Hand Function. Beta values, indicating the level of activation, and lateralization index (LI), indicating the pattern of brain activation, were computed from fMRI. White matter integrity of major fibers was assessed using DTI. 11/12 children showed improvement after intervention in at least one measure, with 8/12 improving on two or more tests. Changes were retained in 6/8 children at follow-up. Beta activation in the affected hemisphere increased at follow-up, and LI increased both after intervention and at follow-up. Correlations between LI and motor function emerged after intervention. Increased white matter integrity was detected in the corpus callosum and corticospinal tract after intervention in about half of the participants. Results provide first evidence for neuroplasticity changes following bimanual intervention in CH.

  • 4578.
    Weinstein, Maya
    et al.
    Centre for Rehabilitation, Oxford Brookes University, Oxford, UK.
    Green, Dido
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för rehabilitering. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD. Centre for Rehabilitation, Oxford Brookes University, Oxford, UK.
    Rudisch, Julian
    Centre for Rehabilitation, Oxford Brookes University, Oxford, UK.
    Zielinski, Ingar M.
    Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
    Benthem-Muñiz, Marta
    Department of Neuroimaging, King's College London, London, UK.
    Jongsma, Marijtje L. A.
    Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
    McClelland, Verity
    Department of Basic and Clinical Neuroscience, King's College London, UK.
    Steenbergen, Bert
    Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands.
    Shiran, Shelly
    Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
    Ben Bashat, Dafna
    The Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
    Barker, Gareth J.
    Department of Neuroimaging, King's College London, London, UK.
    Understanding the relationship between brain and upper limb function in children with unilateral motor impairments: A multimodal approach2018Ingår i: European journal of paediatric neurology, ISSN 1090-3798, E-ISSN 1532-2130, Vol. 22, nr 1, s. 143-154Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Atypical brain development and early brain injury have profound and long lasting impact on the development, skill acquisition, and subsequent independence of a child. Heterogeneity is present at the brain level and at the motor level; particularly with respect to phenomena of bilateral activation and mirrored movements (MMs). In this multiple case study we consider the feasibility of using several modalities to explore the relationship between brain structure and/or activity and hand function: Electroencephalography (EEG), both structural and functional Magnetic Resonance Imaging (sMRI, fMRI), diffusion tensor imaging (DTI), transcranial magnetic stimulation (TMS), Electromyography (EMG) and hand function assessments.

    Methods: 15 children with unilateral CP (ages: 9.4 ± 2.5 years) undertook hand function assessments and at least two additional neuroimaging and/or neurophysiological procedures: MRI/DTI/fMRI (n = 13), TMS (n = 11), and/or EEG/EMG (n = 8). During the fMRI scans and EEG measurements, a motor task was performed to study cortical motor control activity during simple hand movements. DTI tractography analysis was used to study the corpus-callosum (CC) and cortico-spinal tracts (CST). TMS was used to study cortico-spinal connectivity pattern.

    Results: Type and range of severity of brain injury was evident across all levels of manual ability with the highest radiological scores corresponded to children poorer manual ability. Evidence of MMs was found in 7 children, mostly detected when moving the affected hand, and not necessarily corresponding to bilateral brain activation. When moving the affected hand, bilateral brain activation was seen in 6/11 children while 3/11 demonstrated unilateral activation in the contralateral hemisphere, and one child demonstrated motor activation predominantly in the supplementary motor area (SMA). TMS revealed three types of connectivity patterns from the cortex to the affected hand: a contralateral (n = 3), an ipsilateral (n = 4) and a mixed (n = 1) connectivity pattern; again without clear association with MMs. No differences were found between children with and without MMs in lesion scores, motor fMRI laterality indices, CST diffusivity values, and upper limb function. In the genu, midbody, and splenium of the CC, higher fractional anisotropy values were found in children with MMs compared to children without MMs. The EEG data indicated a stronger mu-restoration above the contralateral hemisphere in 6/8 children and above the ipsilateral hemisphere in 2/8 children.

    Conclusion: The current results demonstrate benefits from the use of different modalities when studying upper-limb function in children with CP; not least to accommodate to the variations in tolerance and feasibility of implementation of the differing methods. These exposed multiple individual brain-reorganization patterns corresponding to different functional motor abilities. Additional research is warranted to understand the transactional influences of early brain injury, neuroplasticity and developmental and environmental factors on hand function in order to develop targeted interventions. 

  • 4579.
    Welmer, Anna-Karin
    et al.
    Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa.
    Angleman, Sara
    Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University.
    Rydwik, Elisabeth
    Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University.
    Fratiglioni, Laura
    Department of Neurobiology, Care Sciences and Society, Aging Research Center (ARC), Karolinska Institutet and Stockholm University.
    Can chronic multimorbidity explain the age-related differences in strength, speed and balance in older adults?2012Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 24, nr 5, s. 480-489Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background and aims: It is known that physical performance declines with age in general, however there remains much to be understood in terms of age-related differences amongst older adults across a variety of physical components (such as speed, strength and balance), and particularly in terms of the role played by multimorbidity of chronic diseases. We aimed to detect the age-related differences across four components of physical performance and to explore to what extent chronic diseases and multimorbidity may explain such differences. Methods: We analyzed cross-sectional data from a population-based sample of 3323 people, aged 60 years and older from the SNAC-K study, Stockholm, Sweden. Physical performance was assessed by trained nurses using several tests (grip strength, walking speed, balance and chair stands). Clinical diagnoses were made by the examining physician based on clinical history and examination. Results: Censored normal regression analyses showed that the 72- 90+ year-old persons had 17-40% worse grip strength, 44-86% worse balance, 30-86% worse chair stand score, and 21-59% worse walking speed, compared with the 60-66 year-old persons. Chronic diseases were strongly associated with physical impairment, and this association was particularly strong among the younger men. However, chronic diseases explained only some of the age-related differences in physical performance. When controlling for chronic diseases in the analyses, the age-related differences in physical performance changed 1-11 percent. Conclusion: In spite of the strong association between multimorbidity and physical impairment, chronic morbidities explained only a small part of the age-related differences in physical performance.

  • 4580.
    Welmer, Anna-Karin
    et al.
    Karolinska Institutet.
    Kåreholt, Ingemar
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Åldrande - livsvillkor och hälsa. Högskolan i Jönköping, Hälsohögskolan, HHJ, Institutet för gerontologi. Karolinska Institutet.
    Rydwik, Elisabeth
    Karolinska Institutet.
    Angelman, Sara
    Karolinska Institutet.
    Wang, Hui-Xin
    Karolinska Institutet.
    Education-related differences in physical performance after age 60: a cross-sectional study assessing variation by age, gender and occupation2013Ingår i: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 13Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Having a low level of education has been associated with worse physical performance. However, it is unclear whether this association varies by age, gender or the occupational categories of manual and non-manual work. This study examined whether there are education-related differences across four dimensions of physical performance by age, gender or occupational class and to what extent chronic diseases and lifestyle-related factors may explain such differences.

    Methods: Participants were a random sample of 3212 people, 60 years and older, both living in their own homes and in institutions, from the Swedish National Study on Aging and Care, in Kungsholmen, Stockholm. Trained nurses assessed physical performance in grip strength, walking speed, balance and chair stands, and gathered data on education, occupation and lifestyle-related factors, such as physical exercise, body mass index, smoking and alcohol consumption. Diagnoses of chronic diseases were made by the examining physician.

    Results: Censored normal regression analyses showed that persons with university education had better grip strength, balance, chair stand time and walking speed than people with elementary school education. The differences in balance and walking speed remained statistically significant (p < 0.05) after adjustment for chronic diseases and lifestyle. However, age-stratified analyses revealed that the differences were no longer statistically significant in advanced age (80+ years). Gender-stratified analyses revealed that women with university education had significantly better grip strength, balance and walking speed compared to women with elementary school education and men with university education had significantly better chair stands and walking speed compared to men with elementary school education in multivariate adjusted models. Further analyses stratified by gender and occupational class suggested that the education-related difference in grip strength was only evident among female manual workers, while the difference in balance and walking speed was only evident among female and male non-manual workers, respectively.

    Conclusions: Higher education was associated with better lower extremity performance in people aged 60 to 80, but not in advanced age (80+ years). Our results indicate that higher education is associated with better grip strength among female manual workers and with better balance and walking speed among female and male non-manual workers, respectively.

  • 4581. Wendt, E
    et al.
    Fridlund, Bengt
    Lunds universitet.
    Lidell, E
    Trust and confirmation in a gynecologic examination situation: a critical incident technique analysis2004Ingår i: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 83, nr 12, s. 1208-1215Artikel i tidskrift (Refereegranskat)
  • 4582.
    Wengström, Y.
    et al.
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden / Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Bolam, K. A.
    Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden / School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Australia.
    Mijwel, S.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Sundberg, C. J.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden / Unit for Bioentrepreneurship, Karolinska Institutet, Solna, Sweden.
    Backman, M.
    Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden / Department of Oncology, Karolinska University Hospital, Stockholm, Sweden.
    Browall, Maria
    Högskolan i Skövde, Institutionen för hälsa och lärande.
    Norrbom, J.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Rundqvist, H.
    Department of Cell and Molecular Biology, Karolinska Institutet, Stockholm, Sweden.
    Optitrain: a randomised controlled exercise trial for women with breast cancer undergoing chemotherapy2017Ingår i: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 17, artikel-id 100Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Women with breast cancer undergoing chemotherapy suffer from a range of detrimental disease and treatment related side-effects. Exercise has shown to be able to counter some of these side-effects and improve physical function as well as quality of life. The primary aim of the study is to investigate and compare the effects of two different exercise regimens on the primary outcome cancer-related fatigue and the secondary outcomes muscle strength, function and structure, cardiovascular fitness, systemic inflammation, skeletal muscle gene activity, health related quality of life, pain, disease and treatment-related symptoms in women with breast cancer receiving chemotherapy. The second aim is to examine if any effects are sustained 1, 2, and 5 years following the completion of the intervention and to monitor return to work, recurrence and survival. The third aim of the study is to examine the effect of attendance and adherence rates on the effects of the exercise programme.

    Methods: This study is a randomised controlled trial including 240 women with breast cancer receiving chemotherapy in Stockholm, Sweden. The participants are randomly allocated to either: group 1: Aerobic training, group 2: Combined resistance and aerobic training, or group 3: usual care (control group). During the 5-year follow-up period, participants in the exercise groups will receive a physical activity prescription. Measurements for endpoints will take place at baseline, after 16 weeks (end of intervention) as well as after 1, 2 and 5 years.

    Discussion: This randomised controlled trial will generate substantial information regarding the effects of different types of exercise on the health of patients with breast cancer undergoing chemotherapy. We expect that dissemination of the knowledge gained from this study will contribute to developing effective long term strategies to improve the physical and psychosocial health of breast cancer survivors.

  • 4583. Wenneberg, Stig
    et al.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Illness narratives of persons with post-polio syndrome.2000Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 31, nr 2, s. 354-361Artikel i tidskrift (Refereegranskat)
    Abstract [en]

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

  • 4584. Wenneberg, Stig
    et al.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Personer med post-polio berättar om sina erfarenheter av att insjukna i polio och den påföljande anpassningen till ett nytt liv.1999Ingår i: Dokumentation: Människa, handikapp, livsvillkor, 7:e forskningskonferensen, Örebro den 13 och 15 april 1999, Örebro: Näringslivskontoret : Psykiatri och habilitering, Örebro läns landsting , 1999Konferensbidrag (Refereegranskat)
  • 4585. Wenneberg, Stig
    et al.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Gunnarsson, Lars-Gunnar
    Kan qigong förbättra hälsan hos personer med muskeldystrofi?2004Ingår i: Perspektiv på komplementär medicin: Medicinsk pluralism i mångvetenskaplig belysning, Lund: Studentlitteratur , 2004, s. 177-189Kapitel i bok, del av antologi (Övrigt vetenskapligt)
  • 4586. Wenneberg, Stig
    et al.
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Gunnarsson, Lars-Gunnar
    Rehabilitering av personer med muskeldystrofi: interventionsstudie med komplementära hälsometoder.2002Ingår i: Vardagsliv, livskvalitet, habilitering: 8:e forskningskonferensen i Örebro den 13-14 mars 2002 : programbok, Örebro: Psykiatri och habilitering, Örebro läns landsting , 2002Konferensbidrag (Refereegranskat)
  • 4587. Wenneberg, Stig
    et al.
    Gunnarsson, Lars-Gunnar
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Using a novel exercise programme for patients with muscular dystrophy. Part I: a qualitative study.2004Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 10, s. 586-594Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Muscular dystrophy patients have often experimented with different alternative or complementary methods since there is at present no curative medical treatment. PURPOSE: To evaluate, through qualitative analysis of interview data, the subjective experiences of twenty-eight patients with muscular dystrophy practising a complementary method, qigong. METHODS: Semi-structured qualitative interviews were performed and data were analysed by a method inspired by Grounded Theory. The material was first coded into 119 categories, thereafter condensed to 59 categories through a constant comparison analysis. In the final analysis, six broad categories were formed out of these 59 categories. RESULTS: These broad categories were: (1) experience of health care and alternative methods; (2) expectations, acceptance and compliance; (3) qigong as an adaptable form of exercise; (4) stress reduction and mental effects; (5) increased body awareness and physical effects; (6) psychosocial effects of group training. CONCLUSION: Qigong was accepted as a novel exercise regimen and there was a wide variation of experience regarding it among the participants. Depending upon factors such as expectation of benefits, time available to do qigong and perceived effects doing it, compliance varied. One major advantage of qigong is the ability to adapt the different exercises to the physical capability of the person practising qigong. There were reports of mental, physical and psychosocial effects of the qigong, which reduced the feeling of stress and improved well-being.

  • 4588. Wenneberg, Stig
    et al.
    Gunnarsson, Lars-Gunnar
    Ahlström, Gerd
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. Kvalitetsförbättringar, innovationer och ledarskap inom vård och socialt arbete.
    Using a novel exercise programme for patients with muscular dystrophy. Part II: a quantitative study.2004Ingår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 10, s. 595-602Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To quantitatively evaluate the effects of qigong in patients with muscular dystrophy. METHODS: Thirty-six patients with muscular dystrophy were assigned to either a treatment or comparison group, by means of a stratified randomization procedure. The intervention period lasted for 3 months. Balance and respiratory function were assessed by means of Berg's Balance Scale and an electronic spirometer, respectively. Health-related quality of life was tested by means of a Swedish version of the Medical Outcome Study Short Form Health Survey (SF-36), coping levels by means of a Swedish version of the Ways of Coping Questionnaire and depression levels by means of a modified version of the Montgomery åsberg Depression Rating Scale. RESULTS: Perceived general health was maintained in the treatment group whereas this was not the case in the comparison group (p=0.05). Positive reappraisal coping decreased in the treatment group but not in the comparison group (p=0.05). There was a tendency to maintain balance function during training and performance of qigong whilst there was a decline when not training. CONCLUSION: Qigong may be useful as an adjunct therapy regimen in patients with muscular dystrophy in that it can bring about a decreased rate of decline in general health. The change in coping pattern in this study needs more investigation. More research is also needed in order to more fully investigate the effects of qigong on such physical variables as balance function.

  • 4589.
    Wennerstam, Adina
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Marias, Linda
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Att leva med diabetes typ 1: En litteraturöversikt om ungdomars upplevelser2016Självständigt arbete på grundnivå (högskoleexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 4590.
    Wennick, Anne
    et al.
    Faculty of Health and Society, Malmö University, Malmö, Sweden.
    Huus, Karina
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad. Högskolan i Jönköping, Hälsohögskolan, HHJ. CHILD.
    What it is like being a sibling of a child newly diagnosed with type 1 diabetes: an interview study2012Ingår i: European Diabetes Nursing, ISSN 1551-7853, E-ISSN 1551-7861, Vol. 9, nr 3, s. 88-92Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although previous studies have stressed that having a brother or sister with a chronic condition may affect the healthy sibling, few have specifically focused on healthy siblings of children with type 1 diabetes.

    Hence, this study aimed to illuminate what it is like to be a brother or sister of a child newly diagnosed with type 1 diabetes.

    Individual interviews were conducted with seven siblings aged 10–17 years (median=12) from six different families. Each interview was analysed using content analysis.

    Three different categories emerged – Living differently, Being concerned and Participating in caring for the affected child – indicating that, for the healthy sibling, the illness entails a transformed everyday life including worry about the affected child and the need to help in the home.

    In conclusion, the paediatric health care service may need to develop new strategies to meet the siblings' desired level of knowledge in educational team sessions related to diabetes. As the sibling relationship is probably the longest one that an affected child will experience in her/his lifetime, it is worth investing in it to promote this long-term support resource.

  • 4591.
    Werner, Ulrica
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Kullberg, Ingela
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Vårdsökande personers upplevelse av delaktighet vid hemodialysbehandling- en litteraturöversikt2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Hemodialysbehandling är en livsuppehållande behandling vid terminal njursvikt. Behandlingen utförs flera gånger i veckan och medför stora livsförändringar. Delaktighet är i fokus i dagens hälso- och sjukvård, vilket forskning och lagstiftning bekräftar. Syftet med denna litteraturöversikt var att beskriva upplevelsen av delaktighet hos vårdsökande personer som genomgår hemodialysbehandling på sjukhus. Metoden som valdes var litteraturöversikt med kvalitativ ansats. Nio artiklar granskades genom induktiv innehållsanalys och mynnade ut i kategorierna; hämmande maktlöshet och att känna sig säker med underkategorierna kommunikationsbrister och brister i bemötandet respektive kunskap ger trygghet och känna tillit. Resultatet visar att vårdsökande person upplever en kamp för delaktighet i sin behandling.  De som upplever att de är delaktiga beskriver ett ökat välbefinnande. Slutsatsen är att vårdpersonalen behöver utöka sin kunskap om vad som främjar delaktighet hos personer som genomgår hemodialysbehandling.

     

  • 4592.
    Wernersson, Peter
    et al.
    Högskolan i Jönköping, Hälsohögskolan.
    Ovesson, Gertrud
    Högskolan i Jönköping, Hälsohögskolan.
    Omvårdnadspersonalens erfarenheter av utbildning och överlämnande av läkemedel inom äldreomsorgen2019Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Antalet multisjuka äldre i världen ökar stadigt. De som inte klarar att ta sina läkemedel själva är beroende av att få hjälp med detta från någon annan. I äldreomsorgen utförs läkemedelsöverlämnande av omvårdnadspersonal efter att de erhållit delegering för detta enligt SOSFS 1997:14. Distriktssköterskan är ansvarig för att utbilda och utfärda delegeringar till omvårdnadspersonalen. Patientsäkerheten kan äventyras om kommunikationen mellan olika personalkategorier inom äldreomsorgen brister, likaså om utbildningen inför erhållandet av delegering inte ger nödvändiga kunskaper. Syfte: Syftet var att beskriva omvårdnadspersonalens erfarenheter av läkemedelsdelegering avseende utbildning och överlämning inom äldreomsorgen. Metod: Studien genomfördes som en kvalitativ studie med semistrukturerade intervjuer av tolv informanter. Materialet analyserades med hjälp av innehållsanalys.Resultat: Fyra kategorier framkom: en komplex arbetssituation, brister i patientsäkerheten, teamsamverkan samt betydelsen av utbildning och vårderfarenhet, med tillhörande underkategorier. Stress påverkar antalet misstag som begås, likaså bidrar felaktiga och otydliga dokument till problem, både för omvårdnadspersonalen och för distriktssköterskan. Stödet från den egna arbetsgruppen var viktigt, men även stödet från distriktssköterskan. Utbildningen var tillräcklig men erfaren personal önskade fördjupad kunskap. Slutsats: Studien visar att omvårdnadspersonalen upplever att delegerat läkemedelsöverlämnande är en viktig del av deras arbete med vårdtagarna. Verksamhetens behov styr hur snabbt efter anställning som delegering för läkemedelsöverlämnande erhålls.

  • 4593. Weslien, M
    et al.
    Nilstun, T
    Lundqvist, A
    Fridlund, Bengt
    Lunds universitet.
    Narratives about resuscitation: family members differ about presence2006Ingår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 5, nr 1, s. 68-74Artikel i tidskrift (Refereegranskat)
  • 4594. Weslien, M
    et al.
    Nilstun, T
    Lundqvist, A
    Fridlund, Bengt
    Lunds universitet.
    When the unreal becomes real: family members' experiences of cardiac arrest2005Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 10, nr 1, s. 15-22Artikel i tidskrift (Refereegranskat)
  • 4595.
    Wessbo, Elin
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Thuresson, Jenny
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Tonårsflickors Kroppsuppfattning, Självbild, Välbefinnande Och BMI: En enkätstudie2017Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Bakgrund: Tidigare forskning visar att många ungdomar är missnöjda med sin kropp. Ungdomstiden innebär sociala, psykiska och emotionella förändringar. Under denna tid blir kroppens utseende viktigt, där samhällets normer och ideal påverkar ungdomens uppfattning om hur deras kropp skall se ut. Det är under denna tid som kroppsuppfattningen hos ungdomar påverkas mest.

    Syfte: Syftet med denna studie var att undersöka kroppsuppfattning, självbild, välbefinnande och isoBMI hos flickor som går på högstadiet.

    Metod: En tvärsnittsstudie med kvantitativ design genomfördes utifrån en hälsoenkät som används i samband med hälsobesök hos skolsköterskan för elever på högstadiet. Frågor avseende kroppsuppfattning, självbild, välbefinnande och Body Mass Index (BMI) har analyserats och jämförts. Resultatet redovisas både deskriptivt och analytiskt, där skillnader mellan variabler har undersökts.

    Resultat: Merparten av flickorna upplever ett högt välbefinnande och är nöjda med sin kropp och sig själva. Dock framkommer att en stor andel av flickorna önskar väga mindre och har försökt att förändra sin vikt och att missnöjet kring kroppen ökar vid stigande isoBMI. Resultatet visar också att flickornas kroppsuppfattning och självbild har betydelse för deras upplevelse av hälsa och välbefinnande.

    Slutsats: Det är av stor vikt att belysa detta ämne då det finns ett behov av att främja ett positivt tankesätt kring kroppsuppfattning hos unga flickor. Barnsjuksköterskan kan utifrån ett öppet förhållningssätt i sitt hälsofrämjande arbete uppmärksamma och stödja dessa flickor i ett tidigt skede

  • 4596.
    Westergren, Robert
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Nasser, Mehdi
    Högskolan i Jönköping, Hälsohögskolan, HHJ. Ortopedteknisk plattform.
    Patient satisfaction and mobility with their assistive device and service2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [en]

    Objective: To gather knowledge related to patient satisfaction and mobility with lower limb prosthetic and orthotic devices and to investigate satisfaction with services received. Another purpose of this study is to analyze potential differences between orthotic and prosthetic patients in relation to patient satisfaction and mobility.

    Design: Cross-sectional study

    Subjects: 21 participants with a mean age of 58 (SD 16) with an average duration of use of devices of 10 (SD 10) years. 12 out of the 21 participants were orthotic users and 9 were prosthetic users.

    Methods: Patients were asked to complete two questionnaires, one regarding satisfaction with assistive device and service (QUEST 2.0) and one regarding mobility.

    Results: Patients mean score regarding satisfaction with assistive device and service were 4.0 (SD 0.8) and 4.2 (SD 1.0) respectively. 91% reported that they had the ability to walk at least 100 meters with their assistive device. The areas where participants experienced most difficulties were walking on uneven ground (70%), walking up and down a hill (57%) and walking on stairs (57%).

    Conclusion: Overall this study demonstrates that participants were quite satisfied with their assistive device and the service received by the P&O clinic. No statistically significant differences regarding satisfaction with assistive device and service, or mobility, were found between prosthetic and orthotic participants.

  • 4597.
    Westerlind, Björn
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Geriatrics, County Hospital Ryhov, Jönköping, Sweden.
    Östgren, Carl Johan
    Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
    Mölstad, Sigvard
    Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    Midlöv, Patrik
    Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden.
    Hägg, Staffan
    Futurum, Jönköping, Region Jönköping County, Sweden.
    Use of non-benzodiazepine hypnotics is associated with falls in nursing home residents: a longitudinal cohort study2019Ingår i: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 31, nr 8, s. 1087-1095Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Falls and related injuries are common among older people, and several drug classes are considered to increase fall risk.

    Aims: This study aimed to investigate the association between the use of certain drug classes and falls in older nursing home residents in Sweden, and relate these to different age groups.

    Methods: Information on falls that occurred in the previous year and regular use of possible fall risk drugs including non-benzodiazepine hypnotics (zopiclone and zolpidem) was collected from 331 nursing home residents during 2008–2011. Over the following 6 months, the occurrence of serious falls, requiring a physician visit or hospital care, was registered. Association between serious falls and drug use was compared between an older (≥ 85 years) and a younger group.

    Results: An increased fall risk (Downton Fall Risk Index ≥ 3) was found in 93% of the study subjects (aged 65–101 years). Baseline data indicated an association between falls that occurred in the previous year and regular use of non-benzodiazepine hypnotics (p = 0.005), but not with the other studied drug classes. During the following 6 months, an association between use of non-benzodiazepine hypnotics and serious falls in the older group (p = 0.017, odds ratio 4.311) was found. No association was found between the other studied drug classes and serious falls.

    Discussion: These results indicate an association between falls and the use of non-benzodiazepine hypnotics, compounds that previously have been considered generally well-tolerated in older people.

    Conclusions: Caution is advocated when using non-benzodiazepine hypnotics regularly in older people living in nursing homes. 

  • 4598.
    Westerlund, Jessica
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Rynvall-Hult, Olle
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Kvinnors upplevelser av livskvalitet vid en bröstcancerdiagnos: En litteraturöversikt2016Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
  • 4599. Westholm, Carl
    et al.
    Bjällmark, Anna
    KTH, Medicinsk teknik.
    Larsson, Matilda
    KTH, Medicinsk teknik.
    Jacobsen, Per
    Brodin, Lars-Åke
    KTH, Medicinsk teknik.
    Winter, Reidar
    Velocity tracking, a new and user independent method for detecting regional function of the left ventricle2009Ingår i: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 29, nr 1, s. 24-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The use of two-dimensional echocardiography (2D echo) for detection of ischaemia is limited due to high user dependency. Longitudinal motion is sensitive for ischaemia and usable for quantitative measurement of longitudinal myocardial function but time consuming. Velocity tracking (VeT) is a new method that gives an easy three-dimensional understanding of both systolic and diastolic regional motion, using colour coded bull's eye presentation of longitudinal velocity, derived from colour coded tissue Doppler. The aim of this study was to test the accuracy of VeT in detecting ischaemia in non-ST-segment elevation myocardial infarction (NSTEMI) patients bedside. Twenty patients with NSTEMI and 10 controls were included. Echocardiography was performed within 24 h of symptoms and prior to coronary angiography. Bull's eye plots presenting the peak systolic velocity (PSV) and the sum of PSV and the E-wave-velocity (PSV+E) were created using our developed software. VeT was compared to expert wall motion scoring (WMS) and bedside echo. We used the clinical conclusion based on ECG, angiography and clinical picture as 'gold standard'. Sensitivity for ischaemia with VeT (PSV+E) was 85% and specificity 60%. The corresponding sensitivities for expert WMS were 75% (specificity 40%). For regional analysis VeT and WMS showed comparable results with correct regional outcome in 11/20 of patients both superior to bedside echo. Velocity tracking is a promising technique that provides an easily understandable three-dimensional bull's eye plot for assessment of regional left ventricular longitudinal velocity with great potential for detection of regional dysfunction and myocardial ischaemia.

  • 4600.
    Westin, Andreas
    et al.
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Hansson, Lotta
    Högskolan i Jönköping, Hälsohögskolan, HHJ, Avd. för omvårdnad.
    Hur personer med HIV upplever stigmatisering från vårdpersonal2019Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
89909192939495 4551 - 4600 av 4789
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