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  • 51.
    Enskär, Karin
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    von Essen, Louise
    Physical problems and psychosocial function in children with cancer2008In: Paediatric Nursing, ISSN 0962-9513, Vol. 20, no 3, p. 37-41Article in journal (Refereed)
  • 52.
    Enskär, Karin
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    von Essen, Louise
    Prevalence of aspects of distress, coping, support and care among adolescents and young adults undergoing and being off cancer treatment2007In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 11, no 5, p. 400-408Article in journal (Refereed)
  • 53.
    Enskär, Karin
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    von Essen, Louise
    Swedish mothers and fathers perception of distress, coping, support and care2007In: Pediatric Blood & Cancer Vol. 49 Issue 4: Abstracts of the 39th Annual Congress of the International Society of Paediatric Oncology (SIOP), November 1-3, 2007, Mumbai, India., 2007, p. 411-412Conference paper (Refereed)
  • 54.
    Gimbler Berglund, Ingalill
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Björkman, Berit
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine.
    Huus, Karina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Management of children with Autism Spectrum Disorder in the anesthesia and radiographic context2017In: Journal of Developmental and Behavioral Pediatrics, ISSN 0196-206X, E-ISSN 1536-7312, Vol. 38, no 3, p. 187-196Article in journal (Refereed)
    Abstract [en]

    Objective: As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these children's preparation for anesthesia and radiologic procedures.

    Methods: Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden. A list of items was created from a previous survey and the literature. In the first round, the items with <60% agreement were discarded. Items were merged, and a new list was created. Two more similar rounds were performed. In the last 2 rounds, 21 participants responded, and 80% agreement was considered to be consensus.

    Results: The final guidelines consisted of 14 items and a checklist of 16 factors. The 5 areas covered by the items and the checklist were as follows: planning involving parents/guardians, features in the environment, and use of time, communication, and the health care professionals. The organization was important in making it possible for the health care professional to care for the individual child according to the child's needs. It was important to involve the parents/guardians to obtain knowledge about the functioning of the child.

    Conclusion: A caring encounter involving a child with ASD in the anesthesia and radiology contexts requires advance planning, catered specifically to the individual needs of each child. To accomplish this, general knowledge regarding ASD and ASD's particular manifestation in the child entrusted to their care, is required from the health care workers. The organization needs to have structures in place to facilitate this process.

  • 55.
    Gimbler Berglund, Ingalill
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Huus, Karina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Björkman, Berit
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Perioperative and anesthesia guidelines for children with autism: A nationwide survey from Sweden2016In: Journal of Developmental and Behavioral Pediatrics, ISSN 0196-206X, E-ISSN 1536-7312, Vol. 37, no 6, p. 457-464Article in journal (Refereed)
    Abstract [en]

    Objective: The overall aim of this study was to describe the current set of guidelines for the preparation and care for children with autism spectrum disorder (ASD) in the perioperative setting across Sweden and explore the content of these guidelines in detail.

    Method: An online questionnaire was distributed to the chairpersons of all anesthesia departments (n = 68) and pediatric departments (n = 38) throughout Sweden. Follow-up phone calls were made to those departments that did not return the questionnaire. The presence of guidelines was analyzed through descriptive statistics. These guidelines and comments on routines used in these departments were analyzed inspired by conventional content analysis.

    Results: Seven of the 68 anesthesia departments and none of the 38 pediatric departments across Sweden have guidelines for preparing and/or administering care to children with ASD within the perioperative setting. From the guidelines and routines used, 3 categories emerge: "lacking the necessary conditions," "no extra considerations needed," and "care with specific consideration for children with ASD." These 3 categories span a continuum in the care. In the first category, the anesthesia induction could result in the child with ASD being physically restrained. In the last category, the entire encounter with the health care service would be adapted to the specific needs of the child.

    Conclusion: There is a lack of evidence-based guidelines specifically designed to meet the needs of children with ASD in the preoperative period in Sweden. Further research is needed to understand if children with ASD would benefit from evidence-based guidelines.

  • 56.
    Gimbler Berglund, Ingalill
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Huus, Karina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Møller Christensen, Berit
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Faresjö, Maria
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Biomedical Platform.
    Jacobsson, Brittmarie
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    How do we care for children with Autism Spektrum Disorder when coming for a procedure requiring anesthesia?2019Conference paper (Refereed)
  • 57.
    Gimbler Berglund, Ingalill
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Ljusegren, Gunilla
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    FACTORS INFLUENCING NURSES PAIN MANAGEMENT OF CHILDREN:  2006In: 7th International Symposium on Pediatric Pain, Vancover, June 25-29, 2006, 2006Conference paper (Other academic)
  • 58.
    Gimbler Berglund, Ingalill
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Ljusegren, Gunilla
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Factors influencing pain management in children2008In: Paediatric Nursing, ISSN 0962-9513, Vol. 20, no 10, p. 21-24Article in journal (Refereed)
    Abstract [en]

    Aim: To identify factors that influence nurses' pain management in children.

    Method: A qualitative design was used. Twenty-one nurses working in one paediatric department were interviewed using semi-structured interviews. Data were analysed by means of content analysis.

    Findings: The way nurses manage pain in children is affected by factors such as co-operation between nurses and physicians and between nurses and patients, children's behaviour, routines in the organisation, and the experience and knowledge of nurses.

    Conclusion: Pain management in children could be improved through increased co-operation between nurses, physicians and parents. Planning time and good routines could facilitate pain management. Education about pain management and children's pain behaviour might also improve nurses' ability to manage pain in children.

  • 59.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Elevcentrerade hälsosamtal med hjälp av ett strukturerat hälsoverktyg2012In: Skolsköterskans hälsofrämjande arbete / [ed] Clausson, E & Morberg, S, Lund: Studentlitteratur, 2012, 1, p. 153-172Chapter in book (Other (popular science, discussion, etc.))
  • 60.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Harder, Maria
    School of Health Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Nurses' encounters with children in child and school health care: negotiated guidance within a given frame2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 28, no 3, p. 591-599Article in journal (Refereed)
    Abstract [en]

    Background: Throughout childhood, children take part in health visits according to a health-monitoring programme. The visits are aimed to promote the children's development and health and to strengthen them to take own responsibility for their health. Nurses' actions when encountering children at these visits are not explored to any great extent. Exploring nurses' actions can facilitate their reflections on their actions towards children and thereby promote children's involvement in such visits.

    Aim: The aim of this study was to explore nurses' actions when encountering children at health visits.

    Method: A qualitative explorative design, based on 30 video recordings of health visits in child and school health care, was used in this study. These visits were ordinary real-life health visits. The data were subjected to qualitative content analysis. The right to conduct video recordings during health visits was approved by appropriate research ethics committees.

    Results: The findings show that nurses, in order to carry out the health visits, encounter children through negotiated guidance. This guidance is understood as the process through which the nurses reach agreement with the children, and is comprised of directed and pliable strategies. At one moment, the nurse can use a directed strategy to inform the child and at the next moment a pliable strategy to provide the child space within the given frame, the health-monitoring programme. By using these strategies intertwined, the nurse can provide the child space within the given frame and, at the same time, fulfil his/her responsibility to promote children's health and development.

    Conclusion: The results highlight nurses' challenging and complex assignment of guiding children to promote their engagement in the health visits, thereby enabling the nurses to promote the children's health and development according to the national health-monitoring programme.

  • 61.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Futurum Academy for Health and Care, Region Jönköping County, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Knutsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Contributing to making the school a safe place for the child: School nurses’ perceptions of their assignment when caring for children having parents with serious physical illness2017In: Nursing Open, E-ISSN 2054-1058, Vol. 4, no 4, p. 267-273Article in journal (Refereed)
    Abstract [en]

    Aim: To explore how school nurses perceive their assignment when caring for children having parents with serious physical illness.

    Design: An explorative inductive qualitative design.

    Method: The study is based on interviews with 16 school nurses. The interviews were subjected to qualitative content analysis.

    Results: The main category, “Contribute in making the school a safe place for the child”, reveals how the school nurses try to contribute to making the school a safe place for a child when his/her parent has a serious physical illness. They support children through individual support, as well as at an overall level in the school health team to make the school, as an organization, a safe place. Routines and collaboration to recognize the child when his/her parent has become ill is described as crucial to accomplishing this assignment

  • 62.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Child Health Services and Futurum Academy for Health and Care, Region Jönköping County, Jönköping, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Knutsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Parents’ perceptions of how nurses care for children as relatives of an ill patient: Experiences from an oncological outpatient department2019In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 39, p. 35-40Article in journal (Refereed)
    Abstract [en]

    Purpose:

    Research has shown that a child's knowledge about what is happening to a parent when he/she has a cancer disease is crucial to the child's health and wellbeing. Therefore the purpose of this study was to explore parents’ perceptions of how nurses in clinical practice care for children as relatives when one parent in the family has a cancer disease.

    Method:

    A qualitative explorative design with interviews was used. Altogether 28 parents (17 patients and 11 partners) were interviewed. The transcripts from the interviews were subjected to qualitative content analysis.

    Results:

    The parents perceive that the nurses make efforts to support the child as well as them as parents, but feel that the care needs to be more tailored to the specific child and his/her situation. The children are initially invited, generally informed and seen by the nurses, but the parents perceive that they themselves need repeated support and advice over time to uphold their parental responsibility for caring for their children during the illness trajectory.

    Conclusion:

    The parents argue for the importance of receiving repeated advice and support for how to talk to their children about the disease and treatment. The parents describe how the nurses were helpful by asking after the children and explaining the value of their visiting the hospital.

  • 63.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Lingfors, Hans
    Primärvårdens fou-enhet Jönköpings läns landsting.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Health counselling: parental-oriented health dialogue - an innovation for child health nurses2009In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 13, no 1, p. 75-88Article in journal (Refereed)
    Abstract [en]

    The Health Curve, used by nurses in community-based health care, is an educational tool for conducting goal-directed dialogues concerning lifestyle and health. The aim of this study was to investigate how child health nurses experienced the Health Curve as a tool for conducting dialogues with parents. Fourteen nurses were interviewed. The data were analysed according to qualitative analysis. The results showed that nurses working in child health care experienced the Health Curve as a useful tool for conducting health dialogues with parents. Through their work with the Health Curve, the nurses gained a greater insight into, and understanding of, the families' health and life situation. The results indicated that working with the Health Curve could increase the opportunity for nurses to provide parents with support early in the process, helping the family to lead a healthy lifestyle.

  • 64.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Andersson-Gäre, Boel
    Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Lingfors, Hans
    Att arbeta med Hälsokurvan inom Barnhälsovården2006Conference paper (Other academic)
  • 65.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Futurum-Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Fast, Annika
    Futurum-Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Bergman-Lind, Sara
    Futurum-Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    School nurses' health dialogues with pupils about physical activity2015In: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 10, no 7, p. 330-336Article in journal (Refereed)
    Abstract [en]

    The aim was to explore school nurses' health dialogues with pupils regarding physical activity. A descriptive explorative qualitative design based on video recordings of 15 nurses performing 24 ordinary real-life health visits with pupils aged 10,14 and 16 years was used to accomplish this. Audio files from the video recordings were transcribed verbatim and subjected to qualitative content analysis. The results showed that the school nurses created a flow and kept the conversation going to enable the progress of the health dialogue about physical activity. To gain the pupils' trust, the nurses used social talk and gave positive feedback. By assessing information about the pupils' activity the nurses created an overview and then, based on this overview, tried to create a potential for change in physical activity.

  • 66.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Futurum Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Henricson, Maria
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Knutsson, Susanne
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Are children as relatives our responsibility? How nurses perceive their role in caring for children as relatives of seriously ill patients2016In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 25, p. 33-39Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to elucidate how nurses perceive their role in caring for children as relatives to a parent with a serious physical illness.

    Method: A qualitative explorative design with focus group interviews was used. In total, 22 nurses working at one neurological, one haematological and two oncological wards were interviewed. The transcripts from the interviews were analysed in steps in accordance with inductive qualitative content analysis.

    Results: This study revealed six variations in how nurses perceived their role in the encounter with child relatives, ranging from being convinced that it is not their responsibility to being aware of the children's situation and working systematically to support them.

    Conclusion: Nurses should consider whether their patients have children who might be affected by their parent's illness. The nurses' self-confidence when meeting these children must be increased by education in order to strengthen their professional role. Furthermore, guidelines on how to encounter child relatives are required.

  • 67.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Futurum Academy for Health and Care Region Jönköping County, Sweden.
    Johansson, Lars-Olof
    Futurum Academy for Health and Care Region Jönköping County, Sweden.
    Harder, Maria
    Mälardalen University, Sweden.
    General practitioners’ accounts of how to facilitate consultations with toddlers: An interview study2017In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 36, no 1, p. 3-9Article in journal (Refereed)
    Abstract [en]

    Objective: To describe general practitioners’ (GPs’) accounts of how to facilitate consultations with children aged 1–2 years.

    Design: A qualitative study based on focus group interviews.

    Setting and subjects: Five focus group interviews were conducted with a total of 25 GPs at Swedish primary health care (PHC) centres. The GPs regularly invited toddlers to consultations.

    Result: The GPs’ accounts of how to facilitate consultations with toddlers revealed descriptions of making efforts to instil confidence in the situation to enable the consultation. Toddlers in need of health care always visit the GP with adults such as their parents, guardians or other relatives. Therefore, the GP directs efforts towards the adults and the child more or less simultaneously, as they both need to rely on the GP. The GPs describe how they instil confidence in the adults by establishing a mutual understanding that the consultation is necessary to secure the child’s health. Regarding the child, the GP instils confidence by establishing a relationship in order to approach the child and accomplish bodily examinations.

    Conclusion: The result shows that GPs’ encounters with children in consultations are two-sided. The GP needs to conduct bodily examinations to secure the child’s health and development, but to do so he/she needs to establish purposeful relationships with the adults and the child by instilling confidence. This indicates that establishing relationships in the consultation is significant, and a way to achieve a child-centred consultation.

    KEY POINTS Research regarding GPs’ encounters with toddlers in consultation is limited, even though toddlers frequently visit PHC. GPs make efforts to instil confidence by establishing mutual understanding with parents and a relationship with the child. Establishing purposeful relationships with both the child and parent is significant in enabling the consultation. Establishing a relationship with the child overrides conducting the bodily examination, t opromote the child’s feeling of ease and allow a child-centred consultation.

  • 68.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Lingfors, Hans
    Unit for Research and Development in Primary Health Care, Futurum, County Council of Jönköping.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Health dialogues between pupils and school nurses: a description of the verbal interaction2012In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 89, no 2, p. 260-266Article in journal (Refereed)
    Abstract [en]

    Objective:The purpose of this study was to explore and describe the content and the verbal interaction in health dialogues between pupils and school nurses.

    Method: Twenty-four health dialogues were recorded using a video camera and the conversations were analysed using the paediatric version of the Roter Interaction analysis system.

    Results:The results showed that the age appropriate topics suggested by national recommendations were brought up in most of the health dialogues. The nurses were the ones who talked most, in terms of utterances. The pupils most frequently gave information about their lifestyle and agreed with the nurses’ statements. The nurses summarized and checked that they had understood the pupils, asked closed-ended questions about lifestyle and gave information about lifestyle. Strategies aimed to make the pupil more active and participatory in the dialogues were the most widely used verbal interaction approaches by the nurses.

    Conclusion:The nurses’ use of verbal interaction approaches to promote pupils’ activity and participation, trying to build a partnership in the dialogue, could indicate an attempt to build patient-centred health dialogues. 

    Clinical implications: The nurses’ great use of questions and being the ones leading the dialogues in terms of utterances point at the necessity for a nurses to have an openness to the pupils own narratives and an attentiveness to what he or she wants to talk about.

  • 69.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Futurum – Academy for Health and Care, Region Jönköping County, Sweden .
    Norlin, Åsa
    Futurum – Academy for Health and Care, Region Jönköping County, Sweden .
    Nilsson, Hanna
    Futurum – Academy for Health and Care, Region Jönköping County, Sweden .
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    School nurses’ health dialogues with pupils regarding food habits2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 3, p. 136-141Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the content of school nurses’ health dialogues with pupils regarding food habits. A qualitative content analysis of 24 recorded health dialogues resulted in five categories describing the content of the dialogues, regarding food habits. Current food habits covered food, mealtimes and food related to physical activity. Social context and food habits showed that social groups in the pupils’ surroundings affected their food habits. Society and food habits included external factors that affected food habits, such as school and laws. School nurses’ advice and support regarding food habits described how nurses offered advice, support and information. Pupils’ understanding of health in connection to food habits comprised the pupils’ knowledge, participation and willingness to change. The results showed a variety of interacting factors which affected the pupils’ food habits, upon which health-promotional work can be based.

  • 70.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Lingfors, Hans
    Primärvårdens fou-enhet Jönköpings läns landsting.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Adolescents' and school nurses' perceptions of using a health and lifestyle tool in health dialogues2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 17-18, p. 2573-2583Article in journal (Refereed)
    Abstract [en]

    Aim and objective. To describe and explore adolescents’ and nurses’ perceptions of using a health and lifestyle tool in healthdialogues in the School Health Service.

    Background. In Sweden, dialogues concerning health and lifestyle are offered to adolescents aged 14 years with the purpose of encouraging an interest in a healthy lifestyle. A health and lifestyle tool including a health questionnaire and a health profile has recently been developed, with the aim of facilitating the communication about health and lifestyle in these dialogues.

    Design.Qualitative descriptive design.

    Method. Twenty-nine adolescents and 23 nurses participated in focus group interviews, which were subjected to qualitative content analysis.

    Results. The health and lifestyle tool was perceived as constituting a structure for the dialogues and as a clear and applicable starting point, focusing on individual aspects. The tool contributed to an understanding of the health situation and to the transmittal of health information on an individual as well as a group level.

    Conclusion.The tool was perceived as constituting a useful structure for the dialogues about health and lifestyle. When it was used the individual’s health and lifestyle were concretised, which opened up for a dialogue and different aspects of health and lifestyle were detected. However, in some cases the outcome of the tool could be conceived as a stringent assessment and thereby complicate the dialogues.

    Relevance to clinical practice.The use of a tool, such as the one used in this study, is one way to improve the dialogues in the School Health Service, allowing them to be more focused on the individual’s needs and to detect aspects that would otherwise not be so easily detected. The implications of this study include using the findings to guide counselling sessions in the schools and other health care settings.

  • 71.
    Golsäter, Marie
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Lingfors, Hans
    Primärvårdens Fou-enhet Jönköpings läns landsting.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Pupils' perspectives on preventive health dialogues2010In: British Journal of School Nursing, ISSN 1752-2803, E-ISSN 2052-2827, Vol. 5, no 1, p. 26-33Article in journal (Refereed)
  • 72.
    Harder, Maria
    et al.
    School of Health Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Nurses’ use of pliable and directed strategies when encountering children in child and school healthcare2017In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 21, no 1, p. 55-64Article in journal (Refereed)
    Abstract [en]

    Nurses in Swedish child and school healthcare need to balance their assignment of promoting children’s health and development based on the national health-monitoring programme with their responsibility to consider each child’s needs. In this balancing act, they encounter children through directed and pliable strategies to fulfil their professional obligations. The aim of this study was to analyse the extent to which nurses use different strategies when encountering children during their recurrent health visits throughout childhood. A quantitative descriptive content analysis was used to code 30 video recordings displaying nurses’ encounters with children (3–16 years of age). A constructed observation protocol was used to identify the codes. The results show that nurses use pliable strategies (58%) and directed strategies (42%) in encounters with children. The action they use the most within the pliable strategy is encouraging (51%), while in the directed strategy, the action they use most is instructing (56%). That they primarily use these opposing actions can be understood as trying to synthesize their twofold assignment. However, they seem to act pliably to be able to fulfil their public function as dictated by the national health-monitoring programme, rather than to meet each child’s needs.

  • 73.
    Herngren, B.
    et al.
    Lund University, Department of Clinical Sciences, Lund, Sweden.
    Stenmarker, M.
    Futurum - Academy for Health and Care, Jonkoping County Council, Department of Orthopaedics, Ryhov County hospital, Jonkoping, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hägglund, G
    Department of Orthopaedics, Skane University Hospital, Lund, Sweden.
    Outcomes after slipped capital femoral epiphysis: a population-based study with three-year follow-up.2018In: Journal of Children's Orthopaedics, ISSN 1863-2521, E-ISSN 1863-2548, Vol. 12, no 5, p. 434-443Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate outcomes three years after treatment for slipped capital femoral epiphysis (SCFE): development of a vascular necrosis (AVN), subsequent surgery, hip function and the contralateral hip.

    Methods: This prospective cohort study included a total national population of 379 children treated for SCFE between 2007 and 2013. A total of 449 hips treated for SCFE and 151 hips treated with a prophylactic fixation were identified. The Barnhöft questionnaire, a valid patient-reported outcome measure (PROM), was used.

    Results: In all, 90 hips had a severe slip, 61 of these were clinically unstable. AVN developed in 25 of the 449 hips. Six of 15 hips treated with capital realignment developed AVN. A peri-implant femur fracture occurred in three slipped hips and in two prophylactically pinned hips. In three of these five hips technical difficulties during surgery was identified. In 43 of 201 hips scheduled for regular follow-up a subsequent SCFE developed in the contralateral hip. Implant extraction after physeal closure was performed in 156 of 449 hips treated for SCFE and in 51 of 151 prophylactically fixed hips. Children with impaired hip function could be identified using the Barnhöft questionnaire.

    Conclusion: Fixation in situ is justified to remain as the primary treatment of choice in SCFE. Overweight is more common in children with SCFE than in the average population. Prophylactic fixation is a safe procedure when performed using a correct technique. The number of patients who developed AVN after capital realignment is of concern. We recommend rigorous follow-up of both hips, including PROM evaluation, until physeal closure.

    Level of Evidence: II - prospective cohort study.

  • 74.
    Huus, Karina
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Castor, Maria
    Rosander Ek, Charlotte
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Hur syskon påverkas av att ha en bror eller syster med diabetes - ett föräldraperspektiv2012In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 32, no 2, p. 41-45Article in journal (Refereed)
  • 75.
    Huus, Karina
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Adolescents' experience of living with diabetes2007In: Paediatric Nursing, ISSN 0962-9513, Vol. 19, no 3, p. 29-31Article in journal (Refereed)
  • 76.
    Huus, Karina
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Living with diabetes type 1 from an adolescent's perspective2006In: Diabetic medicine: journal of diabetes UK Vol. 23 Suppl. 4: Abstracts of the 19th World Diabetes Congress, Cape Town, South Africa, 3-7 December 2006., 2006, p. 261-Conference paper (Other academic)
  • 77.
    Huus, Karina
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Division of Pediatrics, Diabetes Research Centre, Linköping University, Linköping, Sweden .
    Ludvigsson, Jonas F
    Department of Pediatrics, Clinical Research Centre, Örebro University Hospital, Örebro, Sweden; Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden .
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Ludvigsson, Johnny
    Division of Pediatrics, Diabetes Research Centre, Linköping University, Linköping, Sweden .
    Exclusive breastfeeding of Swedish children and its possible influence on the development of obesity: a prospective cohort study2008In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 8, article id 42Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Overweight and obesity are increasing among children all over the world. Socio-economic factors may influence the development of overweight and obesity in childhood, and it has been proposed that breastfeeding may protect against obesity. The aim of our study was to examine the relationship between exclusive breastfeeding and obesity when potential confounders, such as socioeconomic factors, are considered. METHODS: The data analyzed was from ABIS (All Babies in Southeast Sweden), a prospective cohort study. All parents with children born between October 1, 1997 and October 1, 1999 in Southeast Sweden (n = 21,700) were asked to participate. Parents were asked to answer periodic questionnaires from the time of the child's birth (n = 16,058) until he/she was five years of age (n = 7,356). Cutoffs for overweight and obesity were defined according to Cole et al, age and gender adjusted. Short-term exclusive breastfeeding was defined as < 4 months of exclusive breastfeeding. Multiple logistic regressions were used to identify variables that predict the child's BMI (Body Mass Index) at five years of age. RESULTS: At five years of age, 12.9% of the children in the study were overweight and 4.3% were obese. At the age of three months, 78.4% of the children were being breastfed exclusively. The median exclusive breastfeeding duration was four months. High maternal BMI > 30 (AOR = 1.07; CI = 1.05-1.09; P < 0.001), maternal smoking (AOR = 1.43; CI = 1.05-1.95; P = 0.023) and being a single parent (AOR = 2.10; CI = 1.43-3.09; P < 0.001) were associated with short-term exclusive breastfeeding (less than 4 months). Short-term exclusive breastfeeding was less common if one of the parents had a university degree (Mother: AOR = 0.74; CI = 0.61-0.90; P = 0.003 Father: AOR = 0.73; CI = 0.58-0.92; P = 0.008) or if the father was more than 37 years old (AOR = 0.74; CI = 0.55-0.99; P = 0.045). Short-term exclusive breastfeeding was associated with obesity in five-year-old children (simple logistic regression: OR = 1.44; CI = 1.00-2.07; P = 0.050), but when including other independent factors in the analysis, short-term exclusive breastfeeding did not attain statistical significance. CONCLUSION: We cannot exclude the possibility that exclusive breastfeeding influences weight development, but it does not seem to protect against obesity at five years of age.

  • 78.
    Huus, Karina
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Ludvigsson, Jonas F
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Ludvigsson, Johnny
    Risk factors in childhood obesity: findings from the All Babies In Southeast Sweden (ABIS) cohort2007In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 96, no 9, p. 1321-1325Article in journal (Refereed)
  • 79.
    Huus, Karina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Ngoc, Luc Dang
    Da Nang University of Medical Technology and Pharmacy, Viet Nam.
    Dam, Kim An
    Da Nang University of Medical Technology and Pharmacy, Viet Nam.
    Ljusegren, Gunilla
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Gimbler Berglund, Ingalill
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Caring for children in pain: a Vietnamese perspective2016In: Annals of Nursing and Practice, ISSN 2379-9501, Vol. 3, no 7, article id 1071Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to identify and describe Vietnamese nurse’s pain management in children.

    Methods: A quantitative cross-sectional study using a questionnaire measuring 110 registered Vietnamese nurse’s perception of pain and pain management in children.

    Results: The results showed that many nurses in Vietnam are using pain assessment instruments as well as non-pharmacological alleviations methods extensively. Vietnamese nurses had high levels of knowledge in physiology of pain. Nurses’ knowledge about the use of pain medication was correlated to attitudes. The higher level of knowledge the nurses had about pain medication, the more positive was their attitude towards pain management in general.

    Conclusion: In conclusion, the most commonly used non-pharmacology pain alleviation method among the nurses was talking to the child and be close to the child. This method to attempt to relive pain is valuable as it doesn’t require any specific equipment. Vietnamese nurses had high levels of knowledge about physiology of pain.

  • 80.
    Jenholt Nolbris, Margaretha
    et al.
    Queen Silvia Children’s Hospital and Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hellström, Anna-Lena
    Queen Silvia Children’s Hospital and Institute of Health and Care Sciences, Sahlgrenska Academy, Göteborg.
    Grief related to the experience of being the sibling of a child with cancer2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 5, p. E1-E7Article in journal (Refereed)
    Abstract [en]

    Background: Few studies have described the well siblings' experience of grief when a brother or sister is treated for cancer. Knowing how sibling grief is expressed will guide clinician and family efforts to provide appropriate support.

    Objective: The aim of this study was to describe siblings' reports of grief related to the experience of having a brother or sister with cancer.

    Methods: A qualitative descriptive method was chosen based on open-ended interviews with 29 siblings aged 8 to 24 years. Qualitative content analysis was applied to the interview data.

    Results: Four categories of grief were identified: anticipatory grief after receiving information about the cancer diagnosis, grief and concern about the ill sibling's loss of a normal life, grief about being unimportant and forgotten in the family, and grief that continues after the sibling's death as a kind of bond.

    Conclusion: Despite variations in age and gender among participating siblings, their thoughts were similar. Grief was experienced differently from the time of the diagnosis onward, in the form of concerns related to the illness and situation of the ill sibling. Grief related to sibling bonds remained after death.

    Implication for practice: This study recommends offering siblings realistic information about their ill sibling and support for them in their situation from diagnosis and continuously thereafter. To meet the needs of well siblings, it is necessary to ask the siblings about their thoughts and discuss with them their emotions and worries.

  • 81.
    Karlsson, Katarina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden .
    Dalheim Englund, Ann-Charlotte
    Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden .
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Nyström, Maria
    Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden .
    Rydström, Ingela
    Faculty of Caring Sciences, Work Life and Social Welfare, University of Borås, Borås, Sweden .
    Experiencing support during needle-related medical procedures: a hermeneutic study with young children (3–7 years)2016In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 31, no 6, p. 667-677Article in journal (Refereed)
    Abstract [en]

    Background Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures.

    Aim: This study aims to explain and understand the meaning of the research phenomenon: support duringNRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children.

    Method: The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7 years of age who have experienced NRMPs.

    Results: The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources.

    Conclusions: The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive.

  • 82.
    Karlsson, Katarina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Rydström, Ingela
    School of Health Sciences, University of Borås, Borås, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Englund, Ann-Charlotte Dalheim
    School of Health Sciences, University of Borås, Borås, Sweden.
    Nurses' perspectives on supporting children during needle-related medical procedures2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, no 23063Article in journal (Refereed)
    Abstract [en]

    Children state that among their worst fears during hospitalization are those related to various nursing procedures and to injections and needles. Nurses thus have a responsibility to help children cope with needle-related medical procedures (NRMP) and the potentially negative effects of these. The aim of the study is to describe the lived experience of supporting children during NRMP, from the perspective of nurses. Fourteen nurses took part in the study, six of whom participated on two occasions thus resulting in 20 interviews. A reflective lifeworld research approach was used, and phenomenological analysis was applied. The result shows that supporting children during NRMP is characterized by a desire to meet the child in his/her own world and by an effort to reach the child's horizon of understanding regarding these actions, based on the given conditions. The essential meaning of the phenomenon is founded on the following constituents: developing relationships through conversation, being sensitive to embodied responses, balancing between tact and use of restraint, being the child's advocate, adjusting time, and maintaining belief. The discussion focuses on how nurses can support children through various types of conversation and by receiving help from the parents' ability to be supportive, and on whether restraint can be supportive or not for children during NRMP. Our conclusion is that nurses have to see each individual child, meet him/her in their own world, and decide on supportive actions while at the same time balancing their responsibility for the completion of the NRMP. This work can be described as "balancing on a tightrope" in an unpredictable situation.

  • 83.
    Karlsson, Katarina
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Rydström, Ingela
    University of Borås, Sweden.
    Nyström, Maria
    University of Borås, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Dalheim Englund, Ann-Charlotte
    University of Borås, Sweden.
    Consequences of needle-related medical procedures: A hermeneutic study with young children (3–7 years)2016In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 31, no 2, p. e109-e118Article in journal (Refereed)
    Abstract [en]

    Background

    Needle-related medical procedures (NRMPs) are often frightening and cause children anxiety and pain. Only a few studies have examined the perspectives of younger children. More knowledge is needed about younger children's experiences in caring situations such as NRMPs.

    Aim

    The aim of this study was to explain and understand the consequences related to NRMPs from younger children's perspectives.

    Methods

    Participant observations and interviews with younger children who had experienced NRMPs were analysed using a lifeworld hermeneutic approach.

    Results

    Experiencing fear is central for younger children during an NRMP and interpretation of its consequences formed the basis for the following themes: seeking security, realizing the adult's power, struggling for control, feeling ashamed, and surrendering. A comprehensive understanding is presented wherein younger children's experiences of NRMPs vary across time and space related to weakening and strengthening their feelings of fear.

    Conclusions

    Awareness is needed that adults' power becomes more obvious for children during an NRMP. Children's surrender does not necessarily imply acceptance of the procedure. Providing children with opportunities to control elements of the procedure creates a foundation for active participation, and vice versa.

  • 84.
    Knutsson, Susanne
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Futurum-Academy for Health and Care, Region Jönköping County, Sweden.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD. Futurum-Academy for Health and Care, Region Jönköping County, Sweden.
    Children as relatives to a sick parent: Healthcare professionals’ approaches2017In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 37, no 2, p. 61-69Article in journal (Refereed)
    Abstract [en]

    An illness or injury sustained by a family member affects all family members. It is consequently important that a child’s need to be involved in a family member’s care is clearly recognized by healthcare professionals. The aim of this study was to describe healthcare professionals’ approaches to children as relatives of a parent being cared for in a clinical setting. A web-based study-specific questionnaire was sent and responded to by 1052 healthcare professionals in Sweden. Data were analysed using descriptive statistics and qualitative analysis. The results show that guidelines and routines are often lacking regarding involving children in the care of a parent. Compared to other areas, psychiatric units seem to have enacted routines and guidelines to a greater extent than other units. The results indicate that structured approaches based on an awareness of the children’s needs as well as a child-friendly environment are vital in family-focused care. These aspects need to be prioritized by managers in order to support children’s needs and promote health and wellbeing for the whole family.

  • 85.
    Knutsson, Susanne
    et al.
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Golsäter, Marie
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Futurum Academy for Health and Care Region Jönköping County, Jönköping, Sweden.
    Nurses' experiences of what constitutes the encounter with children visiting a sick parent at an adult ICU2017In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 39, p. 9-17Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Despite a cultural change in visitation policies for children (0-17 years) in the intensive care unit (ICU) to a more open approach, children are still restricted from visiting for various reasons. To overcome these obstacles, it is vital to determine what is needed while encountering a child.

    AIM:

    To elucidate nurses' experiences of what constitutes the encounter with children visiting a sick parent in an adult ICU.

    METHOD:

    An explorative inductive qualitative design was used, entailing focus group interviews with 23 nurses working at a general ICU. The interviews were analysed according to inductive content analysis.

    RESULTS:

    The findings show components that constitute the encounter with children as relatives at the ICU, as experienced by ICU nurses: nurses need to be engaged and motivated; parents need to be motivated; the child needs individual guidance; and a structured follow-up is needed. This reflects a child-focused encounter.

    CONCLUSIONS:

    Nurses need to adopt a holistic view, learn to see and care for the child individually, and be able to engage parents in supporting their children. To accomplish this the nurses need engagement and motivation, and must have knowledge about what constitutes a caring encounter, in order to achieve a caring child-focused encounter.

  • 86.
    Kästel, Anne
    et al.
    The Red Cross University College, Stockholm, Sweden.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Family participation in childhood cancer care2013In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 4, no 3, p. 112-123Article in journal (Refereed)
    Abstract [en]

    Background: Child cancer care is becoming increasingly successful, the treatment brought more success through intensified therapy, but this development has not been easy to achieve due to the pain and anxiety that the treatment often causes. It is not possible to eliminate the chaos the family experiences, but it can be reduced through a deepened understanding of the situation.

    Purpose: The aim of the study is to highlight families views on participation in childhood cancer care.

    Method: A qualitative design, appropriate to gain a holistic view, has been chosen. Eight families with children diagnosed with cancer, of various ages and gender and from various backgrounds, participated in five interviews each during the first year of the child´s illness.

    Findings: The families constitute a cornerstone in paediatric oncology care today, but the results indicate that all the various tasks and commitments for the families, sometimes entail too heavy a burden. They are in need of better support and clearer instructions to be able to cope with the situation including rules and measures concerning the child. Therefore, it is urgent to clarify who has the formal responsibility for medical consequences that might occur in connection with delegated responsibility. The study shows that there is a lack of pedagogical thought and a need to create a pedagogical model.

    Conclusion: There is a need for guiding principles and education for the parents, which would contribute to their increased confidence.

  • 87. Kästel, Anne
    et al.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Björk, Olle
    Parents' views on information in childhood cancer care.2011In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 15, no 4, p. 290-295Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of the study is to highlight parents' views on information in childhood cancer care. METHOD: A qualitative design, appropriate to gain a holistic view, has been chosen. Eight families with children diagnosed with cancer, of various ages and gender and from various backgrounds, participated in five interviews each during the first year of the child's illness. RESULTS: If the parents' needs were fulfilled, they were better equipped to handle the illness of their child, which is totally dependant on how the matter of information is dealt with. Information is a complex and demanding issue for the persons involved and the families' views were divergent in this area. Sometimes they seemed to obtain the information successfully and sometimes there were great problems in this respect. Therefore their preferences must be considered. CONCLUSION: There has to be an improvement from the aspects of what, when and how information is provided. The major findings of this study indicate that the families need better support and more distinct instructions to be able to cope with the situation.

  • 88. Kästel, Anne
    et al.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Höghielm, Robert
    Björk, Olle
    Parental views on participation in childhood cancer care2007In: Pediatric blood & cancer Vol. 49 Issue 4: Abstracts of the 39th Annual Congress of the International Society of Paediatric Oncology (SIOP), November 1-3, 2007, Mumbai, India., 2007, p. 557-Conference paper (Refereed)
  • 89.
    Ljusegren, Gunilla
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Johansson, I.
    Jönköping University, School of Health Science.
    Gimbler Berglund, Ingalill
    Jönköping University, School of Health Science, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ. CHILD. Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Nurses' experiences of caring for children in pain2012In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 38, no 4, p. 464-470Article in journal (Refereed)
    Abstract [en]

    Aim  To describe nurses' experiences when caring for children in pain.

    Background  Earlier studies have shown that nurses are key actors in pain management and that there is a need to focus on the nurses' own experiences of caring for children in pain.

    Method  Semi-structured interviews were conducted with 21 nurses at one paediatric clinic. The data were analysed by means of content analysis.

    Results  The interviews suggested that when a child's pain followed an expected pattern and they complied with treatment, the nurses trusted their knowledge and felt comfortable. On the other hand, in unpredictable situations the nurses felt fearful, powerless, abandoned and distrustful.

    Conclusion  The nurses were comfortable in predictable situations, but if a situation was unpredictable, they felt they had lost control over it.

    Implications for pain management  To reduce feelings of abandonment, work shifts should be organized so that more experienced nurses can work side by side with those who are less experienced. Pain assessment tools and guidelines for pain management should be introduced into the daily work, and systematic reflection should be used for nurses' professional development.

  • 90. Mogotlane, Sophi
    et al.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Principles and standards of care of sick children in hospital2005In: Juta's Manual of Nursing, volume 4 Medical Surgical Nursing: Part 1: Cross-System, Lansdowne, Cape Town: Juta , 2005, p. 2-1Chapter in book (Other (popular science, discussion, etc.))
  • 91.
    Nilsson, Stefan
    et al.
    School of Health Sciences, Borås University, Borås, Sweden.
    Björkman, Berit
    Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Almqvist, Anna-Lena
    School of Health, Care and Social Welfare, Mälardalen University, Sweden.
    Almqvist, Lena
    School of Health, Care and Social Welfare, Mälardalen University, Sweden.
    Björk-Willén, Polly
    Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
    Donohue, Dana
    Centre for AAC, University of Pretoria, South Africa.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Granlund, Mats
    Jönköping University, School of Health and Welfare, HHJ. CHILD. Jönköping University, School of Education and Communication, HLK, CHILD.
    Huus, Karina
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hvit, Sara
    Jönköping University, School of Education and Communication, HLK, CHILD.
    Children’s voices – Differentiating a child perspective from a child’s perspective2015In: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 18, no 3, p. 162-168Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this paper was to discuss differences between having a child perspective and taking the child's perspective based on the problem being investigated.

    Methods: Conceptual paper based on narrative review.

    Results: The child's perspective in research concerning children that need additional support are important. The difference between having a child perspective and taking the child's perspective in conjunction with the need to know children's opinions has been discussed in the literature. From an ideological perspective the difference between the two perspectives seems self-evident, but the perspectives might be better seen as different ends on a continuum solely from an adult's view of children to solely the perspective of children themselves. Depending on the research question, the design of the study may benefit from taking either perspective. In this article, we discuss the difference between the perspectives based on the problem being investigated, children's capacity to express opinions, environmental adaptations and the degree of interpretation needed to understand children's opinions.

    Conclusion: The examples provided indicate that children's opinions can be regarded in most research, although to different degrees.

  • 92.
    Nilsson, Stefan
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Virtual reality in a child oncology unit2007In: Pediatric blood & cancer Vol. 49 Issue 4: Abstracts of the 39th Annual Congress of the International Society of Paediatric Oncology (SIOP), November 1-3, 2007, Mumbai, India., 2007, p. 412-Conference paper (Refereed)
  • 93.
    Nilsson, Stefan
    et al.
    School of Health Sciences, Borås University, Borås, Sweden.
    Enskär, Karin
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. CHILD.
    Hallqvist, Carina
    Department of Information Technology and Media, Mid Sweden University, Sundsvall, Sweden.
    Kokinsky, Eva
    Department of Paediatric Anaesthesia and Intensive Care Unit, the Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Active and Passive Distraction in Children Undergoing Wound Dressings2013In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 28, no 2, p. 158-166Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to test how distraction influences pain, distress and anxiety in children during wound care. Sixty participants aged 5-12years were randomized to three groups: serious gaming, the use of lollipops and a control group. Self-reported pain, distress, anxiety and observed pain behaviour were recorded in conjunction with wound care. Serious gaming, an active distraction, reduced the observed pain behaviour and self-reported distress compared with the other groups. A sense of control and engagement in the distraction, together, may be the explanation for the different pain behaviours when children use serious gaming.

  • 94.
    Nilsson, Stefan
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Finnström, Berit
    Kokinsky, Eva
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    The use of Virtual Reality for needle-related procedural pain and distress in children and adolescents in a paediatric oncology unit2009In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 13, no 2, p. 102-109Article in journal (Refereed)
    Abstract [en]

    Aim: It is essential to minimize pain and distress during painful procedures in children. This study examined the effect of using non-immersive Virtual Reality (VR) during a needle-related procedure on reported pain or distress of children and adolescents in a paediatric oncology unit and surveyed their response to the use of VR-equipment during the procedure.

    Method: Twenty-one children and adolescents were included in an intervention group with non-immersive VR and another 21 children and adolescents in a control group where they underwent either venous punctures or subcutaneous venous port devices. Self-reported pain and distress, heart rate and observational pain scores were collected before, during and after the procedures. Semi-structured qualitative interviews were conducted in conjunction with the completed intervention.

    Results: Self-reported and observed pain and distress scores were low and few significant differences of quantitative data between the groups were found. Two themes emerged in the analysis of the interviews; the VR game should correspond to the child and the medical procedure and children enjoyed the VR game and found that it did distract them during the procedure.

    Conclusion: The interviews showed that non-immersive VR is a positive experience for children undergoing a minor procedure such as venous puncture or a subcutaneous venous port access.

  • 95.
    Nilsson, Stefan
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Finnström, Berith
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Non-immersive Virtual Reality for reduction of pain2008In: NOBOS: Linköping, Sweden, 10-13 maj 2008, 2008Conference paper (Refereed)
  • 96.
    Nilsson, Stefan
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Hallqvist, Carina
    CITIZYS Research Group, Department of Information Technology and Media, Mid Sweden University, Sundsvall.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Children's experiences of procedural pain management in conjunction with trauma wound dressings2011In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 67, no 7, p. 1449-1457Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 97.
    Nilsson, Stefan
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Johansson, Gunilla
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Himmelmann, Kate
    Massage therapy in post-operative rehabilitation of children and adolescents with cerebral palsy: a pilot study2011In: Complementary therapies in clinical practice, ISSN 1873-6947, Vol. 17, no 3, p. 127-131Article in journal (Refereed)
    Abstract [en]

    AIM: The purpose of this pilot study was to explore the use of massage therapy in children with cerebral palsy undergoing post-operative rehabilitation.

    MATERIAL AND METHOD: Three participants were randomized to massage therapy and another three participants to rest. All children had undergone surgery in one or two lower limbs. Pain, wellbeing, sleep quality, heart rate and qualitative data were collected for each child.

    RESULTS: The scores of pain intensity and discomfort were low in all participants. Heart rate decreased in participants who were randomized to rest, but no change was found in the massage therapy group.

    CONCLUSIONS: The lack of decrease in heart rate in the study group of massage therapy may imply an increased sensitivity to touch in the post-operative setting. Further research with larger study populations are needed to evaluate how and when massage therapy is useful for children with cerebral palsy.

  • 98.
    Nilsson, Stefan
    et al.
    Jönköping University, School of Health Science, HHJ. CHILD.
    Kokinsky, Eva
    Nilsson, Ulrica
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    School-aged children's experiences of postoperative music medicine on pain, distress, and anxiety.2009In: Pediatric Anaesthesia, ISSN 1155-5645, E-ISSN 1460-9592, Vol. 19, no 12, p. 1184-1190Article in journal (Refereed)
    Abstract [en]

    Aim: To test whether postoperative music listening reduces morphine consumption and influence pain, distress, and anxiety after day surgery and to describe the experience of postoperative music listening in school-aged children who had undergone day surgery. Background: Music medicine has been proposed to reduce distress, anxiety, and pain. There has been no other study that evaluates effects of music medicine (MusiCure((R))) in children after minor surgery. Methods: Numbers of participants who required analgesics, individual doses, objective pain scores (Face, Legs, Activity, Cry, Consolability [FLACC]), vital signs, and administration of anti-emetics were documented during postoperative recovery stay. Self-reported pain (Coloured Analogue Scale [CAS]), distress (Facial Affective Scale [FAS]), and anxiety (short State-Trait Anxiety Inventory [STAI]) were recorded before and after surgery. In conjunction with the completed intervention semi-structured qualitative interviews were conducted. Results: Data were recorded from 80 children aged 7-16. Forty participants were randomized to music medicine and another 40 participants to a control group. We found evidence that children in the music group received less morphine in the postoperative care unit, 1/40 compared to 9/40 in the control group. Children's individual FAS scores were reduced but no other significant differences between the two groups concerning FAS, CAS, FLACC, short STAI, and vital signs were shown. Children experienced the music as 'calming and relaxing.' Conclusions: Music medicine reduced the requirement of morphine and decreased the distress after minor surgery but did not else influence the postoperative care.

  • 99.
    Nolbris, Margaretha
    et al.
    Queen Silvia Children’s Hospital, Sahlgrenska Academy at Göteborg University, Institute of Health Care Sciences, Göteborg, Sweden.
    Abrahamsson, Jonas
    Queen Silvia Children’s Hospital, Göteborg, Sweden.
    Hellström, Anna-Lena
    Queen Silvia Children’s Hospital, Sahlgrenska Academy at Göteborg University, Institute of Health Care Sciences, Göteborg, Sweden.
    Olofsson, Lisa
    Queen Silvia Children’s Hospital, Göteborg, Sweden.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    The experience of therapeutic support groups by siblings of children with cancer2011In: Pediatric Nursing, ISSN 0097-9805, Vol. 36, no 6, p. 298-304; quiz 305Article in journal (Refereed)
    Abstract [en]

    When a child is diagnosed with cancer, the whole family, including siblings, lives in fear of how the cancer will affect the sick child and how it will influence other family members. The aim of this article is to describe the experiences expressed by the siblings in a support group environment when their families have or have had a child diagnosed with cancer. Fifteen siblings 8 to 19 years of age with a brother or sister who was receiving treatment for or had died from cancer were interviewed after participating in therapeutic support groups. These interviews were conducted two weeks after the last group interaction and were analyzed using qualitative content analysis. Regardless of gender and age, the siblings felt a sense of belonging and comfort by being in a group, which they appreciated. They were able to share their experiences and help each other with advice and encouragement. They all drew strength from each other. A therapeutic support group for siblings of children with cancer is beneficial. Follow-up interviews with the siblings indicated they found the groups helpful in coping with their situation.

  • 100. Nolbris, Margaretha
    et al.
    Enskär, Karin
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. CHILD.
    Hellström, Anna-Lena
    Experience of siblings of children treated for cancer2007In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 11, no 2, p. 106-112Article in journal (Refereed)
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