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  • 51. Boström, Katrin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Living with a hereditary disease: persons with muscular dystrophy and their next of kin.2005In: American Journal of Medical Genetics, ISSN 0148-7299, E-ISSN 1096-8628, Vol. 136A, no 1, p. 17-24Article in journal (Refereed)
    Abstract [en]

    This qualitative study describes conceptions and experiences of the hereditary aspect of muscular dystrophy (MD) from both the patients' and the next of kin's perspective. Different diagnoses of MD are included: dystrophia myotonica, myopathia distalis tarda hereditaria, Becker MD, facioscapulohumeral MD, limb-girdle MD, Emery-Dreifuss and undetermined proximal MD (Duchenne MD is not included). Interviews were conducted with 46 persons with MD and 36 next of kin. The interviews were subjected to inductive content analysis. Only two in each group did not spontaneously mention anything related to the fact that MD is disease with dominant or recessive inheritance. It was found that heredity has a prominent place in the thoughts and feelings of the family. These thoughts were classified as Becoming aware of MD and its hereditary nature, looking into the pedigree, acquiring an understanding of MD, thoughts about genetic testing, interpreting the risk, whether to have children or not, feelings related to the future, and feelings of responsibility and guilt. Families with MD need medical information and the opportunity for genetic testing as well as support and counseling in coming to terms with living with a hereditary disease, whether or not that includes a decision to take a test.

  • 52. Boström, Katrin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Quality of life in patients with muscular dystrophy and their next of kin2005In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 28, no 2, p. 103-109Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate quality of life (QoL) among adult patients with muscular dystrophy (n=46) and their next of kin (n=36) and to investigate the influence of disease-related and demographic factors on QoL. The questionnaire "Subjective estimation of quality of life" was used. The results show that patients had lower QoL than their next of kin regarding having no work or meaningful occupation, energy, self-assuredness, self-acceptance and emotional experiences. Age of onset of disease had an impact on QoL. The need for a ventilator had an influence only on assessment of energy. Patients without a partner assessed lower than those who had a partner. In the case of a person who is young and single the onset of muscular dystrophy reduces the likelihood of having a partner or children and affects personal economy negatively. Assessment of relationship to friends was lower among next of kin who provided daily help than among those who provided help once a week. There is a need for recurrent rehabilitation during life-long disabilities and a need to give particular support to those with early onset of disease, those who are single and those who are childless. It is also important to include the patient's close relations when giving rehabilitation.

  • 53. Boström, Katrin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Sunvisson, Helena
    Being the next of kin of an adult person with muscular dystrophy2006In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 15, no 2, p. 86-104Article in journal (Refereed)
    Abstract [en]

    A chronic disorder affects all members of the family in various ways. The aim of this study is to elucidate the next of kin's (N= 36) experiences when an adult family member has muscular dystrophy. The relationships were partner (36%, n= 14), parent (18%, n= 7), child (21%, n= 8), sibling (15%, n= 6), and other relative (3%, n= 1). Latent content analysis is employed and involves an interpretation of the interviewtext. The results showthe meaning of being close to a person with muscular dystrophy through the themes that emerged: exposure of the family; the span between obligation and love; being vigilant, protective, and supportive; and striving for an ordinary life. This study reveals a need for healthcare staff to understand the next of kin's narrated meaning of changes when a family member has a progressive disease.

  • 54. Boström, Katrin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Sunvisson, Helena
    Experiences of kinship with a person with muscular dystrophy.2005In: 9th Quadrennial World Federation of Neuroscience Nurses, 2005Conference paper (Refereed)
  • 55. Boström, Katrin
    et al.
    Sjöquist Nätterlund, Birgitta
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Sickness impact in people with muscular dystrophy: a longitudinal study over 10 years.2005In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 19, no 6, p. 686-694Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe changes of function in terms of sickness impact over 10 years in adult patients with different types of muscular dystrophy. DESIGN: Patients with muscular dystrophy answered the Sickness Impact Profile and Self-report ADL questionnaires in 1991 and 2001. SETTING: The study population was identified in a comprehensive prevalence study in the county of Orebro, Sweden. SUBJECTS: The study group comprised 44 people grouped according to whether they had myotonic dystrophy or muscular dystrophy with proximal or distal muscles affected. MAIN MEASURES: Comparison was made between assessments of sickness impact in terms of function at the two time points. RESULTS: Most obvious deterioration over time was in activities of daily living that require finger and arm strength. Ambulation was significantly decreased in myotonic dystrophy and proximal muscular dystrophy. Those walking without assistive devices decreased from 91% to 52%, and the number with a disability pension increased from 36 to 55%. There was a relatively small influence with regard to psychosocial dysfunction assessed by the Sickness Impact Profile. CONCLUSIONS: This longitudinal study shows the deteriorating functions reported by patients with muscular dystrophy. This knowledge could be used to formulate new interventions in order to offer appropriate support and treatment to this patient group.

  • 56. Boström, Katrin
    et al.
    Sunvisson, Helena
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    From becoming aware of to an everyday life with a hereditary disease.2006In: 5th International Conference on Social Work in Health and Mental Health, 2006Conference paper (Refereed)
  • 57. Boström, Katrin
    et al.
    Syrén, Marie
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Gunnarsson, Lars-Gunnar
    Experience from a multidisciplinary rehabilitation programme for individuals with muscular dystrophy described from a psychosocial angle.1996In: Acta Neurologica Scandinavica, 1996Conference paper (Refereed)
  • 58. Dahlbom, Kathe
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Barany, Michael
    Kihlgren, Annika
    Gunnarsson, Lars-Gunnar
    Muscular dystrophy in adults: a five-year follow-up.1999In: Scandinavian Journal of Rehabilitation Medicine, ISSN 0036-5505, E-ISSN 1940-2228, Vol. 31, no 3, p. 178-184Article in journal (Refereed)
    Abstract [en]

    The aim was to describe the natural history of adults with hereditary muscular dystrophies, including myotonic dystrophy, with respect to muscular function, ventilation and electrocardiogram. In a prospective study, 46 subjects were followed over a period of five years. In 1991 and 1996, their muscle function was assessed according to an observation scheme and their lung vital capacity was measured by spirometer. Electrocardiograms were obtained in 1991, 1993 and 1996. Deterioration of muscular function was seen with regard to both the functional muscle tests and the vital capacity. The proportion of pathological electrocardiograms increased from 38% in 1991 to 54% in 1996 in the 26 patients with myotonic dystrophy without an increase in clinically detected cardiac abnormalities. Timely examinations using standard methods can reveal medically important information on deterioration, which often passes clinically unnoticed because of the insidious progress of the diseases.

  • 59.
    Edvardsson, Tanja
    et al.
    Örebro universitet.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Being the next of kin of a person with a low-grade glioma2008In: Psycho-Oncology: journal of the psychological, social and behavioral dimensions of cancer, ISSN 1057-9249, Vol. 17, no 6, p. 584-591Article in journal (Refereed)
    Abstract [en]

    There is a paucity of knowledge for health-care professionals who come into contact with next of kin of persons diagnosed with low-grade gliomas. Therefore, the aim of this study was to explore the experience of being the next of kin of an adult person diagnosed with a low-grade glioma.Twenty-eight next of kin of persons with a low-grade glioma were interviewed. The data were subjected to qualitative content analysis. A quantitative data analysis was added to explore how the themes from the qualitative analysis occurred among different next of kin.Four main themes emerged: Extremely stressful emotions, Being invisible and neglected, Changed relations and roles, and Enabling strength in everyday life. The first of these occurred mainly in the early period of illness. This theme was especially predominant in the case of the patient's parents. The theme of Changed relations and roles occurred more often among next of kin some years after the person's diagnosis. The most statements occurred in all four themes were by female next of kin.Many next of kin requested emotional support for themselves and indicated that it is important that health-care staff should not forget them.

  • 60. Edvardsson, Tanja
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Det dagliga livet, coping och livskvalitet som det ter sig för personer med hjärntumör och deras närstående.2002In: Vardagsliv, livskvalitet, habilitering: 8:e forskningskonferensen i Örebro den 13-14 mars 2002 : programbok, Örebro: Psykiatri och habilitering, Örebro läns landsting , 2002Conference paper (Other academic)
  • 61. Edvardsson, Tanja
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Illness-related problems and coping among persons with low-grade glioma.2005In: Psycho-Oncology, ISSN 1057-9249, E-ISSN 1099-1611, Vol. 14, no 9, p. 728-737Article in journal (Refereed)
    Abstract [en]

    The literature reveals no qualitative study concerning the consequences of low-grade glioma in adults. The aim of the present study was to describe perceived illness-related problems in persons with low-grade glioma and the coping used in everyday living. The study was cross-sectional within a well-defined population. A semi-structured qualitative interview was conducted with each of 39 persons, and the data were subjected to inductive content analysis. There was a wide range of perceived problems, mainly concerning bodily functions, memory, cognition, emotion, communication and perception. Several coping strategies emerged, the most frequent being searching for a solution, which was often related to memory and communication problems. One characteristic of communication was the creation of new words. Other common strategies were refraining from and avoiding and laughing and joking. Caring about self involved prioritizing of personal needs. A striving to feel a sense of solidarity within seeking social affinity was coping with a novel content. The study provides vivid narratives about previously unreported phenomena, conveying a deeper understanding. The variety and endurance of problems revealed verifies the need of support from several professionals, including in the form of out-patient post-medical care.

  • 62. Edvardsson, Tanja
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Problems and coping strategies of people with low-malignancy brain tumours.2004In: 9th Research Conference HANDICAP-EVERYDAY LIFE-REHABILITATION, 2004Conference paper (Refereed)
  • 63.
    Edvardsson, Tanja
    et al.
    Centre for Rehabilitation Research, Orebro County Council, Orebro, Sweden.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Subjective quality of life in persons with low-grade glioma and their next of kin.2009In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 32, no 1, p. 64-70Article in journal (Refereed)
    Abstract [en]

    Patients with low-grade glioma have a longer survival than patients with highly malignant glioma, and for this reason questions of quality of life (QoL) are of particular importance to such patients as well as to their next of kin. No studies have been found in which both adult patients with low-grade glioma and their next of kin have estimated their own QoL. This study was therefore designed to investigate the subjective QoL of these two groups. Thirty-nine patients with low-grade glioma selected from a well-defined county population and 27 next of kin participated in the study. The questionnaire used in the study was the subjective estimation of QoL. The main results and conclusions are as follows: the variable absence of work/meaningful occupation showed statistically significant lower ratings among patients than among next of kin. The results show significant influence mainly on the patients' and their next of kin's internal psychological condition; related to background variables but the pattern in the results was inconsistent. There is a need for recurrent rehabilitation during this long-term disease, and a need to give vocational rehabilitation to support the patient's desire to have a meaningful occupation. It is also of importance to include the patient's next of kin when offering rehabilitation.

  • 64. Edvardsson, Tanja
    et al.
    Påhlson, Anneli
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Experiences of onset and diagnosis of low-grade glioma from the patient's perspective.2006In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 29, no 5, p. 415-422Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe adult patients' experiences of falling ill and being diagnosed with low-grade glioma. Information concerning such experiences is lacking in the literature. The study population were adults identified within a well-defined population. Interviews were conducted with 27 patients. The interview texts were analyzed using inductive content analysis. Illness onset was described as a sequence of events. Nineteen patients narrated rapid onset and 8 patients prolonged onset. The most commonly described symptoms in both types of onset were headache, epileptic seizures, vomiting, and vision changes. Racing thoughts, depression, and tinnitus were 3 of the more uncommon symptoms. The most prominent negative experiences regarding healthcare included disrespectful encounters and a lack of opportunity for participation. The salient negative life-situation consequences included a lack of social support and attitudes expressing a lack of understanding. However, to some extent, positive experiences also emerged in the interviews concerning healthcare and life situation despite the onset of the illness. In conclusion, most of the patients in the study experienced the illness onset as stressful. Healthcare staff need particular knowledge to understand the vulnerability of the patient in the onset of low-grade glioma.

  • 65. Forsberg, Anette
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Holmqvist, Lotta Widén
    Falling ill with Guillain-Barré syndrome: patients' experiences during the initial phase.2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 2, p. 220-226Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Research describing the personal experiences of Guillain-Barré syndrome (GBS) is limited, but is important for identifying the patients' need of support. The aim of this study was to describe experiences of falling ill with GBS, with the focus on the onset of disease, the diagnosis and the illness progress during hospital care. METHODS: The study included 35 persons, 20-78 years old. They were interviewed 2 years after the onset of GBS. The interviews were analysed using qualitative content analysis. RESULTS: The onset was described as either an incomprehensible, prolonged, increasing deterioration with puzzling sensations or as a frightening, rapid onset with a sudden loss of body control. The majority of the persons relied heavily on the reassurance of a positive prognosis, and expressed immense confidence in being able to recover. During the early phase at the hospital, a rapid and steady course of improvement inspired hope in many persons. In contrast, even in this early phase of hospital care some individuals expressed doubts of a slow recovery. Feelings of fear and insecurity were evident when losing body functions, thus causing helplessness. Sensations of pain, numbness and lost body image increased their vulnerability. Half of the ventilator-treated persons expressed vivid memories of scary hallucinations. CONCLUSION: The onset is characterized by an incomprehensible bodily deterioration or a frightening, rapid paralysis. In the initial phase, there is hope for recovery, which for many individuals is reinforced by a steady recovery. In contrast, early psychosocial support may be necessary for some persons with an alarmingly slow recovery.

  • 66. Granat, Anneli
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Smits, Anja
    Ett nytt integrerat omhändertagande av patienter med gliom.2003In: Vårdstämman, 2003Conference paper (Refereed)
  • 67. Granat, Anneli
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Smits, Anja
    Ett nytt integrerat omhändertagande av patienter med gliom.: ett vårdutvecklingsprojekt hos Cancerfonden 2000-2002 : slutrapport2003Report (Other academic)
  • 68. Gunnarsson, Lars-Gunnar
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    New methods for the grading of impairment and disability in individuals with muscular dystrophies and their predictive value regarding experienced quality of life.1994In: The VIII International Congress on Neuromuscular Diseases., 1994Conference paper (Refereed)
  • 69.
    Gunnarsson, Lars-Gunnar
    et al.
    Jönköping University.
    Ahlström, Gerd
    The prevalence of neuromuscular disease and the post-polio sequelae in a swedish county and health care utilisation.1993In: The XVth World Congress of Neurology., 1993Conference paper (Refereed)
  • 70. Gustafsson, Margareta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Emotional distress and coping in the early stage of recovery following acute traumatic hand injury: a questionnaire survey.2006In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 43, no 5, p. 557-565Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Emotional distress is frequent in patients with acute traumatic hand injury during the first weeks after the accident. Knowledge of coping in relation to emotional distress could help to identify those who need support. OBJECTIVES: To describe the different kinds of coping used by patients in the early stage of recovery following an acute traumatic hand injury and to investigate differences in coping patterns in patients with and without symptoms of emotional distress. DESIGN: Questionnaire survey with a descriptive and comparative design. Setting/participants: A total of 112 patients with acute traumatic hand injury requiring inpatient treatment at the hand surgical clinic. Those with injuries caused by a suicide attempt or with known drug abuse were excluded. Method/main outcome measures: The patients answered a postal questionnaire at home 1-2 weeks after the accident. Emotional distress was assessed with the Hospital Anxiety and Depression scale. Coping was measured with the Jalowiec Coping Scale-40. RESULTS: Coping by "trying to keep the situation under control" and "trying to look at the problems objectively and see all sides" were most frequent. These strategies are typical for the confrontive coping style, which dominated in the actual illness-situation. Symptoms of emotional distress occurred in 32% of the patients. These patients used significantly more kinds of coping strategies and used confrontive and emotive coping strategies more often than the others. Coping by "hoping for improvement", "working tension off with physical activity", "trying to put the problem out of one's mind", "worrying", "getting nervous or angry" and "taking off by one self" were associated with emotional distress. Coping by "accepting the situation as it is" and "thinking that it is nothing to worry about" were more frequent in patients without emotional distress. CONCLUSIONS: Observations of the coping strategies associated with emotional distress in this study could help to identify patients in clinical practice that need nursing support. Coping associated with less emotional distress should be encouraged.

  • 71. Gustafsson, Margareta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Nursing diagnoses in patients with acute traumatic hand injuries.2004In: WENR-conference, 2004Conference paper (Refereed)
  • 72. Gustafsson, Margareta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Problems experienced during the first year of an acute traumatic hand injury: a prospective study.2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 8, p. 986-995Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Evidence-based nursing of patients with acute traumatic hand injuries treated at the hand-surgical clinic calls for knowledge about long-term implications. AIMS AND OBJECTIVES: The aim of the study was to investigate consequences of an acute traumatic hand injury during the first year after the accident. Specifically, the objectives were to investigate changes in the experience of physical and psychological problems over time, frequencies of remaining problems and the impact of the injury on work situation and life situation 1 year after the accident. DESIGN: The study was prospective and followed the patients from the first weeks to 1 year after the accident. METHOD: Ninety-one patients were assessed three times during the year. Each time the patients answered study-specific questions, the Impact of Event Scale and the Hospital Anxiety and Depression Scale. RESULTS: Problems experienced decreased during the first 3 months but tended to remain unchanged during the rest of the year. In the 1-year follow-up, the majority of the patients experienced slight or moderate functional limitations in the hand, one-third had symptoms of trauma-related distress and one out of seven had troublesome pain. Half of the patients who had returned to work reported a worse work situation and 16% were still on the sick list. One-third of all patients considered their whole life situation to be worse as a result of the injury. Patients with amputations more often experienced a worse life situation. Blue-collar workers reported functional limitations and a worse life situation more often than white-collar workers. CONCLUSIONS: Patients with acute traumatic hand injuries requiring surgical treatment may experience problems, such as functional limitations, trauma-related distress and troublesome pain, with long-term implications for their work situation and life situation. RELEVANCE TO CLINICAL PRACTICE: Caring for hand-injured patients should include, not only surgical treatment and other actions for restoring the function of the hand, but also preventive action and follow-up of trauma-related distress and pain.

  • 73. Gustafsson, Margareta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Uppföljning av traumatiska upplevelser i samband med en akut traumatisk handskada.2003In: Vårdstämman, 2003Conference paper (Refereed)
  • 74. Gustafsson, Margareta
    et al.
    Amilon, Anders
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Characteristics in the early stage of acute traumatic hand injury.2002In: Scandinavian Hand Society Meeting, 2002Conference paper (Refereed)
  • 75. Gustafsson, Margareta
    et al.
    Amilon, Anders
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Trauma-related distress and mood disorders in the early stage of an acute traumatic hand injury.2003In: Journal of Hand Surgery - British and European Volume, ISSN 0266-7681, E-ISSN 1532-2211, Vol. 28, no 4, p. 332-338Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to estimate the incidence of trauma-related distress and mood disorders in the early stages after acute traumatic hand injuries and identify characteristics associated with these reactions. Data were obtained from 112 patients by means of mailed questionnaires and medical records. Nearly half of the patients had increased levels of intrusive and avoidance symptoms, indicating trauma-related distress. One-third showed signs of a mood disorder. Mood disorders were associated with the need for help with activities of daily living, pain and avoidance symptoms. The study showed that emotional problems in the early stages after injury are related to the consequences of both the injury and the traumatic experience. Negative reactions to the sight of the hand were associated with both trauma-related distress and mood disorders, suggesting that observation of the reactions to the sight of the hand could help to identify patients in need of psychological support.

  • 76. Gustafsson, Margareta
    et al.
    Amilon, Anders
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Traumatic stress and coping in the early stage of acute traumatic hand injury.2002In: Morgondagens vårdforskning, 2002Conference paper (Refereed)
  • 77. Gustafsson, Margareta
    et al.
    Edvardsson, Tanja
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    The relationship between function, quality of life and coping in patients with low-grade gliomas2006In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 14, no 12, p. 1205-1212Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The principal aim of the study was to describe function, quality of life and coping with illness-related problems in patients with low-grade gliomas (LGG), to evaluate the need of support. A second aim was to investigate how function, quality of life and coping were related. MATERIALS AND METHODS: Thirty-nine patients with a diagnosis of LGG answered the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC-QLQ-C30) and the Ways of Coping Questionnaire (WCQ). The patients' level of function was assessed in accordance with the WHO performance status scale. RESULTS AND DISCUSSION: Nearly all patients were capable of self-care, but less than half were able to carry out normal activities without restriction. Problems with fatigue, sleep disturbances and pain were most frequent. Most difficulties were reported in the domains, Role, Cognitive and Emotional functioning. Seventeen patients (45%) had scores indicating low overall quality of life. Ratings of overall quality of life and fatigue had the strongest relationship. The trend in the results suggested that mental problems have a stronger impact on quality of life than physical ones. Emotion-focused coping dominated. There was a significant relationship between coping by escape-avoidance and lower level of emotional functioning. CONCLUSIONS: The results of this study indicate that a multidisciplinary team is needed for assessment and treatment of the different problems in patients with LGG. Furthermore, special attention should be paid to patients who use coping by escape-avoidance, as this is associated with emotional distress.

  • 78. Hansson, Birgitta
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Coping with chronic illness: a qualitative study of coping with postpolio syndrome.1999In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 36, no 3, p. 255-262Article in journal (Refereed)
    Abstract [en]

    The study describes how 24 people with postpolio syndrome (PPS) cope with their problems. Two qualitative interviews were conducted, 6 weeks apart. The interviews were analysed inductively. It was found that the participants experienced many types of illness-related problems in their everyday lives. Furthermore, they describe the progressive deterioration in terms of a general weakness, fatigue and pain--these adding to the emotional stress. A variety of coping strategies are employed and the result of the analysis shows it to be impossible to carry out a clearly differentiated grouping into problem-focused and emotion-focused. By and large the participants have learnt to live with the changes and feel that they have 'a good life in spite of everything'.

  • 79. Holmberg, Eva
    et al.
    Nordqvist, Kent
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Prevalence of dysarthria in adult myotonic dystrophy (M. Steinert) patients: speech characteristics and intelligibility1996In: Logopedics, Phoniatrics, Vocology, ISSN 1401-5439, E-ISSN 1651-2022, Vol. 21, no 1, p. 21-27Article in journal (Refereed)
  • 80. Holmström, Ulrika
    et al.
    Nilsagård, Ylva
    Martinsson, Gunilla
    Sundström, Anette
    Ehrenbåge, Ylva
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Rehabiliteringsprogram för personer med Multipel Skleros (MS) och deras personliga assistenter.1999In: Dokumentation: Människa, handikapp, livsvillkor, 7:e forskningskonferensen, Örebro den 13 och 15 april 1999, Örebro: Näringslivskontoret , 1999Conference paper (Other academic)
  • 81. Horttana, Britt-Marie
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Fahlström, Gunilla
    Patterns of and reasons for relocation in dementia care2007In: Geriatric Nursing, ISSN 0197-4572, E-ISSN 1528-3984, Vol. 28, no 3, p. 193-200Article in journal (Refereed)
    Abstract [en]

    Because dementia is a progressive disease, the need for care in municipal shelter accommodations might change over time, raising the crucial question whether to relocate an individual. The aim of the study was to investigate the number of relocations between municipal dementia housing units and to examine the patterns and reasons for relocation, together with the various municipal prerequisites for carrying out relocation. Thirty-three managers of 101 dementia care units in 12 municipalities in Sweden were interviewed, and records of persons who had moved into or out of the dementia care units during the year 2002 were reviewed retrospectively. The results showed that turnover occurred in 35% of the 865 rooms during the year. Of those relocations, 78 (9%) were persons who moved to another accommodation-either into (59), between (13), or out of (6) a dementia care unit. This finding indicates that there are situations in which remaining in place was considered less appropriate than relocating a single individual with dementia to other accommodations with or without dementia specialization. The most common reason for relocation within the municipal shelters was an increased need for care.

  • 82. Hägglund, Doris
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    The meaning of women's experience of living with long-term urinary incontinence is powerlessness2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 10, p. 1946-1954Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to illuminate the meaning of women's experiences of living with urinary incontinence (UI). BACKGROUND: Living with long-term UI means a variety of consequences for everyday life. Women's narratives about their lived experiences are important in enabling nurses to better understand and to help women achieve symptom control. No previous study could be found that has focused on the meaning of women's experience of living with UI from a symptom management perspective. METHOD: Fourteen women with UI (range: 34-52 years) who had sought professional help were interviewed. A phenomenological hermeneutic method was used to analyse and interpret the interview texts. FINDINGS: The women's experiences of living with UI are presented in terms of two interlaced themes of being in a vulnerable situation and striving for adjustment. Being in a vulnerable situation means that the women had no control over UI and experienced powerlessness. The sub-themes in this case were living with an uncontrolled body, living with incontinence as taboo and experiencing a less satisfying encounter. Striving for adjustment means that the women tried to handle their incontinence in different ways to regain power and continue to live as normal. The sub-themes here were living in readiness, making urine leakage comprehensible, accepting living with UI and being familiar with the situation. CONCLUSION: The meaning of women's experience of living with UI is powerlessness. RELEVANCE TO CLINICAL PRACTICE: Nurses should supervise women in pelvic floor muscle training to achieve control over incontinence, thereby helping them regain power. Additionally, Integrated Approach to Symptom Management can help nurses enhance women's self-care abilities.

  • 83. Isaksson, Ann-Kristin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    From symptom to diagnosis: illness experiences of multiple sclerosis patients.2006In: Journal of Neuroscience Nursing, ISSN 0888-0395, Vol. 38, no 4, p. 229-237Article in journal (Refereed)
    Abstract [en]

    This interview study describes 61 multiple sclerosis (MS) patients' conceptions of the disease before they were diagnosed and their experiences of the initial symptoms and the diagnosis. Qualitative content analysis was applied. The patients' perception of MS was in most cases disablement and death, but some narrated a more nuanced image of MS. The experiences of the initial symptoms and the diagnosis were stressful. The patients became and remained vulnerable through diagnosis. They managed the situation in a variety of ways to acquire strength. Nurses who encounter MS patients require specialized knowledge to understand the vulnerability of these patients and to provide support.

  • 84. Isaksson, Ann-Kristin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    From symptom to diagnosis, illness experiences of Multiple Sclerosis patients.2003In: Morgondagens Forskning, 2003Conference paper (Refereed)
  • 85. Isaksson, Ann-Kristin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Managing chronic sorrow in patients with multiple sclerosis: emotional distress but also personal growth.2007In: 8th Quadrennial Congress of The European Association of Neuroscience Nurses (EANN), 2007Conference paper (Refereed)
  • 86. Isaksson, Ann-Kristin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Patients' experiences of being informed of the Diagnosis of Multiple Sclerosis.2005In: 9th Quadrennial World Federation of Neuroscience Nurses, 2005Conference paper (Refereed)
  • 87. Isaksson, Ann-Kristin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    The meaning of chronic sorrow: working with latent content analyses.2006In: 7th International Interdisciplinary Conference Advances in Qualitative Methods, 2006Conference paper (Refereed)
  • 88. Isaksson, Ann-Kristin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Gunnarsson, Lars-Gunnar
    Quality of life and impairment in patients with Multiple Sclerosis.2002In: Morgondagens vårdforskning, 2002Conference paper (Refereed)
  • 89. Isaksson, Ann-Kristin
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Gunnarsson, Lars-Gunnar
    Quality of life and impairment in patients with multiple sclerosis2005In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 76, no 1, p. 64-69Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: The aims of this study were to describe the quality of life in patients with multiple sclerosis (MS) given immunological treatment and in those not given immunological treatment and to investigate the relationship between impairment and quality of life. METHODS: Twenty nine patients given immunological treatment were matched with the same number of patients not given such treatment. Matching variables were sex, Kurtzke's Expanded Disability Status Scale (EDSS), years since diagnosis, and age (total n = 58). The patients were interviewed using the self-reported impairment checklist and they answered two questionnaires on quality of life, the 36-Item Short-Form Health Survey (SF-36) and the Subjective Estimation of Quality of Life (SQoL). RESULTS: The self-reported impairment checklist captured a more differentiated picture of the patients' symptoms of MS than the EDSS. Health related quality of life was markedly reduced, while the subjective quality of life was less affected. There was a stronger association between self-reported ratings of impairment and health related quality of life on the SF-36 than between impairment and global ratings of quality of life on the SQoL. Subjective quality of life on the SQoL was not directly dependent on impairment expressed in physical limitations. There were no statistically significant differences between the treated and untreated groups. A non-significant trend towards better health related quality of life was found in favour of the treated group with respect to emotional role, physical role, and social function on the SF-36. CONCLUSIONS: The self-reported impairment checklist and SF-36 proved to be valuable complements to the well established EDSS in describing the diverse symptoms of MS. Measuring both health related quality of life and subjective wellbeing provides valuable knowledge about the consequences of MS.

  • 90. Isaksson, Ann-Kristin
    et al.
    Gunnarsson, Lars-Gunnar
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    The presence and meaning of chronic sorrow in patients with multiple sclerosis2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 11C, p. 315-324Article in journal (Refereed)
    Abstract [en]

    Aim and objectives: The aim of this study was to explore the presence and meaning of chronic sorrow and the presence of depression in a fairly large group of persons with multiple sclerosis (MS). Background: MS is a chronic and progressive neurological disease with a variety of symptoms. The patients have to live with losses of different kinds. A few earlier studies have used the concept of chronic sorrow to illustrate the emotional situation of such patients. Method: Sixty-one patients were interviewed about the occurrence of chronic sorrow and, thereafter, screened for depression. Thirty-eight (62%) of them fulfilled the criteria for chronic sorrow. The interviews were analysed with latent content analysis. Results: Seven themes describe the losses that caused sorrow: loss of hope, loss of control over the body, loss of integrity and dignity, loss of a healthy identity, loss of faith that life is just, loss of social relations and loss of freedom. The sorrow was constantly present or periodically overwhelming. Only four of the 38 patients with chronic sorrow had symptoms of being mildly depressed. Conclusion: Chronic sorrow meant loss of hope, of control over the body, of integrity and of identity. The concept of chronic sorrow complements that of depression in providing important new knowledge relevant to understanding the consequences MS can have for the individual. Relevance to clinical practice: Knowledge of the meaning of chronic sorrow can contribute to the nurse's ability to give psychological support and promote a sense of hope and control in the MS patient.

  • 91. Johansson, Ingrid
    et al.
    Hildingh, Cathrine
    Wenneberg, Stig
    Fridlund, Bengt
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Theoretical model of coping among relatives of patients in intensive care units: a simultaneous concept analysis.2006In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 56, no 5, p. 463-471Article in journal (Refereed)
    Abstract [en]

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

  • 92. Larsson, Britt-Marie
    et al.
    Fahlström, Gunilla
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Boendebyte i demensvård: förekomst och orsaker.2005In: Vårdstämman, 2005Conference paper (Refereed)
  • 93. Larsson, Britt-Marie
    et al.
    Fahlström, Gunilla
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Principen om kvarboende i demensvården: hur tillämpas den?2004In: Nordisk Gerontologisk kongress, 2004Conference paper (Refereed)
  • 94. Larsson, Britt-Marie
    et al.
    Fahlström, Gunilla
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Relocation within community sheltered housing for demented persons during one year.2005In: 12th Congress of the International Psychogeriatric Association, 2005Conference paper (Refereed)
  • 95. Lidskog, Marie
    et al.
    Löfmark, Anna
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Interprofessional education on a training ward for older people: students' conceptions of nurses, occupational therapists and social workers.2007In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 21, no 4, p. 387-399Article in journal (Refereed)
    Abstract [en]

    Collaboration between professionals in health and social care is essential to meet the needs of the patient. The collaboration is dependent on knowledge and understanding of each other's roles. One means of improving communication and collaboration among professionals is interprofessional education. The aim of this study was to describe the variation in how students in nursing, occupational therapy and social work perceived their own and the other professions. Over a three-week period two interviews were conducted with each of 16 students who were on an interprofessional training ward for older people in a municipal setting in Sweden. A phenomenographical approach was used in the analysis of the interviews. The findings showed great variation in how the students perceived the professions, from simplistic in terms of tasks to a more complex conception in terms of knowledge, responsibility and values. Differences in the ways professions were described concerning their professional stance towards the patients were especially accentuated. The findings indicate that the students need opportunities for reflection on and scrutiny of each other's beliefs and knowledge. The influence of interprofessional education involving reflection on the different health-care professions needs to be explored in future research.

  • 96.
    Lidskog, Marie
    et al.
    Örebro University.
    Löfmark, Anna
    Gävle University.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Learning through participating on an interprofessional training ward.2009In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 23, no 5, p. 486-497Article in journal (Refereed)
    Abstract [en]

    Learning in clinical education can be understood as a process of becoming a legitimate participant in the relevant context. Interprofessional training wards (IPTWs) are designed to give students from educational programmes in health and social care a realistic experience of collaboration for the purpose of developing teamwork skills. IPTWs have been found to be appreciated by the students and to influence students' understanding of each other's professions. The aim of this study was to describe and analyse the students' learning on an interprofessional training ward in care for older persons through focusing on the students' ways of participating in the communities of practice on the ward. A case study design was chosen. Multiple data sources were used. The findings show that the students engaged as active participants in the care. At the same time there was sometimes a discrepancy between on the one hand expectations and goals, on the other hand actual participation. There were difficulties in making the training relevant for all the student groups involved. The findings indicate that in the planning of interprofessional education the choice of setting and learning situations is crucial with regard to the learning that will occur.

  • 97. Lidskog, Marie
    et al.
    Löfmark, Anna
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. HHJ. Quality improvements, innovations and leadership in health care and social work.
    Students' conceptions about their own and others' profession before and after inter-professional education at a training ward.2006In: 14th Congress of the World Federation of Occupational Therapists (WFOT), 2006Conference paper (Refereed)
  • 98.
    Lidskog, Marie
    et al.
    Örebro universitet.
    Löfmark, Anna
    Högskolan i Gävle.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Students' learning experiences from interprofessional collaboration on a training ward in municipal care2008In: Learning in Health and Social Care, ISSN 1473-6853, E-ISSN 1473-6861, Vol. 7, no 3, p. 134-145Article in journal (Refereed)
    Abstract [en]

    One way to offer students pursuing health and social care programmes realistic experiences of teamwork is interprofessional training wards where students from different educational programmes learn teamwork by working together. In the present study, a training ward in municipal care for older people was evaluated. Students from occupational therapy, nursing and social work programmes worked together on the ward for 3 weeks to learn with, from and about each other. The aim of the study was to compare students’ attitudes towards practice on a training ward before and after and to evaluate goal fulfilment after 3 weeks’ interprofessional education on a training ward. An attitude questionnaire was distributed to all students before and after their time on the ward, supplemented with a retrospective goal-fulfilment questionnaire afterwards. The results show that the collaborative, social experience the training ward offers was appreciated by the students and in most respects, met the learning goals set up for the course. The most important learning experience was working together in a real-life setting. However, there are some issues to take into consideration when planning and developing training wards. The setting needs to be realistic and relevant in relation to future roles for all of the student groups involved. The value and purpose of engaging together in basic patient care needs to be the subject of further investigation. When it comes to fostering competent team-workers, training wards seem to be one way forward. But to fully understand the challenges and difficulties involved in planning these wards, the learning achieved must be understood in the context of the setting as a whole, in all its aspects.

  • 99. Lundqvist, Lars-Olov
    et al.
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    Psychometric evaluation of the Ways of Coping Questionnaire as applied to clinical and nonclinical groups.2006In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 60, no 5, p. 485-493Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The purpose of this study is to describe coping and evaluate the psychometric properties and the factor structure of the Ways of Coping Questionnaire (WCQ) applied to clinical and nonclinical groups. METHOD: The responses of 510 subjects (chronically disabled patients, their next of kin, and students) who completed the Swedish version of the WCQ were the basis for confirmatory factor analyses of the original eight-factor model as well as of the model consistency across samples. RESULTS: The coping patterns that emerged in the case of the patients were very similar to those of the next of kin. The exceptions were greater use of Distancing by patients and of Positive Reappraisal by next of kin. The results showed support for the original eight-factor model, but deviation from the equality of factor structures among the subsamples indicated a limited use of the WCQ in between-sample comparisons. CONCLUSION: Modifications to the eight-factor model adequately described the subsamples, supporting the use of the WCQ in within-sample settings. This was particularly evident from the evaluation of alternative factor structures based on previously described models derived from clinical samples.

  • 100. Löf, Lennart
    et al.
    Berggren, Lars
    Ahlström, Gerd
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work.
    ICU patients' recall of emotional reactions in the trajectory from falling critically ill to hospital discharge: Follow-ups after 3 and 12 months.2008In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 24, no 2, p. 108-121Article in journal (Refereed)
    Abstract [en]

    Patients' memories of frightening ICU experiences may be a threat to later psychological recovery. The purpose of the study is to describe ICU patients' recall of their emotional reactions, from falling critically ill to hospital discharge; this at 3 and 12 months following discharge from the ICU. The study is qualitative and concerns eight ICU patients ventilated for more than 72h. The participants were interviewed twice and the data were subjected to qualitative content analysis. It emerged that the memories of emotions during the trajectory of critical illness were extensive, detailed and strong, and that unpleasant emotions were clearly stable over time. At 12 months as compared with 3 months, the unpleasant emotions were less intense and had less prominent; furthermore the ICU care was more greatly associated with a sense of security, and there was greater recall of caring doctors and nurses (though not of their names) as well as next of kin. CONCLUSIONS: The study generated knowledge not previously described about how ICU patients' recollection of their emotions during the trajectory of critical illness changes over time. This has implications regarding future study of patients' ICU memories and regarding patients' need for support in coping with such memories.

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