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  • 1.
    Ancillotti, Mirko
    et al.
    Uppsala universitet.
    Eriksson, Stefan
    Uppsala universitet.
    Veldwijk, Jorien
    Nederländerna.
    Nihlén Fahlquist, Jessica
    Uppsala universitet.
    Andersson, Dan I
    Uppsala universitet.
    Godskesen, Tove
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Uppsala universitet.
    Public awareness and individual responsibility needed for judicious use of antibiotics: a qualitative study of public beliefs and perceptions.2018In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 18, no 1, article id 1153Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: High consumption of antibiotics has been identified as an important driver for the increasing antibiotic resistance, considered to be one of the greatest threats to public health globally. Simply informing the public about this consequence is insufficient to induce behavioral change. This study explored beliefs and perceptions among Swedes, with the aim of identifying factors promoting and hindering a judicious approach to antibiotics use. The study focused primarily on the medical use of antibiotics, also considering other aspects connected with antibiotic resistance, such as travelling and food consumption.

    METHODS: Data were collected through focus group discussions at the end of 2016. Twenty-three Swedes were recruited using an area-based approach and purposive sampling, aiming for as heterogeneous groups as possible regarding gender (13 women, 10 men), age (range 20-81, mean 38), and education level. Interview transcripts were analyzed using qualitative content analysis. The Health Belief Model was used as a theoretical framework.

    RESULTS: Antibiotic resistance was identified by participants as a health threat with the potential for terrible consequences. The severity of the problem was perceived more strongly than the actual likelihood of being affected by it. Metaphors such as climate change were abundantly employed to describe antibiotic resistance as a slowly emerging problem. There was a tension between individual (egoistic) and collective (altruistic) reasons for engaging in judicious behavior. The individual effort needed and antibiotics overprescribing were considered major barriers to such behavior. In their discussions, participants stressed the need for empowerment, achieved through good health communication from authorities and family physicians.

    CONCLUSIONS: Knowledge about antibiotic consumption and resistance, as well as values such as altruism and trust in the health care system, has significant influence on both perceptions of individual responsibility and on behavior. This suggests that these factors should be emphasized in health education and health promotion. To instead frame antibiotic resistance as a slowly emerging disaster, risks diminish the public perception of being susceptible to it.

  • 2.
    Bullington, Jennifer
    Ersta Sköndal University College, Department of Health Care Sciences.
    Hälsa ur ett psykosomatiskt perspektiv2011In: Perspektiv på kvinnors hälsa i arbetslivet / [ed] Hélène Sandmark, Lund: Studentlitteratur, 2011, p. 65-84Chapter in book (Other academic)
  • 3.
    Bullington, Jennifer
    et al.
    Linköpings universitet.
    Karlsson, G
    Hur uppfattar en blind person sin kropp?1998In: Social forskning, ISSN 0283-202X, Vol. 13, p. 8-10Article in journal (Refereed)
  • 4.
    Carlander (Goliath), Ida
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Me-ness och We-ness: Individuell och gruppidentitet hos döende personer och deras familjemedlemmar2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 90, no 1, p. 165-171Article in journal (Refereed)
    Abstract [sv]

    Följande artikel är baserad på en avhandling som beskriver människors upplevelser av sin vardag hemma när en i familjen är svårt sjuk och döende och  fokuserar på centrala begrepp som identitet, död och gemenskap. Intervjuer med patienter och deras familjemedlemmar, delvis genomförda över tid, har möjliggjort analyser av berättelser som speglar vardagliga processer, liksom transitioner och rollförändringar. För både patienter och familjemedlemmar medförde vardagen i hemmet en rad fysiska, psykiska och sociala påfrestningar. För familjemedlemmarna innebar det bland annat att dela livet med en förändrad person i en förändrad relation. Vardagen nära döden innebar att möta nya situationer och erfarenheter som utmanade den personliga identiteten; me-ness liksom familjeidentiteten; we-ness.

  • 5.
    Eriksson, Ulrika
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Sellström, Eva
    Mittuniversitetet.
    Growing up in rural community: children's experiences of social capital from perspectives of wellbeing2010In: Rural and remote health, ISSN 1445-6354, Vol. 10, no 3, article id 1322Article in journal (Refereed)
    Abstract [en]

    Introduction: People are influenced by the neighborhood in which they live. The neighborhood may be particularly important for children’s wellbeing because of the constraints it imposes on their patterns of daily activities. Furthermore, the neighborhood is a central context for social development, being a place where children form networks and learn social skills and values. The aim of this study was to describe how social capital in the neighborhood is perceived by children living in rural areas, and to reveal what this adds to their sense of wellbeing.

    Methods: The study had a descriptive research design with a qualitative approach. Seven single-sex focus group interviews were conducted with children the in 6th grade (aged 11–12 years). Data were analyzed using deductive content analysis.

    Results: The children perceived a lack of social capital due to environmental and social constraints in their everyday lives. However, their wellbeing was enhanced by strong cohesion in the neighborhood. In addition, settings such as the school, the natural environment, and sporting associations were highly valued and emerged as crucial factors for enhancing the children’s wellbeing. The spatial isolation that characterizes rural areas created a special context of social network structures, cohesion and trust, but was also a breeding ground for exclusion and social control. The stories revealed paradoxical feelings of living in a good and safe area that simultaneously felt isolated and restricted.

    Conclusions: From a rural perspective, this study reveals the complexity of the children’s perceptions of their social environment, and the ways in which these perceptions have both positive and negative effects on wellbeing. The results highlight how important it is for health professionals in rural areas to consider the complex influence of bonding social capital on children’s wellbeing, and to be aware that it can promote exclusion as well as cohesion.

  • 6.
    Gärde, Johan
    Ersta Sköndal Bräcke University College, Department of Social Sciences.
    Intervention logics in global and international poverty reduction schemes for the extreme poor and the most deprived with a focus on wellbeing and health2017In: O Mundo da Saúde, ISSN 0104-7809, E-ISSN 1980-3990, Vol. 40, no A, p. 483-506Article in journal (Refereed)
    Abstract [en]

    This article will treat the intervention logics of three major global and international poverty reduction programs with a focus on wellbeing and health. The analytical framework of the Millennium Development Goals, the Sustainable Development Goals and the EU Fund for European Aid to the Most Deprived were compared using content and discourse analysis with an interpretative and critical approach. A major shift is taking place globally in the view of poverty reduction, with enhanced intervention logics which are complex as the targets and indicators are formulated by different stakeholders in both developed and developing contexts during diverse time-spans and a variety of priorities, which might not converge in core-dimensions, such as wellbeing, health and social protection. A more interdisciplinary and holistic view is now part of frameworks such as the Sustainable Development Goals, emphasizing environmental and eco-system dimensions in addition to traditional human development dimensions, like income, health, and education, where the impact also should be able to be measured, understood and valued in the interplay of environmental, economic and social determinants affecting wealth, welfare and ultimately, the health and wellbeing of persons and communities. International development funding is now not only restricted to development cooperation to the least developed countries, but middle development countries in Europe and other places, can now also access these aid funds. In addition, to reach out to the most deprived, welfare spending from developed nations are increasingly being allocated to international poverty reduction schemes through regional agendas, like the Europe Strategy 2020. The risk is that too many schemes and policies are not converging in the intervention logics. Another challenge is related to indicators and the resource allocation mainly emphasizing long-term and environmental concerns, such as eco-systems on the macro-level, which might affect short-and medium terms efforts to address human and humanitarian needs and essential health services for the extreme poor and the most deprived, wherever they are, as the geography of the poor is changing.

  • 7.
    Håkanson, Cecilia
    et al.
    Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska institutet.
    Öhlén, Joakim
    Ersta Sköndal University College, Palliative Research Centre, PRC. Göteborgs universitet.
    Morin, Lucas
    Karolinska institutet.
    Cohen, Joachim
    Vrije Universiteit Brussel (VUB) and Ghent University, Brussels, Belgium .
    A population-level study of place of death and associated factors in Sweden2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 7, p. 744-751Article in journal (Refereed)
    Abstract [en]

    Aims: The aims of this study were to examine, on a population level, where people die in Sweden, and to investigate associations between place of death and underlying cause of death, socioeconomic and environmental characteristics, with a particular interest in people dying from life-limiting conditions typically in need of palliative care. Methods: This population-level study is based on death certificate data for all deceased individuals in Sweden in 2012, with a registered place of death (n=83,712). Multivariable logistic regression was performed to investigate associations between place of death and individual, socioeconomic and environmental characteristics. Results: The results show that, in 2012, 42.1% of all deaths occurred in hospitals, 17.8% occurred at home and 38.1% in nursing home facilities. Individuals dying of conditions indicative of potential palliative care needs were less likely to die in hospital than those dying of other conditions (OR = 0.73; 95% CI = 0.70–0.77). Living at home in urban areas was associated with higher likelihood of dying in hospital or in a nursing home (OR = 1.04 and 1.09 respectively). Educational attainment and marital status were found to be somewhat associated with the place of death. Conclusions: The majority of deaths in Sweden occur in institutional settings, with comparatively larger proportions of nursing home deaths than most countries. Associations between place of death and other variables point to inequalities in availability and/or utilization of health services at the end of life.

  • 8.
    Johansson, Henrik
    Ersta Sköndal University College, Department of Health Care Sciences.
    Stressors in Ugandan nurses’ working- environment: An observational study2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Stress is a common problem for nurses around the world. In Uganda, the enormous pressure on the healthcare in the country makes it no different.

    Aim: To describe stressors in nurses’ working-environment in one hospital, one clinic and one refugee-camp in central and western Uganda.

    Methods: A qualitative observational study with observations from three different health facilities. The data was analyzed using content analysis by Graneheim and Lundman.

    Results: The results showed that factors like lack of equipment, improper handling of needles, exposure to contagion, environmental factors and information were all contributing to stress.

    Discussions: The result was discussed from two themes: Lack of safety and Knowledge related to lack of equipment. The first theme described the environmental hazards the nurses were exposed to in their proffession. The second described the relationship between knowledge, lack of equipment and stress.

  • 9.
    Junehag, Lena
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Svedlund, Marianne
    Mittuniversitetet.
    A qualitative study: Perceptions of the psychosocial consequences and access to support after an acute myocardial infarction2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 1, p. 22-30Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to describe individuals' perceptions of the psychosocial consequences of an acute myocardial infarction (AMI) and of their access to support one year after the event. Methods: The study included 20 participants (14 men and six women) who lived in rural areas and had experienced their first AMI. Eleven were offered contact with a mentor. The participants were interviewed one year after their AMI. Results: The findings are presented in three themes: having a different life, having to manage the situation and having access to support, with 11 subthemes. During their recovery, the participants experienced psychosocial consequences, consisting of anxiety and the fear of being afflicted again. Most mentees appreciated their mentor and some of those without mentors wished they had received organised support. Participants were often more dissatisfied than satisfied with the follow-up provided during recovery. Conclusions: After an AMI, follow-up is important during recovery, but the standardised information provided is inadequate. During recovery, people need help dealing with existential crises. After discharge, receiving peer support from lay people with similar experiences could be valuable. The knowledge gleaned from this study could be used in education at coronary care units and in health care outside the hospital setting. © 2013 Elsevier Ltd.

  • 10.
    Kitzmüller, Gabriele
    et al.
    Norge.
    Häggström, Terttu
    Norge.
    Asplund, Kenneth
    University of Tromsø, Norway; Mittuniversitetet.
    Living an unfamiliar body: the significance of the long-term influence of bodily changes on the perception of self after stroke2013In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633, Vol. 16, no 1, p. 19-29Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to illuminate the significance of the long-term influence of bodily changes on the perception of self after stroke by means of narrative interviews with 23 stroke survivors. A phenomenological-hermeneutic approach inspired by the philosophy of Merleau-Ponty and Ricoeur is the methodological framework. Zahavi's understanding of the embodied self and Leder's concept of dys-appearance along with earlier research on identity guide the comprehensive understanding of the theme. The meaning of bodily changes after stroke can be understood as living with an altered perception of self. Stroke survivors perceive their bodies as fragile, unfamiliar and unreliable and tend to objectify them. The weak and discomforting body that 'cannot' demands constant, comprehensive awareness to keep itself in play. These long-term and often permanent consequences of bodily weakness may turn stroke survivors' intentionality inwards, away from external activities and projects and relationships with others. Negative judgements from others are added to lost roles and positions and threaten the vulnerable self. Stroke survivors try to regain familiarity with their body by their life-long project of testing its boundaries. Mastering important tasks helps them strengthen their self-concept. Health care workers should be aware of the embodied self and engage in long-term dialogues with stroke survivors to strengthen positive perceptions of body and self. More research is needed to understand destructive post-stroke phenomena such as fatigue and pain and to find effective methods to help stroke survivors regain wholeness of body and self.

  • 11.
    Kvamme, Brita Odland
    et al.
    Norge.
    Asplund, Kenneth
    Mittuniversitetet.
    Bjerke, Trond Nergaard
    Norge.
    Drinking resumption: problematic alcohol use relapse after rehabilitation. A phenomenological hermeneutical perspective2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 716-723Article in journal (Refereed)
    Abstract [en]

    The majority of patients being treated for alcohol abuse disorders experience one or more relapses after treatment. The fact that people use this inebriant in a way leading to so much harm and suffering might seem a conundrum. Therapists, family and others might find the person's relapse to be dramatic and upsetting, and one might question whether the person has the sufficient will or motivation to change. However, few previous studies have explored relapse from the patient's perspective. The aim of this study was to illuminate the patient's lived experience of relapse and to develop a deeper understanding of this phenomenon. The study consisted of qualitative interviews using a phenomenological hermeneutical approach. Three main themes emerged from the analyses: 'craving', 'self-image' and 'time'. The findings were discussed in the context of phenomenological literature. Cravings could occur unpredictably; nevertheless, craving was a common experience for the patients and signified a risk of relapse. Bodily experiences of craving were frequently mentioned, and alcohol addiction could be understood as to be a disease or a learned habit. Self-image was, at times, adversely affected by relapse episodes. Therefore, feelings of shame, self-respect and recognition were significant concepts. This study found that the perception of time as past, present and future greatly influenced the participants' experiences of relapse and rehabilitation. Thus, relapse was an upsetting and dramatic experience that could cause great discomfort and sometimes life-threatening situations. However, relapse could also be viewed as a planned event. This study highlights important truth and reality about alcoholism and relapse grounded in people's lived experience.

  • 12.
    Landstedt, Evelina
    et al.
    Mittuniversitetet.
    Asplund, Kenneth
    Mittuniversitetet.
    Gillander Gådin, Katja
    Mittuniversitetet, Institutionen för hälsovetenskap.
    Understanding adolescent mental health: the influence of social processes, doing gender and gendered power relations2009In: Sociology of Health and Illness, ISSN 0141-9889, E-ISSN 1467-9566, Vol. 31, no 7, p. 962-978Article in journal (Refereed)
    Abstract [en]

    Despite a well-documented gender pattern in adolescent mental health, research investigating possible explanatory factors from a gender-theoretical approach is scarce. This paper reports a grounded theory study based on 29 focus groups. The aim was to explore 16- to 19-year-old students' perceptions of what is significant for mental health, and to apply a gender analysis to the findings in order to advance understanding of the gender pattern in adolescent mental health. Significant factors were identified in three social processes categories, including both positive and negative aspects: (1) social interactions, (2) performance and (3) responsibility. Girls more often experienced negative aspects of these processes, placing them at greater risk for mental health problems. Boys' more positive mental health appeared to be associated with their low degree of responsibility-taking and beneficial positions relative to girls. Negotiating cultural norms of femininity and masculinity seemed to be more strenuous for girls, which could place them at a disadvantage with regard to mental health. Social factors and processes (particularly responsibility), gendered power relations and constructions of masculinities and femininities should be acknowledged as important for adolescent mental health.

  • 13.
    Lerner, Henrik
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    A critical analysis of definitions of health as balance in a One Health perspective.2019In: Medicine, Health care and Philosophy, ISSN 1386-7423, E-ISSN 1572-8633Article in journal (Refereed)
    Abstract [en]

    Definitions of health in terms of some kind of balance form a category of their own within the sphere of health definition. Such definitions have their roots in the beginnings of scientific medicine, and popular versions are common among lay people. It has even been claimed that balance is fundamental to health for all species. Several present-day definitions of health in terms of balance are presented here. Particular attention is given to the call for a definition of health applicable to both humans and animals within the One Health approach, involving human medicine, veterinary medicine and ecology. Definitions in terms of balance have been suggested but none has been thoroughly analysed with regard to its suitability. There are therefore three concerns in this paper. The first is to introduce versions of the category of balance, as a first step towards a nomenclature of health definitions. The second is to analyse the claim made recently that balance is a universal criterion of health in all species including humans. The third is to ascertain whether any of the versions discussed is suited to the One Health approach.

  • 14.
    Lerner, Henrik
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    A Proposal for a Comprehensive Human–Animal Approach of Evaluation for Animal-Assisted Interventions2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 22, p. 1-4, article id 4305Article in journal (Refereed)
    Abstract [sv]

    Background: An important field of human–animal interactions is animal-assisted interventions (AAIs), which refers to research on human–animal interactions in order to promote or facilitate health or education in humans. Very few studies among the rich literature on AAIs seem to include aspects of animal welfare and/or animal ethics. Also, very few studies on AAIs have a comprehensive human–animal approach that studies animals, humans, and the relations between them at the same time. This paper tries to argue for and present a possible comprehensive human–animal approach to evaluate AAIs.

    Methods: A combination of the species and role approach proposed by Lerner, the capability approach proposed by Nussbaum, and a modified comprehensive human–animal approach to evaluate AAIs proposed by Lerner and Silfverberg was philosophically analyzed.

    Results: This paper shows that the combination is the modified role and species version of the capabilities approach, and by following it one could do a comprehensive human–animal approach of an evaluation of AAIs.

    Conclusion: Although the aim was reached for horses and animal-assisted therapy, further work needs to be done for all species suggested in the IAHAIO (International Association of Human–Animal Interaction Organizations) White Paper as well as for all branches of AAIs in order to establish this comprehensive human–animal approach

  • 15. Sermeus, Walter
    et al.
    Aiken, Linda H
    Van den Heede, Koen
    Rafferty, Anne Marie
    Griffiths, Peter
    Moreno-Casbas, Maria Teresa
    Busse, Reinhard
    Lindqvist, Rikard
    Ersta Sköndal University College.
    Scott, Anne P
    Bruyneel, Luk
    Brzostek, Tomasz
    Kinnunen, Juha
    Schubert, Maria
    Schoonhoven, Lisette
    Zikos, Dimitrios
    Nurse forecasting in Europe (RN4CAST): Rationale, design and methodology.2011In: BMC nursing, ISSN 1472-6955, Vol. 10, p. 6-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care.

    METHODS/DESIGN: A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences.This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of changing different aspects of the nursing work environment on quality of care and satisfaction of the nursing workforce.

    DISCUSSION: RN4CAST is one of the largest nurse workforce studies ever conducted in Europe, will add to accuracy of forecasting models and generate new approaches to more effective management of nursing resources in Europe.

  • 16.
    Wiklund, Susanne
    et al.
    Stockholms läns landsting, Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Örtqvist, Åke
    Karolinska institutet, Stockholms läns landsting.
    Broliden, Kristina
    Karolinska institutet.
    Tammelin, Ann
    Stockholms läns landsting, Karolinska institutet.
    Acquisition of extended spectrum β-lactamases during travel abroad: A qualitative study among Swedish travellers examining their knowledge, risk assessment, and behaviour2016In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 11, p. 32378-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Travel to foreign countries involves the risk of becoming a carrier of antibiotic-resistant bacteria, especially when the destination is a country with a high prevalence of this type of bacteria.

    AIM AND METHODS: The aim of this study was to learn about the knowledge of antibiotic resistance, and the behaviour and risk-taking among travellers, who had become carriers of extended spectrum beta-lactamases (ESBL)-producing bacteria during travel to a high-prevalence country. A modified version of grounded theory was used to analyse 15 open interviews.

    RESULTS: The analysis resulted in a core category: A need for knowledge to avoid risk-taking. Before the journey, the participants did not perceive there to be any risk of becoming a carrier of antibiotic- resistant bacteria. The low level of knowledge of antibiotic-resistant bacteria and transmission routes influenced their behaviour and risk-taking during their journey, resulting in them exposing themselves to risk situations. After their trip, the majority did not believe that their personal risk behaviour could have caused them to become carriers of ESBL.

    CONCLUSION: The participants' lack of knowledge of antibiotic-resistant bacteria resulted in unconscious risk-taking during their journey, which may have resulted in becoming carriers of ESBL-producing bacteria.

  • 17.
    Wiklund, Susanne
    et al.
    Stockholms läns landsting, Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Örtqvist, Åke
    Karolinska institutet, Stockholms läns landsting.
    Broliden, Kristina
    Karolinska institutet.
    Tammelin, Ann
    Karolinska institutet.
    Staff experiences of caring for patients with extended-spectrum β-lactamase–producing bacteria: A qualitative study2015In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 43, no 12, p. 1302-1309Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Patients who become carriers of antibiotic-resistant bacteria are sometimes stigmatized by health professionals. Staff members' fears of becoming infected could affect their willingness to care for these patients.

    METHODS:The purpose of this study was to increase the knowledge of what it means for staff in acute care settings and nursing homes to care for patients with extended-spectrum β-lactamase (ESBL)-producing bacteria. Assistant nurses, registered nurses, and physicians from acute care settings and nursing homes were interviewed. A modified version of Grounded Theory was used for the analysis.

    RESULTS:The analysis resulted in the core category "to operate as an expert in a chaotic environment" in acute care settings. Despite a lack of resources, hospital staff try to provide the best possible care for patients with ESBL. The analysis of the interviews in the nursing homes resulted in the core category "the employee who, despite uncertainty, provides good care." Despite some fear, and a lack of knowledge, the study participants tried to provide the residents with good care.

    CONCLUSION: Staff in acute care settings and nursing homes must have adequate knowledge and reasonable working conditions to be able to provide high-quality care for patients and residents who are ESBL carriers.

  • 18.
    Wiklund, Susanne
    et al.
    Stockholms läns landsting, Karolinska institutet.
    Fagerberg, Ingegerd
    Ersta Sköndal University College, Department of Health Care Sciences.
    Örtqvist, Åke
    Karolinska institutet, Stockholms läns landsting.
    Vading, Malin
    Karolinska institutet.
    Giske, Göran
    Karolinska institutet.
    Broliden, Kristina
    Karolinska institutet.
    Tammelin, Ann
    Stockholms läns landsting, Karolinska institutet.
    Knowledge and understanding of antibiotic resistance and the risk of becoming a carrier when travelling abroad: A qualitative study of Swedish travelers.2015In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 43, no 3, p. 302-308Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Increasing globalisation, with the migration of people, animals and food across national borders increases the risk of the spread of antibiotic-resistant bacteria. To avoid becoming a carrier of antibiotic-resistant bacteria when travelling, knowledge about antibiotic resistance is important.

    MATERIALS AND METHODS: We aimed to describe the knowledge and understanding of antibiotic-resistant bacteria, and of the risk for becoming a carrier of such bacteria, among Swedish travellers before their travel to high-risk areas. A questionnaire with three open-ended questions was distributed to 100 individuals before departure.

    RESULTS: The travellers' answers were analysed using content analysis, resulting in the theme 'To be an insecure traveller who takes control over one's own journey'. Our results showed that the travellers were aware of what the term 'antimicrobial resistance' meant, but did not understand its real significance, nor the consequences for the individual nor for society. They also distanced themselves from the problem. Few thought that their travel would entail a risk of becoming a carrier of resistant bacteria. The lack of knowledge caused an uncertainty among the travellers, whom tried to master the situation by using coping strategies. They proposed a number of measures to prevent carriership. The measures were general and primarily aimed at avoiding illness abroad, particularly acute gastro-intestinal infection.

    CONCLUSIONS: In health care and vaccination clinics, there is a need for improved information for persons intending to travel to high-risk areas, both about the risks of contracting antibiotic-resistant bacteria and about effective preventive measures.

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