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  • 1.
    Backman, Ellen
    Högskolan i Halmstad, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Ordinary mealtimes under extraordinary circumstances: Routines and rituals of nutrition, feeding and eating in children with a gastrostomy and their families2021Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis is to explore routines and rituals related to feeding, eating, and mealtimes in families that have a child with a gastrostomy tube (G-tube), from the perspectives of healthcare professionals, the children, and their parents. The thesis is based on four empirical studies. Study I is a longitudinal, quantitative study with the aim to describe children with developmental or acquired disorders receiving a G-tube, and to compare characteristics, contacts with healthcare professionals, and longitudinal eating outcomes. Findings from Study I demonstrated that children with developmental disorders needed G-tube feeding for longer than children with acquired disorders. Children with developmental disorders were also younger at G-tube placement, and had more multidisciplinary healthcare. These findings led to the subsequent studies focused specifically on children with developmental disorders. 

    Study II applies mixed methods and explores everyday life, health care, and intervention goals during the first year following G-tube placement through the documentation in medical records. In Studies III and IV, the experiences of family mealtimes for children with a G-tube and their parents are collected through individual interviews that are analysed qualitatively. Triangulation of methods, participants, researchers, and data across the four studies is applied to search for confirmation between findings, as well as to identify areas of discrepancy. Ecocultural theory, the WHO framework ICF, and the concept of participation form the conceptual framework of the thesis. Taken together, findings from the studies describe how the main experiences of feeding, eating, and mealtime relate to specific impairments of the child, the collective value attached to family mealtimes, and the parental responsibility to harmonise competing interests and conflicts among family members and/or healthcare professionals. 

    This thesis extends previous research by focusing on the ecocultural context of the child in combination with a dimensional understanding of health. The findings shed light on measures taken by the families themselves to adjust to and handle their daily lives, as well as spell out areas where more support is needed. Furthermore, this thesis suggests that an expanded focus on children’s participation in everyday mealtimes, and in the healthcare follow-up of G-tube feeding, is important in enhancing intervention outcomes.

  • 2.
    Backman, Ellen
    Högskolan i Halmstad, Wigforss-gruppen.
    Ätutveckling hos barn – en gemensam utmaning för barn och dess vårdnadshavare2016In: Små & stora nyheter, ISSN 1400-4186, no maj, p. 10-11Article in journal (Other (popular science, discussion, etc.))
  • 3.
    Backman, Ellen
    et al.
    Region Halland, Kungsbacka.
    Eberhart, Barbara
    Västerbottens läns landsting, Umeå.
    Gustafsson, Carin
    Region Skåne, Malmö.
    Häggström Qvist, Camilla
    Västra Götalandsregionen, Göteborg.
    Lindberger, Lena
    Stockholms läns landsting.
    Nolemo, Maria
    Landstinget Västmanland, Västerås.
    Nylander, Eva-Marie
    Västra Götalandsregionen, Vänersborg.
    Ragnar, Catarina
    Region Kronoberg, Växjö.
    Holck, Pernille
    Region Skåne, Malmö.
    Metoder för att stimulera språk och kommunikation hos barn, ungdomar och vuxna inom habiliteringen2015Report (Other academic)
    Abstract [sv]

    Språkliga och kommunikativa begränsningar är vanligt förekommande vid ett flertal av de diagnoser och tillstånd som återfinns hos personer inom habiliteringsverksamheter i Sverige och förutsätter en tvärprofessionell och långvarig insats. Syftet med föreliggande arbete är att systematiskt beskriva bästa tillgängliga evidens avseende interventioner fokuserade på språklig och kommunikativ förmåga för personer med medfödda funktionsnedsättningar från sex års ålder och uppåt inom habiliteringsverksamhet. Arbetet kan ses som en fortsättning på EBH-rapporten ”Tidiga kommunikations- och språkinsatser till förskolebarn”.

    Internationellt publicerade interventionsstudier från de senaste 15 åren med fokus på språkliga och kommunikativa förmågor vid typiskt förekommande diagnoser inom habiliteringsverksamhet granskades och sammanfattades. Initialt inkluderades endast översiktsartiklar och metaanalyser, men då dessa till största delen hade fokus på autism och/eller Alternativ och Kompletterande Kommunikation (AKK) utökades sökningen till att även inkludera ett antal primärstudier med annat fokus. Rapporten omfattar 67 studier.

    Resultatet visar att ”stark rekommendation att använda” (enligt GRADE) endast förekommer i begränsad utsträckning, och när det förekommer är det vid insatser relaterade till autism och/eller AKK. ”Stark rekommendation att inte använda” finns vid insatser relaterade till akupunktur/akupressur och faciliterad kommunikation. Det kan konstateras att det finns en stor brist på studier avseende vuxna personer respektive intellektuell funktionsnedsättning.

    Detta arbete tillför ytterligare kunskap till området för evidensbaserade insatser vid svårigheter när det gäller kommunikation och språk, och visar att evidens i strikt bemärkelse är svår att erhålla bland annat beroende på de små och heterogena patientgrupperna och, som en konsekvens av detta, en brist på stora randomiserade studier.

  • 4.
    Backman, Ellen
    et al.
    Högskolan i Halmstad, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Granlund, Mats
    CHILD Research group, SIDR, School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Karlsson, Ann-Kristin
    Department of Research and Development, Region Halland, Halmstad, Sweden.
    Documentation of everyday life and health care following gastrostomy tube placement in children: a content analysis of medical records2020In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 42, no 19, p. 2747-2757Article in journal (Refereed)
    Abstract [en]

    Background: Everyday routines play a vital role in child functioning and development. This study explored health professionals’ documentation of everyday life and health care during the first year following gastrostomy tube placement in children and the content of intervention goals. Methods: The medical records of 39 children (median age 38 months, min–max: 15–192) in one region of Sweden were analysed. A content analysis approach was used with an inductive qualitative analysis supplemented by a deductive, quantitative analysis of documented intervention goals following the ICF-CY. Results: One overall theme, “Seeking a balance”, captured the view of life with a gastrostomy and the health care provided. Two categories, “Striving for physical health” and “Depicting everyday life” with seven sub-categories, captured the key aspects of the documentation. Twenty-one children (54%) had intervention goals related to the gastrostomy, and these goals primarily focused on the ICF-CY component “Body functions”. Conclusions: To some extent the medical records reflected different dimensions of everyday life, but the intervention goals clearly focused on bodily aspects. Understanding how health care for children using a gastrostomy is documented and planned by applying an ecocultural framework adds a valuable perspective and can contribute to family-centred interventions for children using a gastrostomy.Implications for Rehabilitation There is a need for increased awareness in healthcare professionals for a more consistent and holistic healthcare approach in the management of children with gastrostomy tube feeding. This study suggests that an expanded focus on children’s participation in everyday mealtimes and in the healthcare follow-up of gastrostomy tube feeding is important in enhancing the intervention outcome. Multidisciplinary teams with a shared bio-psycho-social understanding of health would contribute to a situation in which the everyday lives of households adapt to living with gastrostomy. Routine care for children with gastrostomy should follow a checklist combining crucial physiological aspects of gastrostomy tube feeding with seemingly mundane family functions in order to achieve a successful gastrostomy tube feeding intervention.  © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

  • 5.
    Backman, Ellen
    et al.
    Högskolan i Halmstad, Centrum för forskning om välfärd, hälsa och idrott (CVHI).
    Karlsson, Ann-Kristin
    Department of Research and Development, Region Halland, Halmstad, Sweden.
    Sjögreen, Lotta
    Mun-H-Center Orofacial Resource Center for Rare Diseases, Public Dental Service, Gothenburg, Sweden.
    Gastrostomy tube feeding in children with developmental or acquired disorders: A longitudinal comparison on health care provision, and eating outcomes four years after gastrostomy2018In: Nutrition in clinical practice, ISSN 0884-5336, Vol. 33, no 4, p. 576-583Article in journal (Refereed)
    Abstract [en]

    Background: Studies on long‐term feeding and eating outcomes in children requiring gastrostomy tube feeding (GT) are scarce. The aim of this study was to describe children with developmental or acquired disorders receiving GT and to compare longitudinal eating and feeding outcomes. A secondary aim was to explore healthcare provision related to eating and feeding.

    Methods: This retrospective cohort study reviewed medical records of children in 1 administrative region of Sweden with GT placement between 2005 and 2012. Patient demographics, primary diagnoses, age at GT placement, and professional healthcare contacts prior to and after GT placement were recorded and compared. Feeding and eating outcomes were assessed 4 years after GT placement.

    Results: The medical records of 51 children, 28 boys and 23 girls, were analyzed and grouped according to “acquired” (n = 13) or “developmental” (n = 38) primary diagnoses. At 4 years after GT placement, 67% were still using GT. Only 6 of 37 (16%) children with developmental disorders transferred to eating all orally, as opposed to 10 of 11 (91%) children with acquired disorders. Children with developmental disorders were younger at the time of GT placement and displayed a longer duration of GT activity when compared with children with acquired disorders.

    Conclusions: This study demonstrates a clear difference between children with developmental or acquired disorders in duration of GT activity and age at GT placement. The study further shows that healthcare provided to children with GT is in some cases multidisciplinary, but primarily focuses on feeding rather than eating.

  • 6.
    Backman, Ellen
    et al.
    Marie Cederschiöld University, Department of Social Sciences. Regional habilitation center, Region Halland, Sweden.
    Åsberg Johnels, Jakob
    Speech and Language Pathology Unit, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
    Thunberg, Gunilla
    DART centre for AAC and AT, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Parental perceptions of social life before and after attending a parent training program for children with complex communication needs: the ComAlong example2024In: Augmentative and Alternative Communication: AAC, ISSN 0743-4618, E-ISSN 1477-3848, Vol. 40, no 1, p. 46-56Article in journal (Refereed)
    Abstract [en]

    Parent training programs aimed at improving language outcomes for children with complex communication needs have predominantly been evaluated on child-centered outcomes and less often on the impact on social life or parental well-being. This study examined parent perceptions of social life before and after ComAlong, a group intervention providing parents with knowledge and training in responsive communication, environmental-milieu teaching strategies and augmentative and alternative communication (AAC). Parents (N = 467) completed questionnaires during the first and last sessions of ComAlong groups held in Sweden 2012 to 2018. Main outcome measure was change in the Social Life Scale from the Family Impact Questionnaire. Associations between this measure and demographic factors of parents and children were analyzed, along with reported change in parents’ use of AAC. Pre-post comparisons revealed small significant positive changes in perceived impact of social life following intervention. The magnitude of the positive change was larger among parents of children with non-syndromic diagnoses and parents of children with autism spectrum disorder or attention deficit hyper activity disorder (ADHD). Differences in social life impact was not associated with parents’ gender, language proficiency, age, or educational background. In conclusion, communication-focused parent training programs can have a positive impact on social family life and may thereby influence children’s participation.

  • 7.
    Beck, Ingela
    et al.
    Lunds universitet.
    Olsson Möller, Ulrika
    Lunds universitet.
    Malmström, Marlene
    Lunds universitet.
    Klarare, Anna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Samuelsson, Henrik
    Palliativ vård och ASIH Ystad .
    Lundh Hagelin, Carina
    Sophiahemmet högskola; Karolinska institutet.
    Rasmussen, Birgit
    Lunds universitet.
    Fürst, Carl Johan
    Lunds universitet.
    Translation and cultural adaptation of the Integrated Palliative care Outcome Scale including cognitive interviewing with patients and staff2017In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 16, p. 1-10, article id 49Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To expand our clinical and scientific knowledge about holistic outcomes within palliative care, there is a need for agreed-upon patient-reported outcome measures. These patient-reported outcome measures then require translation and cultural adaptation, either from country-specific languages to English, or the other way around. The aim of this study was to translate and cross-culturally adapt the Integrated Palliative care Outcome Scale (IPOS) to the Swedish care context.

    METHODS: Swedish versions of IPOS Patient and IPOS Staff were developed and culturally adapted using recommended guidelines including cognitive interviews with patients (n = 13) and staff (n = 15) from different care contexts including general and specialised palliative care.

    RESULTS: The comprehension and judgement difficulties identified in the pre-final patient and staff versions were successfully solved during the cognitive interviewing process. IPOS was well accepted by both patients and staff, none of the questions were experienced as inappropriate, and all questions were judged important.

    CONCLUSIONS: In this study, we translated and culturally adapted the patient and staff versions of IPOS, and demonstrated face and content validity and acceptability of the scale through cognitive interviewing with patients and staff within residential care facility, surgical and specialised palliative home care units. Cognitive interviewing in parallel with patients and staff in rounds, with tentative analysis in between, was a suitable method for identifying and solving challenges with comprehension and evaluation in the pre-final version of IPOS. The Swedish IPOS is now available for use in a variety of clinical care settings.

  • 8.
    Berzell, Martin
    et al.
    Linköpings universitet.
    Lerner, Henrik
    Ersta Sköndal University College, Department of Health Care Sciences.
    Medicinska mätvärdens ontologiska status i ljuset av universaliestriden2014In: Filosofisk Tidskrift, ISSN 0348-7482, Vol. 35, no 3, p. 26-34Article in journal (Other academic)
  • 9.
    Bullington, Jennifer
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Group supervision for healthcare professionals within primary care for patients with psychosomatic health problems: A pilot intervention study2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In primary health care, efficacious treatment strategies are lacking for these patients, although the most prominent symptoms accounting for consultation in primary care often cannot be related to any biological causes.

    AIM: The aim was to explore whether group supervision from a specific phenomenological theory of psychosomatics could provide healthcare professionals treating patients with psychosomatichealth issues within primary care a deeper understanding of these conditions and stimulate profession-specific treatment strategies. Our research questions were as follows: (i) What is the healthcare professionals' understanding of psychosomatics before and after the intervention? (ii) What are the treatment strategies for this group of patients before and after the intervention?

    METHODS: The study was an explorative qualitative intervention pilot study. The six participants from a primary healthcare setting in a medium-sized city in Sweden participated in the study. A supervision group was formed, based on a mix of professions, age, gender and years of clinical experience. Supervision consisted of one 75-minutes meeting every month during the course of 6 months. Participants were interviewed before and after the supervision intervention.

    FINDINGS:The study showed two distinct categories emerged from the data. One category of healthcare professionals espoused a psycho-educative approach, while the other lacked a cohesive approach. The supervision improved the second category of healthcare professionals' understanding of psychosomatics. The psycho-educative group did not change their understanding of psychosomatics, although they felt strengthened in their approach by the supervision. Profession-specific strategies were not developed.

    IMPLICATIONS: This pilot study indicates that a relatively short supervision intervention can aid clinicians in their clinical encounters with these patients; however, further research is necessary to ascertain the value of the specific phenomenologically based supervision intervention.

  • 10.
    Chiguer, Linda
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Inborr, Sara
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sjuksköterskors handhygien: Skydda patienten eller sig själv?2012Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Varje år orsakar vårdrelaterade infektioner patienterna och deras anhöriga ett lidande, vilket dessutom kostar samhället miljontals kronor på grund av förlängda vårdtider. Detta kan i stor utsträckning förhindras om handhygienen sköts på rätt sätt. Dock har det kommit till känna att riktlinjer kring handhygien inte följs, trots att det idag finns tydliga föreskrifter och lokala riktlinjer på varje sjukhus. Man är skyldig att följa dessa riktlinjer som sjuksköterska.

    Syfte: Syftet är att beskriva orsaker till varför sjuksköterskor inte följer riktlinjer gällande handhygien.

    Metod: En litteraturöversikt enligt Friberg (2006) gjordes med nio vetenskapliga artiklar som analyserades och kategoriserades efter funnet innehåll.

    Resultat: Följande kategorier utformades i de funna resultaten; tidsbrist i relation till arbetsbörda, okunskap samt personalens inverkan på handhygien.

    Diskussion: De olika aspekterna som framkom i resultatet diskuterades och reflekterades över med hjälp av kopplingar till Nightingales teorier om omvårdnad och dess betydelse för patientens säkerhet. Anmärkningsvärt nog följer inte sjuksköterskorna handhygienrutinerna, det har framkommit tydligt och även mellan raderna att man främst skyddar sig själv och inte tänker på patienten och smittspridningen i första hand. Detta framkommer genom den okunskap de visar gentemot gällande riktlinjer trots många års erfarenhet inom vården.

    Download full text (pdf)
    sjuksköterskorshandhygien
  • 11.
    Gabrielsson, Hanna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Örebro universitet, Institutionen för hälsovetenskaper.
    Adults with Spina bifida: voices from everyday life and exploration of living conditions2020Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to generate knowledge about living with Spina bifida, by mapping the condition and together with the adults with Spina bifida explore their living conditions and experiences in everyday life. Methods Study I was a quantitative study with a cross-sectional design. In Study II, individual experiences of daily life were explored by deep interviews using a reflective lifeworld approach. Study III had a participatory approach including five members of a photovoice group who met for eight sessions. Photographs taken by the members served as a starting point for the dialogue about what was of interest in their daily life. A narrative analysis was conducted by the researchers, incorporating the analysis the group did together. Study IV focused on alignment with the methodology in which photovoice is grounded. By returning to the ideological cornerstones of photovoice, the empirical experiences from Study III and examples from the literature were elaborated through processes within photovoice. The findings show that those adults with Spina bifida who were >46 years old had less complex medical conditions and better physical and cognitive functions, and had attained a higher level of education. The main theme in Study II was presented as “The contradictory path towards wellbeing in daily life.” In Study III, the members’ experiences in everyday life showed that many solutions offered by society were “An adaptation for us, but it works for no one.” The findings are further presented under three themes: “Accessibility – a never-ending project,” “Tensions of a normative view” and “Power to influence.” By focusing on action and narrative in Study IV, it is shown that dialogue, action, and interaction are important aspects of using photovoice. In conclusion, not all adult persons receive the support they need in everyday life, something future generations of adult persons with Spina bifida may have a higher need for. The stories and experiences of adults with Spina bifida in this thesis paint a history of not being asked, concerning their own situation. This shows that there is insufficient integration of the persons’ experiences in society’s efforts to plan for, and support, these individuals. The photovoice method was feasible for this group, providing opportunity for being part of dialogue, action, and interaction.

  • 12.
    Hultman, Lill
    et al.
    Karolinska Institutet.
    Forinder, Ulla
    Karolinska Institutet; Stockholms universitet.
    Pergert, Pernilla
    Karolinska Institutet.
    Assisted normality: A grounded theory of adolescent’s experiences of living with personal assistance2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 11, p. 1053-1062Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of the study was to explore how adolescents with disabilities experience everyday life with personal assistants.

    Method: In this qualitative study, individual interviews were conducted at 35 occasions with 16 Swedish adolescents with disabilities, in the ages 16–21. Data were analyzed using grounded theory methodology.

    Results: The adolescents' main concern was to achieve normality, which is about doing rather than being normal. They try to resolve this by assisted normality utilizing personal assistance. Assisted normality can be obtained by the existing relationship, the cooperation between the assistant and the adolescent and the situational placement of the assistant. Normality is obstructed by physical, social and psychological barriers.

    Conclusion: This study is from the adolescents’ perspective and has implications for understanding the value of having access to personal assistance in order to achieve assisted normality and enable social interaction in everyday life.

    Implications for Rehabilitation

    • Access to personal assistance is important to enable social interaction in everyday life.
    • A good and functional relationship is enabled through the existing relation, co-operation and situational placement of the assistant.
    • If the assistant is not properly sensitized, young people risk turning into objects of care.
    • Access to personal assistants cannot compensate for disabling barriers in the society as for example lack of acceptance.
  • 13.
    Lerner, Henrik
    Linköpings universitet.
    Definitioner av begreppet hälsa respektive kondition hos veterinärer och läkare2008In: Djuren är väl också människor: en antologi om hälsa och välbefinnande i djurens och människornas värld, Skara: Institutionen för husdjurens miljö och hälsa, Sveriges lantbruksuniversitet , 2008, p. 103-110Chapter in book (Other academic)
  • 14.
    Lerner, Henrik
    Ersta Sköndal University College, Department of Health Care Sciences.
    Proceedings of the Second Nordic Seminar on Equine Assisted Therapy: Communication and Relations in Equine Assisted Therapy2014Conference proceedings (editor) (Other academic)
  • 15.
    Lerner, Henrik
    Linköpings universitet.
    The philosophical roots of the "One Medicine" movement: an analysis of some relevant ideas by Rudolf Virchow and Calvin Schwabe with their modern implications2013In: Studia Philosophica Estonica, ISSN 2228-110X, Vol. 6, no 2, p. 97-109Article in journal (Refereed)
    Abstract [en]

    During the last decade there has been increasing interest in combining veterinary and human medicine, mainly in the areas of vaccination and the eradication of zoonotic and vector-borne diseases. Although the roots of this “One Health-One Medicine” approach can be found in ancient Egypt and Greece, the roots of the philosophy of “one medicine” have not been so thoroughly discussed. In this paper I will analyse some ideas that could unite veterinary and human medicine, from Rudolf Virchow (1821-1902) and Calvin W. Schwabe (1927-2006). Both are recognized as important theoretical founders of the philosophy of one medicine. I will also further develop these thoughts to meet some of the discussions taking place today.

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    fulltext
  • 16.
    Lerner, Henrik
    Linköpings universitet.
    Transeminarium om eutanasi för människa och av djur2010In: Svensk Veterinärtidning, Vol. 62, no 10, p. 23-25Article in journal (Other academic)
  • 17.
    Lerner, Henrik
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Berzell, Martin
    Linköpings universitet.
    Reference values and the problem of health as normality: a veterinary attempt in the light of a one health approach2014In: Infection Ecology & Epidemiology, E-ISSN 2000-8686, Vol. 4, p. 24270-Article in journal (Refereed)
    Abstract [en]

    Reference values seem crucial to both veterinary medicine and human medicine. The main critique is that thetheoretical connections between the concepts of reference values, normality, and health are weak. In this paper,we analyze especially one attempt in veterinary medicine to establish such a theoretical connection. We findthat this attempt fails because it is circular. In conclusion, we would postulate that there are two apparent waysforward: to aim for a definition of health not based on the concept of normality, or to develop the concept ofnormality as separate from statistical normality. These goals can be reached with a one health perspective.

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    fulltext
  • 18.
    Lerner, Henrik
    et al.
    Linköpings universitet.
    Skillnäs, NicklasLinköpings universitet.
    Essäer om hälsa: En antologi från forskarutbildningen på Tema Hälsa och samhälle2006Collection (editor) (Other academic)
  • 19.
    Norberg, Astrid
    Ersta Sköndal University College, Department of palliative care research. Ersta Sköndal University College, Department of Health Care Sciences.
    The meaning of evidence-based nursing.2006In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 13, no 5, p. 453-4Article in journal (Refereed)
    Abstract [en]

    The article discusses the meaning of evidence-based nursing. Evidence-based medicine is an explicit and conscientious use of current best medical approach in the care of individual patients. In clarifying this issue, several considerations are needed to be underlined. These are clinical experience, local context, and patient's preference. The need to reflect and research about ethics relative to evidence-based nursing is mentioned.

  • 20.
    Pettersen, Rossana
    et al.
    Karolinska institutet.
    Omerov, Pernilla
    Karolinska institutet.
    Steineck, Gunnar
    Karolinska sjukhuset; Göteborgs universitet.
    Titelman, David
    Karolinska institutet.
    Dyregrov, Atle
    Center for Crisis Psychology, Bergen, Norway.
    Nyberg, Tommy
    Karolinska institutet.
    Nyberg, Ullakarin
    Karolinska institutet.
    Lack of Trust in the Health-Care System After Losing a Child to Suicide: A Nationwide Population Survey2015In: Crisis, ISSN 0227-5910, E-ISSN 2151-2396, Vol. 36, no 3, p. 161-172Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Lack of trust in the health-care system after losing a child to suicide may prevent bereaved parents from seeking professional treatment when needed, thus diminishing their chances of recovery.

    AIMS: This is the first large study to aim at evaluating the incidence of lack of trust in the health-care system and associated variables in suicide-bereaved parents.

    METHOD: This nationwide population-based survey included 569 parents who lost a child to suicide 2-5 years earlier and a matched comparison group of 326 nonbereaved parents. Using a study-specific questionnaire, we asked bereaved and nonbereaved parents if they trusted the health-care system and measured psychological and background variables.

    RESULTS: Prevalence of lack of trust in the health-care system differed between the bereaved (46.5%) and the nonbereaved parents (18.3%), giving a relative risk of 2.5 (95% CI = 2.0-3.3). After multivariable modeling, high scores of depression, living in big cities, and being single were identified as variables associated with lack of trust in suicide-bereaved parents.

    CONCLUSION: Suicide-bereaved parents show lack of trust in the health-care system. We present possible effect modifiers that may be considered in professional interventions aiming at influencing suicide-bereaved parents' level of trust.

  • 21.
    Saldert, Charlotta
    et al.
    University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Backman, Ellen
    University of Gothenburg, Gothenburg, Sweden.
    Hartelius, Lena
    University of Gothenburg, Gothenburg, Sweden; University of Gothenburg Centre for Person-Centred Care (GPCC), Gothenburg, Sweden.
    Conversation partner training with spouses of persons with aphasia: A pilot study using a protocol to trace relevant characteristics2013In: Aphasiology, ISSN 0268-7038, E-ISSN 1464-5041, Vol. 27, no 3, p. 271-292Article in journal (Refereed)
    Abstract [en]

    Background: Conversation partner training can be effective in improving communication in aphasia. However, there is a need for further research about effects of specific training programmes as well as about the relevant characteristics of the conversation partners who are to be candidates for training.

    Aims: This pilot study explores the applicability of an adaptation of a conversation partner training programme. In addition, a protocol for assessment of variables relating to the person with aphasia and the conversation partner that may be involved in changes in conversational interaction is examined.

    Methods & Procedures: Three dyads with persons with aphasia and their spouses participated in this explorative study with a case-series design. The training outcome was monitored with measures of perceived functional communication and analysis of multiple video-recorded natural conversations obtained at baseline, post intervention, and at a 12-week follow-up. Repeated measures of comprehension, word fluency, and psychological well-being were obtained as well as descriptive measures of the executive function and a profiling of attitudes and behaviour in communication in the spouses.

    Outcomes & Results: All three persons with aphasia and two of the spouses reported a slight improvement in the measure of perceived functional communication. This perception of improvement was also reflected in blinded, independent assessments of ability to support communication in conversations for the two spouses who reported improvement. The profiling of the third spouse indicated problems in attitudes to communication and also in aspects of executive function, and may account for the lack of intervention effects seen in the third dyad.

    Conclusions: The results show that intervention with the adapted training programme may be effective. It might be argued that the outcome measures as well as other measures fulfil their purpose. The profiling of relevant traits in the conversation partner may be useful, although the prognostic validity of the instruments needs to be further evaluated. © 2013 Copyright Taylor and Francis Group, LLC.

  • 22.
    Simm, Kadri
    et al.
    University of Tartu, Estonia.
    Lerner, Henrik
    Linköpings universitet.
    Medical philosophy and medical ethics in the Nordic and the Baltic countries: Some pressing issues2013In: Studia Philosophica Estonica, ISSN 1736-5899 (online) 2228-110X (print), Vol. 6, no 2, p. 1-5Article in journal (Other academic)
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  • 23.
    Sveen, Josefin
    et al.
    Uppsala universitet.
    Dyster-Aas, Johan
    Uppsala universitet.
    Willebrand, Mimmie
    Uppsala universitet.
    Attentional bias and symptoms of posttraumatic stress disorder one year after burn injury2009In: Journal of Nervous and Mental Disease, ISSN 0022-3018, E-ISSN 1539-736X, Vol. 197, no 11, p. 850-855Article in journal (Refereed)
    Abstract [en]

    Trauma-related attentional bias is suggested to play a role in maintaining posttraumatic stress disorder (PTSD). Although being burn injured is a traumatic event for many patients, there are no prospective studies investigating attentional bias. The aims were to assess burn-specific attentional bias 1 year after burn, and its associations with risk factors for PTSD and symptoms of PTSD. A total of 38 adult patients with burns were assessed with a structured clinical interview and a Swedish version of the Impact of Event Scale-Revised up to 1-year after burn. The Emotional Stroop Task was used to assess attentional bias 1 year after burn. In total 29 participants displayed burn-specific attentional bias. This group had more previous life events, perceived life threat, larger burns, and higher PTSD symptom severity. In conclusion, the majority of the patients had burn-specific attentional bias 1 year after burn and this was related to symptoms of PTSD.

  • 24.
    Sveen, Josefin
    et al.
    Uppsala universitet.
    Low, Aili
    Uppsala universitet.
    Dyster-Aas, Johan
    Uppsala universitet.
    Ekselius, Lisa
    Uppsala universitet.
    Willebrand, Mimmie
    Uppsala universitet.
    Gerdin, Bengt
    Uppsala universitet.
    Validation of a swedish version of the impact of event scale-revised (IES-R) in patients with burns2010In: Journal of Anxiety Disorders, ISSN 0887-6185, E-ISSN 1873-7897, Vol. 24, no 6, p. 618-622Article in journal (Refereed)
    Abstract [en]

    The Impact of Event Scale (IES) and the Impact of Event Scale-Revised (IES-R) are often used as self-reportinstruments for symptoms of post-traumatic stress disorder (PTSD). However, there are few validationsof the IES and the IES-R against structured clinical interviews. In this study the two scales, together withthe three subscales of the IES-R, were assessed for their agreement with a diagnosis of PTSD in patientswith burns 1 year after injury. Sixty patients with burns were evaluated 1 year after injury using theStructured Clinical Interview for the DSM-IV Axis I (SCID-I) psychiatric disorders and a Swedish versionof the IES-R. The total score of the IES-R had the best discriminant ability (0.89) with a sensitivity of 1.0and a specificity of 0.78. In conclusion, the total IES-R had good properties as a screening tool for PTSDand subsyndromal PTSD 1 year after burn injury.

  • 25.
    Sveen, Josefin
    et al.
    Uppsala universitet.
    Orwelius, Lotti
    Linköpings universitet.
    Gerdin, Bengt
    Uppsala universitet.
    Huss, Fredrik
    Linköpings universitet.
    Sjöberg, Folke
    Linköpings universitet.
    Willebrand, Mimmie
    Uppsala universitet.
    Psychometric properties of the impact of event scale-revised in patients one year after burn injury2010In: Journal of Burn Care & Research, ISSN 1559-047X, E-ISSN 1559-0488, Vol. 31, no 2, p. 310-318Article in journal (Refereed)
    Abstract [en]

    Burn injury can be a life-threatening and traumatic event. Despite considerable risk for psychological morbidity, few outcome measures have been evaluated. The aim of this study was to examine the psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) in patients 1 year after burn injury (N = 147). A principal component analysis was performed, and the results supported the three-factor structure of the IES-R. High internal consistency and intelligible associations with concurrent psychological symptoms and known risk factors for distress after trauma indicate satisfactory psychometric properties. Thus, the study supports the use of the IES-R as a screening tool for measuring traumatic distress after burn.

  • 26.
    Thoresen, Lisbeth
    et al.
    University of Oslo, Oslo, Norway.
    Öhlén, Joakim
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Ersta sjukhus, Stockholm; Göteborgs universitet.
    Lived Observations: Linking the Researcher's Personal Experiences to Knowledge Development.2015In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 25, no 11, p. 1589-98Article in journal (Refereed)
    Abstract [en]

    As researchers in palliative care, we recognize how involvement with seriously ill and dying persons has an impact on us. Using one's own senses, emotional and bodily responses in observations might open intersubjective dimensions of the research topic. The aim of the article is to highlight how phenomenological theories on intersubjectivity can be useful to develop rich and transparent data generation and analysis. We present three field note examples from observation in a hospice ward, which illuminate how researcher awareness of aspects of intersubjectivity can add valuable insights to data and analysis. Out of the examples, we elaborate on three arguments: (a) how the researcher's lived experience of time and space during fieldwork triggers new research questions, (b) how observations as an embodied activity can bring new insights and open new layers of meaning, and (c) the value of observations in gaining insight into relational aspects in a hospice.

  • 27.
    Tistad, Malin
    et al.
    Karolinska Institutet; Högskolan Dalarna.
    Hultman, Lill
    Karolinska Institutet; Södertörns högskola; Karolinska Universitetssjukhuset.
    Åkerlund, Mikael
    Karolinska Institutet.
    Nelson, Jeanette
    Karolinska Institutet.
    Sandman, Fredrik
    Karolinska Institutet.
    Von Koch, Lena
    Karolinska Institutet.
    United for Participation in Society: The exploration of an ongoing research process in a participatory health research project.2022In: International Journal of Integrated Care, E-ISSN 1568-4156, Vol. 22, no S3, p. 276-276Article in journal (Refereed)
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  • 28.
    Willebrand, Mimmie
    et al.
    Uppsala universitet.
    Sveen, Josefin
    Uppsala universitet.
    Ramklint, Mia
    Uppsala universitet.
    Bergquist, Maria
    Uppsala universitet.
    Huss, Fredrik
    Uppsala universitet.
    Sjöberg, Folke
    Linköpings universitet.
    Psychological problems in children with burns: parents' reports on the strengths and difficulties questionnaire2011In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 37, no 8, p. 1309-1316Article in journal (Refereed)
    Abstract [en]

    Burns may have a devastating effect on psychological health among children, although previous studies report difficulties as well as positive findings. The aims were to describe the rate of psychological problems in children with burns using a standardised instrument and to explore statistical predictors of these problems. Parents (n = 94) of children aged 3-18 years who sustained burns 0.3-9.0 years previously answered the Strengths and Difficulties Questionnaire (SDQ) covering Emotional symptoms, Conduct problems, Hyperactivity/Inattention, Peer relationship problems, Prosocial behaviour, and a Total difficulties score. Questions regarding parental psychological health and family situation were also included. The results for three of the SDQ subscales were close to the norm (10%) regarding the rate of cases where clinical problems were indicated, while the rate of cases indicated for Conduct, Peer problems and Total difficulties was 18-20%. Statistical predictors of the SDQ subscales were mainly parents' psychological symptoms, father's education, and changes in living arrangements. Visible scars were relevant for the Total difficulties score and Hyperactivity/Inattention. In summary, a slightly larger proportion of children with burns had psychological problems than is the case among children in general, and family variables exerted the most influence on parental reports of children's psychological problems.

  • 29.
    Österlind, Jane
    et al.
    Ersta Sköndal University College, Department of palliative care research.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lantz, Göran
    Ersta Sköndal University College, Department of Health Care Sciences.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Enheten för forskning i palliativ vård.
    Pathways in end-of-life care for older people: care managers' reasoning.2008In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 14, no 9, p. 420-5Article in journal (Refereed)
    Abstract [en]

    Seven care managers employed by a large municipality in Sweden were interviewed concerning their reasoning regarding end-of-life care for older people. Data were analyzed using a hermeneutic approach. The results showed that end-of-life care was considered to constitute a small part of the care managers' work and was something they did not focus on in general when assessing care needs. Two different pathways to death--the natural and the medical--were identified. In the natural pathway, death was invisible and the care was more routine-oriented. In the medical pathway, death was visualised and the care more individualised. Neither of the pathways paid attention to communication or existential needs. Thus, there is a need for a palliative pathway to death based on the philosophy of palliative care, which could provide guidance for care managers and promote opportunities for older people to achieve a dignified dying and death.

1 - 29 of 29
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