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  • 1.
    Beck, Ingela
    et al.
    Lunds universitet; Högskolan Kristianstad.
    Olsson Möller, Ulrika
    Lunds universitet.
    Malmström, Marlene
    Lunds universitet.
    Klarare, Anna
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences, Palliative Research Centre, PRC.
    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, ISSN 1472-684X, 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.

  • 2.
    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)
  • 3.
    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.

  • 4.
    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.

  • 5.
    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)
  • 6.
    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)
  • 7.
    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 1736-5899 (online) 2228-110X (print), 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.

  • 8.
    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)
  • 9.
    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, ISSN 2000-8686, 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.

  • 10.
    Lerner, Henrik
    et al.
    Linköpings universitet.
    Skillnäs, NicklasLinköpings universitet.
    Essäer om hälsa: En antologi från forskarutbildningen på Tema Hälsa och samhälle2006Collection (editor) (Other academic)
  • 11.
    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.

  • 12.
    Pettersen, Rossana
    et al.
    Karolinska institutet.
    Omerov, Pernilla
    Karolinska institutet.
    Steineck, Gunnar
    Karolinska sjukhuset, Göteborgs universitet.
    Titelman, David
    Karolinska institutet.
    Dyregrov, Atle
    Norge.
    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.

  • 13.
    Simm, Kadri
    et al.
    University of Tartu.
    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)
  • 14.
    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.

  • 15.
    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.

  • 16.
    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.

  • 17.
    Thoresen, Lisbeth
    et al.
    Oslo universitet, Norge.
    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.

  • 18.
    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.

  • 19.
    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.

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