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  • 1.
    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.

  • 2.
    Bullington, Jennifer
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Söderlund, Mona
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Bos Sparén, Elisabeth
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Kneck, Åsa
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Omérov, Pernilla
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    Communication skills in nursing: A phenomenologically-based communication training approach2019In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 9, p. 136-141Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to present a communication skills training curriculum for nursing students, based upon phenomenology. Research shows that nurses have difficulty prioritizing dialogue with patients, due to lack of time, organizational and cultural factors. Like other health care professionals, nurses may also have difficulties communicating with patients due to personal fears and shortcomings. The communication training curriculum based upon phenomenology aims at systematically training students to stay focused upon patients' and relatives' narratives, allowing them to reflect upon and better understand their current situation. This approach to communication is applicable in any clinical situation where it important to provide space for the patients' experiences. The philosophical principles guiding the training are presented here as well as the practical steps in the program. Finally, the approach is compared to other common communication methods used in nursing (motivational interviewing, caring conversations, empathy training). The authors hope that the article will highlight the nurses’ role as dialogue partner as well as emphasize the importance of communication skills training in nursing education. This approach can be refined, tested and modified in future research and may serve as an inspirational model for creating a generic communicative competence for nurses.

  • 3.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    The moral enterprise in intensive care nursing2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aims of this thesis were to explore nurses' experiences of stress in the ICU (I), to analyze experiences of moral concerns in intensive care nursing from the perspective of relational ethics (II), to describe the synthesis of the concept of moral stress and to identify preconditions for moral stress (III) and to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care (IV).The design was exploratory and descriptive. Material in studies I, II and IV consisted of interviews with intensive care nurses (10 head nurses and 26 staff nurses) employed in general, thoracic and neonatal intensive care units in five hospitals located in different parts of Sweden. The material in study III data from two studies of professional issues in nursing were used for the analysis: one concerned psychiatric nursing and the other was the previously referred study I.In study I qualitative content analysis and descriptive interpretation was used in the analysis. The main theme 'stress induced by dissonant imperatives' formulated in the analysis. Dissonant imperatives are composed of the four sub-themes: 1) controlled by the working situation - needing to be in control, 2) constrained by prioritisation - wanting to do more, 3) lacking authority to act - knowing that something should be done, and 4) professional distance - interpersonal involvement. In study II qualitative content analysis and descriptive interpretation were used in the analysis. A main theme was formulated, 'caring about-caring for: tensions between moral obligations and work responsibilities in intensive care nursing'. Five sub-themes were formulated 1) believing in a good death, 2) knowing the course of events, 3) feelings of distress, 4) reasoning about the physicians and 5) expressing moral awareness. In the study III a hypothetical-deductive method was used. The findings indicate that moral stress is independent of context-given specific pre-conditions: 1) nurses are morally sensitive to the patient's vulnerability, 2) nurses experience external factors preventing them from doing the best for the patient, and 3) nurses feel that they have no control over the situation. In the study IV an interpretive method was used. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. Thereafter five tentative interpretations were revealed: 1) receiving organised support is a matter of self-determination, 2) whether to participate or to be off duty is experienced mutually as exclusive, 3) dealing with moral stress is experienced as a private matter, 4) colleagues managing moral stress serve as models in stress support, and 5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation of data was: "lived experience of moral stress support involves an interconnectedness between structural and existential factors".A comprehensive understanding was formulated using the four studies (I, II, III and IV). Moral stress was found to be influential on the caring competence. Conflicts between different competences were found leading to a shift in focus away from the patients leading to a possible decrease in the caring competence. Moreover, the subtle resistance among nurses toward participation in organized moral stress support may obstruct the development of nurses' caring competence. Accordingly, imbalance, due to moral stress, between different competences hinders the development of collectively shared caring competence.

  • 4.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Faager, Gun
    Karolinska Institutet.
    Larsen, Fleming
    Karolinska Instititet.
    Schenck-Gustavsson, Karin
    Karolinska Institutet.
    Step-wise versus symptom-limited in-hospital mobiliization after acute myocardial infarction1996In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 12, no 2, p. 68-75Article in journal (Refereed)
  • 5.
    Cronqvist, Agneta
    et al.
    Centre of Caring Sciences North, Karolinska Institute, Borgmästarvillan, Karolinska Hospital, S-171 76 Stockholm, Sweden.
    Klang, B
    Centre of Caring Sciences North and Department of Medicine, Karolinska Institute, Borgmästarvillan, Karolinska Hospital, S-171 76 Stockholm, Sweden.
    Björvell, H
    Centre of Caring Sciences North and Department of Medicine, Karolinska Institute, Borgmästarvillan, Karolinska Hospital, S-171 76 Stockholm, Sweden.
    The use and efficacy of coping strategies and coping styles in a Swedish sample.1997In: Quality of Life Research, ISSN 0962-9343, E-ISSN 1573-2649, Vol. 6, no 1, p. 87-96Article in journal (Refereed)
    Abstract [en]

    This paper presents Swedish reference values for the Jalowiec Coping Scale (JCS-60), a questionnaire measuring the use and efficacy of coping strategies. The strategies are grouped in eight coping styles. The sample used was randomly selected from a Swedish urban population. The sample consisted of 268 individuals (135 men and 133 women), divided into three age-groups, 26-40, 41-55 and 56-70 years. There were no significant differences between the three age-groups or between men and women when comparing the total scores for use and efficacy on the JCS-60. No significant differences were found between the genders within each age-group. The most commonly used coping styles were the confrontational, the optimistic and the self-reliant. The least used style was the fatalistic. Men, as compared with women, used the confrontational and self-reliant coping styles more while women used the supportive coping style more than men. The youngest age-group used the emotive coping style more, compared with the other age groups. Cronbach's alpha for the total scores indicates acceptable reliability. The results of this study may be useful as Swedish reference values for comparison with the research results of studies on patients.

  • 6.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lützén, Kim
    Nyström, Maria
    Nurses' lived experiences of moral stress support in the intensive care context.2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 5, p. 405-13Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse and describe lived experiences of support in situations characterized by critical care situations and moral stress in intensive care nursing. An exploratory interpretative study was conducted. Data consisted of interviews with 36 nurses from different types of intensive care units. The first level of analysis of data identified contextual factors, such as type and purpose of support and working conditions. On the next level of analysis five tentative interpretations were identified: (1) receiving organized support is a matter of self-determination, (2) whether to participate in organized support or to be off duty are experienced as mutually exclusive, (3) dealing with moral stress is experienced as a private matter, (4) colleagues managing moral stress serve as models in stress support and (5) not being able to deal with moral stress urges one to seek outside support. A comparison of these interpretations identified three major themes: availability, accessibility and receptivity of support. The main interpretation and conclusion were: lived experience of moral stress support involves an interconnectedness between structural and existential factors. Thus, adequate moral stress support presupposes an allowable professional climate and access to caring supervision.

  • 7.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nyström, Maria
    A theoretical argumentation on the consequences of moral stress.2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 4, p. 458-65Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Intensive care units are characterized by heavy workloads, increasing work complexity and ethical concerns related to life-and-death decisions. In the present study, it is assumed that there is a relationship between moral stress, support and competence for nurses in intensive care units. AIM: To analyse and describe the theoretical relationship between moral stress and support on the one hand and competence on the other, in the context of intensive care. METHOD: A form of qualitative secondary analysis based on the findings from three original studies. In the analytic process a theory on professional competence was used. FINDINGS: The findings suggest that imbalance due to moral stress between different competences hinders the development of collectively shared caring competence. CONCLUSIONS: Moral stress cannot be totally eliminated in the intensive care unit. But moral stress is not only a problem. It can also become a driving force to stimulate competence.

  • 8.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sundh, Kenneth
    Ersta Sköndal University College, Department of Social Work.
    Första året för demensprojektet i skarpnäcks stadsdel2009Report (Other (popular science, discussion, etc.))
  • 9.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sundh, Kenneth
    Ersta Sköndal University College, Department of Social Work.
    Första året för projektet förebyggande hembesök i Skarpnäcks stadsdel2009Report (Other (popular science, discussion, etc.))
  • 10.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sundh, Kenneth
    Ersta Sköndal University College, Department of Social Work.
    Första året för projektet mötesplats servicehuset i Skarpnäcks stadsdel2009Report (Other (popular science, discussion, etc.))
  • 11.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sundh, Kenneth
    Ersta Sköndal University College, Department of Social Work.
    Första året för projektet projektsamordnare i Skarpnäcks stadsdel2009Report (Other (popular science, discussion, etc.))
  • 12.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sundh, Kenneth
    Ersta Sköndal University College, Department of Social Work.
    Projektet rehabilitering i vardagen i Skarpnäcks stadsdel2009Report (Other (popular science, discussion, etc.))
  • 13.
    Cronqvist, Agneta
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Sundh, Kenneth
    Ersta Sköndal University College, Department of Social Work.
    Slutrapport år 2 för äldreprojekten i Skarpnäcks stadsdel2010Report (Other (popular science, discussion, etc.))
  • 14.
    Cronqvist, Agneta
    et al.
    Department of Nursing, Karolinska Institutet, Stockholm, Sweden.
    Theorell, T
    Burns, T
    Lützén, Kim
    Dissonant imperatives in nursing: a conceptualization of stress in intensive care in Sweden.2001In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 17, no 4, p. 228-36Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to explore nurses' experiences of stress within the context of intensive care. The theoretical perspective for the study builds on a cognitive-phenomenological-transactional theory of stress and coping and the theory of cognitive dissonance. Respondents were 36 registered nurses recruited from 10 intensive care units (general, neonatal and thoracic units). Their experience as nurses ranged from one to 32 years. These intensive care units had similar structural characteristics, namely a high working pace, advanced technology, constrained finances, frequent reorganizations, a shortage of registered nurses and all were filled to overcapacity. Data were collected in open-ended interviews that were audio-taped and transcribed. A content analysis identified four contradictory themes: (1) controlled by the work situation--needing to be in control; (2) constrained by prioritization--wanting to do more; (3) lacking the authority to act--knowing that something should be done; and (4) professional distance--interpersonal involvement. These four themes were synthesized at a higher level of abstraction into a main theme: stress induced by dissonant imperatives, which conceptualizes nursing stress in the intensive care unit. In conclusion, dissonant imperatives might lead to stress in intensive care nursing.

  • 15. Cronqvist, Agneta
    et al.
    Theorell, Töres
    Burns, Tom
    Lützén, Kim
    Caring about--caring for: moral obligations and work responsibilities in intensive care nursing.2004In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 11, no 1, p. 63-76Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse experiences of moral concerns in intensive care nursing. The theoretical perspective of the study is based on relational ethics, also referred to as ethics of care. The participants were 36 intensive care nurses from 10 general, neonatal and thoracic intensive care units. The structural characteristics of the units were similar: a high working pace, advanced technology, budget restrictions, recent reorganization, and shortage of experienced nurses. The data consisted of the participants' examples of ethical situations they had experienced in their intensive care unit. A qualitative content analysis identified five themes: believing in a good death; knowing the course of events; feelings of distress; reasoning about physicians' 'doings' and tensions in expressing moral awareness. A main theme was formulated as caring about--caring for: moral obligations and work responsibilities. Moral obligations and work responsibilities are assumed to be complementary dimensions in nursing, yet they were found not to be in balance for intensive care nurses. In conclusion there is a need to support nurses in difficult intensive care situations, for example, by mentoring, as a step towards developing moral action knowledge in the context of intensive care nursing.

  • 16.
    Cronqvist, Agneta
    et al.
    Department of Nursing, Karolinska Institut.
    Wredling, R.
    Division of Nursing Research, Department of Nursing, Karolinska Hospital, Karolinska Institut, Stockholm, Sweden; Department of Nursing, Karolinska Institut.
    Nordlander, R.
    Division of Cardiology, Department of Medicine, Stockholm Söder Hospital, Stockholm, Sweden.
    Langius, A.
    Division of Nursing Research, Department of Nursing, Karolinska Hospital, Karolinska Institut, Stockholm, Sweden; Department of Nursing, Karolinska Institut.
    Björvell, H.
    Division of Nursing Research, Department of Nursing, Karolinska Hospital, Karolinska Institut, Stockholm, Sweden; Department of Nursing, Karolinska Institut.
    Perceived discomfort and related coping phenomena in patients undergoing percutaneous transluminal coronary angioplasty2000In: Coronary Health Care, ISSN 1362-3265, E-ISSN 1532-2025, Vol. 4, no 3, p. 123-129Article in journal (Refereed)
    Abstract [en]

    The aims of the study were to describe the perceived discomfort in relation to percutaneous transluminal coronary angioplasty (PTCA) in a group of 56 patients from a cardiac outpatient clinic and to investigate their coping strategies and styles, as measured by the Jalowiec Coping Scale (JCS) before and after PTCA, and their sense of coherence, as measured by the Sense of Coherence Scale (SOC). Thirty-eight patients (68%) experienced some sort of discomfort in the immediate postoperative phase after PTCA. The most unbearable discomfort was lower back pain. The most commonly used coping styles were the confrontational, the optimistic and the self-reliant. It is suggested that the three most commonly used styles, as given by the patients in the present study, could be used as a foundation for cognitive training in a nursing program for this group of patients.

  • 17.
    Ewertzon, Mats
    et al.
    Örebro universitet. ; Högskolan Dalarna.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Lützén, Kim
    Karolinska Institutet.
    Andershed, Birgitta
    Ersta Sköndal University College, Palliative Reserch Centre, PRC.
    A lonely life journey bordered with struggle: being a sibling of an individual with psychosis 2012In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 33, no 3, p. 157-164Article in journal (Refereed)
    Abstract [en]

    Research suggests that siblings of individuals with severe mental illness are affected by the situation of their affected sibling and that the health care services seem to partly fail in meeting their needs for support. The aim of this study was therefore to explore how siblings of individuals with a psychotic illness, and who have participated in a support group, experience their situation. Thirteen informants participated in focus group interviews, which were analysed by inductive content analysis. The findings were interpreted in an overall single theme: A lonely life journey bordered with struggle. This theme consists of three categories: facing existential thoughts, facing ambiguity in approach and engagement, and facing disparate attitudes and expectations.

  • 18.
    Karlberg Traav, Malin
    et al.
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences. Örebro universitet.
    Forsman, Henrietta
    Högskolan Dalarna.
    Eriksson, Mats
    Örebro univeristet.
    Cronqvist, Agneta
    Ersta Sköndal Bräcke University College, Department of Health Care Sciences.
    First line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing.2018In: Nursing open, ISSN 2054-1058, Vol. 5, no 4, p. 634-641Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to explore first line nurse managers' experiences of opportunities and obstacles to support evidence-based nursing.

    Design: A qualitative study with a phenomenographical approach.

    Method: Data were collected through focus group interviews with 15 first line nurse managers' in four settings.

    Results: The results are presented in four categories of description headed: Manage the everyday work vs. evidence-based nursing; Uncertainties about evidence-based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness-towards an active approach to evidence-based nursing. The overarching category of description has been formulated as follows: The internal relation-how active leadership influences evidence-based nursing. The outcome space is presented as: The individual path-how to make vision and reality become a working entity around evidence-based nursing.

  • 19. Klang, B
    et al.
    Björvell, H
    Cronqvist, Agneta
    Patients with chronic renal failure and their ability to cope.1996In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 10, no 2, p. 89-95Article in journal (Refereed)
    Abstract [en]

    The subject studied in this paper, describing uremic patients' use of coping strategies and their sense of coherence, was 48 consecutively selected patients with chronic renal failure at a Swedish hospital. The questionnaires used were the Jalowiec Coping Scale (JCS-40) and the Sense of Coherence Scale (SOC). The results showed that the patients used a variety of coping strategies, such as maintaining control, finding out more about the situation and hoping. In the use of coping styles, the confrontational style was the most favoured one, compared with the palliative and the emotive styles. There was a significant distinction between the predialysis patients and those on dialysis treatment concerning the use of strategies and coping styles. Patients on dialysis treatment showed significantly higher scores in overall strategies and in confrontational and palliative coping styles. The results revealed significant correlations between the JCS and the SOC scores, age and duration of kidney disease. Knowledge of the patients' commonly used coping strategies and sense of coherence is important when nursing care is being planned for the patient.

  • 20.
    Leander, Mai
    et al.
    Uppsala universitet, Arbets- och miljömedicin) (Arbets- och miljömedicin.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Janson, Christer
    Uppsala universitet, Lungmedicin och allergologi) (Lungmedicin och allergologi.
    Uddenfeldt, Monica
    Uppsala universitet, Arbets- och miljömedicin) (Arbets- och miljömedicin.
    Rask-Andersen, Anna
    Uppsala universitet, Arbets- och miljömedicin) (Arbets- och miljömedicin.
    Health-related quality of life predicts onset of asthma in a longitudinal population study.2009In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 103, no 2, p. 194-200Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Health-related quality of life (HRQL) has been increasingly used as an outcome measure in asthma, but less is known about the prognostic implication of low health-related quality of life. The purpose of this study was to investigate if a set of quality of life measures could predict onset of asthma. METHODS: In the baseline study 391 subjects without asthma answered a respiratory questionnaire and the Gothenburg Quality of Life (GQL) instrument in 1990. The GQL questionnaire included two parts: (1) the prevalence of HRQL-related symptoms and (2) well-being scores for physical, mental and social dimensions. The participants were also investigated with spirometry and allergy testing. In 2003, the same respiratory questionnaire that had been used in 1990 was sent. There were 290 responders, of whom 22 subjects had developed asthma. RESULTS: Participants who had developed asthma by the follow-up had a higher prevalence of sleep disturbances (30% vs. 10%), problems with chest pain (16% vs. 2%), depression (40% vs. 20%) difficulty relaxing (40% vs. 13%) and constipation (25% vs. 2%) at baseline than participants who did not develop asthma (p<0.05). Subjects who developed asthma also scored significantly lower on well-being variables as sleep, energy, mood, patience, memory, appetite, fitness and sense of appreciation outside home. These differences remained after adjusting for age, sex, smoking habits, asthma heredity, socioeconomic groups and building dampness. CONCLUSION: Participants with low health-related quality of life at baseline were more likely to report having developed asthma 12 years later.

  • 21.
    Leander, Mai
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Janson, Christer
    Uddenfeldt, Monica
    Rask-Andersen, Anna
    Non-respiratory symptoms and well-being in asthmatics from a general population sample.2009In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 46, no 6, p. 552-9Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Different instruments have been developed to assess health-related quality of life (HRQL) in asthma patients. However, relatively few studies have assessed HRQL in asthma patients from a general population, and it is still unclear which instrument is most suitable. The purpose of this study was to compare HRQL in clinically verified asthmatics with subjects with respiratory symptoms without asthma and with subjects with no respiratory symptoms from a general population. The generic instrument Gothenburg Quality of Life (GQL) was used. A secondary aim was to study if GQL had any prognostic value in asthma. METHODS: A cohort of three age groups in Sweden was investigated in 1990 using a respiratory questionnaire and GQL. The cohort consisted of 616 subjects with asthma, 488 subjects with respiratory symptoms but no asthma, and 347 subjects without respiratory symptoms. The participants were also investigated by spirometry and allergy testing. In a follow-up study, subjects were identified who had persistent and improved asthma. RESULTS: The prevalence of 28 of the 30 common symptoms in GQL was significantly increased (p < 0.001) in subjects with asthma as compared to non-asthmatics. All symptoms in the domains heart and lung, head, musculoskeletal, tension, and depression were significantly increased among the asthmatics. The asthmatics also rated their physical well-being lower (p < 0.001) than subjects with no respiratory symptoms. Subjects with persistent asthma had a significantly higher prevalence of 7 of the 30 symptoms and lower social well-being than subjects showing improvement in asthma during the follow-up. All differences remained significant after adjusting for age, sex, and smoking habits. CONCLUSION: Subjects with asthma had different symptom-profiles compared to those of non-asthmatics, with a higher prevalence of both respiratory and non-respiratory symptoms. Asthma is also a disease that is related to low well-being. The use of quality-of-life questionnaires such as the GQL may provide useful information for evaluating the non-respiratory aspects of asthma as well as for assessing the impact of disease on health status and well-being.

  • 22.
    Leander, Mai
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Janson, Christer
    Uddenfeldt, Monica
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Rask-Andersen, Anna
    Associations between mortality, asthma, and health-related quality of life in an elderly cohort of Swedes2010In: Journal of Asthma, ISSN 0277-0903, E-ISSN 1532-4303, Vol. 47, no 6, p. 627-32Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Asthma is a common chronic health condition among the elderly and an important cause of morbidity and mortality. Some studies show that subjective assessments of health-related quality of life (HRQL) are important predictors of mortality and survival. The primary aim of this study was to investigate whether low HRQL was a predictor of mortality in elderly subjects and whether such an association differed between subjects with and without asthma. METHODS: In 1990, a cohort in middle Sweden was investigated using a respiratory questionnaire. To assess HRQL, the generic instrument Gothenburg Quality of Life (GQL) was used. The participants were also investigated by spirometry and allergy testing. The present study was limited to the subjects in the oldest age group, aged 60-69 years in 1990, and included 222 subjects with clinically verified asthma, 148 subjects with respiratory symptoms but no asthma or other lung diseases, and 102 subjects with no respiratory symptoms. Mortality in the cohort was followed during 1990-2008. RESULTS: Altogether, 166 of the 472 subjects in the original cohort had died during the follow-up period of 1990-2008. Mortality was significantly higher in men, in older subjects, in smokers, and subjects with a low forced expiratory volume in one second (FEV(1)). There was, however, no difference in mortality between the asthmatic and the nonasthmatic groups. A higher symptoms score for GQL was significantly related to increased mortality. No association between HRQL and mortality was found when limiting the analysis to the asthmatic group, although the asthmatics had a lower symptom score for GQL compared to the other groups. CONCLUSION: A higher symptom score in the GQL instrument was significantly related to increased mortality, but this association was not found when analyzing the asthmatic group alone. The negative prognostic implications of a low HRQL in the whole group and the fact that the asthmatic group had a lower HRQL than the other group supports the use of HRQL instruments in clinical health assessments.

  • 23.
    Lützén, Kim
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Magnusson, Annabella
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska institutet.
    Andersson, Lars
    Ersta Sköndal University College, Department of Health Care Sciences.
    Moral stress: synthesis of a concept2003In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 10, no 3, p. 312-322Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to describe the synthesis of the concept of moral stress and to attempt to identify its preconditions. Qualitative data from two independent studies on professional issues in nursing were analysed from a hypothetical-deductive approach. The findings indicate that moral stress is independent of context-given specific preconditions: (1) nurses are morally sensitive to the patient's vulnerability; (2) nurses experience external factors preventing them from doing what is best for the patient; and (3) nurses feel that they have no control over the specific situation. The findings from this analysis are supported by recent research on stress in the workplace but differ that the imperatives directing work are moral in nature. Stress researchers have found that persons who experience that they have no control over their work situation and at the same time experience high demands may be prone to cardiovascular diseases. An important question raised by this study is whether moral stress should be recognized as a health risk in nursing. Further research is required in order to generate intervention models to prevent or deal with moral stress.

  • 24. Schnelle, J F
    et al.
    Newman, D R
    White, M
    Volner, T R
    Burnett, J
    Cronqvist, Agneta
    Ory, M
    Reducing and managing restraints in long-term-care facilities.1992In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 40, no 4, p. 381-5Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To evaluate a management system designed to improve staff adherence to a federal regulation that stated restrained residents should be released, exercised, and repositioned every 2 hours. DESIGN: A delayed intervention, controlled, cross-over design with three phases. During phase one, baseline, the length of intervals that residents remained in restraints was monitored. The intervention was implemented at site A in Phase two while site B remained in baseline. During Phase three, the intervention was replicated at site B. SETTING: Two long-term care proprietary nursing facilities. PATIENTS: Sixty-three physically restrained residents in the two facilities. INTERVENTION: The intervention was a system of restraint release using colored pads corresponding to specific hours. The management rule was that the resident should be on a different colored pad every 2 hours. Staff had to lift residents to place the pad, and the colors made the system easy for supervisors to check. MAIN OUTCOME MEASURES: Checks by research personnel by black light and invisible ink, to detect movement of the knot tying the restraints. RESULTS: During the baseline phase, the majority of residents at both sites were inappropriately restrained longer than 2 hours (site A: 54.1%; site B: 60.1%). The percentage of residents restrained over 2 hours was significantly reduced during the intervention phase to 13.9% (site A) and 19.4% (site B). Three weeks after the end of the intervention, inappropriate use of restraints remained low, 14.2%, but rose to 47.7% after another 3 weeks. CONCLUSION: The management system is an effective way to increase the consistency with which nursing-home staff release and reposition restrained residents.

  • 25.
    Sundh, Kenneth
    et al.
    Ersta Sköndal University College, Department of Social Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    On collaboration between nurses and social workers in the service of older people living at home: A critical literature review2013In: International Practice Development Journal, ISSN 2046-9292, E-ISSN 2046-9292, Vol. 3, no 2, p. Article 6-Article in journal (Refereed)
    Abstract [en]

    Background: Western European countries are facing financial constraints that mean reduced spending on health and social care. Collaboration between disciplines may be one way to make the necessary savings. Collaboration between health and social workers in providing services to older people living at home is promoted by the public authorities, but no guidance is given on how to achieve it.

    Aim: Our aim was to perform a literature review to describe and analyse strategies for collaboration between health and social workers in the provision of care for older people living at home.

    Methods: Systematic, unsystematic and manual searches were undertaken to find international primary research. Databases searched were: Academic Search Premier; AgeLine; Applied Social Sciences Index and Abstracts; Cumulative Index to Nursing and Allied Health Literature; Cochrane Library; MedLine; ProQuest Nursing and Allied Health Source; PubMed; Social Services Abstracts; Sociological Abstracts; and SocINDEX. Separate search strategies were developed for each database in line with its stipulated controlled vocabulary.

    Findings: During the analysis, the following themes were identified: purpose; participants; setting; country; method; results; rationale for the study; collaboration; conclusions; authors’ comments; and reviewers’ comments. Nine articles were found, indicating that this subject is short on evidence. The results are explained from the perspective of critical social theory.

    Conclusions: Reports exist on collaboration between nurses and social workers in the care of older people showing that it can be beneficial both for recipients of care and carers, although few articles were identified. From a critical social theory perspective, effective collaboration may occur in well defined and strictly limited areas, such as preventive home visits. This must be taken into consideration in order to create a successful collaboration in practice to support older people living at home.

    Implications for practice:

    • Collaboration between nurses and social workers in older persons’ care could be beneficial for recipients and carers
    • Successful collaboration may occur in a well defined and strictly limited area; preventive home visits in elderly care is such area
    • When planning for a collaboration project there is a need to discriminate between collaboration and cooperation; in the latter delegation could be a key feature, giving an asymmetric working relationship
  • 26.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC.
    Conversations between residents with dementia disease and nurses: evaluation of an intervention with the Validation methodManuscript (preprint) (Other academic)
  • 27.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Palliative Research Centre, PRC. Ersta Sköndal University College, Department of Health Care Sciences. Umeå universitet.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of Health Care Sciences. Ersta Sköndal University College, Palliative Research Centre, PRC. Karolinska Institutet, Stockholm Sjukhem.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences. Karolinska Institutet.
    Conversations between persons with dementia disease living in nursing homes and nurses: qualitative evaluation of an intervention with the validation method2016In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 30, p. 37-47Article in journal (Refereed)
    Abstract [en]

    Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons’ communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one-to-one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one’s mind and speaking more freely about what is on one’s mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses’ communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.

  • 28.
    Söderlund, Mona
    et al.
    Ersta Sköndal University College, Department of Health Care Sciences.
    Cronqvist, Agneta
    Ersta Sköndal University College, Department of Health Care Sciences.
    Norberg, Astrid
    Ersta Sköndal University College, Department of palliative care research.
    Ternestedt, Britt-Marie
    Ersta Sköndal University College, Department of palliative care research.
    Hansebo, Görel
    Ersta Sköndal University College, Department of Health Care Sciences.
    Nurses’ movements within and between various paths when improving their communication skills – an evaluation of validation method training2013In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 3, no 2, p. 265-273Article in journal (Refereed)
1 - 28 of 28
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