Change search
Link to record
Permanent link

Direct link
BETA
Alternative names
Publications (10 of 12) Show all publications
Hedén, L. E., von Essen, L. & Ljungman, G. (2019). Children's self‐reports of fear and pain levels during needle procedures. Nursing Open, 7(1), 376-382
Open this publication in new window or tab >>Children's self‐reports of fear and pain levels during needle procedures
2019 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 7, no 1, p. 376-382Article in journal (Refereed) Published
Abstract [en]

Aim: The objective was to determine the levels of and potential relationships be‐ tween, procedure‐related fear and pain in children.

Design: Clinical based cross‐sectional.

Methods: Ninety children aged between 7–18 years were included consecutively and self‐reported levels of pain and fear on a 0–100 mm visual analogue scales (VAS) when undergoing routine needle insertion into a subcutaneously implanted intrave‐ nous port following topical anaesthesia.

Results: The needle‐related fear level was reported to be as high as the needle‐re‐ lated pain level (mean VAS: 14 mm and 12 mm, respectively, N = 90). With fear as the dependent variable, age and pain were significantly associated and explained 16% of the variance. With pain as the dependent variable, fear was significantly associated and explained 11% of the variance. A post hoc analysis indicated that younger chil‐ dren reported their fear levels to be higher than their pain levels.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
cancer, children, fear, needle, nurses, nursing, pain, self‐report
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-22305 (URN)10.1002/nop2.399 (DOI)31871722 (PubMedID)2-s2.0-85074367103 (Scopus ID)
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-01-10Bibliographically approved
Hedén, L. E. & Ljungman, G. (2019). Do children's self-reports differ from the proxy reports of fear levels during needle procedures in children with cancer?. In: : . Paper presented at 12th International Symposium on Pediatric Pain, Basel, June 16-20, 2019..
Open this publication in new window or tab >>Do children's self-reports differ from the proxy reports of fear levels during needle procedures in children with cancer?
2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction

Needle procedures in relation to cancer disease and treatment are often experienced as frightening and painful for children. To assess fear a proxy report by nurses or parents are often clinically used.

Objective

To investigate fear levels experienced by children in connection with needle procedures and use findings to optimise the recurring needle process.

Aim

The aim was to determine if child self-report and proxy report of needle fear levels are in agreement.

Methods

Data was collected during 90 needle insertions in children 7 to 18 years of age, included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port following topical anaesthesia. Fear in connection with the needle procedure was independently assessed on a 100 mm Visual Analogue Scale (VAS) with anchors at the extreme ends (no fear - worst possible fear) by the child, nurse and parent and investigated with one-way ANOVA within subjects and post hoc with Bonferroni correction.

Results

The reported fear level differed between children’s self-reports (VAS mean 14 mm), nurse ratings (VAS mean 21 mm), and parents ratings (VAS mean 21 mm) during a needle insertion in a subcutaneously implanted port (F(2, 178)= 6.211, p=0.002). Post hoc tests revealed differences between (i) children’s self-reports and nurses reports (p=0.017) and (ii) children’s self-reports vs. parents reports (p=0.006) but showed no differences between nurses reports and parents reports (p=1).

Conclusion

Nurses and parents significantly overestimated the child’s fear level of the needle procedure. Therefore children, as far as possible, should be (i) more actively involved as partners throughout the needle procedures and (ii) encouraged to self-report their fear level in connection with needle procedures for improved analysis and treatment.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-22300 (URN)
Conference
12th International Symposium on Pediatric Pain, Basel, June 16-20, 2019.
Funder
Swedish Childhood Cancer Foundation
Available from: 2019-12-20 Created: 2019-12-20 Last updated: 2020-01-10Bibliographically approved
Kleye, I., Darcy, L., Karlsson, K., Hedén, L. E. & Sundler, A. J. (2019). "This is the way i want it": Children's strategies for dealing with fear and pain during hospital care. In: Ida Kleye (Ed.), : . Paper presented at 12th International Symposium on Pediatric Pain, Basel, 16-20 June, 2019..
Open this publication in new window or tab >>"This is the way i want it": Children's strategies for dealing with fear and pain during hospital care
Show others...
2019 (English)In: / [ed] Ida Kleye, 2019Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Introduction

The aim of this study was to describe children's self-identified strategies for dealing with fear and pain during hospital care and treatment

Keywords
child, fear, pain, strategies
National Category
Pediatrics
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-22378 (URN)
Conference
12th International Symposium on Pediatric Pain, Basel, 16-20 June, 2019.
Available from: 2020-01-07 Created: 2020-01-07 Last updated: 2020-01-07Bibliographically approved
Israelsson-Skogsberg, Å., Hedén, L. E., Lindahl, B. & Laakso, K. (2018). 'I'm almost never sick': Everyday life experiences of children and young people with home mechanical ventilation.. Journal of Child Health Care, 1(13)
Open this publication in new window or tab >>'I'm almost never sick': Everyday life experiences of children and young people with home mechanical ventilation.
2018 (English)In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 1, no 13Article in journal (Refereed) Published
Abstract [en]

Developments in medical technology and treatment have increased the survival rates of children with serious illnesses or injuries, including those receiving home mechanical ventilation, which is a small but growing group. The aim of this study was to explore everyday life experiences of children and young people living with home mechanical ventilation (HMV). Data were obtained through interviews with nine participants. The interviews were supported by photovoice methodology: photographs taken by the participants before or during the interviews were used to facilitate conversation. Interview data were analyzed using qualitative content analysis. The findings revealed that everyday life on a ventilator can be described as including power but simultaneously as characterized by vulnerability to the outside world, comparable to balancing on a tightrope. Various types of technology, both information and communication technology (ICT) and vital medical technology, enabled the participants to engage with the world around them. This study contributes knowledge about the experiences of children and young people with HMV, who depict their lives as good and valuable. The study also underscores, when designing plans and home support, it is necessary to take a sensible approach to personal experiences of what a good life is and what resources are needed to attain and maintain health.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hb:diva-13611 (URN)10.1177/1367493517749328 (DOI)000429864300002 ()29298495 (PubMedID)2-s2.0-85042497737 (Scopus ID)
Available from: 2018-02-01 Created: 2018-02-01 Last updated: 2020-01-08Bibliographically approved
Sundler, A. J., Johansson, E., Johansson, L. & Hedén, L. E. (2018). Incidents reported by nurse anesthetists in the operating room. Journal of Interprofessional Care, 32(6), 699-705
Open this publication in new window or tab >>Incidents reported by nurse anesthetists in the operating room
2018 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 32, no 6, p. 699-705Article in journal (Refereed) Published
Abstract [en]

The quality of health care and patient safety in the operating room is a major concern for nurse anaesthetists. However, few studies have focused on the experiences of nurse anaesthetists’ and their contributions to safety in this setting. Therefore, this study aims to explore the content and frequency of incidents reported by nurse anaesthetists in the operating room and the risks involved in these incidents. A retrospective study with a descriptive design was conduct. Data were gathered concerning 220 incidents reported by nurse anaesthetists from 2012 to 2015 in operating rooms at a middle-sized hospital in Sweden. These were analysed with a method for qualitative and quantitative content analysis. The findings are presented in five categories: communication and teamwork; routines and guidelines; patient care; nurses’ work environment; devices, materials and technologies. In 184 (73%) of the incidents, there was either a risk of harm or there was an actual harm to patients or nurses. Of all incidents only 23 (10%) had harmed patients or nurses. Few of these incidents involved patient harm (= 6), while a greater number involved harm to nurses (= 17). The findings reveal lack of communication and interprofessional teamwork as the two most common areas for the reported incidents, followed by problems related to lack of compliance with guidelines and routines. The findings suggest that strategies are needed to improve these areas. Patient safety reporting systems may be important to identify risk in preventing patients and health care professionals from being harmed. In addition, the findings indicate that the nurses sought to prevent harm to patients rather than to themselves. Consequently, increased attention to the work environments of nurses, and most likely other professionals, in the operating room may be needed to prevent health care professionals from being harmed.

Keywords
incidents, patient safety, quality improvement, nurses, operating room, content analysis
National Category
Nursing
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-15143 (URN)10.1080/13561820.2018.1500452 (DOI)000456939800005 ()30040519 (PubMedID)2-s2.0-85050536779 (Scopus ID)
Available from: 2018-10-04 Created: 2018-10-04 Last updated: 2020-01-07Bibliographically approved
Berglund, M., Nässén, K., Hedén, L. & Gillsjö, C. (2016). Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study.. Journal of Gerontology & Geriatric Research
Open this publication in new window or tab >>Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study.
2016 (English)In: Journal of Gerontology & Geriatric Research, ISSN 2167-7182Article in journal (Refereed) Published
Abstract [en]

Background: A major health problem that frequently accompanies old age is long-term pain, but pain must be acknowledged by older adults and health care providers. Interventions are needed to alleviate pain and suffering while holistically providing health care that promotes wellbeing. The intervention project, Reflective STRENGTHGiving Dialogues© (STRENGTH) was implemented to increase health and wellbeing among community dwelling older adults living with long-term musculoskeletal pain at home. Aim: The aim of this study was to describe the older adults' experiences of the intervention Reflective STRENGTH-Giving Dialogue. Method: A life world hermeneutic approach was used in collection and analysis of data. Twenty community dwelling older adults participated were interviewed in their homes after the intervention. Findings: The findings consisted of five themes and showed that the older adults experienced the Reflective STRENGTH-Giving Dialogues as a continuous and trusting relationship that alleviates the pain and breaks the loneliness. They expressed it as a new way to talk about life with pain. The dialogues supported reflection and memory and resulted in a transition in orientation in life. Conclusion: The Reflective STRENGTH-Giving Dialogues helped the older adults to increase their intellectual, emotional, and physical engagement in daily living. The dialogues facilitated a transition in orientation from past to present, to the future, and from obstacles to opportunities. The dialogues were oriented towards enjoyments, meaning, courage and strength in life as a whole which promoted the older adults’ sense of well-being and vitality. The dialogues also facilitated carrying out small and large life projects. The Reflective STRENGTH-Giving Dialogues created a deepened caring relationship that contributed to an increased sense of security, strength and courage, all of which enhanced the potential for better health and wellbeing.

Keywords
Older adults, Long-term musculoskeletal pain, Home experience, Qualitative research
National Category
Medical and Health Sciences
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-11872 (URN)10.4172/2167-7182.1000304 (DOI)
Available from: 2017-01-31 Created: 2017-01-31 Last updated: 2017-05-04Bibliographically approved
Hedén, L. & Åhlström, L. (2015). Individual response technology to promote active learning within the caring sciences: An experimental research study.. Nurse Education Today
Open this publication in new window or tab >>Individual response technology to promote active learning within the caring sciences: An experimental research study.
2015 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: One major challenge in delivering lectures to large and diverse classes is the maintenance of a high standard of lecturing in order to engage students and increase their participation and involvement. The lecturer's assignment is to arrange and prepare the lecture before teaching, hence enabling students' enhanced learning. Individual response technology could encourage students' active learning and activate higher cognitive levels.

OBJECTIVES: The aim of this study was to evaluate individual response technology as a complement during lectures for students in higher education, in terms of the students' experiences of participation, engagement, and active learning. Also of interest was whether this technology can be considered a supportive technical system.

DESIGN: Data were collected through a questionnaire where levels of each condition were reported on a numeric rating scale (0-10) at baseline and after the introduction of individual response technology. To get a broader perspective, two types of lectures (pediatric and statistical) were included, giving a total of four assessment times.

PARTICIPANTS: The participants comprised 59 students in Bachelor of Nursing program at a Swedish metropolitan university.

RESULTS: Overall, when individual response technology was used, students reported increased experience of engagement (n=82, mean 6.1 vs. n=65, mean 7.3, p<0.001), participation (n=92, mean 6.1 vs. n=79, mean 7.7, p<0.001), and active learning (n=92, mean 7.3 vs. n=79, mean 8.2 p<0.001). Additionally, the students experienced this technology as a supportive technical system during lectures (mean 6.6 vs. mean 8.1, p<0.001).

CONCLUSIONS: The use of individual response technology during teaching is one way to enhance students' experiences of engagement, participation, and learning within the caring sciences.

National Category
Nursing Pedagogy
Research subject
Människan i vården
Identifiers
urn:nbn:se:hb:diva-4074 (URN)10.1016/j.nedt.2015.10.010 (DOI)000367117000034 ()26515492 (PubMedID)2-s2.0-84949933596 (Scopus ID)
Available from: 2016-01-08 Created: 2015-12-15 Last updated: 2018-12-21Bibliographically approved
Hedén, L., von Essen, L. & Ljungman, G. (2014). Effect of high-dose paracetamol on needle procedures in children with cancer: a RCT. Acta Paediatrica, 103(3), 314-319
Open this publication in new window or tab >>Effect of high-dose paracetamol on needle procedures in children with cancer: a RCT
2014 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 314-319Article in journal (Refereed) Published
Abstract [en]

AIM: The aim was to investigate whether children experience less pain, fear and/or distress when they receive high-dose paracetamol compared with placebo, using a needle insertion in a subcutaneously implanted intravenous port as a model. METHODS: Fifty-one children ranging from 1 to 18 years of age being treated in a paediatric oncology setting were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port. All children were subjected to one needle insertion following topical anaesthetic (EMLA) application in this double-blind, placebo-controlled RCT, comparing orally administered paracetamol (n = 24) 40 mg/kg body weight (max 2000 mg) with placebo (n = 27). The patients' pain, fear and distress were reported by parents, nurses and children (≥7 years of age) using 0- to 100-mm visual analogue scales (VAS). In addition, pain observation, procedure time and cortisol reduction were assessed. RESULTS: No differences between the paracetamol and the placebo group were found with respect to demographic characteristics. According to VAS reports, paracetamol did not reduce pain, fear and distress compared with placebo. Pain observation, cortisol reduction and procedure time did not differ between the study groups. CONCLUSION: Paracetamol provides no additive effect in reducing pain, fear and distress when combined with topical anaesthesia in children undergoing port needle insertion.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Ltd., 2014
National Category
Cancer and Oncology Medical and Health Sciences
Research subject
Integrated Caring Science
Identifiers
urn:nbn:se:hb:diva-2046 (URN)10.1111/apa.12509 (DOI)24219618 (PubMedID)2320/14674 (Local ID)2320/14674 (Archive number)2320/14674 (OAI)
Available from: 2015-11-13 Created: 2015-11-13 Last updated: 2017-12-01Bibliographically approved
Hedén, L., Pöder, U., von Essen, L. & Ljungman, G. (2013). Parents' perceptions of their child's symptom burden during and after cancer treatment.. Journal of Pain and Symptom Management, 46(3)
Open this publication in new window or tab >>Parents' perceptions of their child's symptom burden during and after cancer treatment.
2013 (English)In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 46, no 3Article in journal (Refereed) Published
Abstract [en]

CONTEXT: Previously reported studies of children with cancer mostly provide cross-sectional knowledge of the prevalence of symptoms but do not show when during the disease trajectory and after the end of successful treatment certain symptoms are most prevalent and/or distressing.

OBJECTIVES: The aim was to describe parents' perceptions of their child's symptom burden longitudinally during and after cancer treatment and to investigate whether parents' perceptions vary with child characteristics and parent gender.

METHODS: One hundred sixty parents (49% fathers) of 89 children answered a modified version of the Memorial Symptom Assessment Scale (MSAS) 10-18 at six different time points from one week after the child's diagnosis (T1) to 12-18 months after the end of successful treatment (T6).

RESULTS: Feeling drowsy, pain, and lack of energy are initially the most prevalent symptoms. During treatment, the most prevalent symptom is less hair than usual. Pain, feeling sad, and nausea are initially the most distressing symptoms. Pain is both prevalent and distressing throughout the treatment. The child's symptom burden decreases over time. There is no difference regarding the reported symptom burden between the parents of a daughter or a son, or parents of a child older or younger than seven years of age. Mothers' and fathers' assessments of the symptom number, total MSAS and the subscales, are associated, but mothers' assessments are often higher than fathers' assessments.

CONCLUSION: The prevalence and distress of symptoms and symptom burden decrease over time. However, even though the cancer is cured, feeling sad is reported as being prevalent and psychological distress is an issue. A dialogue between staff and the family about distressing symptoms and when they can be expected may increase acceptance and adaptation in children and parents during the disease trajectory.

National Category
Cancer and Oncology Pediatrics
Identifiers
urn:nbn:se:hb:diva-4072 (URN)10.1016/j.jpainsymman.2012.09.012 (DOI)000324026700006 ()23498966 (PubMedID)2-s2.0-84888643928 (Scopus ID)
Available from: 2016-01-08 Created: 2015-12-15 Last updated: 2018-04-20Bibliographically approved
Hedén, L. E., von Essen, L. & Ljungman, G. (2011). Effect of morphine in needle procedures in children with cancer.. European Journal of Pain, 15(10)
Open this publication in new window or tab >>Effect of morphine in needle procedures in children with cancer.
2011 (English)In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 15, no 10Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim was to investigate whether children experience less fear, distress, and/or pain when they receive oral morphine vs. placebo before a needle is inserted in a subcutaneously implanted intravenous port when combined with topical anesthesia.

METHOD: Fifty children 1-18 years of age who were treated in a pediatric oncology and hematology setting were included consecutively when undergoing routine needle insertion into an intravenous port. All children were subjected to one needle insertion following topical anesthetic (EMLA) application in this randomized, triple-blind, placebo-controlled study comparing orally administered morphine (n=26) 0.25 mg/kg body weight with placebo (n=24). The patients' fear, distress, and pain were reported by parents, nurses and the children themselves (if ≥ 7 years of age) on 0-100 mm Visual Analogue Scales. In addition, observational methods were used to measure distress and procedure pain.

RESULTS: No differences between the morphine and the placebo group were found with respect to age, weight, height, physical status, sex, weeks from diagnosis, or weeks from latest needle insertion. According to, parents, nurses, and children, oral morphine at a dose of 0.25 mg/kg body weight did not reduce fear, distress or pain compared with placebo.

CONCLUSION: We could not reject the null hypothesis that there is no difference between the oral morphine and placebo groups assuming an effect size of 15 mm on VAS. Therefore it seems that oral morphine at 0.25 mg/kg does not give any additional reduction of fear, distress or pain compared with placebo when combined with topical anesthesia in pediatric patients undergoing subcutaneous port needle insertion, and would not be expected to be of any advantage for similar procedures such as venipuncture and venous cannulation when topical anesthesia is used.

National Category
Cancer and Oncology Pediatrics
Identifiers
urn:nbn:se:hb:diva-4070 (URN)10.1016/j.ejpain.2011.05.010 (DOI)21680210 (PubMedID)
Available from: 2016-01-08 Created: 2015-12-15 Last updated: 2018-04-20Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7067-2687

Search in DiVA

Show all publications