Change search
Refine search result
1234567 101 - 150 of 993
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 101.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Berg, Marie
    Hall, Elisabeth
    Olafsdottir, Olöf Asta
    Störe Brinchmann, Berit
    Vehviläinen-Julkunen, Katri
    Evidence-based care and childbearing: a critical approach2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 4, p. 239-247Article in journal (Refereed)
    Abstract [en]

    Developing the best care for clients and patients is a paramount aim of all health care practices, which therefore, should be based on best evidence. This is also crucial for care during the childbearing period here defined as pregnancy, childbirth, and infancy. However, due to dominance of the evidence-based medicine (EBM) model, health care practice has encountered problems especially regarding its relationship to qualitative research. In this article, we analyze and discuss how research based on a lifeworld perspective fits with evidence-based care (EBC), and how a circular model instead of a hierarchy is suitable when attributing value to knowledge for EBC. The article focuses on the history of EBM and EBC, the power of the evidence concept, and EBC from a narrow to a broad view. Further qualitative research and its use for developing EBC is discussed and examples are presented from the authors’ own lifeworld research in the Nordic childbearing context. Finally, an alternative circular model of knowledge for EBC is presented. In order to develop evidence-based care, there is need for multiple types of scientific knowledge with equal strength of evidence, integrated with clinical experience, setting, circumstances and health care resources, and incorporating the experiences and clinical state of the childbearing woman and her family.

  • 102.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Hall, E
    Challenges in approaching metasynthesis research2007In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 17, no 1, p. 113-121Article in journal (Refereed)
    Abstract [en]

    The overall aim of this study was to contribute to the development of metasynthesis through an analysis of the challenges involved. The study grew out of the critique of qualitative metaresearch raised by current developers of metamethodologies. Different views on the application of methodologies have emerged in the literature, contributing to confusion and ambiguity concerning the challenging questions of what, why, how, and who in metasynthesis research, which might increase the risk of misunderstanding. The roots of metasynthesis research are seen as multifaceted and influencing the development of the methods in different directions. The primary worth of metasynthesis is theoretical and/or methodological development (synthesis) combined with the potential for reflection: going beyond and behind the studies (meta). Metasynthesis research has also the potential to raise questions of research collaboration, culture, and language.

  • 103.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Hall, Elisabeth
    A decade of metasynthesis research in health sciences: a meta-method study2007In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 2, p. 101-113Article in journal (Other academic)
    Abstract [en]

    The overall aim of this study was to analyze the methods applied in previous metasynthesis research and to inform future researchers of epistemological and methodological issues based on this analysis. Meta-method analysis was applied to a decade of 45 published metasynthesis studies that pertain to nursing and allied health studies. The findings show that the metasynthesis research can be classified into three areas: (1) health, illness and suffering, (2) care and support, and (3) parenting, newborn and childcare. Meta ethnography dominates the research area. Metastudy, metasummary, qualitative metasynthesis, and grounded formal theory are emerging methods. The metasynthesis studies suffer from modifications without explications, use of secondary method references, missing sample and search data and differences in the type of findings and the meta-concepts depicting the findings. The worth of metasynthesis research is questioned when the core ideas of qualitative meta studies, theoretical and/or methodological development (‘‘synthesis’’) combined with the potential of going beyond and behind the studies (‘‘meta’’), is missing. Metasynthesis research requires knowledge in both the substance and the various qualitative methods, and systematic attendance to the method accompanied by the openness and the creativity of a qualitative approach. Conclusions and recommendations are presented as epistemological reflections and a guide for future metasynthesis research in health sciences.

  • 104.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Lundgren, Ingela
    University of Borås, School of Health Science.
    Women’s experiences of childbirth, care and support: a metasynthesis2009Conference paper (Refereed)
  • 105.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Michelsson, B
    Tjäna patienten: Skapande av vårdande kultur med utvecklingsarbeten2005Report (Other academic)
  • 106.
    Bondas, Terese
    et al.
    University of Borås, School of Health Science.
    Olausson, Sepideh
    University of Borås, School of Health Science.
    Photography as a Data Collection Method in Intensive Care2009Conference paper (Refereed)
    Abstract [en]

    The suffering patient is thrown into a strange and unfamiliar environment of different technological devices in an Intensive care unit. The intensive room is a place for care and treatment, for rest and recovery, a visiting room, and a working place for the staff. In this context patients and relatives are very vulnerable and are in a need of support. Patients may suffer from unreal experiences, often very traumatic during their stay in ICU and many patients also suffer from unpleasant memories, and some develop post traumatic stress after their discharge. In order to design optimal rooms in ICU it would be important to identify factors which are meaningful for the patients and relatives. The aim of this study, as part of a larger research project, is to illuminate patients’ and relatives’ experiences of the physical room, the design and the interior in the ICU. Photographs combined with interviews are used as data collection methods within the ICU-context. Relatives and former patients are asked to photograph different aspects of the room that they remember or associate with a feeling. The pictures were used later during an interview with the informants. In total the researcher meets the informants three times, first time to inform, the second time to take the photos and a third time for the interview. This method gives the researcher opportunity to deepen the understanding and capture aspects of the room that otherwise might have been hidden. The presentation will focus on photography as a research method.

  • 107. Borovszky, Helena
    et al.
    Svensson, Leif
    Bolin, Peter
    Nyström, Maria
    University of Borås, School of Health Science.
    Stroke2009In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Stockholm: Liber , 2009, p. 325-330Chapter in book (Other academic)
  • 108. Brandstrom, Y
    et al.
    Brink, E
    Grankvist, G
    Alsen, P
    Herlitz, Johan
    University of Borås, School of Health Science.
    Karlson, BW
    Physical Activity Six Months after a Myocardial Infarction2009In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 15, no 3, p. 191-197Article in journal (Refereed)
    Abstract [en]

    In the present study, we wished to explore physical activity in middle-aged patients 6 months after a myocardial infarction and to compare the patients' self-reported activity level with pedometric measures of footsteps/day. The sample comprised 89 patients with myocardial infarction, aged < 40% of the patients were engaged in at least 30 min of physical activity every day. The pedometric physical activity data showed a daily mean number of steps of 6719. The self-report question was correlated with the pedometric registration data. Among myocardial infarction patients, physical activity 6 months after the acute heart attack was insufficient in the majority of patients, both when evaluated with a self-report question and when evaluated with a pedometer. Efforts to increase physical activity after myocardial infarction are warranted.

  • 109.
    Bremer, Anders
    University of Borås, School of Health Science.
    Ambulanspersonalen måste ha utrymme för de närstående2012In: Vårdfokus, ISSN 2000-5717, no 3, p. 48-Article in journal (Other (popular science, discussion, etc.))
  • 110.
    Bremer, Anders
    University of Borås, School of Health Science.
    Ambulanssjukvård mellan liv och död: ett etiskt perspektiv2009Conference paper (Other academic)
    Abstract [sv]

    Patienters hjärtstopp utanför sjukhus orsakar lidande och död. Det påverkar även närståendes fortsatta livssituation. Bakgrund: För ambulanspersonal kan det vara svårt ta etiskt riktiga beslut vid vård av patient med hjärtstopp. I balansen mellan nytta och risk med återuppliv-ning är det svårt att avgöra vad som är rätt eller fel och när det är meningslöst eller emot patientens vilja. De drabbades erfarenheter, och ett normativt per-spektiv, kan bidra med kunskap om vad etiskt god vård vid hjärtstopp kan vara. Syfte: Att beskriva vad det innebär att överleva hjärtstopp utanför sjukhus re-spektive närvara vid närståendes hjärtstopp, samt belysa de etiska aspekter och problem som framträder. Metod: Kvalitativa intervjuer med fenomenologisk livsvärldsansats. Nio över-levande patienter och sju närstående intervjuades. Resultat: Överlevande patienter beskriver hur ogripbart det är att drabbas av hjärtstopp och hur uppvaknandet ur medvetslösheten innebär vilsenhet och för-lust av sammanhang. Efteråt, via andra människors berättelser och egna minnen, söker överlevande efter sammanhang så att händelsen och livssituationen kan ges mening och förklaring till tankar, känslor och upplevelser. I det fortsatta li-vet finns existentiell otrygghet där identiteten och meningen i livet omvärderas i takt med en växande insikt om hur kroppen påverkats. Där finns tacksamhet och glädje över välbefinnande och trygghet i ett förändrat liv där det passerade livs-hotet införlivas i ett liv där nära relationer blivit viktigare. Närstående upplever patientens hjärtstopp som overkligt. Tiden tycks stanna upp. Samtidigt är verk-ligheten extremt påtaglig med ett överväldigande, ensamt ansvar med känsla av otillräcklighet. Ambulanspersonalens ankomst väcker närståendes hopp om att patienten ska överleva, samtidigt som allt är kaotiskt, ångestfyllt och omtumlan-de då närstående kastas mellan hopp och misströstan. Livets grundvalar skakas om. Efter händelsen finns frågor och oro. Närståendes ensamhet i sorg eller oro för den överlevandes framtid, riskerar att leda till uppoffringar av egna behov. Slutsats: I det akuta skedet är det svårt att avgöra om patienten kan räddas till ett fortsatt acceptabelt liv varför återupplivningsförsök bör göras vid behand-lingsbara hjärtstopp. Undantagsvis är det rätt att avstå från, eller avbryta, åter-upplivning och vid förekomst av giltigt förhandsdirektiv är det primära att främ-ja en värdig död. Ambulanssjuksköterskor kan antas kunna ta ett utökat etiskt ansvar när det gäller beslutsrätten att avstå/avbryta återupplivning vid hjärtstopp och i eftervården av överlevande patienter kan ambulanspersonal hjälpa till att återskapa förlorade sammanhang. Ett rimligt vårdansvar för närstående är att ge stöd i krissituationen, dels under pågående återupplivning och dels då patienten avlidit. Däremot är hjärtlungräddning utförd som en ritual för närstående skull inte att betrakta som ett gott akut vårdande.

  • 111.
    Bremer, Anders
    University of Borås, School of Health Science.
    Att vara patient inom ambulanssjukvården2012In: Akut vård ur ett patientperspektiv / [ed] Sofia Almerud Österberg, Lena Nordgren, Studentlitteratur , 2012, p. 29-49Chapter in book (Other academic)
  • 112.
    Bremer, Anders
    University of Borås, School of Health Science.
    Att överleva hjärtstopp2007Conference paper (Other academic)
  • 113.
    Bremer, Anders
    University of Borås, School of Health Science.
    Caring for families at sudden cardiac death: A balance between closeness and distance2012Conference paper (Refereed)
    Abstract [en]

    Out-of-hospital cardiac arrest (OHCA) is a lethal health problem that affects more than half a million people in the United States and Europe each year. As resuscitation attempts are unsuccessful in most of the cases, ambulance professionals often face the needs of bereaved family members. Decisions to continue or terminate resuscitation attempts at OHCA are influenced by factors other than patient clinical characteristics, such as the personnel’s knowledge, attitudes, and beliefs regarding family emotional preparedness. Research exploring how ambulance personnel are affected by family dynamics and the emotional context, and how they are able to provide care for bereaved family members is sparse. It is also a lack of research into why ambulance professionals sometimes administer physiologically futile cardiopulmonary resuscitation (CPR) to patients with cardiac arrest to benefit family members. This way of meeting families’ grief reactions implies ethical problems. Based on an empirical study of ambulance professional’s experiences of caring for families when patients suffer cardiac arrest and sudden death, and an ethical analysis exploring arguments for providing physiologically futile CPR, the issue of caring for bereaved family members in ethical good and bad ways is explored. The empirical study results show that ambulance personnel experience a concomitant responsibility, sometimes failing to prioritize between responsibilities as a result of their own perceptions, feelings and reactions. Moving from patient care to family care imply a movement from well-structured guidance to a situational response where the personnel are forced to balance between interpretive reasoning and a more direct emotional response at their own discretion. With such affective response in decision-making, the personnel risk erroneous conclusions and care relationships with elements of dishonesty, misguided benevolence and false hopes. The ability to recognize and respond to people’s existential questions and needs is essential, and dependent on the ambulance personnel’s balance between closeness and distance, and on their courage to meet emotional expressions of the families, as well as the personnel’s own vulnerability. A need for ethical competence is invoked by the presence of family members, placing great demands on mobility in the decision-making process, between medical care of the patient and caring for family members. The conclusion is that the strategy of ambulance professionals in the care of bereaved family members should be to avoid additional suffering by focusing on the relevant care needs of the family members and provide support, arrange for a peaceful environment and administer acute grief counseling at the scene, which might call for a developed ethical caring competence. Opportunities to reflect on these situations within a framework of care ethics, continuous moral education, and clinical ethics training are needed. Ambulance personnel also need training in awareness of the needs of families suffering sudden bereavement, as well as support and help to deal with personal discomfort.

  • 114.
    Bremer, Anders
    University of Borås, School of Health Science.
    "Ej HLR”: Rätten att få dö2013Conference paper (Other academic)
  • 115.
    Bremer, Anders
    University of Borås, School of Health Science.
    En andra chans2012In: Forskning för hälsa, ISSN 1653-9753, no 3, p. 18-19Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Överlevare av plötsligt hjärtstopp utanför sjukhus är en unik och växande patientgrupp. Men hur blir livet efteråt? Frågeställningen finns med i den forskning Anders Bremer bedriver och som tidigare i år utmynnade i en avhandling. I syfte att beskriva samtliga inblandades erfarenheter vid plötsligt hjärtstopp intervjuade han överlevare, närstående och ambulanspersonal, som inte sällan ställs inför etiska frågeställningar vid hjärtstopp.

  • 116.
    Bremer, Anders
    University of Borås, School of Health Science.
    Etiska aspekter vid HLR2012Conference paper (Other academic)
  • 117.
    Bremer, Anders
    University of Borås, School of Health Science.
    Etiska frågeställningar vid drunkning2014Conference paper (Other academic)
    Abstract [sv]

    WHO uppskattar att 450 000 människor årligen avlider i världen till följd av drunkning, varav majoriteten är barn. Hjärtstopp och plötslig död som orsakas av drunkning är betydligt vanligare i låginkomstländer. Detta innebär att många liv går förlorade till följd av drunkningsolyckor, samtidigt som fattiga länder drabbas särskilt hårt. Mot bakgrund av detta framträder den etiska frågan: Hur kan fler liv räddas? Även rättviseprincipen blir viktig och bör rimligen föranleda åtgärder för att förhindra drunkning och rädda drunkningsoffer i särskilt utsatta delar av världen. Vilket ansvar har vi i Sverige för detta arbete? Etiker använder ofta drunkning som exempel för att tydliggöra den moraliska plikten att rädda liv. Vid ett drunkningstillbud kräver denna plikt specifika förmågor, mod och självuppoffring. Ett fullgörande av plikten kan å ena sidan riskera egna förluster och ytterst det egna livet, och å andra sidan ge belöning i form av självaktning och framför allt minskat lidande och död för andra. Plikten att göra allt för patientens bästa grundas i godhetsprincipen som innebär att främja nyttan för den drabbade, samtidigt som riskerna med fortsatta återupplivningsförsök övervägs i ett senare skede. Här framträder den etiska frågan: Hur kan liv räddas, samtidigt som överlevnad till ett ovärdigt liv minimeras?

  • 118.
    Bremer, Anders
    University of Borås, School of Health Science. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Etiska frågeställningar vid drunkning2014Conference paper (Other academic)
    Abstract [sv]

    WHO uppskattar att 450 000 människor årligen avlider i världen till följd av drunkning, varav majoriteten är barn. Hjärtstopp och plötslig död som orsakas av drunkning är betydligt vanligare i låginkomstländer. Detta innebär att många liv går förlorade till följd av drunkningsolyckor, samtidigt som fattiga länder drabbas särskilt hårt. Mot bakgrund av detta framträder den etiska frågan: Hur kan fler liv räddas? Även rättviseprincipen blir viktig och bör rimligen föranleda åtgärder för att förhindra drunkning och rädda drunkningsoffer i särskilt utsatta delar av världen. Vilket ansvar har vi i Sverige för detta arbete?

    Etiker använder ofta drunkning som exempel för att tydliggöra den moraliska plikten att rädda liv. Vid ett drunkningstillbud kräver denna plikt specifika förmågor, mod och självuppoffring. Ett fullgörande av plikten kan å ena sidan riskera egna förluster och ytterst det egna livet, och å andra sidan ge belöning i form av självaktning och framför allt minskat lidande och död för andra. Plikten att göra allt för patientens bästa grundas i godhetsprincipen som innebär att främja nyttan för den drabbade, samtidigt som riskerna med fortsatta återupplivningsförsök övervägs i ett senare skede. Här framträder den etiska frågan: Hur kan liv räddas, samtidigt som överlevnad till ett ovärdigt liv minimeras?

  • 119.
    Bremer, Anders
    University of Borås, School of Health Science.
    Etiska ställningstaganden vid hjärtstopp2013Conference paper (Other academic)
  • 120.
    Bremer, Anders
    University of Borås, School of Health Science.
    Ett överväldigande ansvar: att vara närstående vid hjärtstopp2010Conference paper (Other academic)
    Abstract [sv]

    Denna fenomenologiska livsvärldsstudie beskriver sju närståendes erfarenheter av att en nära person drabbats av hjärtstopp i hemmet eller ute i samhället. Resultatet visade hur närstående plötsligt upplevde kontrollförlust och en känsla av overklighet. De upplevde sig ensamt ansvariga, otillräckliga och med svårigheter att möta ett överväldigande ansvar. I den ensamma och utsatta situationen blev allt kaotiskt, ångestfyllt och omtumlande. När ambulanspersonal anlände väcktes närståendes hopp. Beroende på vilken föreställning eller kunskap närstående hade om patientens tillstånd kastades de mellan förhoppningar om överlevnad och tvivel över det meningsfulla med livräddande åtgärder. Efter händelsen kände sig närstående ofta lämnade ensamma med oro och frågor inför framtiden. Oron motverkade välbefinnande och hotade viktiga värden i ett gott liv eftersom de riskerade att bli ensamma i sorg efter den döde, eller i oro för den överlevandes framtid. Närstående försummade egna och viktiga behov. Resultatet visar att ambulanspersonal har en prima facie plikt att stödja närstående i samband med en patients hjärtstopp och död. Detta förutsätter uppmärksamhet, känslighet och öppenhet inför närståendes outsagda eller uttryckliga frågor och behov. Vid dödsfall i hemmet bör ambulanspersonal finnas till hands så länge som det krävs för att hjälpa närstående i kris.

  • 121.
    Bremer, Anders
    University of Borås, School of Health Science.
    Hjärtstopp utanför sjukhus2012Conference paper (Other academic)
  • 122.
    Bremer, Anders
    University of Borås, School of Health Science.
    Svensson, Leif (Editor)
    Mötet med närstående2009In: Prehospital akutsjukvård, Stockholm: Liber , 2009, p. 150-161Chapter in book (Other academic)
  • 123.
    Bremer, Anders
    University of Borås, School of Health Science.
    Nytta mot risker: etiska riktlinjer för HLR2014Conference paper (Other academic)
    Abstract [sv]

    När en person drabbas av plötsligt hjärtstopp gör sjukvårdspersonal i regel allt för att få igång hjärtat igen. Ibland kan det dock vara mer etiskt försvarbart att avstå från HLR. Här får vi inblick i Svenska Läkaresällskapet, Svensk sjuk-sköterskeförening och Svenska HLR-rådets etiska riktlinjer, som stöd till sjukvårdspersonalens ställningstagande om HLR ska påbörjas eller inte och skälen som kan motivera ett ställningstagande att avstå.

  • 124.
    Bremer, Anders
    University of Borås, School of Health Science.
    När livet skakas om: patienters och närståendes erfarenheter av hjärtstopp utanför sjukhus2008Licentiate thesis, monograph (Other academic)
  • 125.
    Bremer, Anders
    University of Borås, School of Health Science.
    Specialistsjuksköterska med inriktning mot ambulanssjukvård2014In: Att bli specialistsjuksköterska eller barnmorska – utbildningar för framtiden / [ed] Sofia Almerud Österberg, Lena Nordgren, Studentlitteratur , 2014, p. 19-46Chapter in book (Other academic)
    Abstract [sv]

    Behovet av specialistutbildade sjuksköterskor ökar. I den här boken presenteras tolv utbildningar som leder till en examen som specialistsjuksköterska eller barnmorska. Vidare ger boken en inblick i vad de olika yrkena innebär. Boken presenterar arbetsplatser och karriärvägar och ger också konkreta exempel på vad specialistsjuksköterskor eller barnmorskor kan komma att möta en vanlig dag på jobbet. Därutöver presenteras Högskoleverkets examensmål för respektive inriktning samt länkar till fastställda kompetensbeskrivningar. Kapitlet "Specialistsjuksköterska med inriktning mot ambulanssjukvård" beskriver professionen, utbildningen och utmaningar inför framtiden.

  • 126.
    Bremer, Anders
    University of Borås, School of Health Science.
    Vid existensens gräns: etiskt vårdande och professionellt ansvar vid hjärtstopp utanför sjukhus2012Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Aim: To describe and interpret patients’, family members’ and ambulance personnel’s experiences with regard to survival, attendance, and caring at cardiac arrests and deaths, and to analyze ethical conflicts that arise in relation to families and how the personnel’s ethical competence can affect caring and the ability to handle ethical problems. Method: The three interview studies were guided by a reflective lifeworld approach grounded in phenomenology and analyzed by searching for the essence of the phenomenon in two studies and by attaining a main interpretation in one study. In the fourth study, the general approach was supplemented by “reflective equilibrium” that guided the ethical analysis. Results: The survivors are striving towards a good life by means of efforts to reach meaning and coherence, facing existential fear and insecurity as well as gratitude and the joy of life. Family members lose everyday control through feelings of unreality, inadequacy and overwhelming responsibility. Ambulance personnel’s care mediates hope and despair until the announcement of survival or death. After the event, family members risk involuntary loneliness and anxiety about the future. For the ambulance personnel, caring for families involves a need for mobility in decision making, forcing the personnel to balance their own perceptions, feelings and reactions against interpretative reasoning. To base decision making on emotional reactions creates the risk of erroneous conclusions and a care relationship with elements of dishonesty, misdirected benevolence and false hopes. Identification with family members can promote recognition of and response to their existential needs, but also frustrate meeting family members emotions’ and handling one’s own vulnerability and inadequacy. It was found that futile cardiopulmonary resuscitation, administered to patients for the benefit of family members, is not an acceptable moral practice, due both to norms of not deliberately treating persons as mere means and to norms of taking care of families. Conclusions: Ethical conflicts exist when it comes to conveying realistic hope, relief from guilt, participation, responsibility for decision making, and fairness in the professional role. Ambulance personnel need support to enhance ethical caring competence and to deal with personal discomfort, as well as clear guidelines on family support.

  • 127.
    Bremer, Anders
    University of Borås, School of Health Science.
    Vilka möjligheter finns att använda register för uppföljning?”2013Conference paper (Other academic)
    Abstract [sv]

    Svenska Hjärt-lungräddningsregistret innehåller sedan länge beskrivande data med kontinuerliga variabler som ålder och tidsfördröjningar till påbörjande av behandling. Det innehåller också kategoriska variabler om defibrillerbar rytm, hjärtstoppets inträffande i hemmet, kardiell etiologi etc. Cerebral funktion registreras med CPC-score. Sedan 1 maj 2013 kompletterades registret med patientskattningar och mätningar av kvalitativa livskvalitetsvariabler. Den hälsorelaterade livskvaliteten kommer framledes att bedömas med det generiska instrumentet Euro Quality Life Scale (EQ-5D-5L) som mäter rörlighet, egenvård, vardagsaktiviteter, smärta-obehag och ängslan-depression. Dessutom används EQ-VAS för skattning av upplevd hälsa. Ängslan, oro och depression kommer mer detaljerat att bedömas med The Hospital Anxiety and Depression Scale (HADS). Utöver detta inhämtas data om kognitiv funktion och sysselsättning, totalt sju frågor med fasta svarsalternativ. Denna uppföljning av livskvaliteten hos överlevande efter hjärtstopp är en intensifiering av det rutinmässiga omhändertagandet av patientgruppen. Men framför allt innebär detta initiala och systematiska inhämtande av kvalitativa data från patienterna själva en möjlighet att tidigt upptäcka hur de mår och de behov av uppföljande vård och stöd som kan finnas. Genom registrets datainsamling ges även anhöriga en möjlighet att diskutera problem relaterade till den överlevandes situation. Med den utökade datainsamlingen kommer ny och viktig kunskap om patientgruppens cerebrala funktion och hälsorelaterade livskvalitet att genereras över tid, till gagn för patienter och anhöriga.

  • 128.
    Bremer, Anders
    University of Borås, School of Health Science.
    Vilken livskvalitet har patienter efter hjärtstopp?2013Conference paper (Other academic)
  • 129.
    Bremer, Anders
    University of Borås, School of Health Science.
    Vårdpersonal i ’dokusåpor’: är det etiskt försvarbart?2014Conference paper (Other academic)
    Abstract [sv]

    Att som vårdpersonal medverka i s.k. dokusåpor är förknippat med en rad etiska problem. Kan dessa problem lösas på ett etiskt försvarbart sätt, dvs. så att patienters och närståendes rätt till värdighet, integritet och autonomi säkerställs? Slutsatsen är att detta inte är möjligt. Risken att tillfoga skada är större än den potentiella nyttan.

  • 130.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Sandman, Lars
    University of Borås, School of Health Science.
    Balancing between closeness and distance: emergency medical services personnel's experiences of caring for families at out-of-hospital cardiac arrest and sudden death2012In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 27, no 1, p. 42-52Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Out-of-hospital cardiac arrest (OHCA) is a lethal health problem that affects between 236,000 and 325,000 people in the United States each year. As resuscitation attempts are unsuccessful in 70-98% of OHCA cases, Emergency Medical Services (EMS) personnel often face the needs of bereaved family members. PROBLEM: Decisions to continue or terminate resuscitation at OHCA are influenced by factors other than patient clinical characteristics, such as EMS personnel's knowledge, attitudes, and beliefs regarding family emotional preparedness. However, there is little research exploring how EMS personnel care for bereaved family members, or how they are affected by family dynamics and the emotional contexts. The aim of this study is to analyze EMS personnel's experiences of caring for families when patients suffer cardiac arrest and sudden death. METHODS: The study is based on a hermeneutic lifeworld approach. Qualitative interviews were conducted with 10 EMS personnel from an EMS agency in southern Sweden. RESULTS: The EMS personnel interviewed felt responsible for both patient care and family care, and sometimes failed to prioritize these responsibilities as a result of their own perceptions, feelings and reactions. Moving from patient care to family care implied a movement from well-structured guidance to a situational response, where the personnel were forced to balance between interpretive reasoning and a more direct emotional response, at their own discretion. With such affective responses in decision-making, the personnel risked erroneous conclusions and care relationships with elements of dishonesty, misguided benevolence and false hopes. The ability to recognize and respond to people's existential questions and needs was essential. It was dependent on the EMS personnel's balance between closeness and distance, and on their courage in facing the emotional expressions of the families, as well as the personnel's own vulnerability. The presence of family members placed great demands on mobility (moving from patient care to family care) in the decision-making process, invoking a need for ethical competence. CONCLUSION: Ethical caring competence is needed in the care of bereaved family members to avoid additional suffering. Opportunities to reflect on these situations within a framework of care ethics, continuous moral education, and clinical ethics training are needed. Support in dealing with personal discomfort and clear guidelines on family support could benefit EMS personnel.

  • 131.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Sandman, Lars
    University of Borås, School of Health Science.
    Experiencing Out-of-Hospital Cardiac Arrest: Significant Others’ Lifeworld Perspective2009In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 19, no 10, p. 1407-1420Article in journal (Refereed)
    Abstract [en]

    When patients suffer out-of-hospital cardiac arrests (OHCA), significant others find themselves with no choice about being there. After the event they are often left with unanswered questions about the life-threatening circumstances, or the patient’s death, or emergency treatment and future needs. When it is unclear how the care and the event itself will affect significant others’ well-being, prehospital emergency personnel face ethical decisions. In this article we describe the experiences of significant others present at OHCA, focusing on ethical aspects and values. Using a lifeworld phenomenological approach, 7 significant others were interviewed. The essence of the phenomenon of OHCA can be stated as unreality in the reality, which is characterized by overwhelming responsibility. The significant others experience inadequacy and limitation, they move between hope and hopelessness, and they struggle with ethical considerations and an insecurity about the future. The study findings show how significant others’ sense of an OHCA situation, when life is trembling, can threaten values deemed important for a good life.

  • 132.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Dahlberg, Karin
    Sandman, Lars.
    University of Borås, School of Health Science.
    To survive out-of-hospital cardiac arrest: a search for meaning and coherence2009In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 19, no 3, p. 323-338Article in journal (Refereed)
    Abstract [en]

    The primary responsibility of prehospital emergency personnel at out-of-hospital cardiac arrests (OHCA) is to provide lifesaving care. Ethical considerations, decisions, and actions should be based in the patient's beliefs about health and well-being. In this article, we describe patients' experiences of surviving OHCA. By using a phenomenological approach, we focus on how OHCA influences patients' well-being over time. Nine survivors were interviewed. Out-of-hospital cardiac arrest is described as a sudden and elusive threat, an awakening in perplexity, and the memory gap as a loss of coherence. Survival means a search for coherence with distressing and joyful understanding, as well as existential insecurity exposed by feelings of vulnerability. Well-being is found through a sense of coherence and meaning in life. The study findings show survivors' emotional needs and a potential for prehospital emergency personnel to support them as they try to make sense of what has happened to them.

  • 133.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Herrera Jiménez, María
    Ethical profiles in the Spanish and Swedish Emergency Medical Services2013Conference paper (Refereed)
    Abstract [en]

    Introduction: The ambulance crew faces in their daily work different kinds of ethical problems, such as conflicts between ethical values and standards that are critical for the health care. This gives a complexity of the situations and becomes a constant challenge in the care practice for these professionals. Sandman and Nordmark (2006) describe that decision-making in this area of care often creates high pressure and discomfort among the ambulance personnel. Adams, Arnold, Siminoff and Wolfson (1992) identified ethical conflicts in 14.4% of the alerts made by the ambulance crews. In Sweden, Sandman and Nordmark (2006) found ethical conflicts in out-of-hospital care regarding the care relationship, the patient’s autonomy, the patient’s best interest, professional ideals, the professional role and self-identity, family members and bystanders, other care professionals, organizational structure and resource management, societal ideals, and other professionals. In Spain, Jiménez (2009) presented some ethical problems that arouse during CPR, pain relief, death and in situations when the right to autonomy was at stake. None of these studies are presenting tools for mapping or help for understand the different situation. The ethical value profile is a help to create tools for mapping and understanding. The first part of this project aims to translate, adapt and test a previous used instrument to map the ethical profile among ambulance crew in Spain and Sweden and in a pilot compare ethical values among the professionals. Result: The Managerial Value Profile (MVP) was translated from English to Swedish and Spanish. The translation was made forward and backward and then subjected to a psychometric test. To adapt the questions in regard to cultural aspects a pilot study was made in both countries (Sweden n=26, Spain n=20). In the pilot we found that ambulance personnel in Sweden and Spain tended to stress the value of individual rights and partly social justice while an utilitaristic approach was regarded as less important. On three items we found a huge difference between the two groups. In those items the Spanish professionals tended to consider social justice more often than the Swedish ambulance personnel that considered individual rights.

  • 134.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Jimenéz-Herrera, Maria
    Axelsson, Christer
    University of Borås, School of Health Science.
    Burjalés Martí, D
    Sandman, Lars
    University of Borås, School of Health Science.
    Casali, Luca
    Ethical values in emergency medical services: A pilot study.2015In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, no 8, p. 928-942Article in journal (Refereed)
    Abstract [en]

    Background: Ambulance professionals often address conflicts between ethical values. As individuals’ values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. Objectives: To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals’ value profiles in Spain and Sweden. Methods: The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. Ethical considerations: This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. Findings: Spanish professionals favoured justice and Swedish professionals’ rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. Discussion: Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals’ moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer’s professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. Conclusion: A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally – especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care.

  • 135.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Jiménez Herrera, María
    Axelsson, Christer
    University of Borås, School of Health Science.
    Burjalés Martí, Dolors
    Sandman, Lars
    University of Borås, School of Health Science.
    Casali, Gian Luca
    Ethical values in emergency medical services: A pilot study2015In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 22, no 8, p. 928-942Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Ambulance professionals often address conflicts between ethical values. As individuals' values represent basic convictions of what is right or good and motivate behaviour, research is needed to understand their value profiles. OBJECTIVES: To translate and adapt the Managerial Values Profile to Spanish and Swedish, and measure the presence of utilitarianism, moral rights and/or social justice in ambulance professionals' value profiles in Spain and Sweden. METHODS: The instrument was translated and culturally adapted. A content validity index was calculated. Pilot tests were carried out with 46 participants. ETHICAL CONSIDERATIONS: This study conforms to the ethical principles for research involving human subjects and adheres to national laws and regulations concerning informed consent and confidentiality. FINDINGS: Spanish professionals favoured justice and Swedish professionals' rights in their ambulance organizations. Both countries favoured utilitarianism least. Gender differences across countries showed that males favoured rights. Spanish female professionals favoured justice most strongly of all. DISCUSSION: Swedes favour rights while Spaniards favour justice. Both contexts scored low on utilitarianism focusing on total population effect, preferring the opposite, individualized approach of the rights and justice perspectives. Organizational investment in a utilitarian perspective might jeopardize ambulance professionals' moral right to make individual assessments based on the needs of the patient at hand. Utilitarianism and a caring ethos appear as stark opposites. However, a caring ethos in its turn might well involve unreasonable demands on the individual carer's professional role. Since both the justice and rights perspectives portrayed in the survey mainly concern relationship to the organization and peers within the organization, this relationship might at worst be given priority over the equal treatment and moral rights of the patient. CONCLUSION: A balanced view on ethical perspectives is needed to make professionals observant and ready to act optimally - especially if these perspectives are used in patient care. Research is needed to clarify how justice and rights are prioritized by ambulance services and whether or not these organization-related values are also implemented in patient care.

  • 136.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Sandman, Lars
    University of Borås, School of Health Science.
    Etiska aspekter på HLR2011Conference paper (Refereed)
    Abstract [sv]

    Hälso- och sjukvårdens övergripande mål kan uttryckas som främjande av optimal livslängd med god livskvalitet och ett gott liv. Målet kan betraktas som etiskt. Vid en patients hjärt-stopp är målet med den medicinska behandlingen (hjärtlungräddning, HLR) att personen överlever med åtminstone acceptabel livskvalitet. I det akuta, prehospitala skedet är det dock svårt att bedöma utfallet avseende framtida livskvalitet förutom i vissa få och relativt välbestämda fall. Det är dessutom svårt att få vetskap om patientens eventuella önskemål om sin vård. Som regel påbörjas därför HLR. Etiska riktlinjer kan ge viss vägledning i beslut om att avbryta HLR när det finns skäl att tro att målet inte kan uppnås. Ramarna för sådana riktlinjer bygger på respekt för patientens autonomi och integritet, rättvisa samt rimlighet i vårdarens yrkesroll. Detta innebära exempel-vis respekt för patientens eventuella önskemål avseende HLR, undvikande av att patienten exponeras samt ansvar för att resurserna används så rättvist som möjligt. Det sistnämnda kan ibland innebära att ambulanspersonal avviker från en HLR-plats efter att HLR avbrutits för något som är viktigare än vården av närstående. Vård av närstående bör dock betraktas som en rimlig uppgift i ambulanspersonalens yr-kesroll där ansvaret handlar om att tillvarata närståendes kunskap och erfarenhet, visa dem omtanke och respekt samt ge stöd, vägledning och information. Närståendes delaktighet ska främjas och kommunikationen med dem ske respektfullt, lyhört och empatiskt. Närståendes initiala roll vid en patients hjärtstopp är viktig genom att de kan bidra med värdefull informa-tion om patienten och även återge patientens vilja i förekommande fall. I händelse av att pati-enten avlider är målet att lindra närståendes lidande. Forskning visar dock att ambulansperso-nalens uppfattningar om närståendevården och närståendes närvaro under HLR varierar från att anses som viktig för närståendes sorgeprocess och återhämtning, till att inte ingå i vår-darrollen, negativt påverka HLR-beslut och innebära emotionell belastning för vårdarna. När-ståendes närvaro vid HLR tycks för en del ambulanspersonal innebära svårigheter att ge när-stående emotionellt stöd och ibland leda till att HLR fortsätter längre än vad som är medici-niskt motiverat, antingen som ett sätt att lindra närståendes lidande eller för att vårdarna inte förmår att skifta från patientvård till vårdande av närstående. Att utföra HLR för någon annan skull än för patienten och längre än medicinskt motive-rat är emellertid etiskt tveksamt och flyttar dessutom fokus från närståendes behov. Närståen-des känslor av överväldigande ansvar och ofrivillig ensamhet belyser istället vikten av att uppmärksamhet på närståendes verkliga behov, främjande av kontrollkänsla och försök till skuldavlastning. Ambulanspersonalens uppriktighet, medmänsklighet och närvaro framstår som centrala aspekter i en etiskt god vård av närstående i samband med en patients hjärtstopp och plötsliga död.

  • 137.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Sandman, Lars
    University of Borås, School of Health Science.
    Futile cardiopulmonary resuscitation for the benefit of others: An ethical analysis2011In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 18, no 4, p. 495-504Article in journal (Refereed)
    Abstract [en]

    It has been reported as an ethical problem within prehospital emergency care that ambulance professionals administer physiologically futile cardiopulmonary resuscitation (CPR) to patients having suffered cardiac arrest to benefit significant others. At the same time it is argued that, under certain circumstances, this is an acceptable moral practice by signalling that everything possible has been done, and enabling the grief of significant others to be properly addressed. Even more general moral reasons have been used to morally legitimize the use of futile CPR: That significant others are a type of patient with medical or care needs that should be addressed, that the interest of significant others should be weighed into what to do and given an equal standing together with patient interests, and that significant others could be benefited by care professionals unless it goes against the explicit wants of the patient. In this article we explore these arguments and argue that the support for providing physiologically futile CPR in the prehospital context fails. Instead, the strategy of ambulance professionals in the case of a sudden death should be to focus on the relevant care needs of the significant others and provide support, arrange for a peaceful environment and administer acute grief counselling at the scene, which might call for a developed competency within this field.

  • 138.
    Bremer, Anders
    et al.
    University of Borås, School of Health Science.
    Wireklint Sundström, Birgitta
    University of Borås, School of Health Science.
    Vårdrum: ett vårdande rum2014In: Akut omhändertagande av trauma - på skadeplats och akutmottagning / [ed] Carina Elmqvist, Sofia Almerud Österberg, Liber , 2014, p. 23-53Chapter in book (Other academic)
    Abstract [sv]

    Syftet med detta kapitel är att bidra med fördjupad förståelse av begreppet vårdrum och samtidigt presentera en vårdvetenskaplig ram. I detta kapitel beskrivs skadeplatsens oordnade miljö och skiftande villkor, kännetecken och utmaningar som finns för ambulanspersonal att planera för och upprätta vårdrum för patienter som utsatts för trauma, i samverkan med räddnings- tjänst och polis. Därefter beskrivs villkor för patienternas och de närståen- des vårdrum på akutmottagningen. I kapitlet ges exempel på hur vårdande rum kan främjas och upprättas samt hur vårdrummet kan upplevas av de närvarande, vilket gestaltas utifrån forskning och erfarenheter som gjorts av vårdare, patienter och närstående. Kapitlet bygger främst på vårdveten- skaplig forskning.

  • 139. Brink, E
    et al.
    Alsén, P
    Herlitz, Johan
    University of Borås, School of Health Science.
    Kjellgren, K
    Cliffordson, C
    General self-efficacy and health-related quality of life after myocardial infarction2012In: Psychology, Health & Medicine, ISSN 1354-8506, E-ISSN 1465-3966, Vol. 17, no 3Article in journal (Refereed)
    Abstract [en]

    Fatigue after myocardial infarction (MI) has been found to be distressing. A person's self-efficacy will influence his/her health behavior and plays an active role in tackling illness consequences. This study investigated associations between fatigue, disturbed sleep, general self-efficacy, and health-related quality of life (HRQoL) in a sample of 145 respondents admitted to hospital for MI two years earlier. The aim was to identify the predictive value of general self-efficacy and to elucidate mediating factors between self-efficacy and HRQoL. General self-efficacy measured four months after MI was positively related to HRQoL after two years. In tests of indirect effects, fatigue meditated the effects between self-efficacy and the physical and the mental dimension of HRQoL, respectively. The indirect effect of disturbed sleep went through that of fatigue. To conclude, patients who suffer from post-MI fatigue may need support aimed at helping them increase their self-efficacy as well as helping them adapt to sleep hygiene principles and cope with fatigue, both of which will have positive influences on HRQoL.

  • 140.
    Brorström, Björn
    et al.
    University of Borås, School of Business and IT.
    Forsgren, Olov
    University of Borås, School of Business and IT.
    Hallnäs, Lars
    University of Borås, Swedish School of Textiles.
    Höglund, Lars
    University of Borås, Swedish School of Library and Information Science.
    Lindecrantz, Kaj
    University of Borås, School of Engineering.
    Nyström, Maria
    University of Borås, School of Health Science.
    Ordell Björkdahl, Susanne
    University of Borås, School of Education and Behavioural Science.
    Forskning vid Högskolan i Borås2007Report (Other academic)
  • 141. Bruce, K
    et al.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    The hand-over process and triage of ambulance-borne patients: The experience of emergency nurses2005In: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 10, no 4, p. 201-209Article in journal (Refereed)
    Abstract [en]

    One of the most important tasks that a nurse faces in the emergency room, when receiving a patient, is handover and the triage function. The aim of the study was to explore the experiences of nurses receiving patients who were brought into hospital as emergencies by ambulance crews through an analysis of the handover and triage process. A qualitative descriptive interview study inspired by the phenomenological method was used with six emergency nurses. There are three elements to a handover: a verbal report, handing over documented accounts and the final symbolic handover when a patient is transferred from the ambulance stretcher onto the hospital stretcher. The study identified that the verbal communication between ambulance and emergency nurses was often very structured. The ideal handovers often involved patients with very distinct medical problems. The difficult handover or the ‘non-ideal’ one was characterized by a significantly more complicated care situation. The handover function was pivotal in ensuring that the patient received the correct care and that care was provided at the appropriate level. The most seriously afflicted patients arrived by ambulance; therefore, the interplay between pre-hospital and hospital personnel was vital in conveying this important information. To some extent, this functioned well, but this research has identified areas where this care can be improved.

  • 142. Brändström, Yvonne
    et al.
    Brink, Eva
    Institute of Health and Care Sciences, the Sahlgrenska Academy at University of Gothenburg.
    Grankvist, Gunne
    Alsén, Pia
    Herlitz, Johan
    University of Borås, School of Health Science.
    Karlson, Björn W
    Physical activity six months after a myocardial infarction2009In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 15, no 3, p. 191-197Article in journal (Refereed)
    Abstract [en]

    In the present study, we wished to explore physical activity in middle-aged patients 6 months after a myocardial infarction and to compare the patients' self-reported activity level with pedometric measures of footsteps/day. The sample comprised 89 patients with myocardial infarction, aged <or= 65 years. The self-report question showed that < 40% of the patients were engaged in at least 30 min of physical activity every day. The pedometric physical activity data showed a daily mean number of steps of 6719. The self-report question was correlated with the pedometric registration data. Among myocardial infarction patients, physical activity 6 months after the acute heart attack was insufficient in the majority of patients, both when evaluated with a self-report question and when evaluated with a pedometer. Efforts to increase physical activity after myocardial infarction are warranted.

  • 143.
    Byström, Katriina
    et al.
    University of Borås, Swedish School of Library and Information Science.
    Ekwall, Daniel
    University of Borås, School of Engineering.
    Ericson, Mathias
    University of Borås, School of Education and Behavioural Science.
    Sandman, Lars
    University of Borås, School of Health Science.
    Rolandsson, Bertil
    University of Borås, School of Education and Behavioural Science.
    Torstensson, Håkan
    University of Borås, School of Engineering.
    Risker och säkerhet i professionell vardag: tekniska, organisatoriska och etiska perspektiv2010Report (Other academic)
    Abstract [sv]

    Vid Högskolan i Borås bedrivs ett utredningsarbete med syfte att klargöra förutsättningarna för att inrätta ett centrum för studier av risk, profession och säkerhet. Parallellt med resonemang rörande lämpliga styr- och organisationsformer behandlas hur utbildningen inom området bör utformas. I skrivande stund är inriktningen att utveckla och erbjuda ett magisterprogram inom området management där en inriktning är mot risk och säkerhet. En satsning på utbildning fordrar forskningsanknytning och förekomsten av forskning inom området risk och säkerhet utgör därför en viktig utgångspunkt för det fortsatta arbetet. Vid högskolan finns idag forskning som belyser risk och säkerhetsfrågor inom skilda verksamhetsområden och med olika teoretiska utgångspunkter. Området spänner från hur risker hanteras i det vardagliga arbetet för olika professioner till hur risker kan elimineras och osäkerhet reduceras i samband med extra ordinära händelser. Högskolan i Borås ska vara ett komplett professionslärosäte och bedriva nydanande och samhällsrelevant utbildning och forskning. Ett flervetenskapligt ideal präglar utbildning och forskning, där problemet som ska belysas är i centrum och inte den akademiska disciplinen. Att bedriva utbildning och forskning inom risk och säkerhet är i enlighet med lärosätets ideal och inriktning. Genom att anlägga ett risk- och säkerhetsperspektiv på olika typer av samhälleliga fenomen i utbildning och forskning uppmärksammas dels nya frågor, dels beforskas områden och fenomen utifrån ett i förhållande till traditionell disciplinär forskning alternativt perspektiv, och därigenom kan ny kunskap erhållas. Ett led i utvecklingen av forskningsverksamheten vid högskolan är sammanställningen och publiceringen av föreliggande antologi. Två av de ledande forskarna inom området, Bertil Rolandsson och Håkan Torstensson, har tagit initiativ till antologin och fungerat som redaktörer. Fem bidrag publiceras i rapporten som tillsammans visar vad forskning kring risk och säkerhet kan vara och vilken inriktning forskningen har vid Högskolan i Borås. Tre bidrag har fokus på transportbranschen, ett på polisiär verksamhet och ett på vårdverksamhet. Det finns således en spridning över praktiska fält och även spridning vad gäller teoretiska utgångspunkter. Rapporten är nummer tretton i högskolans rapportserie Vetenskap för profession, vars syfte är att redovisa resultat från pågående och avslutade forskningsprojekt. Rapporten är också ett underlag för fortsatta resonemang inom högskolan om satsningen på utbildning och forskning inom området risk och säkerhet och kring frågan om vilken inriktning forskningen ska ha.

  • 144. Bäck, M
    et al.
    Cider, Å
    Gillström, J
    Herlitz, J
    University of Borås, School of Health Science.
    Physical activity in relation to cardiac risk markers in secondary prevention of coronary artery disease2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 168, no 1, p. 478-483Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The relationship between physical activity and cardiac risk markers in secondary prevention for patients with coronary artery disease (CAD) is uncertain. The aims of the study were therefore to examine the level of physical activity in patients with CAD, and to investigate the association between physical activity and cardiac risk markers. METHODS: In total, 332 patients, mean age, 65 ± 9.1 years, diagnosed with CAD at a university hospital were included in the study 6 months after their cardiac event. Physical activity was measured with a pedometer (steps/day) and two questionnaires. Investigation of cardiac risk markers included serum lipids, oral glucose-tolerance test, twenty-four hour blood pressure and heart rate monitoring, smoking, body-mass index (BMI), waist-hip ratio, and muscle endurance. The study had a cross-sectional design. RESULTS: The patients performed a median of 7,027 steps/day. After adjustment for confounders, statistically significant correlations between steps/day and risk markers were found with regard to; high-density lipoprotein cholesterol (HDL-C) (r=0.19, p<0.001), muscle endurance measures (r ranging from 0.19 to 0.25, p=0.001 or less) triglycerides (r=-0.19, p<0.001), glucose-tolerance (r=-0.23, p<0.001), BMI (r=-0.21, p<0.001), 24-h heart rate recording during night (r=-0.17, p=0.004), and average 24-h heart rate (r=-0.13, p=0.02). CONCLUSIONS: A relatively high level of physical activity was found among patients with CAD. There was a weak, but significant, association between pedometer steps/day and HDL-C, muscle endurance, triglycerides, glucose-tolerance, BMI and 24-h heart rate, indicating potential positive effects of physical activity on these parameters. However, before clinical implications can be formed, more confirmatory data are needed.

  • 145. Bäck, M
    et al.
    Cider, Å
    Herlitz, J
    University of Borås, School of Health Science.
    Lundberg, M
    Jansson, B
    What variables predict participation in exercise-based cardiac rehabilitation in patients with coronary artery disease?2014Conference paper (Refereed)
    Abstract [en]

    Background Despite the well-established positive effects of exercise-based cardiac rehabilitation (CR) participation has been shown to be sub-optimal. A significant association between kinesiophobia (fear of movement) and participation in CR has previously been found. Therefore, the aim of this study was to identify predictors of participation in CR in patients with coronary artery disease (CAD), with a special reference to kinesiophobia. Material and methods In all, 332 patients (75 women; mean age 65±9.1 years) with a diagnosis of CAD were recruited between 2007 and 2009 at Sahlgrenska University Hospital/Sahlgrenska. The patients were tested regarding muscle endurance, level of physical activity, health related quality of life, anxiety, depression and kinesiophobia. A path model with direct and indirect effects via kinesiophobia was used to predict participation in CR. An explorative selection of significant predictors was performed. Results Kinesiophobia (p=.012), waist circumference (p=.023), and a previous history of PCI (p=.037) had direct negative effects on participation in CR, while current incidence of CABG (p<.001), PCI (p=.005) and BMI (p=.008) had positive effects. Compared to patients diagnosed with unstable angina, a diagnosis of myocardial infarction (p=.004) had a positive effect on participation in CR. The following indirect effects on participation in CR were found. Anxiety (p=.001) and previous PCI (p=.025) increased kinesiophobia, while muscle endurance (p=.003), perceptions of general health (p<.001) and physical functioning (p=.009) decreased kinesiophobia. Moreover, men had higher kinesiophobia compared to women (p=.031) and smoking was found to reduce kinesiophobia (p=.004). Conclusion Several important variables with an influence on participation in CR were identified and should be further analysed in relation to clinical practice. A reduction of kinesiophobia can be an efficient way to increase participation in CR and should therefore be given priority in future research.

  • 146. Bäck, M
    et al.
    Jansson, B
    Cider, A
    Herlitz, Johan
    University of Borås, School of Health Science.
    Lundberg, M
    Validation of a questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease.2012In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 44, no 4, p. 363-369Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate the validity and reliability of the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), a brief questionnaire to detect kinesiophobia (fear of movement) in patients with coronary artery disease. Design: Methodological research (cross-sectional study). Subjects: A total of 332 patients, mean age 65 years (standard deviation 9.1) diagnosed with coronary artery disease at a university hospital were included in the study. Methods: The psychometric properties of the TSK-SV Heart were tested. The tests of validity comprised face, content, and construct validity. The reliability tests included composite reliability, internal consistency and stability over time. Results: In terms of reliability, the TSK-SV Heart was found to be stable over time (intra-class correlation coefficient 0.83) and internally consistent (Cronbach's alpha 0.78). Confirmatory factor analysis provided acceptable fit for a hypothesized 4-factor model with inclusion of a method factor. Conclusion: These results provide support for the reliability of the TSK-SV Heart. The questionnaire appears to be valid for use in patients with coronary artery disease. However, some items require further investigation due to low influence on some sub-dimensions of the test. The sub-dimensions of kinesiophobia require future research concerning their implications for the target group.

  • 147. Bäck, Maria
    et al.
    Cider, Åsa
    Herlitz, Johan
    University of Borås, School of Health Science.
    Physical activity in relation to cardiac risk markers in coronary artery disease2012Conference paper (Refereed)
  • 148. Bäck, Maria
    et al.
    Cider, Åsa
    Herlitz, Johan
    University of Borås, School of Health Science.
    Lundberg, Mari
    Jansson, Bengt
    The impact on kinesiophobia (fear of movement) by clinical variables for patients with coronary artery disease2013In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 167, no 2, p. 391-397Article in journal (Refereed)
    Abstract [en]

    Background: The impact on kinesiophobia (fear of movement) for patients with coronary artery disease (CAD) is not known. The aims were to describe the occurrence of kinesiophobia in patients with CAD, and to investigate the influence on kinesiophobia by clinical variables. Material and methods: In total, 332 patients, mean age, 65±9.1 years diagnosed with CAD at a university hospital were included in the study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart) was used to assess kinesiophobia. Comparisons between high versus low levels of kinesiophobia were measured for each variable. Binary logistic regression analyses were performed with a high level of kinesiophobia (TSK-SV Heart >37) as dependent variable, and with the observed variables as independent. The study had an exploratory, cross-sectional design. Results: A high level of kinesiophobia was found in 20% of the patients. The following variables decreased the odds ratio (OR) for a high level of kinesiophobia: Attending cardiac rehabilitation (yes vs no; -56.7%), level of physical activity (medium vs high; -80.2%), Short Form-36: general health (-4,3%), physical functioning (-1.8%). Two variables increased the OR for a high level of kinesiophobia: heart failure as complication at hospital (yes vs no; 418.7%), anxiety (19.2%). Previous heart failure (yes vs no) was unexpectedly found to reduce kinesiophobia (-88.3%) due to suppression. Conclusions: Several important clinical findings with impact on rehabilitation and prognosis for patients with CAD were found to be associated with a high level of kinesiophobia. Therefore, kinesiophobia needs to be considered in secondary prevention for patients with CAD.

  • 149. Bäck, Maria
    et al.
    Herlitz, Johan
    University of Borås, School of Health Science.
    Biochemical markers and blood pressure in relation to physical activity among patients with coronary artery disease2012Conference paper (Refereed)
  • 150.
    Bång, A
    et al.
    University of Borås, School of Health Science.
    Castrén, M
    Herlitz, Johan
    University of Borås, School of Health Science.
    Suserud, B-O
    University of Borås, School of Health Science.
    Svensson, L
    Svensson, L (Editor)
    Forskning och utveckling2009In: Prehospital akutsjukvård, Liber AB , 2009, p. 461-468Chapter in book (Other academic)
1234567 101 - 150 of 993
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf