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  • 201.
    Claesson, Andreas
    University of Borås, School of Health Science.
    Lifesaving after cardiac arrest due to drowning. Characteristics and outcome.2013Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Aims The aim of this thesis was to describe out-of-hospital cardiac arrest (OHCA) due to drowning from the following angles. In Paper I: To describe the characteristics of OHCA due to drowning and evaluate factors of importance for survival. In Paper II: To describe lifesaving skills and CPR competence among surf lifeguards. In Paper III: To describe the characteristics of interventions performed by the Swedish fire and rescue services (SFARS) and evaluate survival with or without rescue diving units. In Paper IV: To describe the prevalence of possible confounders for death due to drowning. In Paper V: To describe changes in characteristics and survival over time and again to evaluate factors of importance for survival Methods Papers I and III-V are based on retrospective register data from the Swedish OHCA Register reported by Emergency Medical Service (EMS) clinicians between 1990-2011. In addition, in Paper III, the data have been analysed and compared with the SFARS database for rescue characteristics. In Paper IV, the data have been compared with those of the National Board of Forensic Medicine (NBFM). Paper II is a descriptive study of 40 surf lifeguards evaluating delay and CPR quality as peformed on a manikin. Results Survival in OHCA due to drowning is about 10% and does not differ significantly from OHCA with a cardiac aetiology. The proportion of witnessed cases was low. Survival appears to increase with a short EMS response time, i.e. early advanced life support. Surf lifeguards perform CPR with sustained high quality, independent of prior physical strain. In half of about 7,000 drowning calls, there was need for a water rescue by the fire and rescue services. Among the OHCA in which CPR was initiated, a majority were found floating on the surface. Rescue diving took place in a small percentage of all cases. Survival when using rescue divers did not differ significantly from drownings where rescue diving units were not used. No survivors were found after >15 minutes of submersion in warm water. After submersion in cold water, survival with a good neurological outcome was extended. Among 2,166 autopsied cases of drowning, more than half were judged as accidents and about one third as intentional suicide cases. Among accidents, 14% were found to have a cardiac aetiology, while the corresponding figure among suicides was 0%. In a 20-year follow-up of OHCA due to drowning in Sweden, both bystander CPR and early survival to hospital admission are increasing. The proportion of cases alive after one month has not changed significantly during the period. Conclusions Survival from OHCA due to drowning is low. A reduction in the EMS response time appears to have high priority, i.e. early ALS is important. The quality of CPR among surf lifeguards appear to be high and not affected by prior physical strain. In all treated OHCA cases, the majority were found at the surface and survival when rescue diving took place did not appear to be poorer than in non-rescue diving cases. In a minor proportion of cases, cardiac disease could be a confounder for death due to drowning. Bystander CPR in OHCA due to drowning has increased over a 20-year period and the proportion of early survivors to hospital admission is increasing. We speculate that our studies were underpowered with regard to the opportunity adequately to assess the effects of bystander CPR on survival to hospital discharge. A uniform Swedish definition of drowning based on the recommended international terms should be implemented throughout Swedish authorities and health care, in order to enhance the quality of data and improve the potential for future research.

  • 202.
    Claesson, Andreas
    et al.
    University of Borås, School of Health Science.
    Karlsson, Tomas
    Thorén, Ann-Britt
    Herlitz, Johan
    University of Borås, School of Health Science.
    Delay and performance of cardiopulmonary resuscitation in surf lifeguards after simulated cardiac arrest due to drowning.2011In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 29, no 9, p. 1044-1050Article in journal (Refereed)
    Abstract [en]

    Abstract PURPOSE: To describe time delay during surf rescue and compare the quality of cardiopulmonary resuscitation (CPR) before and after exertion in surf lifeguards. METHODS: A total of 40 surf lifeguards at the Tylösand Surf Lifesaving Club in Sweden (65% men; age, 19-43 years) performed single-rescuer CPR for 10 minutes on a Laerdal SkillmeteÔ Resusci Anne manikin. The test was repeated with an initial simulated surf rescue on an unconscious 80-kg victim 100 m from the shore. The time to victim, to first ventilation, and to the start of CPR was documented. RESULTS: The mean time in seconds to the start of ventilations in the water was 155 ± 31 (mean ± SD) and to the start of CPR, 258 ± 44. Men were significantly faster during rescue (mean difference, 43 seconds) than women (P = .002). The mean compression depth (millimeters) at rest decreased significantly from 0-2 minutes (42.6 ± 7.8) to 8-10 minutes (40.8 ± 9.3; P = .02). The mean compression depth after exertion decreased significantly (44.2 ± 8.7 at 0-2 minutes to 41.5 ± 9.1 at 8-10 minutes; P = .0008). The compression rate per minute decreased after rescue from 117.2 ±14.3 at 0 to 2 minutes to 114.1 ± 16.1 after 8 to 10 minutes (P = .002). The percentage of correct compressions at 8 to 10 minutes was identical before and after rescue (62%). CONCLUSION: In a simulated drowning, 100 m from shore, it took twice as long to bring the patient back to shore as to reach him; and men were significantly faster. Half the participants delivered continuous chest compressions of more than 38 mm during 10 minutes of single-rescuer CPR. The quality was identical before and after surf rescue. Copyright © 2011 Elsevier Inc. All rights reserved.

  • 203.
    Claesson, Andreas
    et al.
    University of Borås, School of Health Science.
    Lindqvist, J
    Ortenwall, P
    Herlitz, Johan
    University of Borås, School of Health Science.
    Characteristics of lifesaving from drowning as reported by the Swedish Fire and Rescue Services 1996-2010.2012In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 83, no 9, p. 1072-1077Article in journal (Refereed)
    Abstract [en]

    Aim We aimed to describe characteristics associated with rescue from drowning as reported by the Swedish Fire and Rescue Services (SFARS) and their association with survival from the Out of Hospital Cardiac Arrest (OHCA) registry. Method This retrospective study is based on the OHCA registry and the Swedish Civil Contingencies Agency (SCCA) registry. All emergency calls (1996–2010) where the SFARS were dispatched were included (n = 7175). For analysis of survival, OHCAs that matched events from the SCCA registry were included (n = 250). Results Calls to lakes and ponds were predominant (35% of all calls reported). Rescues were more likely in cold water, <10 °C (45%), in open water (80%) and in April–September (68%). Median delay from a call to arrival of rescue services was 8 min, while it was 9 min for rescue diving units. Of all OHCA cases, the victim was found at the surface in 47% and underwater in 38%. In events where rescue divers were used, victims were significantly younger than in non-diving cardiac arrests and the mean diving depth was 6.3 ± 5.8 m. Overall survival to one month was 5.6% (13% in diving and 4.7% in non-diving cases; p = 0.07). Conclusion In half of more than 7000 drowning-related calls to the SFARS during 15 years of practice, water rescue was needed. In all treated OHCA cases, the majority were found at the surface. Only in a small percentage did rescue diving take place. In these cases, survival did not appear to be poorer than in non-diving cases.

  • 204. Cronquist, A
    et al.
    Lützén, K
    Nyström, Maria
    University of Borås, School of Health Science.
    Nurses’ lived experiences of moral stress support in the intensive care context2006In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 14, no 5, p. 405-413Article in journal (Refereed)
    Abstract [en]

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

  • 205. Cronqvist, A
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    A theoretical argumentation on the consequences of moral stress2007In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 15, no 4, p. 458-465Article in journal (Refereed)
    Abstract [en]

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

  • 206. Dahlberg, Karin
    et al.
    Dahlberg, Helena
    Nyström, Maria
    University of Borås, School of Health Science.
    Reflective Lifeword Research, 2. ed.2008Book (Other academic)
  • 207. Dahlberg, Karin
    et al.
    Drew, N
    Nyström, Maria
    University of Borås, School of Health Science.
    Reflective Lifeworld Research2001Book (Other academic)
  • 208. Dahlberg, Karin
    et al.
    Segesten, Kerstin
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Fagerberg, Ingegerd
    Att förstå vårdvetenskap2003Book (Other academic)
  • 209.
    Dahlborg-Lyckhage, Elisabeth
    University of Borås, School of Health Science.
    Määtä, Sylvia (Editor)
    University of Borås, School of Health Science.
    Kvinnor, män och vårdens språk2007In: Vårdens språk – en antologi / [ed] Sylvia Määttä, Kerstin Segesten, Liber , 2007Chapter in book (Other academic)
  • 210.
    Dahlborg-Lyckhage, Elisabeth
    University of Borås, School of Health Science.
    "Systers" konstruktion och mumifiering i TV-serier och studenters föreställningar2003Doctoral thesis, monograph (Other academic)
  • 211. Dahlborg-Lyckhage, Elisabeth
    et al.
    Lindahl, Berit
    University of Borås, School of Health Science.
    Living in Liminality: Being Simultaneously Visible and Invisible: Caregivers' Narratives of Palliative Care2013In: Journal of Social Work in End-of-life & Palliative Care, ISSN 1552-4256, Vol. 9, no 4, p. 272-288Article in journal (Refereed)
    Abstract [en]

    Palliative care is an integral part of care and takes place in many settings—including the home, special accommodations, and hospitals. However, research shows that palliative care often ends with a death in the hospital due to the heavy burden on the primary caregiver. This study explores the meaning of being the primary caregiver of a close one who is terminally ill and is based on qualitative interviews with six primary caregivers of a terminally ill individual at home. The findings are discussed in the light of the theoretical concepts of liminality, lived body, and power. A potential impending risk exists of being abandoned when one is the primary caregiver to a close one who is terminally ill. This situation calls for professional caregivers to take responsibility and to respond to these, often unspoken, needs. This is particularly important concerning bodily care and the medical treatment regimen. In addition, when friends and relatives are absent, there is an ethical demand on professional caregivers to compensate for this lack and to compensate for this need. Palliative home care demands care that is person-centered—including the individual’s history, family and loved ones, and individual strengths and weaknesses.

  • 212.
    Dalheim Englund, Ann-Charlotte
    University of Borås, School of Health Science.
    Associations between Social Capital measures and Return to Work among Women on Long-term Sick Leave2014Conference paper (Refereed)
    Abstract [en]

    Sick leave rates are decreasing in Sweden overall, but these rates follow the international trend of higher sick leave for women than men. This study focuses on the associations between social capital measures and return to work (RTW) among women on long-term sick leave. Questionnaire data were collected at four times from a cohort of long-term sick women (n=324). The preliminary results suggest women that reported having someone they feel very close to, having someone they can share happiness with and being comforted by being held in someone’s arms increased in work ability score and working degree significantly more over time compared to women who had no such friend/relationship. Additionally, women with shared household duties and women allowed to take a short break at work but not at home, increased in work ability score and working degree significantly more over time compared to women with major responsibility for the household, no opportunity for breaks at work and an accepting climate for break taking at home. These results highlight the importance of social attachment, a basis of equality and a good work environment that allows moments of rest in order to increase work ability and improve the RTW process.

  • 213.
    Dalheim Englund, Ann-Charlotte
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    I have to Turn Myself Inside Out”: Caring for Immigrant Families of Children With Asthma2012In: Clinical Nursing Research, ISSN 1054-7738, E-ISSN 1552-3799, Vol. 21, no 2, p. 224-242Article in journal (Refereed)
    Abstract [en]

    In multicultural societies, health care professionals encounter immigrant families of children with asthma. They play an important role in supporting these families, but few studies have focused on this phenomenon. The aim of the present study is to gain a broader understanding of the challenges health care professionals face in their encounters with non-Western immigrant parents of children with asthma. Seventeen professional caregivers were interviewed, and their narratives were analyzed using qualitative content analysis. The results show that health care professionals’ main challenges when encountering immigrant parents can be described by the theme, “Turning oneself inside out.” This theme is characterized by five categories: gender and professional issues, impact on professional relationships, communication challenges, unfamiliar disease and treatment perceptions, and time issues. The results highlight the importance of providing health care professionals with support and organizational conditions that increase opportunities to understand the unique situation of these families

  • 214.
    Dalheim Englund, Ann-Charlotte
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    Rasmussen, Birgit
    Möller, Christian
    Sandman, Per-Olof
    Having a child with asthma--quality of life for Swedish parents.2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 3, p. 386-395Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Asthma is the most common chronic childhood disease. Childhood asthma contributes significantly to morbidity among children and has a significant impact on the quality of life (QoL) and daily routines of both the children and their parents. AIM AND OBJECTIVE: The purpose of this study was to investigate how Swedish parents of children with asthma experience their QoL, and to investigate whether there were differences concerning QoL between parents within the same family. The purpose was also to investigate possible connections between their QoL and background variables. METHOD: A total of 371 parents of children with asthma (57% mothers and 43% fathers) participated in the study. The Paediatric Asthma Caregiver's Quality Of Life Questionnaire (PACQLQ) was used to measure the parents' QoL, i.e. how the child's asthma interferes with the parents' normal activities and how it has made them feel. RESULTS: The findings show that most parents of children with asthma evaluated their QoL as close to the positive end of the scale, and there was close agreement in the scoring between parents within the same family. Significant associations were found between parents' lower QoL outcome and living in the North of Sweden. There were also significant associations between fathers' lower QoL outcome and having a child younger than 13 years of age and mothers' lower QoL outcome and having a child with severe asthma. Although the result shows that a child's asthma did not influence the parents' QoL to a greater degree, it is still important for healthcare workers to help these parents to sustain and improve their well-being. CONCLUSIONS: The fact that they just evaluated their QoL during the preceding week only, and did so at the time when their children were being treated with asthma medication, might have influenced the results in a positive direction. Comment in Commentary on Dalheim-Englund et al. (2004) Having a child with asthma: quality of life for Swedish parents. Journal of Clinical Nursing 13, 386-395. [J Clin Nurs. 2005]

  • 215.
    Dalheim-Englund, Ann-Charlotte
    University of Borås, School of Health Science.
    Skydda & frigöra, En studie av föräldrar till barn med astma och av professionella vårdare2005Doctoral thesis, monograph (Other academic)
  • 216.
    Dalheim-Englund, Ann-Charlotte
    et al.
    University of Borås, School of Health Science.
    Rydström, Ingela
    University of Borås, School of Health Science.
    Getting along with disease-engendered uncertainty in asthma child families2006In: New Developments in Parent-Child Relation / [ed] D.M. Devore, New York: Nova Science Publishers , 2006Chapter in book (Other academic)
    Abstract [en]

    All communities set high expectations on parents and to raise a child is a challenging responsibility. Being a parent includes feelings of pleasure, but is also associated with concem and extra work. If the child is stricken by a chronic illness their concem and extra work more often than not will increase. One of the most common chronic diseases among children world-wide is asthma and it constitutes a considerable health problem. Current literature shows that asthma brings uncertainty and extra work to family life, which influences many aspects of a farnily's health and social life. In a Swedish study, it is found that mothers and fathers of children with asthma manage their uncertainty in different ways - mothers mostly act in a protecting manner and express feelings of sadness, while fathers act in a liberating manner and express feelings of acceptance. Furthermore, another Swedish study points out the fact that the relations among asthma family members are govemed by uncertainty and characterized by control, tight bonds and feelings of being forsaken and lack of understanding. From the literature and studies mentioned above, one can assume that living under such circumstances may not only affect family members' present life, but it may also affect their future. Uncertainty puts a great drain on the family, e.g. misunderstanding between parents can occur, siblings may feel forsaken and the child with asthma may be prevented from taking an own responsibility for life with the disease. One way to get a deeper understanding of human relations is to use different perspectives. In this article, we will try to illurninate asthma family life and relations by using an existentialistic, a Hegelian as well as a gender perspective.

  • 217. Danung, Claes
    et al.
    Salomonsson, Sven Bertil
    Rönnmark, Lars
    University of Borås, School of Health Science.
    BRASS: BRukare och ASSistenter i samverkan2008Report (Other academic)
    Abstract [sv]

    Personer som genom olyckor och sjukdom förlorar väsentliga förmågor kan genom personlig assistans delvis kompensera för ”stora och varaktiga funktionshinder”. Det är en samhällsservice som regleras av LSS. I förlusterna av livsfunktioner följer ofta förluster av aktiviteter, vänner och arenor som tidigare skänkte personen mening, glädje och bekräftelse. Sedan 2003 bedrivs i Borås Stad en fritidsverksamhet för brukare och deras personliga assistenter. Genom BRASS-verksamheten har platser och upplevelser åter blivit tillängliga för många svårt funktionshindrade personer liksom känslan av gemenskap när man delar upplevelser med andra brukare och assistenter.

  • 218.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science. University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
    Björk, M
    Enkär, K
    Knutsson, Susanne
    University of Borås, School of Health Science.
    The process of striving for an ordinary, everyday life, in young children living with cancer, at six months and one year post diagnosis2014In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 18, no 6, p. 605-612Article in journal (Refereed)
    Abstract [en]

    Purpose Health care focus is shifting from solely looking at surviving cancer to elements of attention relating to living with it on a daily basis.The young child's experiences are crucial to providing evidence based care. The aim of this study was to explore the everyday life of young children as expressed by the child and parents at six months and one year post diagnosis. Methods Interviews were conducted with children and their parents connected to a paediatric oncology unit in Southern Sweden. A qualitative content analysis of interview data from two time points, six months and one year post diagnosis, was carried out. Results The process of living with cancer at six months and at one year post diagnosis revealed the child's striving for an ordinary, everyday life. Experiences over time of gaining control, making a normality of the illness and treatment and feeling lonely were described. Conclusion Nurses have a major role to play in the process of striving for a new normal in the world post-diagnosis, and provide essential roles by giving the young child information, making them participatory in their care and encouraging access to both parents and peers. Understanding this role and addressing these issues regularly can assist the young child in the transition to living with cancer. Longitudinal studies with young children are vital in capturing their experiences through the cancer trajectory and necessary to ensure quality care.

  • 219.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science.
    Enkär, K
    Granlund, M
    Someonsson, R J
    Peterson, C
    Björk, M
    Health and functioning in the everyday lives of young children with cancer: documenting with the International Classification of Functioning, Disability & Health – Children & Youth (ICF-CY)2014In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 41, no 3, p. 475-482Article in journal (Refereed)
    Abstract [en]

    Background Health care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY). Aims The aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment. Method Interviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures. Results A comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence.

  • 220.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science.
    Enskär, Karin
    Granlind, Mats
    Simeonsson, Rune J
    Peterson, Christina
    Björk, Maria
    Health and functioning in the everyday lives of young children with cancer: documenting with the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY)2014In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214Article in journal (Refereed)
    Abstract [en]

    Background Health care focus is shifting for children from surviving childhood cancer to living with it on a daily basis. There is a need to document health and function in the everyday lives of young children with cancer using the multidimensional framework and language of the International Classification of Functioning, Disability and Health – Children and Youth (ICF-CY). Aims The aims of this study were (1) to document health and functioning in the everyday lives of young children with cancer using ICF-CY codes and (2) to identify a comprehensive code set that can aid clinical assessment. Method Interviews with children diagnosed with cancer and their parents, were transcribed, reviewed for content and coded to the ICF-CY using linking procedures. Results A comprehensive code set (n = 70) for childhood cancer was identified. The majority of content identified to codes was related to activity and participation describing social relations with family, peers and professionals, preschool attendance and play, as well as issues related to support and independence. Conclusions The ICF-CY can be used to document the nature and range of characteristics and consequences of cancer experienced by children. The identified comprehensive code set could be helpful to health care professionals, parents and teachers in assessing and supporting young children’s health and everyday life through the cancer trajectory. The comprehensive code set could be developed as a clinical assessment tool for those caring for young children with cancer. The universal language of the ICF-CY means that the utility of a clinical assessment tool based on identified codes can have wide reaching effects for the care of young children with cancer.

  • 221.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science.
    Karlsson, Katarina
    University of Borås, School of Health Science.
    How do we best analyze the meaning of the child’s experience and not just the content?2011Conference paper (Other academic)
  • 222.
    Darcy, Laura
    et al.
    University of Borås, School of Health Science.
    Knutsson, S
    Huus, K
    Enskar, K
    The everyday life of the young child shortly after receiving a cancer diagnosis2014In: Cancer Nursing, ISSN 0162-220X, E-ISSN 1538-9804, Vol. 37, no 6, p. 445-456Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:: Providing qualified, evidence-based healthcare to children requires increased knowledge of how cancer affects the young child's life. There is a dearth of research focusing on the young child's experience of everyday life. OBJECTIVE:: The purpose of this study was to explore young children's and their parents' perceptions of how cancer affects the child's health and everyday life shortly after diagnosis. METHODS:: Thirteen children with newly diagnosed cancer aged 1 to 6 years and their parents, connected to a pediatric oncology unit in Southern Sweden, participated in this study through semistructured interviews. Child and parent data were analyzed as a family unit, using qualitative content analysis. RESULTS:: Everyday life was spent at hospital or at home waiting to go back to hospital. Analysis led to the following categories: feeling like a stranger, feeling powerless, and feeling isolated. CONCLUSIONS:: The child wants to be seen as a competent individual requiring information and participation in care. Parents need to be a safe haven for their child and not feel forced to legitimize painful and traumatic procedures by assisting with them. Nurses play a major role in the lives of children. Research with and on the young child is necessary and a way of making them visible and promoting their health and well-being. IMPLICATIONS FOR PRACTICE:: Nurses need to reevaluate the newly diagnosed child's care routines so as to shift focus from the illness to the child. This requires competent nurses, secure in their caring role.

  • 223. Dekkers, W
    et al.
    Sandman, Lars
    University of Borås, School of Health Science.
    Webb, P
    Good Death or Good Life as a Goal of Palliative Care2002In: The ethics of palliative care: European perspectives / [ed] Henk ten Have, D Clark, Buckingham: Open University Press , 2002, p. 106-125Chapter in book (Other academic)
  • 224.
    Dellve, L
    et al.
    University of Borås, School of Health Science.
    Eriksson, A
    Fredman, M
    Kullen-Engstöm, A
    Lean i hälso- och sjukvården2013In: Lean i arbetslivet / [ed] P Sederblad, Liber , 2013, p. 142-161Chapter in book (Other academic)
  • 225.
    Dellve, Lotta
    University of Borås, School of Health Science.
    Imbalanced logics of communicating with media in open management of health care service in Sweden: the managers perspectives and approaches2014Conference paper (Refereed)
  • 226.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Ahlborg, Tone
    Partner relationships and long-term sick leave among female workers: consequences and impact on dimensions of health and return to work2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 4, p. 720-729Article in journal (Refereed)
    Abstract [en]

    Few efforts have been made to prospectively identify resources and obstacles outside work that may predict regained work ability and return to work when workers are on sick leave. This study investigates the association between partner relationships and sick leave. Our research questions were as follows: (i) What is the influence of sick leave, pain, stress and domestic strain on the quality of the dyadic partner relationship?, and (ii) What is the influence of the partner and social relationship on pain, stress, work ability, self-rated health and return to work? A cohort of female workers (n = 225) on long-term sick leave (>60 days), all in a partner relationship, at 6-month intervals completed a questionnaire based on the Quality of Dyadic Relationship (QDR) instrument, the Interview Schedule of Social Interaction (ISSI), the Work Ability Index (WAI) and the Copenhagen Psychosocial Questionnaire (COPSOQ). Univariate and multivariate analyses of baseline and prospective data were performed. The results showed that decreased partner relationship quality was related to having major responsibility for household work despite being on sick leave, having pain and having decreased social integration. Among younger individuals on sick leave, a reduction in the quality of the partner relationship was shown already at the first (6-month) follow-up, while among middle-aged women, such a reduction was seen only at the 12-month follow-up. No dimensions of partner relationship quality at baseline were related to dimensions of return to work, either as a resource or as an obstacle. Consequently, our results show that a good relationship does not keep the woman from returning to work. Having main responsibility for household work, which implies domestic strain while on sick leave, predicts lower partner relationship quality. The practical implications are that healthcare professionals treating women on sick leave should emphasize the importance of keeping a social network as well as making sufficient adjustments at home for the relationship quality to be safeguarded. Special attention should be given to the young woman on sick leave as being on sick leave seems to influence her partner relationship considerably.

  • 227.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Ahlstrom, Linda
    Jonsson, A
    Sandsjö, Leif
    University of Borås, School of Engineering.
    Forsman, M
    Lindegård, A
    Ahlstrand, C
    Kadefors, R
    Hagberg, M
    Myofeedback training and intensive muscular strength training to decrease pain and improve work ability among female workers on long-term sick leave with neck pain: a randomized controlled trial2011In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 84, no 3, p. 335-346Article in journal (Refereed)
    Abstract [en]

    The theoretical framework is that muscle tension in the neck is related to insufficient muscular rest and is a risk factor for chronic pain and reduced work ability. Promoting muscle strength and muscle rest may increase work ability and reduce neck pain. OBJECTIVES: To test whether myofeedback training or intensive strength training leads to decreased pain and increased work ability in women on long-term sick leave. METHODS: This is a randomized controlled trial of two 1-month interventions with myofeedback or muscular strength training in the home environment. Female human service organization workers (n = 60) on long-term (>60 days) sick leave and with chronic neck pain were followed with self-reported and laboratory-observed data of health, pain, muscular activation, and work ability, at baseline, immediately after the intervention and 3 months after baseline. RESULTS: For both intervention groups, pain was lowered over time compared with the control group. Decreased pain and muscular activity was associated with increased self-rated work ability and with laboratory-observed work ability at 3-month follow-up. Decreased pain was also associated with increased self-rated work ability at 1-month follow-up. Muscular strength training was associated with increased self-rated work ability and mental health. Myofeedback was associated with increased observed work ability and self- rated vitality. CONCLUSIONS: The two interventions showed positive results, suggesting that they could be developed for use in health care practice to address pain and work ability. The intensive muscular strength training program, which is both easy to conduct at home and easy to coach, was associated with increased work ability.

  • 228.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Andreasson, Jörgen
    University of Borås, School of Health Science.
    Jutengren, Göran
    University of Borås, School of Health Science.
    Hur kan stödresurser understödja hållbart ledarskap bland chefer i vården?2013In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 90, no 6, p. 866-877Article in journal (Refereed)
    Abstract [sv]

    Chefer kan ha stor betydelse för anställdas hälsa, stress, engagemang i arbetet och prestation. Få tidigare studier har undersökt vilket stöd chefer behöver för ett hållbart och bra ledarskap. Artikeln presenterar resultat från en prospektiv studie om betydelsen av chefers stödresurser för hållbart ledarskap. I studien, som är en del av Chefios-projektet, ingår chefer i kommunal vård och omsorg (n=344). Data från enkätstudier med instrumentet ”Gothenburg Manager Stress Inventory” har analyserats. Resultatet visar att ett stödjande privatliv och en personlig inställning till chefsuppdrag har stor betydelse för chefers hållbarhet över tid. Chefens kontrollspann och erfarenhet som chef påverkade betydelsen av stödresurser. För chefer med kortare chefserfarenhet eller fler underställda (>30) har även stöd från ledning, chefskollegor och externt stöd betydelse.

  • 229.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Eriksson, Andrea
    Williamsson, Anna
    Holden, Richard
    Strömgren, Marcus
    Andreasson, Jörgen
    University of Borås, School of Health Science.
    Lean implementation approaches at different levels in Swedish hospitals: the impor¬tance for working conditions, worker engagement, health and performance.2014Conference paper (Refereed)
    Abstract [en]

    This paper reports result from one-year follow up in a research program with the overall aim to investigate how implementations of lean in health care affect working conditions, health, and performance of employees at five Swedish hospitals. This paper summarizes the implementation approaches, and their importance at short-term follow up for performance (with regard to active work with improvements), perceived working conditions and stress-related health among the healthcare workers. The implementation strategies and pace varied between the hospitals and between the strategic and operative levels. This short-term follow up showed that physical stress-related symptoms had increased overall but the cognitive stress had increased only in hospitals implementing lean. In hospitals with high implementation pace, there were more improvement work among the employees, but higher quantitative demands and lower job satisfaction.

  • 230.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Galvin, Kathleen
    University of Borås, School of Health Science.
    Crafting life-world led leadership2014Conference paper (Refereed)
  • 231.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Jutengren, Göran
    University of Borås, School of Health Science.
    Ahlborg, Gunnar
    Chefsspecifika stressorer och stödresurser: betydelse för hållbart ledarskap bland chefer i vård och omsorg I2014Report (Other academic)
    Abstract [en]

    Aim to assess the importance of managerial support from superior, colleagues, external, employees and private life and its importance for managers’ health- related sustainability Background. Managers and leadership can have a great importance for employees’ health related sustainability. Few published studies, have investigate what kind of support managers need to sustain in their position with preserved health. Design. A prospective cohort study with data collection 2009 and 2011. Methods. All first and second line managers for public health care in seven Swedish municipalities were included (n=344). Managers’ health related sustainability and support resources were measured with Gothenburg Manager Stress Inventory. Analysis with structured equation modeling with a crossed-lagged panel design. Results. All of the studied sources of support were cross-sectional associated with sustainable health, but only support from private life predicted health related sustainability across time. Stratified analyses revealed further prospective associations. First, among less experienced managers, all of the studied sources of support predicted at least some aspect of health-related sustainability. Second, among managers with a large span of control (>30 subordinates), external support and support through good cooperation with subordinates predicted health-related sustainability. Conclusion. It is important to provide health care mangers with adequate support, but only support through private life predicted health-related sustainability. Socializing as well as organisational support was strongly predicting sustainable health among managers new in their role and managers with a large span of control.

  • 232.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Lindgren, Åsa
    Bååthe, Fredrik
    Health care Professionals Motivation and Engagement in Health Care Development.2012Conference paper (Refereed)
  • 233.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Wikström, Ewa
    Tengblad, Stefan
    Liff, Roy
    Andersson, Tomas
    Arman, Rebecka
    Tengelin, Ellinor
    Studiematerial: Hållbart chefskap i hälso- och sjukvården - med vinjetter om engagemang, stress, tidsanvändning, medarbetarskap och vårdpraktik2012Report (Other academic)
  • 234.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Williamsson, Anna
    Eriksson, Andrea
    Health care professionals’ motivation, engagement and collaboration in organizational developments of processes of care2012Conference paper (Refereed)
  • 235.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Wramsten Wilmar, Maria
    Jacobsson, Christian
    Ahlborg, Gunnar Jr
    Ledarskap i vården: att möta media och undvika personfokuserade drev2014Report (Other academic)
    Abstract [sv]

    Frågor om kvalitet, tillgänglighet och effektivitet i vården engagerar många och debatteras ofta i media. Att möta media är idag vanligt för chefer i vården och en viktig del av chefsarbetet. I media kan dock ett komplext problem komma att förenklas till att tillskrivas den ansvarige chefen snarare än t.ex. politiska, ekonomiska och organisatoriska förhållanden och överväganden. Mediebevakningen och debatten kan innehålla mer av en personfokusering än saklig debatt om viktiga frågor. Studier om orsak, förlopp och konsekvenser för en sådan personfokusering har varit få. Under 2011–2013 genomfördes en rad studier som syftade till att få djupare kunskap om hur chefer påverkas av att bli personligt fokuserade i media, vad som kan göras för att förebygga att negativa situationer uppstår och vilket stöd som krävs för att möta intensivt och kritiskt mediafokus. Projektet finansierades av afa försäkring och ett syfte var också att ta fram ett kunskapsunderlag för beredskap och stöd inför, under och efter möte med media. Rapporten har författats av professor Lotta Dellve vid Högskolan i Borås och kth (projektledare), leg. psykolog och doktorand Maria Wramsten Wilmar vid Högskolan Borås, leg. psykolog Christian Jacobsson vid Psykologiska Institutionen Göteborgs Universitet och Gunnar Ahlborg jr, leg. överläkare och docent i arbetsmedicin samt chef för Institutet för Stressmedicin, Västra Götalandsregionen.

  • 236.
    Dellve, Lotta
    et al.
    University of Borås, School of Health Science.
    Wramsten Wilmar, Maria
    Jacobsson, Christian
    Ahlborg, Gunnar jr
    Managers approaches towards media during organizational development processes2012Conference paper (Refereed)
  • 237. Denvall, Verner
    et al.
    Granlöf, Shari J.
    Karlsson, Per-Åke
    University of Borås, School of Health Science.
    Supply and Demand: Evaluation Training for Social Work and Social Care in a Swedish Context2008In: Social Work Education, ISSN 0261-5479, E-ISSN 1470-1227, Vol. 27, no 1, p. 19-34Article in journal (Refereed)
    Abstract [en]

    Only during the last two decades has the discourse on evaluation been on the Swedish agenda of social work and social care. One assumption is that a conscious need for evaluation knowledge and evaluation capacity has finally surfaced. This is based on the view that work efforts of social service organizations are regarded as chiefly authority-based and to a lesser degree based upon scientific knowledge. This article addresses two questions: which actors are involved in training evaluators in, and of, social work in Sweden and what kind of knowledge is communicated in training programmes? Further, is the discourse of evidence-based practice incorporated into the training of social workers? A national study in Sweden, conducted in 2002, reveals that only a minority of social work and social care students are exposed to the concept and practice of evaluation throughout their education, and this is in a most rudimentary way. R&D units offer practitioners more training in evaluation and related knowledge development activities. However, this work is not conducted in a focused manner nor is every Swedish municipality necessarily targeted. If evaluation education and training opportunities are viewed in light of a supply-and-demand situation, we may find an explanation of the current curriculum for evaluation in the social work educational system and the corresponding evaluation practice levels in social service organizations

  • 238.
    Dolatkhah, Susan
    et al.
    University of Borås, School of Health Science.
    Lundgren, Ingela
    University of Borås, School of Health Science.
    Förlossning i en främmande kultur: en studie av iranska kvinnors förlossningsupplevelse i Sverige2007Conference paper (Other academic)
  • 239. dos Santos, MA
    et al.
    Tygessen, H
    Eriksson, H
    Herlitz, J
    University of Borås, School of Health Science.
    Clinical decision support system (CDSS)-effects on care quality.2014In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 27, no 8, p. 707-718Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Despite their efficacy, some recommended therapies are underused. The purpose of this paper is to describe clinical decision support system (CDSS) development and its impact on clinical guideline adherence. DESIGN/METHODOLOGY/APPROACH: A new CDSS was developed and introduced in a cardiac intensive care unit (CICU) in 2003, which provided physicians with patient-tailored reminders and permitted data export from electronic patient records into a national quality registry. To evaluate CDSS effects in the CICU, process indicators were compared to a control group using registry data. All CICUs were in the same region and only patients with acute coronary syndrome were included. FINDINGS: CDSS introduction was associated with increases in guideline adherence, which ranged from 16 to 35 per cent, depending on the therapy. Statistically significant associations between guideline adherence and CDSS use remained over the five-year period after its introduction. During the same period, no relapses occurred in the intervention CICU. PRACTICAL IMPLICATIONS: Guideline adherence and healthcare quality can be enhanced using CDSS. This study suggests that practitioners should turn to CDSS to improve healthcare quality. ORIGINALITY/VALUE: This paper describes and evaluates an intervention that successfully increased guideline adherence, which improved healthcare quality when the intervention CICU was compared to the control group.

  • 240. Ducharme, Francine
    et al.
    Lévesque, Louise
    Caron, Chantal
    Hanson, Elizabeth
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Nolan, Janet
    Nolan, Mike
    Validation d'un outil pour les proches-aidants2009In: Recherche en soins infirmiers, ISSN 0297-2964, Vol. 97, p. 63-73Article in journal (Refereed)
    Abstract [en]

    The purpose of this transcultural study was to translate and adapt for the province of Quebec (Canada) a tool for assessing the support needs of family caregivers of aging persons, as well as to validate the relevance and feasibility of its utilization in Quebec homecare services. Developed jointly in the United Kingdom and Sweden and based on a caregiver-service provider partnership process, the Carers Outcome Agreement Tool (COAT) is presently the focus of a large-scale implementation study in Sweden. Following parallel back-translation and adaptation, the tool, entitled Entente sur le Soutien aux Proches-Aidants (ESPA) in French, was validated in terms of relevance and feasibility via focus groups with service providers and interviews with family caregivers. Results show the ESPA to be a culturally sensitive tool that systematically identifies the support needs of caregivers and indicates the type of help best suited to meet these needs. As with other European studies, the results suggest that the caregiver role comprises a common core of needs and highlights the tool's potential for transfer to the cultural context of French-speaking Europe.

  • 241.
    Efraimsson, Eva
    University of Borås, School of Health Science.
    Vårdplaneringsmötet. En studie av institutionella samtal mellan äldre kvinnor, närstående och vårdare2005Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The overall aim of this thesis is to describe how elderly women’s encounters with an institutionalised world of health care manifest itself in a discharge planning conference (DPC). The thesis is based on eight video recorded DPCs and follow-up interviews with the women who took part in the conferences. The result of study I, a case study, showed that the woman’s experience of taking part in the DPC was characterised as a feeling of powerlessness. The women’s possibility to have influence on the care planning was small (Study II). Study III revealed that the participants adopted or were assigned to different roles during the DPC. As these roles collided dilemmatic situations occurred. Simultaneously the women and family members struggled to manage the institutional frame that surrounded the meeting by trying to find room within it or by challenging it. Study IV revealed that the women found themselves to be in a vulnerable situation. Their body had failed them, their future was insecure and they felt unprepared as they took part in the DPC. They felt as if they were being affiliated with the other participants in a joint project, as if they were standing outside the event or as if they were in focus for the conversation which. The last was a double edged experience: getting confirmative attention but also being exposed as dependent. Four themes characterise the care that was jointly constructed by all participants during the DPC. These themes are “Care as spirit of community and confirmation”, ”Care as alienation”, ”The incomprehensible care” and “The inflexible and betraitful care”.The result gives rise to questions about the relevance of DPCs in their present shape. Further research and developmental projects requested to achieve dicharge planning conferences that are corresponding better to official caring ideals and the patients needs.

  • 242.
    Efraimsson, Eva
    University of Borås, School of Health Science.
    Vårdplaneringsmötet: hur kommer patienten till tals vid institutionella samtal?2008Conference paper (Refereed)
  • 243.
    Efraimsson, Eva
    University of Borås, School of Health Science.
    Vårdplaneringsmötet som institutionellt samtal2007Conference paper (Other academic)
  • 244.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    A Learning Model for Nursing Students during Clinical Studies2011In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 11, no 6, p. 384-389Article in journal (Refereed)
    Abstract [en]

    This paper presents a research project where the aim was to develop a new model for learning support in nursing education that makes it possible for the student to encounter both the theoretical caring science structure and the patient’s lived experiences in his/her learning process. A reflective group supervision model was developed and tested. The supervision was lead by a teacher and a nurse and started in patient narratives that the students brought to the supervision sessions. The narratives were analyzed by using caring science concepts with the purpose of creating a unity of theory and lived experiences. Data has been collected and analyzed phenomenologically in order to develop knowledge of the students’ reflection and learning when using the supervision model. The result shows that the students have had good use of the theoretical concepts in creating a deeper understanding for the patient. They have learned to reflect more systematically and the learning situation has become more realistic to them as it is now carried out in a patient near context. In order to reach these results, however, demands the necessity of recognizing the students’ lifeworld in the supervision process.

  • 245.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Att lära sig vårda med hjälp av handledning2009Book (Other academic)
    Abstract [sv]

    Den livsvärldsdidaktiska forskningen har fokus på hur lärandet kan optimeras med betoning på hur teoretisk praxisrelaterad kunskap kan sammanflätas med den lärandes livsvärld. Reflexionens betydelse i denna lärandeprocess är central i forskningen. Forskningen syftar till att utveckla lärandestöd, såsom handledning, som kan öka vårdstudenters och vårdares möjligheter att möta och förstå patientens värld. Detta är en grundförutsättning för god vård. Avsikten med denna bok, som bygger på resultat av just denna forskning, är att klargöra vad lärande innebär, dess villkor och förutsättningar men också hur lärande om och i vårdsammanhang kan stödjas ur ett livsvärldsdidaktiskt perspektiv. Nyckelfenomenen är reflexion och handledning.

  • 246.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Dedicated Educational Unit: A Scandinavian model2014In: Clinical Learning and Teaching Innovations in Nursing: Dedicated Education Unites Building a Better Future. / [ed] Kay Edgecombe, Margaret Bowden, Springer , 2014, p. 123-130Chapter in book (Other academic)
    Abstract [en]

    This chapter gives a Swedish perspective of the Dedicated Education Unit as a learning environment where caring and learning are united in ‘reflective tutoring’ at the University of Borås. The author discusses the overall purpose and structure of the Borås Dedicated Education Units, their scientific and philosophical bases and their focus on patient-centred student learning, reflection and research. She explains the key tutoring roles within the Borås Dedicated Educational Units, the lifeworld perspective of caring science that forms a frame of reference for learning and tutoring there and strategies that affirm and clarify the fundamental principle that caring and learning are parallel and common phenomena. She also describes the challenge for Borås Dedicated Education Units to focus on active patient care development through research, reflects on what is needed for successful tutoring, explains how Dedicated Education Units contain rich possibilities for concretising caring theory into practice and outlines six themes that characterise a Dedicated Education Unit from the students’ and tutors’ perspectives. The chapter concludes with the results of research evaluating the effectiveness of the DEUs as student clinical learning environments and suggests strategies for future development of the Borås Dedicated Education Units.

  • 247.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Developing a Didactic Method that Emphasizes Lifeworld as a Basis for Learning2009In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 10, no 1, p. 51-63Article in journal (Refereed)
  • 248.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Developing a supervision model in clinical practice that emphasizes lifeworld as a basis for learning2010Conference paper (Refereed)
  • 249.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Didaktik med livsvärlden som grund inom vård och omsorg2011Conference paper (Refereed)
  • 250.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    En grundstruktur med tre didaktiska teser för vårdvetenskapens didaktik2004In: Vårdforskning, ISSN 0786-3578, Vol. 9, p. 85-99Article in journal (Refereed)
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