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  • 301. Friberg, H
    et al.
    Herlitz, Johan
    University of Borås, School of Health Science. [external].
    Rubertsson, S
    Wieloch, T
    Terapeutisk hypotermi efter hjärtstopp: ny länk i kedjan som kan rädda liv2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, p. 212-216Article in journal (Refereed)
  • 302.
    Fridh, Isabell
    University of Borås, School of Health Science.
    Caring for the dying patient in the ICU: The past, present and the future2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 6, p. 306-311Article in journal (Refereed)
    Abstract [en]

    The aim of this paper is to present the state of the science concerning issues in end-of-life (EOL) care which have an impact on intensive care nurses possibilities to provide nursing care for dying patients and their families. The perspective of families is also illuminated and finally ethical challenges in the present and for the future are discussed. The literature review revealed that the problem areas nurses report concerning EOL care have been the same over three decades. Most problems are related to inter-disciplinary collaboration and communication with the medical profession about the transition from cure to comfort care. Nurses need enhanced communication skills in their role as the patient's advocate. Education in EOL care and a supportive environment are prerequisites for providing EOL care. Losing a loved one in the ICU is a stressful experience for close relatives and nursing care has a profound impact on families' memories of the EOL care given to their loved ones. It is therefore important that ICU nurses are aware of families' needs when a loved one is dying and that follow-up services are appreciated by bereaved family members. Ethical challenges are related to changed sedation practices, organ donation, globalisation and cultural sensitivity.

  • 303.
    Fridh, Isabell
    University of Borås, School of Health Science.
    Intensivvårdsmiljöer med plats för omtanke2014In: Vårdmiljöns betydelse / [ed] Helle Wijk, Studentlitteratur , 2014, p. 87-99Chapter in book (Other academic)
  • 304.
    Fridh, Isabell
    University of Borås, School of Health Science.
    Vaka2012In: Vårdvetenskapliga begrepp i teori och praktik / [ed] Lena Wiklund Gustin, Ingegerd Bergbom, Studentlitteratur , 2012, p. 449-459Chapter in book (Other academic)
  • 305.
    Fridh, Isabell
    et al.
    University of Borås, School of Health Science.
    Kenne Sarenmalm, Elisabeth
    University of Borås, School of Health Science.
    Falk, Kristin
    University of Borås, School of Health Science.
    Henoch, Ingela
    University of Borås, School of Health Science.
    Öhlén, Joakin
    University of Borås, School of Health Science.
    Ozanne, Anneli
    University of Borås, School of Health Science.
    Jakobsson Ung, Eva
    University of Borås, School of Health Science.
    Extensive human suffering: a point prevalence survey of patients´most distressing concerns2014In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 3, p. 1-10Article in journal (Refereed)
    Abstract [en]

    AIM: To explore patients' most distressing concerns during a hospital stay. BACKGROUND: The characteristics of hospitalised patients have changed. Care is provided at a higher age, lengths of stay have fallen and the nursing workload is increasing. It is presumed that hospitalised patients are more seriously ill and have more palliative needs than previously. Studies show that inpatients suffer from more distress than similar outpatients although there is a lack of overall knowledge about inpatients' distress and major concerns, regardless of age, diagnosis or care setting. METHODS: This study was part of a point prevalence survey (PPS) concerning symptom prevalence. Of the 710 patients who participated in the PPS, 678 (95%) answered an open-ended question in a questionnaire: What is your main concern or what is most distressing or troublesome for you at present? Using a life-world approach, the text was analysed qualitatively and patients' concerns were interpreted in two main dimensions, an intersubjective dimension and a temporal dimension. FINDINGS: The patients reported extensive suffering due to illness, symptoms and failing health. Patients were concerned about family members, existential issues and the future. Three aspects of the patients' most distressing concerns were interpreted: The suffering self, The suffering person in close relations and The suffering person in a threatening world. CONCLUSION: Hospitalised patients are affected by severe illness, distressing symptoms and existential quandaries, revealing extensive human suffering in the midst of the demanding activities that take place during an ordinary day in a hospital. To support patients and alleviate suffering, hospital staff need to be more sensitive to patients' most distressing concerns. This presupposes a hospital environment in which the value system supports caring and comforting behaviour.

  • 306. Galvin, K
    et al.
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Todres, L
    Lifeworld Theory as a helpful foundation for Caring Science2011Conference paper (Refereed)
  • 307. Galvin, K
    et al.
    Emami, A
    Dahlberg, Karin
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Rosser, E
    Powell, J
    Bach, S
    Edlund, B
    Bondas, Terese
    Uhrenfeldt, L
    European Academy of Caring Science2008Conference paper (Refereed)
  • 308. Galvin, Kathleen
    et al.
    Emami, Azita
    Dahlberg, Karin
    Ekebergh, Margaretha
    University of Borås, School of Health Science.
    Rosser, Elisabeth
    Powell, Jane
    Bach, Shirley
    Edlund, Birgitta
    Bondas, Terese
    University of Borås, School of Health Science.
    Uhrenfeldt, Lisbeth
    Challenges for future caring science research: a response to Hallberg (2006)2008In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 45, no 6, p. 971-974Article in journal (Refereed)
    Abstract [en]

    In a direct and somewhat provocative editorial in IJNS (43) pp. 923–927, Hallberg (2006) raises several challenges for nursing research if it is to provide useful evidence for health-care practice in both the short and the long term. We wish to offer a response to Hallberg’s challenges and to add support to her general call. In particular we wish to consider the challenges she poses in the wider context of caring science rather than the more limited perspective of nursing science. In the spirit of constructive debate we counter some of the claims made and indicate some areas for future direction which embrace a more epistemologically sound view of knowledge generation, which is methodologically sensitive to different research questions. This direction we believe is at the heart of what caring and nursing science is about.

  • 309. Gellerstedt, M
    et al.
    Bång, A
    University of Borås, School of Health Science.
    Herlitz, Johan
    University of Borås, School of Health Science.
    Andréasson, E
    Johansson, A
    Does sex influence the allocation of life support level by dispatchers in acute chest pain?2010In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 28, no 8, p. 922-927Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to evaluate (a) the differences between men and women in symptom profile, allocated life support level (LSL), and presence of acute myocardial infarction (AMI), life-threatening condition (LTC), or death and (b) whether a computer-based decision support system could improve the allocation of LSL. PATIENTS: All patients in Göteborg, Sweden, who called the dispatch center because of chest pain during 3 months (n = 503) were included in this study. METHODS: Age, sex, and symptom profile were background variables. Based on these, we studied allocation of LSL by the dispatchers and its relationship to AMI, LTC, and death. All evaluations were made from a sex perspective. Finally, we studied the potential benefit of using a statistical model for allocating LSL. RESULTS: The advanced life support level (ALSL) was used equally frequently for men and women. There was no difference in age or symptom profile between men and women in relation to allocation. However, the allocation of ALSL was predictive of AMI and LTC only in men. The sensitivity was far lower for women than for men. When a statistical model was used for allocation, the ALSL was predictive for both men and women. Using a separate model for men and women respectively, sensitivity increased, especially for women, and specificity was kept at the same level. CONCLUSION: This exploratory study indicates that women would benefit most from the allocation of LSL using a statistical model and computer-based decision support among patients who call for an ambulance because of acute chest pain. This needs further evaluation.

  • 310. Gellerstedt, M
    et al.
    Bång, Angela
    University of Borås, School of Health Science.
    Herlitz, J
    University of Borås, School of Health Science.
    Could a computer-based system including a prevalence function support emergency medical systems and improve the allocation of life support level?2006In: European journal of emergency medicine, ISSN 0969-9546, E-ISSN 1473-5695, Vol. 13, no 5, p. 290-294Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To evaluate whether a computer-based decision support system could be useful for the emergency medical system when identifying patients with acute myocardial infarction (AMI) or life-threatening conditions and thereby improve the allocation of life support level. METHODS: Patients in the Municipality of Göteborg who dialled the dispatch centre due to chest pain during a period of 3 months. To analyse the relationship between patient characteristics (according to a case record form used during an interview) and the response variables (AMI or life-threatening condition), multivariate logistic regression was used. For each patient, the probability of AMI/life-threatening condition was estimated by the model. We used these probabilities retrospectively to allocate advanced life support or basic life support. This model allocation was then compared with the true allocation made by the dispatchers. RESULTS: The sensitivity, that is, the percentage of AMI patients allocated to advanced life support, was 85.7% in relation to the true allocation made by the dispatchers. The corresponding sensitivity regarding allocation made by the model was 92.4% (P=0.17). The specificity was also slightly higher for the model allocation than the dispatcher allocation. Among the 15 patients with AMI who were allocated to basic life support by the dispatchers, nine died (eight during and one after hospitalization). Among the eight patients with AMI allocated to basic life support by the model, only one patient died (in hospital) (P=0.02). CONCLUSION: A computer-based decision support system including a prevalence function could be a valuable tool for allocating the level of life support. The case record form, however, used for the interview can be refined and a model based on a larger sample and confirmed in a prospective study is recommended.

  • 311. Glantz, H
    et al.
    Thunström, E
    Herlitz, J
    University of Borås, School of Health Science.
    Cederin, B
    Nasic, S
    Ejdebäck, J
    Peker, Y
    Occurrence and predictors of obstructive sleep apnea in a revascularized coronary artery disease cohort2013In: Annals of the American Thoracic Society, ISSN 2329-6933, E-ISSN 2325-6621, Vol. 10, no 4, p. 350-356Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge about the prevalence of obstructive sleep apnea (OSA) in coronary artery disease (CAD) is insufficient. The aim of the current report was to evaluate the occurrence and predictors of OSA among revascularized patients with CAD within the framework of a randomized controlled trial (Randomized Intervention with CPAP in Coronary Artery Disease and Sleep Apnea [RICCADSA]), evaluating the impact of continuous positive airway pressure on cardiovascular outcomes in CAD patients with OSA. Material and Methods: All patients undergoing percutaneous coronary intervention or coronary artery bypass grafting between September 2005 and November 2010 (n = 1,291) were invited to participate. Anthropometrics and medical history were obtained, ambulatory sleep recording was performed, and all subjects completed the Epworth Sleepiness Scale (ESS) questionnaire. Results: In total, 662 patients participated in the sleep study. OSA, defined as an apnea–hypopnea index equal to or greater than 15/hour, was found among 422 (63.7%). The prevalence of hypertension was 55.9%; obesity (body mass index ≥ 30 kg/m2), 25.2%; diabetes mellitus, 22.1%; and current smoking, 18.9%. The patients with CAD who did not participate in the study demonstrated an almost similar anthropometric and clinical profile compared with the studied group. The majority (61.8%) of the patients with OSA were nonsleepy (ESS score < 10). Patients with OSA had a higher prevalence of obesity, hypertension, diabetes mellitus, and history of atrial fibrillation, whereas current smoking was more common in the non-OSA group. Age, male sex, body mass index, and ESS score, but not comorbidities, were independent predictors of OSA. Conclusions: The occurrence of unrecognized OSA in this revascularized CAD cohort was higher than previously reported. We suggest that OSA should be considered in the secondary prevention protocols in CAD. Read More: http://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.201211-106OC?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dpubmed&

  • 312. Gomez-Fabre, PM
    et al.
    Helou, K
    Klinga-Levan, K
    Ståhl, Fredrik
    University of Borås, School of Health Science.
    A rat prediction map2001In: Journal of Molecular Medicine, Springer , 2001, p. 6-Conference paper (Refereed)
    Abstract [en]

    The rat and mouse had a common ancestor 15-40 Myr ago, and although substantial chromosomal rearrangements have occurred since they diverged, there is still a high degree of similarity in gene organization in the two genomes. Taking advantage of this similarity, mapping information can be transferred between the two genomes and prediction of positions for hitherto unmapped genes can be made with a high degree of accuracy. In this work, we have put together available information for 916 orthologous rat and mouse gene pairs and, with very few exceptions, all of the gene pairs fell into 52 distinct chromosomal segments (sex chromosomes not included). Most of these segments were confirmed by mouse-on-rat heterologous painting (zoo-FISH) and they were used to make up the backbone of a rat-mouse comparative map. This comparative map was used as a framework for making a rat-mouse prediction map. Predictions for the rat genome were made in two ways. Firstly, the relative position for each orthologous gene pair that cannot be deduced from rat gene data only was suggested from mouse gene data. Secondly, the tentative position in rat of approximately 5100 genes was inferred from the mouse. Thus, this comparative map confers a six-fold increase in the number of gene localization's available for the rat. In addition, the comparative map offers an efficient tool for exchanging genome information between rat and mouse.

  • 313. Gottfridsson, C
    et al.
    Nyström, B
    Karlsson, T
    Herlitz, Johan
    University of Borås, School of Health Science.
    Edvardsson, N
    Sex difference and factors associated with outcome in patients with sustained ventricular arrhythmias2008In: Scandinavian Cardiovascular Journal, ISSN 1401-7431, E-ISSN 1651-2006, Vol. 42, no 3, p. 182-191Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To describe gender differences and factors of importance for outcome in patients referred for sustained ventricular arrhythmias. RESULTS: Two hundred and fifty three patients took part in the survey, 126 (20 women) had sustained monomorphic ventricular tachycardia (VT) and 127 (31 women) had polymorphic VT/ventricular fibrillation. Ischemic heart disease was less common in women than in men (47 vs. 80%). At discharge, an ICD implant was similarly common in women (33%) and men (29%). One hundred and twenty five (65%) men and 37 (79%) women were alive at follow-up, p =0.08 (median follow-up 53 months). Independent predictors of long-term mortality were: 1) PVT/VF as the presenting arrhythmia, 2) a low ejection fraction, 3) increased QRS duration and 4) diabetes mellitus. CONCLUSION: The lower proportion of women compared to men being referred for evaluation of sustained ventricular arrhythmias may contribute to the lower number of ICD implants in women. The long-term survival in women and men did not differ significantly.

  • 314. Gustavsson-Karlsson, Christina
    et al.
    Olsson, Marianne
    Määttä, Sylvia
    University of Borås, School of Health Science.
    Upplevelser hos patienter med diabetes av att delta i samlat årsbesök2009In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 3, p. 47-50Article in journal (Refereed)
  • 315.
    Hagiwara Andersson, Magnus
    et al.
    University of Borås, School of Health Science.
    Lundberg, Lars
    University of Borås, School of Health Science.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Henricson, Maria
    Sjökvist, Bengt-Arne
    Jonsson, Anders
    University of Borås, School of Health Science.
    Decision support system in prehospital care: a randomized controlled simulation study2013In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171, Vol. 31, no 1, p. 143-153Article in journal (Refereed)
    Abstract [en]

    Introduction Prehospital emergency medicine is a challenging discipline characterized by a high level of acuity, a lack of clinical information and a wide range of clinical conditions. These factors contribute to the fact that prehospital emergency medicine is a high-risk discipline in terms of medical errors. Prehospital use of Computerized Decision Support System (CDSS) may be a way to increase patient safety but very few studies evaluate the effect in prehospital care. The aim of the present study is to evaluate a CDSS. Methods In this non-blind block randomized, controlled trial, 60 ambulance nurses participated, randomized into 2 groups. To compensate for an expected learning effect the groups was further divided in two groups, one started with case A and the other group started with case B. The intervention group had access to and treated the two simulated patient cases with the aid of a CDSS. The control group treated the same cases with the aid of a regional guideline in paper format. The performance that was measured was compliance with regional prehospital guidelines and On Scene Time (OST). Results There was no significant difference in the two group's characteristics. The intervention group had a higher compliance in the both cases, 80% vs. 60% (p < 0.001) but the control group was complete the cases in the half of the time compare to the intervention group (p < 0.001). Conclusion The results indicate that this CDSS increases the ambulance nurses' compliance with regional prehospital guidelines but at the expense of an increase in OST.

  • 316.
    Hagiwara, M
    et al.
    University of Borås, School of Health Science.
    Bremer, A
    University of Borås, School of Health Science.
    Claesson, A
    University of Borås, School of Health Science.
    Axelsson, C
    University of Borås, School of Health Science.
    Norberg, Gabriella
    University of Borås, School of Health Science.
    Herlitz, J
    University of Borås, School of Health Science.
    The impact of direct admission to a catheterisation lab/CCU in patients with ST-elevation myocardial infarction on the delay to reperfusion and early risk of death: results of a systematic review including meta-analysis2014In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 22, no 67Article in journal (Refereed)
    Abstract [en]

    Background For each hour of delay from fist medical contact until reperfusion in ST-elevation myocardial infarction (STEMI) there is a 10% increase in risk of death and heart failure. The aim of this review is to describe the impact of the direct admission of patients with STEMI to a Catheterisation laboratory (cath lab) as compared with transport to the emergency department (ED) with regard to delays and outcome. Methods Databases were searched for from April-June 2012 and updated January 2014: 1) Pubmed; 2) Embase; 3) Cochrane Library; 4) ProQuest Nursing and 5) Allied Health Sources. The search was restricted to studies in English, Swedish, Danish and Norwegian languages. The intervention was a protocol-based clinical pre-hospital pathway and main outcome measurements were the delay to balloon inflation and hospital mortality. Results Median delay from door to balloon was significantly shorter in the intervention group in all 5 studies reported. Difference in median delay varied between 16 minutes and 47 minutes. In all 7 included studies the time from symptom onset or first medical contact to balloon time was significantly shorter in the intervention group. The difference in median delay varied between 15 minutes and 1 hour and 35 minutes. Only two studies described hospital mortality. When combined the risk of death was reduced by 37%. Conclusion An overview of available studies of the impact of a protocol-based pre-hospital clinical pathway with direct admission to a cath lab as compared with the standard transport to the ED in ST-elevation AMI suggests the following. The delay to the start of revascularisation will be reduced. The clinical benefit is not clearly evidence based. However, the documented association between system delay and outcome defends the use of the pathway.

  • 317.
    Hagiwara, Magnus
    University of Borås, School of Health Science.
    Development and evaluation of a computerised decision support system for use in pre-hospital care2014Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The aim of the thesis was to develop and evaluate a Computerised Decision Support System (CDSS) for use in pre-hospital care. The thesis was guided by a theoretical framework for developing and evaluating a complex intervention. The four studies used different designs and methods. The first study was a systematic review of randomised controlled trials. The second and the last studies had experimental and quasi-experimental designs, where the CDSS was evaluated in a simulation setting and in a clinical setting. The third study included in the thesis had a qualitative case study design. The main findings from the studies in the thesis were that there is a weak evidence base for the use of CDSS in pre-hospital care. No studies have previously evaluated the effect of CDSS in pre-hospital care. Due to the context, pre-hospital care is dependent on protocol-based care to be able to deliver safe, high-quality care. The physical format of the current paper based guidelines and protocols are the main obstacle to their use. There is a request for guidelines and protocols in an electronic format among both clinicians and leaders of the ambulance organisations. The use of CDSS in the pre-hospital setting has a positive effect on compliance with pre-hospital guidelines. The largest effect is in the primary survey and in the anamnesis of the patient. The CDSS also increases the amount of information collected in the basic pre-hospital assessment process. The evaluated CDSS had a limited effect on on-the-scene time. The developed and evaluated CDSS has the ability to increase pre-hospital patient safety by reducing the risks of cognitive bias. Standardising the assessment process, enabling explicit decision support in the form of checklists, assessment rules, differential diagnosis lists and rule out worst-case scenario strategies, reduces the risk of premature closure in the assessment of the pre-hospital patient.

  • 318.
    Hagiwara, Magnus
    et al.
    University of Borås, School of Health Science.
    Henricson, M
    Jonsson, Anders
    University of Borås, School of Health Science.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Decision-Support Tool in Prehospital Care:A Systematic Review of Randomized Trials2011In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 26, no 4, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of this study was to evaluate the effects of the decision support tool (DST) on the assessment of the acutely ill or injured out-of-hospital patient. Methods: This study included systematic reviews of randomized controlled trials (RCT) where the DST was compared to usual care in and out of the hospital setting. The databases scanned include: (1) Cochrane Reviews (up to January 2010); (2) Cochrane Controlled Clinical Trials (1979 to January 2010); (3) Cinahl (1986 to January 2010); and (4) Pubmed/ Medline (1926 to January 2010). In addition, information was gathered from related magazines, prehospital home pages, databases for theses, conferences, grey literature and ongoing trials. Results: Use of the DST in prehospital care may have the possibility to decrease “time to definitive care” and improve diagnostic accuracy among prehospital personnel, but more studies are needed. Conclusions: The amount of data in this review is too small to be able to draw any reliable conclusions about the impact of the use of the DST on prehospital care. The research in this review indicates that there are very few RCTs that evaluate the use of the DST in prehospital care.

  • 319.
    Hagiwara, Magnus
    et al.
    University of Borås, School of Health Science.
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Jonsson, Anders
    University of Borås, School of Health Science.
    Henricson, Mia
    Exclusion of context knowledge in the development of prehospital guidelines: results produced by realistic evaluation.2013In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 21, no 46Article in journal (Refereed)
    Abstract [en]

    Background Prehospital work is accomplished using guidelines and protocols, but there is evidence suggesting that compliance with guidelines is sometimes low in the prehospital setting. The reason for the poor compliance is not known. The objective of this study was to describe how guidelines and protocols are used in the prehospital context. Methods This was a single-case study with realistic evaluation as a methodological framework. The study took place in an ambulance organization in Sweden. The data collection was divided into four phases, where phase one consisted of a literature screening and selection of a theoretical framework. In phase two, semi-structured interviews with the ambulance organization's stakeholders, responsible for the development and implementation of guidelines, were performed. The third phase, observations, comprised 30 participants from both a rural and an urban ambulance station. In the last phase, two focus group interviews were performed. A template analysis style of documents, interviews and observation protocols was used. Results The development of guidelines took place using an informal consensus approach, where no party from the end users was represented. The development process resulted in guidelines with an insufficiently adapted format for the prehospital context. At local level, there was a conscious implementation strategy with lectures and manikin simulation. The physical format of the guidelines was the main obstacle to explicit use. Due to the format, the ambulance personnel feel they have to learn the content of the guidelines by heart. Explicit use of the guidelines in the assessment of patients was uncommon. Many ambulance personnel developed homemade guidelines in both electronic and paper format. The ambulance personnel in the study generally took a positive view of working with guidelines and protocols and they regarded them as indispensable in prehospital care, but an improved format was requested by both representatives of the organization and the ambulance personnel. Conclusions The personnel take a positive view of the use of guidelines and protocols in prehospital work. The main obstacle to the use of guidelines and protocols in this organization is the format, due to the exclusion of context knowledge in the development process.

  • 320.
    Hagiwara, Magnus
    et al.
    University of Borås, School of Health Science.
    Wireklint Sundström, Birgitta
    University of Borås, School of Health Science.
    Suserud, Björn-Ove (Editor)
    University of Borås, School of Health Science.
    Vård och bedömning2009In: Prehospital akutsjukvård / [ed] Björn-Ove Suserud, Leif Svensson, Stockholm: Liber , 2009, p. 117-145Chapter in book (Other academic)
  • 321.
    Hallberg, Maria
    et al.
    University of Borås, School of Health Science.
    Höglund, Eva
    FoU-projektet Social dokumentation: redogörelse för arbetet 2006-20082009Report (Other academic)
    Abstract [sv]

    Projektet startades 2004, då Sjuhäradskommunerna (Borås, Bollebygd, Herrljunga, Mark, Svenljunga,Tranemo, Ulricehamn) ville ha stöd i sitt arbete att dokumentera de sociala insatserna i äldreomsorgen. Syftet har varit att utveckla ökade kunskaper i social dokumentation, som i sin tur förväntades ge en kvalitetsutveckling i hjälpinsatserna och stödinsatserna i äldreomsorgen. Projektets mål var att utarbeta en eller flera modeller för social dokumentation och att implementera den framtagna modellen i kommunerna som medverkade. I denna rapport koncentrerar vi oss på implementeringen av arbetsmodellen som togs fram i projektet. Aktiviteter har varit: * Grundläggande utbildning för dokumentationsombud. * Löpande information om projektet. * Målstyrt arbetssätt * Föreläsningar om ”Ett socialt synsätt” * Broschyr till brukarna. * Nätverksbyggande. * Inspirationsdag för att coacha andra * Förläsning i ”Samtalet – vårt viktiga arbetsredskap i social dokumentation.” * 5 dagars utbildning i social dokumentation för enhetschefer. * Introduktionsfilm för nyanställda.

  • 322.
    Halldén, BM
    et al.
    University of Borås, School of Health Science.
    Lundgren, I
    Christensson, K
    Ten Swedish Midwives' Lived Experiences of the Care of Teenagers' Early Induced Abortions2011In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 32, no 5, p. 420-440Article in journal (Refereed)
    Abstract [en]

    This phenomenological hermeneutic study of 10 Swedish midwives illuminates the internal conflicts of values that arise when midwives' professional and personal belief systems clash in encounters with teenagers. Midwives may react emotionally in situations where teenagers ignore advice on contraception by rejecting the use of contraceptives and preferring early abortions as a contraceptive method. The results strengthen the suggestion that caregivers need support in reflecting on how to deal with conflicts of values that may otherwise hinder them in communicating effectively with teenagers and encounter their life-worlds and in challenging their individual assumptions on the shortcomings of using contraceptives.

  • 323.
    Halldén, Britt-Marie
    University of Borås, School of Health Science.
    Att ta ansvar för fruktsamhet och relationer. En kvalitativ studie av unga kvinnors och unga mäns erfarenheter av abort i tidig graviditet samt barnmorskors erfarenheter av att vårda i detta sammanhang2011Conference paper (Refereed)
    Abstract [sv]

    2011-01 01 PRESENTATIONEN AVSER VETENSKAPLIGT ARBETE MUNTLIG PRESENTATION TITEL: Att ta ansvar för fruktsamhet och relationer. En kvalitativ studie av unga kvinnors och unga mäns erfarenheter av abort i tidig graviditet samt barnmorskors erfarenheter av att vårda i detta sammanhang FÖRFATTARE: Britt-Marie Halldén Fil. Dr. Institutionen för vårdvetenskap, Högskolan i Borås ABSTRAKT Bakgrund Komplexiteten i att minska antalet tonårsaborter har visat att olika preventiva insatser inte fungerat särskilt väl. Syfte Syftet med studien är att nå en djupare förståelse av unga kvinnors erfarenheter av att bestämma sig för och genomgå abort, unga mäns erfarenheter av flickväns abort samt barnmorskors erfarenheter av att vårda i detta sammanhang. Metod Studien har en fenomenologisk hermeneutisk ansats och baseras på fyra delstudier. I delstudie I intervjuades tio unga kvinnor (18-19 år) 4–20 dagar före sin abort i graviditetsvecka 6–10. I delstudie II intervjuades tio unga kvinnor (18-19 år) 2–6 veckor efter sin medicinska eller kirurgiska abort i graviditetsvecka 6–12. I delstudie III intervjuades tio unga män (16-19 år) om sina erfarenheter av att flickvännen gjort abort 2–12 veckor efter aborten med ett undantag. Denne mannen hade erfarenhet av flickvännens abort 3 år tidigare. I delstudie IV intervjuades tio barnmorskor med erfarenhet av att vårda ungdomar i samband med abort. Resultat Den tolkade helheten av deltagarnas erfarenheter av inducerad abort i tidig graviditet är att den innebär att ta ansvar för fruktsamhet och relationer. Om det är rätt eller fel att göra abort i tidig graviditet är inte framträdande i resultatet. Istället är vad människor gör för varandra eller mot varandra eller förväntas göra för varandra framträdande. I delstudie I framkommer att det positiva som kom ut av att bestämma sig för abort var att vara glad över att kunna bli gravid men välja att inte föda barn just nu. I delstudie II framkommer att de unga kvinnorna hade en kapacitet att ta ansvar för sina val beträffande egen välfärd och andras välbefinnande här, nu och i framtiden. I delstudie III framkommer att de unga männen önskade att kompensera flickvännen för hennes lidande samt dela ansvaret med henne för att ha avbrutit en livgivande process. I delstudie IV framkommer att värderingskonflikter kan uppstå i mötet med mellan barnmorskor och ungdomar när ungdomarna accepterar abort istället för att använda preventivmedel på grund av sin utseendefixering och nöjet att ha oskyddade samlag. Slutsats Resultatet kan användas för att belysa existentiella frågor som kan uppkomma hos ungdomar i samband med abort i tidig graviditet samt hur barnmorskor kan reagera då ungdomar föredrar abort istället för att acceptera de nackdelar som de förknippar med olika preventivmedel. Kunskapen kan användas för att stödja barnmorskor i det förebyggande arbetet av aborter samt förändra det förebyggande arbetet genom att ungdomar av båda könen bör ta ett likvärdigt ansvar för sin sexualitet och sina reproduktiva val.

  • 324.
    Halldén, Britt-Marie
    University of Borås, School of Health Science.
    Meanings of being pregnant and having decided on abortion: Young Swedish women's experiences2005In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 26, no 9, p. 788-806Article in journal (Refereed)
    Abstract [en]

    In-depth interviews about the experience of being pregnant and having decided on abortion were conducted with 10 young Swedish women. A phenomenological-hermeneutic study disclosed a complex life world summarised as “I’m happy about my fertility but I choose not to give life now.” Four themes were revealed: encountering an unexpected understanding of oneself and one’s fertility, desiring to be understood by trusted others, trying out different positions in relation to pregnancy and abortion, and approaching planned adult motherhood. The results indicate that addressing young women’s concerns about fertility might be important in reproductive care.

  • 325.
    Halldén, Britt-Marie
    University of Borås, School of Health Science.
    Om fruktsamhet, ansvar och relationer: en studie av ungdomars erfarenheter av abort i tidig graviditet samt barnmorskors erfarenheter av att vårda i detta sammanhang2010Doctoral thesis, monograph (Other academic)
    Abstract [en]

    The aim of this thesis is to achieve a deeper understanding of experiences of abortion in early pregnancy through illuminating the meaning both of the experiences of young people who seek to undergo an abortion, and of the midwives’ experiences of caring in this context. - Young women’s experiences of being pregnant and of having decided on an abortion in early pregnancy (Sub-study I), - Young women’s experiences of having undergone an early abortion. (Sub-study II), - Young men’s experiences of their girlfriends’ abortions in early pregnancy (Sub-study III), - Midwives’ experiences of tending young people who were seeking and undergoing abortion in early pregnancy (Sub-study IV). The theoretical perspective of the dissertation is grounded in phenomenological hermeneutics and a life world perspective. The ten young women in sub-studies I–II were recruited from two youth clinics and two gynaecology outpatient clinics. In sub-study I the young women were interviewed 4–20 days prior to their abortions in pregnancy week 6–10. In sub-study II, the young women were interviewed 2–6 weeks after the abortion about their experiences of either the medical or surgical abortion in pregnancy week 6–12. In sub-study III the young men were recruited from two gynaecology outpatient clinics except for one young man who signalled his interest to participate in the study on his own initiative. They were interviewed 2–12 weeks after their girlfriends’ abortions. The young man who participated on his own initiative was interviewed three years after his girlfriend’s abortion. All participants were Swedish speaking and were below twenty years of age. The midwives’ who were interviewed in sub-study III had more than three years experience of working with young people who sought and underwent abortions. The interpreted whole of the participants’ experiences is expressed as “taking responsibility for fertility and relationships”, and is illuminated as a moral act that arises between people who share the experience of an abortion in early pregnancy. This is in line with Walker’s theoretical analysis of moral acts which has been useful in gaining a deeper understanding of the results from this thesis. The moral issue of whether it is right or wrong to have an abortion only emerges to a minor extent in the participants’ experiences of abortion. Instead, it is what people do for, or to, each other or are expected to do for each other that is of greater importance and which constitutes the moral act for the participants in the study. The social interaction surrounding an abortion involves the foetus itself, the young woman, the partner, parents, friends and caregivers such as midwives, social workers and gynaecologists. In sub-study I the experiences are expressed as, “I am happy about my fertility but I choose not to give life now”. In sub-study II the experiences are expressed in a capacity to take responsibility for personal choices by considering personal welfare and of others’ well-being in a life cycle perspective. In sub-study III the experiences are expressed as a wish to compensate the girlfriend for her suffering and to share the responsibility with her for having interrupted a life-giving process. In sub-study IV the experiences are expressed as a conflict of values arising in the meeting between midwives and young people. For the midwives, it was difficult to accept that young people could decide on abortion instead of accepting shortcoming with using contraceptives because it affected their appearance negatively in relation to ideals of beauty or because of the pleasures of unprotected intercourse. Feelings of frustration arose when young people refused to inform their parents about the abortion, lacked parents’ support in an abortion situation, or refuse to use contraceptives. The result of the dissertation can be used to elucidate young men’s and women’s experiences of abortion in early pregnancy and midwives’ experiences of tending young people in this context. This knowledge can be used in educating in young people in sexuality and relationships. In addition, the result can be used in order to develop and redirect work in preventing abortion with the objective of helping young women and young men take equal responsibility for their sexuality and reproductive choices.

  • 326.
    Halldén, Britt-Marie
    University of Borås, School of Health Science.
    Unga kvinnors berättande om att vara i en abortsituation2007Conference paper (Other academic)
  • 327.
    Halldén, Britt-Marie
    et al.
    University of Borås, School of Health Science.
    Christensson, Kyllike
    Swedish Young Men’s Lived Experiences of Girlfriend's Early Induced Abortion2010In: International Journal of Men's Health, ISSN 1532-6306, E-ISSN 1933-0278, Vol. 9, no 2, p. 126-143Article in journal (Refereed)
    Abstract [en]

    Abortion rates worldwide suggest that a large number of young men are in fact exposed to the experience of an abortion. This phenomenological hermeneutic study illuminates ten young men’s experiences of the abortion process including the abortion itself. In view of their different cultural backgrounds and their stable or merely casual relationship with the girlfriend, their experiences are illuminated in four main themes as; having interrupted a life-giving process, having wished to relieve the girlfriend’s pain, having struggled with feelings of helplessness, and standing up for made decisions. The interpreted whole is expressed as; a wish to compensate the girlfriend for her suffering and share with her the responsibility for the abortion. With a view to promoting gender equality in reproductive health the results are discussed in the light of relational ethics and contribute to reflections on current praxis in health-care settings.

  • 328.
    Halldén, Britt-Marie
    et al.
    University of Borås, School of Health Science.
    Olsson, Pia
    Christensson, Kyllike
    Early abortion as narrated by young Swedish women2009In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 23, no 2, p. 243-250Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to illuminate meanings of having had an induced abortion among young Swedish women. Methods: Narrative interviews were conducted with ten 18–20-year-old women 2–6 weeks after a medical or surgical abortion in the sixth to twelfth week of pregnancy. Data were analysed according to a phenomenological hermeneutic method. Results: The study disclosed a multitude of complex meanings in the young women’s lived experiences of induced abortion. Four themes were revealed: having cared for and protected the unimagined pregnancy, taking the life of my child-to-be with pain, being sensitive to the approval of others and imagining the taken away child-tobe. The results are discussed in light of Nussbaum’s theory of development ethics. The young women’s ability to be responsible for their choices regarding their own welfare and others’ well-being in a life cycle perspective was disclosed, despite the pain inherent in the responsibility of taking the life of their own child-to-be. Conclusions: The young women’s narratives were replete with ethical reasoning regarding existential matters related to their responsibility of choosing between induced abortion and parenthood and how to live their lives with this experience. Health-care professionals could promote young women’s capability to be responsible, as well as the development of trust in their own fertility and constructive relationships with significant others. In the development of the prevention of unintended pregnancies and the sexual education of young people in Sweden existential dimensions of undergoing an abortion should be given attention.

  • 329.
    Hallnäs, Lars
    et al.
    University of Borås, Swedish School of Textiles.
    Forsgren, Olov
    University of Borås, School of Business and IT.
    Höglund, Lars
    University of Borås, Swedish School of Library and Information Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    Integrerad design: Några inledande tankar Juni 20062006Report (Other academic)
  • 330. Hallstrom, A
    et al.
    Herlitz, Johan
    University of Borås, School of Health Science.
    Kajino, K
    Olasveengen, TM
    Treatment of Asystole and PEA2009In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 80, no 9, p. 975-6Article in journal (Refereed)
    Abstract [en]

    Recent reports consistently point to a substantial decline in the incidence of ventricular fibrillation (VF) as the initial rhythm observed by Emergency Medical Service (EMS) responders and a complementary increase in pulseless electrical activity (PEA) and asystole. Historically, efforts at improving survival have focused primarily on patients found in VF. Consequently, the approach for other patients has included frequent pauses in cardiopulmonary resuscitation (CPR) to check for VF followed by shock when VF is observed. However, the "yield" of survivors comes largely from the non-shocked patients. Therefore, it is critical that we start evaluating treatments specifically for the PEA and asystole groups.

  • 331. Hamberger, B
    et al.
    Lundin, T
    Riddez, L
    Suserud, Björn-Ove
    University of Borås, School of Health Science.
    Terrorattackerna mot World Trade Center 11 september 20012004Report (Other academic)
    Abstract [sv]

    New York är ett av världens ledande finanscentrum och USA:s främsta handels- och industristad. Ön Manhattan, stadens kärna och administrativa centrum, är ett av världens mest tätbefolkade områden. Där, i World Trade Center, inträffade den terrorattack som kan betecknas som den största katastrof som människan förorsakat under fredstid.

  • 332. Hammarlund, K.
    et al.
    Lundgren, Ingela
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    In the heat of the night it is difficult to get it right: teenager's attitudes and values toward sexual risk-taking2008In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 3, no 2, p. 103-112Article in journal (Refereed)
    Abstract [en]

    This study, using a hermeneutic approach, is based on data from four focus group interviews with 25 Swedish teenagers participating, ranging from 18-19 years of age. The aim is to gain a deeper understanding of teenagers' values and attitudes towards sexually transmitted infections (STIs) and sexual risk-taking. The teenagers seem to seek an excuse to fend off responsibility and deny their sexual risk-taking, an excuse provided by drunkenness. Under the influence of alcohol, teenagers are not too shy to have sex but remain embarrassed to talk about condom use. It seems as though the dialogue feels more intimate than the intercourse when it comes to protecting ones sexual health. To be able to act out in this sexual risk-taking the teenager often views the partner in a one-night-stand as an object, as opposed to a love relationship where they view their partner as subject, a person they care for. Engaging in sexual risk-taking often starts at a club where the teenagers go out to socialize and drink alcohol. They then play a game and a part of the game is to pretend that they do not play a game. In this game, certain rules are to be followed and the rules are set up by the girl, mainly to protect the romantic image of being carefully selected and thereby protected from being stigmatized as “sluts” or “whores”.

  • 333. Hammarlund, K
    et al.
    Lundgren, Ingela
    University of Borås, School of Health Science.
    Nyström, Maria
    University of Borås, School of Health Science.
    To contract genital warts: a risk of losing love? Experiences of Swedish Men Living with Genital Warts2007In: International Journal of Men's Health, ISSN 1532-6306, E-ISSN 1933-0278, Vol. 6, no 2, p. 100-114Article in journal (Refereed)
    Abstract [en]

    Using a life-world hermeneutic approach, this study focused on the interviews with eight Swedish men living with genital warts. The men expressed a need for control over their situation, a control that was easier to maintain if the warts were invisible. Some of the men expressed prejudiced attitudes toward those who contract a venereal infection and their own feelings of shame appeared to correlate with these prejudices. In their meetings with health care providers, the men viewed a competent health care provider as someone who combined professional distance with a personal approach. Finally, the fact that men saw themselves as disease carriers was of great significance to them and influenced their views of future meaningful relationships.

  • 334. Hammarlund, K
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    Jomeen, J
    Young women’s experiences of managing self-treatment for ano-genital warts2012In: Sexual & Reproductive HealthCare, ISSN 1877-5756, E-ISSN 1877-5764, Vol. 3, no 3, p. 117-121Article in journal (Refereed)
    Abstract [en]

    Objectives The purpose of this study is to explore the experiences of self-treatment for anogenital warts from the perspective of a group of young women who received it. Study design Ten young Swedish women were interviewed in the study, aged between16 and 21. The young women had been diagnosed with anogenital warts and self-managed their treatment with 0.5% podophyllotoxin solution. Results Self-management using 0.5% podophyllotoxin solution poses numerous difficulties. The nature of the treatment as a topical liquid is particularly testing for young women in terms of both application and genital pain, with implications for continuation of the treatment regime. The self-treatment challenges both personal integrity as well as interpersonal relations and creates a personal responsibility which appears to be somewhat overwhelming at times. Conclusions Health care professionals need to recognize the challenge that self-treatment poses to their clients. The issues that create difficulty in relation to topical liquid treatment regimes and importantly can lead to poor adherence to the treatment regime and discontinuation could easily be overcome by the use of different preparations. Continuity of care provider across treatments and alternative mechanisms of support would not only address some of the aspects that young women raise as particularly embarrassing and shameful, but also improve quality of care and increase general satisfaction with service provision.

  • 335. Hammarlund, Kina
    et al.
    Nyström, Maria
    University of Borås, School of Health Science.
    The Lived Experience of Genital Warts: The Swedish Example2004In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 25, no 5, p. 489-502Article in journal (Refereed)
    Abstract [en]

    Our aim in this study was to analyze and describe young Swedish women's experiences of living with genital warts. Interviews with 10 young women, aged 16-21 years, were interpreted within a lifeworld hermeneutic tradition. The women experience themselves as victims of a disgusting disease. Furthermore, they appear to disregard the fact that their own lifestyles could be a risk factor for contracting venereal infections. On the other hand they get to know their bodies better after the gynecological examinations where the treatment begins. Their loss of innocence is considerable; thus it seems fair to compare this experience with earlier epochs' ideas about loss of virginity due to the first intercourse. Consequently the young women also start looking at themselves as adults, and they take responsibility for the consequences of their sexuality.

  • 336.
    Hanson, E
    et al.
    University of Borås, School of Health Science.
    Arvidsson, H
    University of Borås, School of Health Science.
    Keady, J
    Magnusson, L
    University of Borås, School of Health Science.
    Claesson, A
    University of Borås, School of Health Science.
    Nolan, M
    Working together with persons with early stage dementia and their family members to design a user-friendly technology based support service2007In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 6, no 3, p. 411-434Article in journal (Refereed)
    Abstract [en]

    This article describes how researchers, practitioners and technicians in West Sweden worked together with older people with early stage dementia and their family members to develop a user-friendly technology-based information, education and support service, based on the generic ACTION participatory design model. Ways of working in partnership with older people with early stage dementia and their family members are explored, and key lessons learned are highlighted. The overriding message is that elders with early stage dementia can be actively involved throughout the entire research and development process. Essential prerequisites are time and ongoing support by skilled practitioners and family members. Preliminary findings reveal that older people with early stage dementia can learn and benefit from user-friendly technology, especially when used together with others in a similar situation.

  • 337.
    Hanson, E
    et al.
    University of Borås, School of Health Science.
    Magnusson, L
    University of Borås, School of Health Science.
    Amilon, K
    E-tjänster öppnar nya världar2009In: Tidningen Äldreomsorg, ISSN 1403-7025, no 3, p. 38-41Article in journal (Other (popular science, discussion, etc.))
  • 338.
    Hanson, E
    et al.
    University of Borås, School of Health Science.
    Magnusson, L
    University of Borås, School of Health Science.
    Torp, S
    Hauge, S
    Ulstein, I
    A Pilot study of how information and communication technology may contribute to health promotion amongst older spousal carers in Norway2008In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 16, no 1, p. 75-85Article in journal (Refereed)
    Abstract [en]

    The objective of this pilot Norwegian intervention study was to explore whether use of information and communication technology (ICT) by informal carers of frail elderly people living at home would enable them to gain more knowledge about chronic illness, caring and coping, establish an informal support network and reduce stress and related mental health problems. Potential participants were close relatives of an elderly person with a diagnosis of a chronic illness dwelling in the same household who wished to continue caring for their relative at home, were 60 years of age or older, had been caring for less than 2 years, were a computer novice and had Norwegian as their first language. Nineteen elderly spousal carers participated in the study from two municipalities in eastern Norway. The project commenced in January 2004 and consisted of a multimethod evaluation model. Outcomes measured included carers’ social contacts (measured by the Family and Friendship Contacts scale); burden of care (measured by the Relative Stress scale); and knowledge about chronic disease and caring, stress and mental health and use of ICT (examined via a composite carer questionnaire). These quantitative data were collected immediately prior to the study and at 12 months. Qualitative data were also collected via focus group interviews with participant carers at 7 months. At follow-up, quantitative measures did not reveal any reduction in carer stress or mental health problems. However, carers reported extensive use of the ICT service, more social contacts and increased support and less need for information about chronic illness and caring. Contact with and support from other carers with similar experiences was particularly valued by participants. The intervention also enhanced contacts with family and friends outside the carer network. Thus, it can be seen that ICT has the potential to contribute to health promotion among elderly spousal carers.

  • 339.
    Hanson, E
    et al.
    University of Borås, School of Health Science.
    Svensson, P
    Arvevik, F
    University of Borås, School of Health Science.
    Magnusson, L
    University of Borås, School of Health Science.
    Nolan, M (Editor)
    Grant, G (Editor)
    Keady, J (Editor)
    ACTION: (Assisting Carers using Telematic Interventions to meet Older People’s Needs): from idea to reality.2007In: User Participation in Health and Social Care Research: voices, values and evaluation. / [ed] M Nolan, E Hanson, G Grant, J Keady, Maidenhead : Open University, 2007 , 2007Chapter in book (Other academic)
  • 340.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Informations- och kommunikationsteknologi i vård och omsorg för äldre: en etisk översikt2004In: Helse og helhet : etiske og tverrfaglige perspektiver på helsefaglig teori og praksis / [ed] Jon Vegar Hugaas, Jan Kåre Hummelvoll, Hans Magnus Solli, Unipub forlag, Oslo , 2004Chapter in book (Other academic)
  • 341.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    The role of ICT support services to promote ageing in place: The ACTION service2011In: Eurohealth, ISSN 1356-1030, Vol. 17, no 2-3, p. 24-26Article in journal (Other academic)
    Abstract [en]

    ACTION (Assisting Carers using Telematics Interventions to meet Older people’s Needs) is an innovative example of an Information and Communication Technology (ICT) based support service that is currently running in Sweden to help empower older people with chronic conditions and their family carers in their daily lives. The service is outlined and the main evaluation findings are presented. Sirpa explains how ACTION has been of direct benefit in her caring situation. The main lessons learned over a fourteen year period of implementing ACTION in Sweden are highlighted, concluding with the main challenges facing researchers, policy makers and decision makers in the immediate future

  • 342.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Brovall, Carita
    Gustafsson, Gunilla
    Alexandersson, Erik
    Alexandersson, Sven
    Benjaminsson, Anneli
    Berg, Åsa
    Blomqvist, Alice
    Johansson, Leni
    Lagerqvist, Gunnel
    Lehtiranta, Lena
    Lundgren, Gunvor
    Skattberg, Vivian
    Sundqvist, Nanny
    Wernering, Göran
    Eriksson, Inger
    Mål och policy vid palliativ vård och vård i livets slutskede för äldre och deras närstående i Tranemo: Ett gemensamt synsätt2004Report (Other academic)
    Abstract [sv]

    Rapporten beskriver ett utvecklingsprojekt med målsättningen att arbeta fram ett mål- och policyprogram för vård i livets slutskede i Tranemo, i samverkan med representanter för medborgare, frivilligorganisationer, kyrka och egen vårdpersonal.

  • 343.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Karlsson, Per-Åke
    University of Borås, School of Health Science.
    Arvevik, Fredrik
    University of Borås, School of Health Science.
    Svensson, Paul
    University of Borås, School of Health Science.
    Arvidsson, Helen
    University of Borås, School of Health Science.
    Claesson, Anette
    University of Borås, School of Health Science.
    Brukarens roll i välfärdsforskning och utvecklingsarbete2011Report (Other academic)
    Abstract [sv]

    På 1980-talet blev ”brukare” ett modeord i offentlig förvaltning och förvaltningsforskning. Termen betecknar den som använder sig av välfärdsservice (jfr. engelskans service user), eller ”slutmottagare” av offentlig nyttighet eller åtgärd. Brukare av välfärdstjänster vet hur hjälp och service fungerar i praktiken och kan därför ge synnerligen viktig återkoppling enligt devisen: ”Den som har skorna på fötterna vet var de skaver”. Välfärdsorganisationer har all anledning att involvera brukare i planering och policyarbete i syfte att utveckla förmågan att göra rätt saker. Det finns inte mycket dokumentation och forskning kring brukarmedverkan i utvecklingsarbete och forskning på välfärdsområdet. I synnerhet saknas kunskap om hur välfärdstjänster tas emot och realiseras i brukarens livssammanhang. En ambition i doktorandkursen ”brukarmedverkan i forskning och utvecklingsarbete inom hälso- och sjukvård, socialt arbete och omsorg” var att samla och presentera kunskaper på området. Kursen genomfördes våren 2009 i ett unikt samarbete mellan Karlstads Universitet, Sheffield University i England, Högskolan i Hedmark i Norge, Hälsohögskolan i Jönköping och Högskolan i Borås/FoU Sjuhärad Välfärd. Texterna i denna bok härrör från kursens föreläsningar och paperarbeten. De ger många exempel på hur brukare kan involveras i forskning och utvecklingsarbete, och presenterar en rad praktiska metoder för brukarsamverkan. Boken rekommenderas till välfärdens politiker och yrkespersoner, till studenter som förbereder sig för välfärdens yrken liksom till forskare och utvecklingsarbetare som vill utveckla samarbete med brukare och brukarorganisationer. Den vänder sig givetvis även till brukare och brukarorganisationer som vill engagera sig i forskning och utvecklingsarbete.

  • 344.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Nolan, Janet
    Swedish experiences of negotiated approach to carer assessment: The Carers Outcome Agrement Tool.2008In: Journal of Research in Nursing, ISSN 1744-9871, E-ISSN 1744-988X, Vol. 13, no 5, p. 391-407Article in journal (Refereed)
    Abstract [en]

    Given that the majority of frail older people living at home are cared for by family members, ensuring appropriate and sensitive support services for family carers is a major policy priority globally. Such assessment of the needs and situation of individual carers is a crucial first step towards ensuring that they receive flexible, quality support services. However, existing assessment practice is still inadequate in many countries. This paper describes a negotiated approach to carer assessment, the Carers Outcome Agreement Tool (COAT) and briefly considers its development with carers and practitioners in an Anglo-Swedish development project (2003–2005) and subsequent implementation within five municipalities in Sweden (2006–2008). A participatory research design was adopted in both projects building on the ÄldreVäst Sjuhärad model, which is a user-focused approach to research and development. This paper provides a short summary of the COAT development before presenting the qualitative findings from the Swedish implementation project (2006–2008), which emerged from focus group interviews with COAT practitioners and telephone follow-up interviews with carers who had a first and second COAT assessment. The findings clearly highlight the value of COAT in enabling partnerships to be developed between carers and practitioners, which recognise the expertise of both parties. They also challenge providers to invest sufficient time and ‘ear-marked' resources for family care support so that COAT becomes an integral part of a comprehensive long-term carer strategy, which feeds directly into local developments in service delivery and organisation.

  • 345.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Nolan, Janet
    Johansson, Lennarth
    Sennemark, Eva
    Planeringsinstrument för anhörigstöd2005Report (Other academic)
    Abstract [sv]

    Detta arbete har syftat till att utveckla och pröva ett instrument för planering, uppföljning och utvärdering av stöd till anhörigvårdare. Arbetet har genomförts i Sverige och England och bygger på tidigare forskning avseende anhörigstöd, brukarmedverkan och partnerskap vid ÄldreVäst Sjuhärad, Högskolan i Borås och Universitetet i Sheffield. Instrumentet benämns COAT (Carers´ Outcome Agreement Tool). Det färdiga instrumentet består av fyra frågeformulär och baseras på områden identifierade som viktiga av anhöriga som vårdar en närstående. Varje formulär innehåller ett antal påståenden som den anhöriga i diskussion med den som svarar för planeringen får möjlighet att värdera. Till varje område hör en stödplan för planering av åtgärder, uppföljning och utvärdering av den överenskomna hjälpen. En användarguide som vänder sig till de anhöriga och en manual som vänder sig till vård- och omsorgspersonalen har utarbetats. Omfattande konsultationer i form av fokusgrupper med anhöriga och vård- och omsorgspersonal har använts för att arbeta fram instrumentet. Instrumentet har prövats i tre svenska kommuner, Göteborg, Ulricehamn och Härnösand, av vård- och omsorgspersonal med erfarenhet av anhörigstöd. Efter varje samtal med anhöriga dokumenterades hur instrumentet hade fungerat och hur anhöriga och de själva upplevt samtalet samt förslag på förbättringar. Uppföljande telefonintervjuer genomfördes med de anhöriga och fokusgruppsintervjuer genomfördes med vård- och omsorgspersonalen. Testarbetet visade att majoriteten av anhörigvårdarna upplevde hembesöket och möjligheten att få tala om sin situation som mycket positivt. De kände sig involverade och lyssnade till. Personalen uppgav att de fick ny kunskap och nya insikter även om det var anhörigvårdare som de känt länge. De synpunkter som framkom har åtgärdats i det instrument som medföljer denna rapport. Anhörigvårdarna och personalen som deltagit i utvecklingsarbetet bedömer nu att instrumentet är färdigt att användas. Det stora intresse och positiva gensvar som framkommit från alla berörda grupper under projektets gång talar för att det finns en ökande vilja att möta anhörigvårdare där de är och att arbeta tillsammans med dem. Planeringsinstrumentet för anhörigstöd, COAT, kan vara till stor nytta i ett sådant arbete.

  • 346.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Nolan, Janet
    Nolan, Mike
    Developing a model of participatory research involving researcher, practitioners, older people and their family carers: An internationel collaboration2006In: Journal of Research in Nursing, ISSN 1744-9871, E-ISSN 1744-988X, Vol. 11, no 4, p. 325-342Article in journal (Refereed)
    Abstract [en]

    The care of frail older people and their family carers present significant challenges for welfare systems throughout the world. In order to address their needs, policy initiatives are promoting partnership working between service users, family carers and providers, whereby the former are increasingly involved in the design and evaluation of services. However, participatory models of working raise fundamental issues about power relations and pose important questions about what constitutes ‘evidence’. Several authors identify tensions between movements such as evidencebased practice and initiatives designed to increase the active participation of service users suggesting that there is a need for a new approach to research that reconciles potentially conflicting goals. This paper describes the evolution of a model of participatory research resulting from a collaboration between Sweden and the United Kingdom, which actively involved older people, family carers, service providers and voluntary organisations. The model is underpinned by constructivist principles that have been adapted by the authors so as to be more intellectually accessible to a nonacademic audience. The conceptual basis for the model is described and a case study illustrates how it is applied in practice. It is argued that the approach could be adopted widely as a means of more fully engaging older people, their families and a range of service providers in important debates about future health and social care provision.

  • 347.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Nolan, Mike
    Sennemark, Eva
    Nolan, Janet
    Johansson, Lennarth
    Carers Outcome Agreement Tool, A new approach to working with family carers2006Report (Other academic)
    Abstract [en]

    This report describes a joit Anglo-Swedish project to develop and pilot both a new instrument, the Carers Outcome Agreement Tool (COAT), and a new model of working with family carers based om creating partnership between carers, practitioners and service systems. Most countries are pursuing a policy of community care for older people and vast majority of the help that older need to remain at home is provided by their family. Ensuring appropriate and senitive support sevices for family carers is therefore a major policy priority. COAT has been designed to help overcome existing limitations by promoting a new approach to carer assesement and service provision. It builds om several years of research om carer assement, and is based om a model that views the carer as a `co-expert`. Carers and practitioners therefore work together to agree the type of goals and outcomes that carers see as important, and the support needed to achieve these.

  • 348.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Sennemark, Eva
    Blended Learning Networks Supported by Information and Communication Technology: An Intervention for Knowledge Transformation Within Family Care of Older People2011In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 51, no 4, p. 561-570Article in journal (Refereed)
    Abstract [en]

    This article describes an innovative practice called Blended Learning Networks (BLNs) whose aim is to enable older people, their families, and care providers to exchange knowledge, learn together, and support each other in local development work so that care is improved for older people. BLNs were established in 31 municipalities, headed up by a local facilitator. They were supported by a national themed network consisting of virtual meetings between local facilitators and national facilitators at the Swedish National Family Care Competence Centre. Design and Methods: An evaluation was conducted to explore the utility of the BLNs so that any improvements to the model could be instigated. Focus group interviews were conducted with members of 9 BLNs, and self-evaluation questions were discussed in 16 BLNs. Limitations are that not all BLN members participated in the evaluation, and local facilitators conducting self-evaluations were not trained in focus group dynamics. Virtual focus groups were carried out with 26 of the 31 local facilitators and with the national facilitators. Results: Participants reported an increased understanding of caregiver issues and of each group’s roles. Of particular value were the stories shared by caregivers and the potential for change locally due to the involvement of decision makers. The practice demanded considerable skills of the local facilitators. An initialeducation for new local facilitators was deemed necessary. Implications: BLNs is a unique practice of community communications and knowledge transfer as it creates partnerships among all key stakeholder groups that act as a catalyst for improving care for older people

  • 349.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Sennemark, Eva
    "Jag har ju barnen som kommer..." Äldres hälsa och levnadsvillkor; en intervjuundersökning med vård och omsorgsberoende i Sjuhäradsbygden2005Report (Other academic)
    Abstract [sv]

    Hälsan och livskvaliteten har förbättrats för den äldre befolkningen, samtidigt som ohälsan ökar med stigande ålder. Antalet äldre ökar, liksom behovet av vård och omsorg, samt stöd till anhöriga. För att möta dessa krav och utveckla vård och omsorg för äldre och deras anhöriga krävs ökad kunskap inom området. Rapporten är en del av ett projekt om äldres hälsa och levnadsvillkor i Sjuhärad och Västra Götaland. Syftet med studien är att kartlägga äldre hälsa och livssituation, bidra med viktigt underlag för planering av vård och omsorg för äldre och identifiera de områden inom vård och omsorg som bör vidareutvecklas.

  • 350.
    Hanson, Elizabeth
    et al.
    University of Borås, School of Health Science.
    Magnusson, Lennart
    University of Borås, School of Health Science.
    Sennemark, Eva
    Practice Concepts and Policy Analysis2011In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 51, no 2, p. 261-272Article in journal (Refereed)
    Abstract [en]

    This article describes an innovative practice called Blended Learning Networks (BLNs) whose aim is to enable older people, their families, and care providers to exchange knowledge, learn together, and support each other in local development work so that care is improved for older people. BLNs were established in 31 municipalities, headed up by a local facilitator. They were supported by a national themed network consisting of virtual meetings between local facilitators and national facilitators at the Swedish National Family Care Competence Centre. Design and Methods: An evaluation was conducted to explore the utility of the BLNs so that any improvements to the model could be instigated. Focus group interviews were conducted with members of 9 BLNs, and self-evaluation questions were discussed in 16 BLNs. Limitations are that not all BLN members participated in the evaluation, and local facilitators conducting self-evaluations were not trained in focus group dynamics. Virtual focus groups were carried out with 26 of the 31 local facilitators and with the national facilitators. Results: Participants reported an increased understanding of caregiver issues and of each group's roles. Of particular value were the stories shared by caregivers and the potential for change locally due to the involvement of decision makers. The practice demanded considerable skills of the local facilitators. An initial education for new local facilitators was deemed necessary. Implications: BLNs is a unique practice of community communications and knowledge transfer as it creates partnerships among all key stakeholder groups that act as a catalyst for improving care for older people.

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