Ändra sökning
Avgränsa sökresultatet
79808182 4051 - 4084 av 4084
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • harvard-cite-them-right
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Träffar per sida
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sortering
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
  • Standard (Relevans)
  • Författare A-Ö
  • Författare Ö-A
  • Titel A-Ö
  • Titel Ö-A
  • Publikationstyp A-Ö
  • Publikationstyp Ö-A
  • Äldst först
  • Nyast först
  • Skapad (Äldst först)
  • Skapad (Nyast först)
  • Senast uppdaterad (Äldst först)
  • Senast uppdaterad (Nyast först)
  • Disputationsdatum (tidigaste först)
  • Disputationsdatum (senaste först)
Markera
Maxantalet träffar du kan exportera från sökgränssnittet är 250. Vid större uttag använd dig av utsökningar.
  • 4051.
    Wüstenhagen, Eva-Britt
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Att förebygga och lindra konfusion: En litteraturstudie2012Självständigt arbete på avancerad nivå (magisterexamen)Studentuppsats (Examensarbete)
    Abstract [sv]

    Konfusion kan drabba vem som helst, men risken ökar med stigande ålder. Det är en störning av medvetande och kognitiva funktioner. Utlösande faktorer kan vara medicinska tillstånd som allvarlig sjukdom, infektioner, metabola rubbningar, dehydrering eller läkemedel. Konfusion ökar risken för skador och komplikationer, försvårar vårdandet, förlänger vårdtiden samt innebär ett lidande för patienter och anhöriga. Syftet är att identifiera omvårdnadsaktiviteter som kan förebygga och lindra konfusion hos patienter som vårdas på sjukhus. Metoden är en litteraturstudie. Sökning har skett i Cinahl och Medline. Sökord har varit ”acute confusion”, delirium, nursing och ”confusion nursing”. 15 artiklar har analyserats. Nio har en kvantitativ ansats och sex har en kvalitativ ansats. Resultatet sammanfattas i tre teman och nio subteman. Ett tema är vikten av beredskap. Denna består i att identifiera riskfaktorer, eliminera riskfaktorer samt identifiera tidiga tecken på konfusion. Det andra temat är anpassning av miljön. En säker miljö för patienterna bör eftersträvas eftersom de ofta utsätter sig själva för fara. Både en stimulerande miljö och en begriplig miljö lindrar konfusion. Det tredje temat handlar om att patienten med konfusion är i behov av ett äkta möte med vårdaren. Patienten känner sig ofta ensam med sina märkliga upplevelser och vårdaren bör ta sig tid att försöka förstå. Vidare kan patienten behöva känna bekräftelse. Slutligen bör patienten få stöd i att bearbeta sina upplevelser. I diskussionen framkommer vikten av att sjuksköterskan tillägnar sig kunskap för att förebygga och lindra konfusion. God omvårdnad är konfusionsförebyggande och kan förhindra onödigt lidande, komplikationer och därmed ökade kostnader.

  • 4052.
    Yama, Mozdah
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Wandawi, Sundus
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Patienters upplevelse av att göra livsstilsförändringar vid diabetes typ 2: En litteraturöversikt2019Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Diabetes typ 2 är en kronisk sjukdom som beror på högt blodsocker på grund av insulinresistens. Livsstilsvanor som fysisk inaktivitet och ohälsosam kost har en stor påverkan för utvecklingen av sjukdomen. Syftet med denna litteraturöversikt är att belysa hur livsstilsändringar av kost och fysisk aktivitet upplevs av patienter med diabetes typ 2. Metoden som används är en litteraturöversikt som baseras på 13 vetenskapliga artiklar. Artiklarna har granskats, analyserats och resultatet beskrivs i två kategorier Motstridiga känslor och Med tiden minskar motstånd. Resultatet påvisar att patienterna med diabetes typ 2 upplever svårigheter med livsstilsförändringar gällande kost och fysisk aktivitet. Trots att patienterna är medvetna om att kost och fysisk aktivitet främjar hälsan och minskar komplikationerna vid diabetes typ 2, har de svårt att utföra dessa förändringar. Patienterna behöver mer kunskap och rådgivning från vårdpersonalen om hur kostförändringar och fysisk aktivitet kan bli en del av vardagen. I diskussionen resoneras det kring hur patienterna upplever livsstilsförändringar, bristfällig information och egenvård. Patienterna behöver motiveras av sjuksköterskan för att upprätthålla ett hälsosamt levnadssätt. Det är viktigt att patienterna får individanpassad information och konkreta råd från sjuksköterskan om sin sjukdom för att främja hälsa och förebygga komplikationer.

  • 4053. Yamasaki, Y
    et al.
    Helou, K
    Watanabw, TK
    Sjöling, Å
    Suzuki, M
    Okuno, S
    Ono, T
    Takagi, T
    Nakamura, Y
    Ståhl, Fredrik
    Tanigami, A
    Mouse Chromosome 19 and Distal Rat Chromosome 1: a Chromosome Segment Conserved in Evolution2001Ingår i: Hereditas, ISSN 0018-0661, E-ISSN 1601-5223, Vol. 134, nr 1, s. 23-34Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Through a combination of radiation hybrid mapping and studies by FISH and zoo-FISH we have made a comparative investigation of the distal portion of rat chromosome 1 (RNO1) and the entire mouse chromosome 19(MMU19). It was found that homologous segments of RNO1 and MMU19 are similar in banding morphology and in length as determined by several different methods, and that the gene order of the 46 genes studied appears to be conserved across the homologous segments in the two species. High-resolution zoo-FISH techniques showed that MMU19 probes highlight only a continuous segment on RNO1 (Iq43-qter), with no detectable signals on other rat chromosomes. We conclude that these data suggest the evolutionary conservation of a chromosomal segment from a common rodent ancestor. This segment now constitutes the entire MMU19 and a large segment distally on RNO1q in the mouse and rat, respectively.

  • 4054. Youcel, A
    et al.
    Bardaji Ruiz, A
    Axelsson, C
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Chest Injuries during resuscitation following the current guidelines: First results of the Recapta Study2014Konferensbidrag (Refereegranskat)
  • 4055. Yusuf, S
    et al.
    Estrada-Yamamoto, M
    Reyes, CP
    Herlitz, Johan
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Hjalmarson, Å
    Factors of Importance for QRS Complex Recovery after Acute Myocardial Infarction1982Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 211, nr 3, s. 157-162Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The regression of the ECG signs of myocardial infarction has been studied in 101 patients. A significant increase in R wave amplitude and decrease in Q wave depth on the standard ECG was observed over three months. In 21% of the patients, Q waves disappeared completely. In inferior infarction, these changes were more apparent in the lateral V leads than in the inferior limb leads. Patients with intraventricular conduction defects were excluded. Two factors associated with the Q and R wave changes have been identified. Lower heart rates appeared to facilitate the recovery of R waves, and smaller infarcts, as assessed by peak LDH, showed greater ECG recovery. This study raises the interesting possibility that modification of the heart rate may affect favourably the healing process after an acute myocardial infarction.

  • 4056.
    Zabihi, Mehri
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Esmaili, Parichehr
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Den vuxna patientens upplevelser kring vad som främjar och hindrar egenvård hos patienter med diabetes typ 2: En litteraturstudie2019Självständigt arbete på grundnivå (kandidatexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Diabetes typ 2 medför oftast förhöjda blodsockernivåer och om sjukdomen inte behandlas kan allvarliga komplikationer uppstå. Egenvård är mycket betydelsefullt för att bibehålla en jämn blodsockernivå. Livsstilsförändringar kan behöva göras vilket kan vara en stor utmaning för patienten. Sjuksköterskan har ett ansvar i att fungera som stöd samt ge god kunskap och försöka motivera patienter till god egenvård och därmed förebygga komplikationer. Även anhöriga utgör ett viktigt stöd och har en roll till att bidra till patientens förmåga att utföra egenvård.

    Syftet med studien är att beskriva den vuxna patientens upplevelser kring vad som främjar och hindrar egenvård hos patienter med diabetes typ 2. En litteraturstudie gjordes och 15 artiklar analyserades med hjälp av Fribergs modell. Resultatet visade både hindrande och främjande faktorer som påverkar egenvård. Faktorerna bestod av familj och sociala nätverk, kunskap, motivation och sjuksköterskans roll. I diskussionen diskuteras familj och sjuksköterskans stöd samt kunskap och motivation och det påvisas hur en fungerande egenvård främjas av dessa faktorer. Sjuksköterskans ansvarsroll för att patienten ska kunna göra livsstilsförändringar som krävs för patientens sjukdom och därmed bidra till en hållbar utveckling i vården, synliggörs.

  • 4057.
    Zamani, Akram
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Superabsorbent Polymers from the Cell Wall of Zygomycetes Fungi2010Doktorsavhandling, monografi (Övrigt vetenskapligt)
    Abstract [en]

    The present thesis presents new renewable, antimicrobial and biodegradable superabsorbent polymers (SAPs), produced from the cell wall of zygomycetes fungi. The cell wall was characterized and chitosan, being one of the most important ingredients, was extracted, purified, and converted to SAP for use in disposable personal care products designed for absorption of different body fluids. The cell wall of zygomycetes fungi was characterized by subsequent hydrolysis with sulfuric and nitrous acids and analyses of the products. The main ingredients of the cell wall were found to be polyphosphates (4-20%) and copolymers of glucosamine and N-acetyl glucosamine, i.e. chitin and chitosan (45-85%). The proportion of each of these components was significantly affected by the fungal strain and also the cultivation conditions. Moreover, dual functions of dilute sulfuric acid in relation to chitosan, i.e. dissolution at high temperatures and precipitation at lowered temperatures, were discovered and thus used as a basis for development of a new method for extraction and purification of the fungal chitosan. Treatment of the cell wall with dilute sulfuric acid at room temperature resulted in considerable dissolution of the cell wall polyphosphates, while chitosan and chitin remained intact in the cell wall residue. Further treatment of this cell wall residue, with fresh acid at 120°C, resulted in dissolution of chitosan and its separation from the remaining chitin/chitosan of the cell wall skeleton which was not soluble in hot acid. Finally, the purified fungal chitosan (0.34 g/g cell wall) was recovered by precipitation at lowered temperatures and pH 8-10. The purity and the yield of fungal chitosan in the new method were significantly higher than that were obtained in the traditional acetic acid extraction method. As a reference to pure chitosan, SAP from shellfish chitosan, was produced by conversion of this biopolymer into water soluble carboxymethyl chitosan (CMCS), gelation of CMCS with glutaraldehyde in aqueous solutions (1-2%), and drying the resultant gel. Effects of carboxymethylation, gelation and drying conditions on the water binding capacity (WBC) of the final products, were investigated. Finally, choosing the best condition, a biological superabsorbent was produced from zygomycetes chitosan. The CMCS-based SAPs were able to absorb up to 200 g water/g SAP. The WBC of the best SAP in urine and saline solutions was 40 and 32 g/g respectively, which is comparable to the WBC of commercially acceptable SAPs under identical conditions (34-57 and 30-37 g/g respectively).

  • 4058.
    Zamani, Akram
    et al.
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Jeihanipour, Azam
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Edebo, Lars
    Niklasson, Claes
    Taherzadeh, Mohammad J.
    Högskolan i Borås, Institutionen Ingenjörshögskolan.
    Determination of glucosamine and N-acetyl glucosamine in fungal cell walls2008Ingår i: Journal of Agricultural and Food Chemistry, ISSN 0021-8561, E-ISSN 1520-5118, Vol. 56, nr 18, s. 8314-8318Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A new method was developed to determine glucosamine (GlcN) and N-acetyl glucosamine (GlcNAc) in materials containing chitin and chitosan, such as fungal cell walls. It is based on two steps of hydrolysis with (i) concentrated sulfuric acid at low temperature and (ii) dilute sulfuric acid at high temperature, followed by one-step degradation with nitrous acid. In this process, chitin and chitosan are converted into anhydromannose and acetic acid. Anhydromannose represents the sum of GlcN and GlcNAc, whereas acetic acid is a marker for GlcNAc only. The method showed recovery of 90.1% of chitin and 85.7-92.4% of chitosan from commercial preparations. Furthermore, alkali insoluble material (AIM) from biomass of three strains of zygomycetes, Rhizopus oryzae, Mucor indicus, and Rhizomucor pusillus, was analyzed by this method. The glucosamine contents of AIM from R. oryzae and M. indicus were almost constant (41.7 +/- 2.2% and 42.0 +/- 1.7%, respectively), while in R. pusillus, it decreased from 40.0 to 30.0% during cultivation from 1 to 6 days. The GlcNAc content of AIM from R. oryzae and R. pusillus increased from 24.9 to 31.0% and from 36.3 to 50.8%, respectively, in 6 days, while it remained almost constant during the cultivation of M. indicus (23.5 +/- 0.8%).

  • 4059. Zedigh, C
    et al.
    Alho, A
    Hammar, E
    Karlsson, Thomas
    Kellerth, T
    Svensson, L
    Grimbrandt, E
    Herlitz, Johan
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Aspects on the intensity and the relief of pain in the prehospital phase of acute coronary syndrome: experiences from a randomized clinical trial2010Ingår i: Coronary Artery Disease, ISSN 0954-6928, E-ISSN 1473-5830, Vol. 21, nr 2, s. 113-120Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The primary aim of this study was to evaluate the pain relief and tolerability of two pain-relieving strategies in the prehospital phase of presumed acute coronary syndrome (ACS), and the secondary aim was to assess the relationship between the intensity and relief of pain and heart rate, blood pressure, and ST deviation. Patients with chest pain judged as caused by ACS were randomized (open) to either metoprolol 5 mg intravenously (i.v.) three times at 2-min intervals (n = 84; metoprolol group) or morphine 5 mg i.v. followed by metoprolol 5 mg three times i.v (n = 80; morphine group). Pain was assessed on a 10-grade scale before randomization and 10, 20, and 30 min thereafter. The mean pain score decreased from 6.5 at randomization to 2.8 30 min later, with no significant difference between groups. The percentages with complete pain relief (pain score <=1) after 10, 20, and 30 min were 11, 16, and 21%, respectively, with no difference between groups. Hypotension was less frequent in the metoprolol group compared with the morphine group (0 vs. 6.3%; P=0.03), as was nausea/vomiting (7.2 vs. 24.0%; P=0.004). At randomization intensity of pain was associated with degree of ST elevation (P=0.009). The degree of pain relief over 30 min was associated with decrease in heart rate (P=0.03) and decrease in ST elevation (P=0.01). In conclusion, in the prehospital phase of presumed ACS, neither a pain-relieving strategy including an anti-ischemic agent alone nor an analgesic plus anti-ischemic strategy in combination resulted in complete pain relief. Fewer side effects were found with the former strategy. Other pain-relieving strategies need to be evaluated.

  • 4060.
    Zetterlund, Sofia
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Sjuksköterskors erfarenheter av bedömningsinstrumentet: Klinisk slutexamination av sjuksköterskans vårdande utifrån omvårdnadsprocessen2019Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Landets sjuksköterskestudenter genomgår i slutet av sin utbildning ett slutprov, där både teoretiska och praktiska moment ingår. Tillvägagångsättet för bedömningen av studenten sker med varierande metoder och utifrån olika bedömningsinstrument beroende på vilket lärosäte studenten studerar vid. Bedömningsinstrumentens gemensamma syfte är att de ska utgöra en garanti för att studenten når den kunskapsnivå som krävs för en svensk sjuksköterskelegitimation. Studenten vid Högskolan i Borås ska inför sin examen genomgå kliniska slutexaminationer och lärosätet har valt att tillsammans med vårdverksamheten utveckla en Boråsmodell: Klinisk slutexamination av sjuksköterskans vårdande utifrån omvårdnadsprocessen, här förkortat (KSE).

    Syftet med studien är att beskriva handledares erfarenheter av att handleda och bedöma studenter utifrån bedömningsinstrumentet KSE. Detta har gjorts med hjälp av sju intervjuer som analyserats utifrån en tematisk metod. Resultatet pekar på att handledarna upplever en tydlig struktur, vilket förenklar handledningsprocessen och minskar stressnivån. Erfarenheterna visar på att bedömningsinstrumentets enkelhet tillsammans med och den handledningsmodell som tillämpas, medverkar till en personlig process hos både handledare och student genom att reflektionen ges stort utrymme. Resultatet ger ett genomgående positivt intryck. Det framkommer dock vissa otillfredsställande detaljer i bedömningsinstrumentet och moment som upplevs påfrestande. Upplevelser som tycks påverka negativt som erfarenheter av samvetsstress. Diskussionen tar fasta på de erfarenheter och tankar som förmedlats om bedömningsinstrumentet i relation till yttre faktorer, där förslag på kliniska implikationer avslutar studien.

  • 4061.
    Zhang, Yanru
    et al.
    University of Shanghai for Science and Technology.
    Jiménez-Herrera, María
    Universitat Rovira I Virgili.
    Axelsson, Christer
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Cheng, Yunzhang
    University of Shanghai for Science and Technology.
    Not Bad: Passive Leg Raising in Cardiopulmonary Resuscitation-A New Modeling Study2017Ingår i: Frontiers in Physiology, ISSN 1664-042X, E-ISSN 1664-042X, Vol. 7, s. 665-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To evaluate, using a simulated haemodynamic circulation model, whether passive leg raising (PLR) is able to improve the effect during cardiopulmonary resuscitation (CPR); to expose the possible reasons why PLR works or not.

    Materials and Methods: We adapted a circulatory model for CPR with PLR. First we compared cardiac output (CO), coronary perfusion pressure (CPP), blood flow to heart (Qheart), and blood flow to neck and brain (Qhead) of standard chest compression-only CPR with and without PLR; second we simulated the effects of PLR in different situations, by varying the thoracic pump factor (TPF) from 0 to 1; third we simulated the effects when the legs are lifted to the different heights. Finally, we compared our results with those obtained from a published clinical study.

    Results: According to the simulation model, (1) When TPF is in the interval (0,1), CPP, CO, Qheart, and Qhead are improved with PLR, among them with half-thoracic/half-cardiac pump effect (TPF is 0.5), CPP, CO, Qhead, and Qheart increase the most (by 14, 14, 15, and 17%). (2) When TPF is 1 (pure thoracic pump, with an emphysema or extremely thick thorax), PLR has almost no effect on CPP, CO, and Qheart (-1, 2, and 0%), whereas Qhead is increased by 9%; (3) Regardless of whether there is a cardiac or thoracic pump effect, PLR is able to increase Qhead by 9-15%. (4) When the legs are lifted to 30 degrees to the ground, the volume transferred from legs to upper body is 36% of the initial volume in legs; when the legs are lifted to 45 degrees , the volume transferred is 43%; when the legs are lifted to 60 degrees , the volume transferred is 47%; when the legs are lifted to 90 degrees , the volume transferred is 50%.

    Conclusion: Generally PLR is able to achieve improved cerebral perfusion and coronary perfusion. In some extreme situations, it has no effect on cardiac output and coronary perfusion, but still improves cerebral perfusion. PLR could be a beneficial supplement to CPR, and it is not necessary to lift the legs too high above the ground.

  • 4062.
    Zijlstra, Jolande A
    et al.
    Department of Cardiology, Academic Medical Center.
    Koster, Rudolph W
    Department of Cardiology, Academic Medical Center.
    Blom, Marieke T
    Department of Cardiology, Academic Medical Center.
    Lippert, Freddy K
    Emergency Medical Services Copenhagen, University of Copenhagen.
    Svensson, Leif
    Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet.
    Herlitz, Johan
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Kramer-Johansen, Jo
    Norwegian National Advisory Unit on Prehospital Emergency Medicine (NAKOS) and Department of Anaesthesiology, Oslo University Hospital.
    Ringh, Mattias
    Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet.
    Rosenqvist, Mårten
    Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet.
    Palsgaard Møller, Thea
    Emergency Medical Services Copenhagen, University of Copenhagen.
    Tan, Hanno L
    Department of Cardiology, Academic Medical Center.
    Beesems, Stefanie G
    Department of Cardiology, Academic Medical Center.
    Hulleman, Michiel
    Department of Cardiology, Academic Medical Center.
    Claesson, Andreas
    Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet.
    Folke, Fredrik
    Emergency Medical Services Copenhagen, University of Copenhagen.
    Olasveengen, Theresa Mariero
    Norwegian National Advisory Unit on Prehospital Emergency Medicine (NAKOS) and Department of Anaesthesiology.
    Wissenberg, Mads
    Department of Cardiology, Copenhagen University Hospital Gentofte.
    Hansen, Carolina Malta
    Department of Cardiology, Copenhagen University Hospital Gentofte.
    Viereck, Soren
    Emergency Medical Services Copenhagen, University of Copenhagen.
    Hollenberg, Jacob
    Department of Medicine, Centre for Resuscitation Science, Karolinska Institutet.
    Different defibrillation strategies in survivors after out-of-hospital cardiac arrest.2018Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 104, nr 23, s. 1929-1936Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In the last decade, there has been a rapid increase in the dissemination of automated external defibrillators (AEDs) for prehospital defibrillation of out-of-hospital cardiac arrest patients. The aim of this study was to study the association between different defibrillation strategies on survival rates over time in Copenhagen, Stockholm, Western Sweden and Amsterdam, and the hypothesis was that non-EMS defibrillation increased over time and was associated with increased survival.

    METHODS: We performed a retrospective analysis of four prospectively collected cohorts of out-of-hospital cardiac arrest patients between 2008 and 2013. Emergency medical service (EMS)-witnessed arrests were excluded.

    RESULTS: A total of 22 453 out-of-hospital cardiac arrest patients with known survival status were identified, of whom 2957 (13%) survived at least 30 days postresuscitation. Of all survivors with a known defibrillation status, 2289 (81%) were defibrillated, 1349 (59%) were defibrillated by EMS, 454 (20%) were defibrillated by a first responder AED and 429 (19%) were defibrillated by an onsite AED and 57 (2%) were unknown. The percentage of survivors defibrillated by first responder AEDs (from 13% in 2008 to 26% in 2013, p<0.001 for trend) and onsite AEDs (from 14% in 2008 to 30% in 2013, p<0.001 for trend) increased. The increased use of these non-EMS AEDs was associated with the increase in survival rate of patients with a shockable initial rhythm.

    CONCLUSION: Survivors of out-of-hospital cardiac arrest are increasingly defibrillated by non-EMS AEDs. This increase is primarily due to a large increase in the use of onsite AEDs as well as an increase in first-responder defibrillation over time. Non-EMS defibrillation accounted for at least part of the increase in survival rate of patients with a shockable initial rhythm.

  • 4063.
    Ädel, Hans
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Orkar anestesisjuksköterskor arbeta fram till pensionsåldern?2009Självständigt arbete på avancerad nivå (magisterexamen)Studentuppsats (Examensarbete)
    Abstract [sv]

    På frågan om vad verksamhetscheferna har för åsikt om hur de skulle kunna förhindra långtidssjukskrivningar, förtidspension eller sjukpension på sin avdelning så tar många i likhet med ambulanscheferna upp fysisk träning och ergonomi som områden där de lägger stor vikt. Ingen nämner handledning eller stödjande samtal som metoder man arbetar med. Ser man till resultatet på vad den vanligaste orsaken till långtidssjukskrivningarna är, nämligen muskel – skelettskador, så kan fysisk träning och ergonomi vara riktiga metoder. Stämmer dessutom arbetsgivarnas bedömning att skadorna uppkommit till stor del på fritiden så är arbetsplatsen och dess belastning inte skyldiga till långtidssjukskrivningarna. Men det finns skäl att tro att denna bild inte riktigt är sann.

  • 4064.
    Ågren, Helena
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Patienters upplevelser av information i samband med hjärtinfarkt under vårdtiden på sjukhus2008Självständigt arbete på grundnivå (kandidatexamen)Studentuppsats (Examensarbete)
    Abstract [sv]

    Hjärtinfarkt är en allvarlig sjukdom, ofta förknippad med oro och ångest hos den drabbade. Patienter kan hamna i en akut kris till följd av sjukdomen och det plötsliga insjuknandet. Ett tydligt samband finns mellan livsstil, utvecklandet av och risken för återinsjuknande i sjukdomen. Patientinformation utgör en viktig del i vården och rehabiliteringen av hjärtinfarktpatienten. Informationens liksom vårdandets yttersta mål är att vägleda patienten mot en högre grad av hälsa och välbefinnande samt att lindra eller förhindra lidande. Vårdtiden för en okomplicerad hjärtinfarkt beräknas till 3-6 dagar. Under vårdtiden ska patienten hinna landa i sin nya situation och samtidigt hinna ta till sig given information. Patientinformation faller till stor del inom sjuksköterskans ansvarsområde. Syftet med denna litteraturstudie är att beskriva patienters upplevelser av information i samband med hjärtinfarkt, under vårdtiden på sjukhus. Sju kvalitativa artiklar har granskats utifrån Evans modell. Kvalitativ forskning syftar till att skapa förståelse för ett fenomen genom att likheter och olikheter identifieras ur informanternas levda erfarenheter. Analysen resulterade i fem teman, två av temana innehåller subteman: Upplevelser av alltför generell information, Svårigheter att ta till sig information, subteman: Tidpunktens betydelse vid information, Betydelsen av rätt mängd information, Upplevelser av informationens innehåll och information som anses viktig, subteman: Medicinsk information, Livsstilsråd, Metoder och hjälpmedel som tydliggör informationen, Det pedagogiska mötets betydelse vid information. Alla temana går in i varandra och måste alla samverka för att nå resultat. Upplevelser av generell information och behov av individuellt anpassad information löper som en röd tråd genom hela resultatet. Det bästa sättet att tillhandahålla individuell information enligt patienterna i resultatet var i det enskilda pedagogiska möte, mellan vårdare och patient, där patientens livsvärld bejakas i den stunden hon eller han fick information.

  • 4065. Ågård, A
    et al.
    Bentley, L
    Herlitz, Johan
    Högskolan i Borås, Institutionen för Vårdvetenskap. [external].
    Experiences and concerns among patients being treated for atypical chest pain2005Ingår i: European journal of internal medicine, ISSN 0953-6205, E-ISSN 1879-0828, Vol. 16, nr 5, s. 339-344Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Many patients who are discharged from the hospital without receiving a clear-cut diagnosis of their chest pain continue to consume health care because of disabling physical and psychological symptoms. By identifying their experiences and concerns following hospitalization, an empirical basis for discussions on ways of improving the care of these particular patients will be obtained. Methods A qualitative analysis of semi-structured interviews with 38 patients with a diagnosis of unspecified chest pain was carried out. Results Two-thirds of the respondents had unanswered questions and concerns that had not been addressed. They found it difficult to understand why they had not undergone more tests. They requested an explanation for their chest pain, at the very least, or were worried about the future. Some respondents accepted the fact that they had not been given a sufficient amount of time and information. They referred to the stressful working situation of the physicians, the view that their admission could be regarded as unnecessary or that physicians at the hospital could not be expected to do more than exclude serious diseases. Conclusions Health professionals should address their patients' questions and fears properly and provide them with the most probable explanation for their symptoms. When taking the harmlessness of their symptoms or the situation of their caregivers into account, patients may find it inappropriate to impose further demands on care.

  • 4066. Ågård, A
    et al.
    Herlitz, Johan
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Castrén, M
    Jonsson, L
    Sandman, Lars
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Guidance for ambulance personnel on decisions and situations related to out-of-hospital CPR2012Ingår i: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 81, nr 1, s. 27-31Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Ethical guidelines on out-of-hospital cardio-pulmonary resuscitation (CPR) are designed to provide substantial guidance for the people who have to make decisions and deal with situations in the real world. The crucial question is whether it is possible to formulate practical guidelines that will make things somewhat easier for ambulance personnel. The aims of this article are to address the ethical aspects related to out-of-hospital CPR, primarily to decisions on not starting or terminating resuscitation attempts, using the views and experience of ambulance personnel as a starting point, and to summarise the key points in a practice guideline on the subject.

  • 4067. Ågård, A
    et al.
    Herlitz, Johan
    Högskolan i Borås, Institutionen för Vårdvetenskap. [external].
    Hermerén, G
    Obtaining informed consent from patients in the early phase of acute myocardial infarction: physicians’ experiences and attitudes2004Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 90, nr 2, s. 208-210Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    It is possible to question whether patients suffering from the early phase of an acute myocardial infarction (AMI) are able to give free and informed consent and whether or not it is ethically defensible to include them—those patients suffering from more severe symptoms, in particular—in research projects. In fact, it has been shown that a reasonable number of patients who have given their consent in this situation are only able to recall very little of the information they received about the study and that only a minority read through the consent form before signing it. The aim of this study is to determine how physicians, who have been involved in including patients in intervention trials in the early phase of their AMIs, experienced the informed consent procedures. In our view, data obtained from those people who are actually confronted by the research subjects and who are responsible for carrying out the consent procedure should also be taken into account, when the most appropriate ways of including these patients in studies are discussed. To our knowledge no survey of physicians relating to this issue has previously been undertaken.

  • 4068. Ågård, A
    et al.
    Hermerén, G
    Herlitz, Johan
    [external].
    Informed consent: Are there ethically justified conditions for exceptions?2002Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 87, nr 2, s. 105-106Artikel i tidskrift (Övrig (populärvetenskap, debatt, mm))
    Abstract [en]

    Are good clinical practice and informed consent inseparable? This depends, to some extent at least, on what is meant by “inseparable”. Does this refer to a logical relation, on the assumption that “good clinical practice” by definition includes informed consent, to an empirical generalisation about current medical practice, or a normative statement about how it ought to be? Different arguments pro and contra are relevant depending on whether the statement is interpreted as a logical statement, an empirical generalisation, or as a normative statement.We do not dispute the moral ground for the requirement of informed consent in general,1 and we agree with the statement that “the clinical duty to obtain proper informed consent is now widely believed to be an essential component of good clinical practice”. Neither do we dispute that improved training in communication skills and more time for doctors to communicate with their patients would be a good thing—and probably make more patients participate in the decision process.2What we wished to do in our paper3 was to discuss whether there might not be situations in which exceptions from the general requirement of informed consent would be acceptable. We hope that such a debate could help to define stringent and precise conditions when such exceptions could be morally and legally acceptable. One general assumption we share is the idea that such an exception is reasonable, if insisting on the requirement of informed consent causes more harm than good. In its turn, this presupposes a discussion of criteria of harm and benefit and who should decide about the relative magnitude of harm and benefit. Verification after the event by the patients in question could in certain situations be worth investigating. If there is a verification by the patients concerned, in the sense that they afterwards confirm that they think that an exception from the general requirement was ethically justified, then the concept of an exception from the general main rule is supported by referring to what the patients themselves want. If autonomy is taken seriously, references to what the patients say they want cannot be dismissed lightly.Our ambition with the study published3 was not to suggest any radical changes regarding the informed consent procedure when a patient is suffering from an acute myocardial infarction and is a potential research subject, nor to draw any general conclusions from the results obtained. Instead, we wanted to elucidate the possible problems and disadvantages associated with the process of obtaining informed consent in this particular situation. Primarily we wanted to stimulate the debate on the following two issues:1. Does a patient in the midst of a life crisis have to put his/her signature on a consent form in order to be included in an intervention trial?2. Are there ethically justified alternatives to informed consent when a researcher wants to include a patient in a study, who is not capable of giving a free and informed consent in research?We stated: “All possible measures to increase the autonomy of the patients under the prevailing circumstances should be carried out”. Thus, we do not suggest that all patients with acute myocardial infarction should be treated as incompetent. However, what we have tried to do in our study is to bring forth and highlight empirical evidence, which seems to show that in this particular situation some patients do not have the capacity to give a true informed consent for study participation.Professor Doyal adds another argument, to the effect that even if the patients afterwards do not remember anything, this does not reduce the moral importance of relevant information disclosure. The main question is what is meant by “relevant information disclosure”, and who decides what this is. Suppose (a) that it is left to the patient to decide what is relevant information disclosure, (b) that additional information does not change the decision of the patient, and (c) they do not want this additional information, which conclusion should be drawn from this?We claim that it is time to adjust the informed consent procedure to the patients' capacity in this particular situation. Moreover, the patient should be spared the “actual demand” of signing the consent form in the early phase of an acute myocardial infarction.

  • 4069. Ågård, A
    et al.
    Hermerén, G
    Herlitz, Johan
    [external].
    Patients' experiences of intervention trials treatment of myocardial infarction: is it time to adjust the informed consent procedure to the patient's capacity?2001Ingår i: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 86, nr 6, s. 632-637Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE—To investigate how patients included in trials on treatment in the early phase of acute myocardial infarction experience the consent procedure. DESIGN—A combined qualitative and quantitative interview concerning the patients' knowledge of the trial, their feelings about being asked to participate, and their attitudes towards the consent procedure. SETTING—Tertiary referral centre. PATIENTS—31 patients who had given written informed consent for their participation in randomised intervention trials of acute myocardial infarction. RESULTS—The patients interviewed had only fragmentary knowledge about the trial they were involved in. Most considered that reading and signing a consent form was an unwanted or unnecessary procedure. Instead, they would have preferred to have been given concise verbal information about the study. Most were willing to allow a physician to decide for them in the event of their being too ill to be asked about their participation. CONCLUSIONS—Patients who are asked to participate in intervention trials in the early phase of acute myocardial infarction often appear to lack sufficient knowledge to reach an autonomous choice. There were problems and disadvantages associated with the process of obtaining written informed consent in this particular situation, especially regarding the need for the patient to sign a consent form during the acute phase of the disease.

  • 4070. Ågård, A
    et al.
    Hermerén, G
    Herlitz, Johan
    [external].
    Should cardiopulmonary resuscitation be performed on patients with congestive heart failure? The role of the patient in the decision-making process2000Ingår i: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 248, nr 4, s. 279-286Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVES: There is an ongoing debate about patients' involvement in the decision of whether or not to start, cardiopulmonary resuscitation (CPR) in the case of cardiac arrest. The objective here is to analyse on what grounds patients with heart failure, who run a relatively high risk of suffering cardiac arrest, form their attitudes towards CPR and to what extent they want to be involved in making decisions concerning CPR. DESIGN: This study employs a combined qualitative and quantitative interview concerning patients' knowledge about CPR, their experiences and preferences regarding involvement in making decisions concerning CPR, and their willingness to undergo CPR. SETTING: The study was performed at the Department of Cardiology, Sahlgrens University Hospital, Gothenburg. SUBJECTS: The subjects involved were 40 patients with various stages of chronic heart failure. RESULTS: Many of the interviewees lacked fundamental knowledge of CPR. The majority of the patients opted for CPR no matter how small their chances of survival were. The issue had not earlier engaged their thoughts, even less been discussed with physicians. The patients relied on the physician's ability to judge if CPR was to be regarded as a potentially beneficial intervention or as an unmotivated one. Nevertheless, the patients welcomed the opportunity to take part in the decision-making process. CONCLUSION: In order to make ethically justified decisions, physicians should consider bringing up the question of CPR with patients suffering from heart failure at the point in time where the progressive disease gives rise to more severe symptoms, corresponding to NYHA classes IIIb-IV. In earlier stages of the disease, one can assume that the patient will opt for CPR unless he or she demonstrates a negative attitude towards life.

  • 4071. Ågård, A
    et al.
    Hermerén, G
    Herlitz, Johan
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    When is a patient with heart failure adequately informed? A study of patients' knowledge of and attitudes toward medical information2004Ingår i: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 33, nr 4, s. 219-226Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The primary aim was to explore patients' knowledge of heart failure and their attitudes toward medical information (prognostic information in particular) and to assess different patient-related factors that might hamper the improvement of patients' knowledge. Moreover, taking the data obtained into account, we analyzed ethical aspects of information disclosure to patients with heart failure. SETTING: The study was performed at Sahlgren's University Hospital in Gothenburg, Sweden. DESIGN: The study was a qualitative analysis of semistructured interviews. PATIENTS: The sample included 40 patients with various stages of chronic heart failure. RESULTS: Many patients had only a limited understanding of their disease, but they still claimed that they were satisfied with the information they received. Some of them seemed to accept, to be indifferent to, or to be unaware of their low level of knowledge. The majority did not request prognostic information. CONCLUSION: We argue that patients with heart failure are adequately informed when they have reached the level of knowledge that enables them to be managed as effectively and securely as possible while being satisfied with the information provided. To give adequate information, health care providers should determine the patients' level of knowledge and explore why those patients who have a limited understanding do not assimilate or request information.

  • 4072.
    Ågård, Anders
    et al.
    Sahlgrenska University Hospital.
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Sallin, Karl
    Uppsala University.
    Engström, Ingemar
    Örebro University.
    Ethical controversies when formulating new national guidelines on cardiopulmonary resuscitation in Sweden2017Ingår i: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101XArtikel i tidskrift (Refereegranskat)
    Abstract [en]

    The Delegation for Medical Ethics within the Swedish Society of Medicine has taken the initiative to create national ethical guidelines on cardiopulmonary resuscitation. The reasons behind this initiative were indications of differences in the way decisions about cardiopulmonary resuscitation were made and documented and requests expressed by health- care professionals for new national ethical guidelines. During the process of creating the guidelines, a number of work- shops were held with representatives from the delegation and clinical experts from various branches of medicine. Several versions of the working document were sent to consultation bodies with requests for comments. We therefore believe that the final guidelines are well supported by the medical profession in Sweden. The purpose of this article is to present ethical issues on which it was difficult to reach consensus due to divergent opinions expressed by the people and organisations involved. The arguments for and against a particular point of view or wording in the text are presented. The main controversies were related to the following six issues; Determining whether or not cardiopulmonary resus- citation is beneficial for the patient – The presence of close loved ones during cardiopulmonary resuscitation – Performing cardiopulmonary resuscitation for the benefit of people other than the patient – Ambulance personnel’s mandate to decide not to initiate and to terminate cardiopulmonary resuscitation outside hospital – Limiting the length and content of cardiopulmonary resuscitation – Whether or not to specify a week of gestation before which cardio- pulmonary resuscitation should not be started. 

  • 4073.
    Åhlström, Linda
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Dellve, Lotta
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. 1KTH – Royal Institute of Technology, School of Technology and Health, Stockholm, Sweden.
    Implementation of lean and the 3-year-trends of sick-leave among health care workers in different hospital care context2015Konferensbidrag (Refereegranskat)
  • 4074.
    Åhsberg, Cecilia
    et al.
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Johansson, Jenny
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Förstagångspappors upplevelser av förlossningen2009Självständigt arbete på avancerad nivå (magisterexamen)Studentuppsats (Examensarbete)
    Abstract [sv]

    Som barnmorska är det viktigt att tänka på hela familjen under förlossningen. Det blir naturligt stort fokus på kvinnan eftersom det är hon som bär på barnet och hon som föder det. Från att det på 60- talet var ovanligt att de blivande papporna var med på förlossningen är det idag konstigt om de inte är med. Syfte med studien är att beskriva mäns upplevelser av att vara med vid sitt första barns födelse. Studien har sin grund i metoden fenomenologi med livsvärldsansats. Det innebär att försöka förstå hur papporna upplever förlossningen. Intervjuer genomfördes med åtta förstagångs pappor 24 till 48 timmar efter förlossningen. Resultatet tydliggörs i fem bärande teman. De är att vara bra förberedd inför förlossningen, att känna sig utsatt i den okända situationen, att få en förändrad självbild under förlossningen, att få trygghet och bekräftelse av barnmorskan, att få vara med om det fantastiska och omtumlande mötet med barnet. Essensen visar att männen strävar mot att vara ett gott stöd för kvinnan på bekostnad av sina egna behov. Männen behöver bli sedda och bekräftade under förlossningen i sin nya papparoll.

  • 4075. Årestedt, Kristofer
    et al.
    Herlitz, Johan
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Israelsson, Johan
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Psychometric properties of the Hospital Anxiety and Depressionscale in sudden cardiac arrest survivors2015Konferensbidrag (Refereegranskat)
  • 4076.
    Årestedt, Kristoffer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Allert, Camilla
    Blekinge Institute of Technology.
    Djucanovic, Ingrid
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Liselott
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Herlitz, Johan
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Health Related Quality of Life Among In-Hospital Cardiac Arrest Survivors in Working Age2018Konferensbidrag (Refereegranskat)
  • 4077.
    Ödman, Elise
    et al.
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Magni, Maria
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Att leva med en obotlig sjukdom.Att leva med en obotlig sjukdom.2012Självständigt arbete på grundnivå (kandidatexamen)Studentuppsats (Examensarbete)
    Abstract [sv]

    HIV är en av de största epidemierna i världen och i Sverige lever ca 5300 personer med HIV idag. HIV är en långvarig sjukdom där behandlingen består av bromsmediciner. Över hela världen är HIV förknippat med fördomar. Att drabbas av HIV innebär stora påfrestningar och omvälvningar i livet. Många upplever en känsla av skam, stigma och diskriminering vilket kan leda till ett lidande. Vårdpersonal behöver kunskap om HIV-sjukdomen och hur den upplevs av personer. Det kan hjälpa vårdpersonalen i vården av och i mötet med HIV-smittade personer. Syftet är att beskriva personers upplevelser av att få diagnosen HIV och hur det är att leva med sjukdomen. Uppsatsen är en litteraturstudie baserat på vårdvetenskapliga artiklar med kvalitativ inriktning. En litteratursökning i vårdvetenskapliga databaser gjordes vilket resulterade i tio artiklar som kvalitetsgranskades och analyserades. Likheter och skillnader i studiernas resultat identifierades och utmynnade i två huvudteman och åtta subteman. Upplevelser i samband med diagnos beskriver olika reaktioner i samband med att personerna får sin diagnos och känslan av att vara annorlunda. Att leva sitt liv med HIV beskriver hur personerna lever vidare, betydelsen av omgivningens stöd och upplevelser av möten i vården. Det mest framträdande i resultatet är livsförändring, stigmatisering, andlighet och upplevelser av möten i vården, vilka tas upp i diskussionen. Där betonas också vikten av att vårdpersonalen individanpassar vården, utgår ifrån ett livsvärldsperspektiv och att han/hon bemöter individen med respekt och värdighet.

  • 4078. Öresland, Stina
    et al.
    Määttä, Sylvia
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Norberg, Astrid
    Lützén, Kim
    Patients as 'Safeguard' and Nurses as 'Substitute' in Home Health Care2009Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 16, nr 2, s. 219-230Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    One aim of this study was to explore the role, or subject position, patients take in the care they receive from nurses in their own home. Another was to examine the subject position that patients say the nurses take when giving care to them in their own home. Ten interviews were analysed and interpreted according to a discourse analytical method. The findings show that patients constructed their subject position as ‘safeguard’, and the nurses’ subject position as ‘substitute’ for themselves. These subject positions provided the opportunities, and the obstacles, for the patients’ possibilities to receive care in their home. The subject positions described have ethical repercussions and illuminate that the patients put great demands on tailored care.

  • 4079. Öresland, Stina
    et al.
    Määttä, Sylvia
    Högskolan i Borås, Institutionen för Vårdvetenskap.
    Norberg, Astrid
    Winther Jörgensen, Marianne
    Lützén, Kim
    Nurses as guests or professionals in home health care2008Ingår i: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 15, nr 3, s. 371-383Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The aim of this study was to explore and interpret the diverse subject of positions, or roles, that nurses construct when caring for patients in their own home. Ten interviews were analysed and interpreted using discourse analysis. The findings show that these nurses working in home care constructed two positions: `guest' and `professional'. They had to make a choice between these positions because it was impossible to be both at the same time. An ethics of care and an ethics of justice were present in these positions, both of which create diverse ethical appeals, that is, implicit demands to perform according to a guest or to a professional norm.

  • 4080.
    Östman, Malin
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Bäck-Pettersson, Siv
    FoUU-centrum Fyrbodal, Research & Development Primary Health Care Fyrbodal, Region Västra Götaland.
    Sandvik, Ann-Helén
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Sundler, Annelie Johansson
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    "Being in good hands": next of kin's perceptions of continuity of care in patients with heart failure2019Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, nr 375Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Heart failure (HF) is a chronic condition with a variety of diverse symptoms. Patients with HF are usually elderly with multimorbidity, which are both multifaceted and challenging. Being a next of kin to patients with HF is described as a complex task consisting of managing care and treatment, monitoring illness and being an emotional support, while also being able to navigate the healthcare system especially in long-term contact. However, few studies have investigated next of kin’s perceptions of continuity of care in connection with HF. The present study aimed to describe continuity of care as perceived by the next of kin who care for patients with HF.

    Methods

    This study used a qualitative descriptive design. Semi-structured interviews were conducted with the next of kin (n = 15) of patients with HF to obtain their perceptions of continuity of care. A phenomenographic analysis method was used to capture the participants’ perceptions of the phenomenon.

    Results

    The analysis reveals that the next of kin perceive that support from healthcare professionals was strongly associated with experiences of continuity of care. Four categories reveal the next of kin’s perceptions of continuity of care: Want to be involved without being in charge; A desire to be in control without acting as the driving force in the care situation; A need for sustainability without being overlooked; and Focusing on making life meaningful while being preoccupied with caregiving activities.

    Conclusions

    Next of kin perceive continuity of care, when they have access to care and treatment and when caregivers collaborate, regardless of healthcare is given by primary care, municipalities or specialist clinics. A sense of “being in good hands” sums up the need for continuous support, shared decision-making and seamless transitions between caregivers. It seems important that healthcare organisations safeguard effective and collaborative models. Moreover, professionals need to plan and perform healthcare in collaboration with patients and next of kin.

  • 4081.
    Östman, Malin
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Bäck-Pettersson, Siv
    Sandvik, Ann-Helén
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Sundler, Annelie Johansson
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Continuity of care as experienced by next of kin in patients with chronic heart failure2019Konferensbidrag (Refereegranskat)
  • 4082.
    Östman, Malin
    et al.
    Göteborgs Universitet.
    Jakobsson Ung, Eva
    Göteborgs Universitet.
    Falk, Kristin
    Göteborgs Universitet.
    Continuity means "preserving a consistent whole" - A grounded theory study.2015Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, artikel-id 29872Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Living with a chronic disease like chronic heart failure (CHF) results in disruptions, losses, and setbacks in the participants' daily lives that affect health and well-being. By using grounded theory method, we illuminate whether persons with CHF experience discontinuity in life and, if so, what helps them to preserve and strengthen continuity in their daily lives. Thirteen individual interviews and one group interview with five participants, aged 62 to 88 years, were carried out. Through data collection and data analysis, we constructed three concepts that make up a model illustrating the participants' experiences in daily life in relation to corporeality, temporality, and identity: experiences of discontinuity, recapturing approaches, and reconciliation. The first concept, experiences of discontinuity, was constructed from the following categories: the alienated body, the disrupted time, and the threatened self. The second concept, recapturing approaches, consists of categories with continuity creative constructions: repossessing the body, maintaining a façade, seizing the day, restoring the balance of time, and preserving self. These actions are intended to overcome problems and master changes in order to maintain balance in daily life through constructions that recreate normality and predictability. The third concept, reconciliation, was constructed from three categories: feel normal, set to adjust, and be positioned. These categories describe how the participants minimize their experiences of discontinuity by recapturing approaches in order to reconcile with various changes and maintain continuity in daily life. Our findings provide a fresh perspective on continuity that may contribute to the development of significant interventions in continuity of care for persons with CHF. However, continuity requires that healthcare systems support each patient's ability to manage change, reorientation, and adjustment to the new situation in order to make it easier for the patient to create and continue living their daily lives as they desire.

  • 4083.
    Östman, Malin
    et al.
    Göteborgs Universitet.
    Ung, Eva Jakobsson
    Göteborgs Universitet.
    Falk, Kristin
    Göteborgs Universitet.
    Health-care encounters create both discontinuity and continuity in daily life when living with chronic heart failure - A grounded theory study.2015Ingår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 10, nr 1, artikel-id 27775Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Living with chronic heart failure (CHF) often involves lifelong contact with health care, more or less frequently, depending on fluctuating health-generating disruptions in everyday life. To reduce the influence on continuity in life, health-care professionals should preferably focus on supporting patients in managing their daily lives, based on their perspective. The aim of this study was to describe how the interaction in health-care encounters contributes to either continuity or discontinuity in the daily life for persons with CHF. Interviews with 18 participants were carried out, using the grounded theory method, through data collection and analysis. Two core concepts were constructed from data which reveal a model that illuminates the characteristics of the encounters, the actions of health-care professionals and the normative discourse. Patient-centred agenda consists of the categories: "Experiencing a subordinate approach," "Objectifying during the encounter" and "Expected to be compliant." This describes how health-care professionals enhance discontinuity in daily life by using a paternalistic approach in the encounter. Person-centred agenda consists of the categories: "Experiencing an empowering approach," "Person-centredness during the encounter" and "Expected to be capable." It describes how participants perceive that health-care professionals enable them to deal with everyday life which enhances continuity. The findings highlight the importance of health-care professionals' attitudes and communication in encounters with patients. Health care must be designed to support and promote patients' own strategic thinking by strengthening their self-image to enhance continuity in everyday life. The experience of discontinuity is based on the prevailing health-care culture which focuses on disease and medical treatment and regards it as superior to the illness experience in an everyday life context. We therefore strongly suggest a paradigm shift in the health-care organisation and culture in order to support the patients in their efforts to live a meaningful, rich life, in spite of the chronic illness CHF.

  • 4084.
    Čengić, Dalila
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Palosaari, Pirjo
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Distriktssköterskans erfarenheter av läkemedelsgenomgångar hos äldre patienter inom hemsjukvård och särskilda boenden2015Självständigt arbete på avancerad nivå (magisterexamen), 10 poäng / 15 hpStudentuppsats (Examensarbete)
    Abstract [sv]

    Många äldre patienter har idag flera sjukdomar och många läkemedel eftersom detta är den vanligaste behandlingsformen. Med antal läkemedel ökar risken för läkemedelsbiverkningar samt sämre livskvalitet och välbefinnande för patienten. Läkemedelsgenomgångar är till för att se över vilka läkemedel patienten använder och varför dessa läkemedel är ordinerade. Även nyttan och risker för läkemedelsbiverkningar ses över.

    Syftet är att undersöka distriktssköterskans erfarenheter av läkemedelsgenomgångar hos äldre patienter inom den kommunala hälso- och sjukvården. För att uppnå syftet i denna studie har författarna använt sig av kvalitativ metod med induktiv ansats. Datainsamlingen genomfördes med halvstrukturerade intervjuer med sju distriktssköterskor och tre sjuksköterskor inom olika stadsdelar i en stad i Västra Götaland. Studien visar att distriktssköterskans erfarenheter av läkemedelsgenomgångar inom hemsjukvård och särskilda boenden är att det finns brister och hinder som kan påverka patientsäkerheten. Studien visar också att distriktssköterskor känner stort ansvar när det kommer till patientens läkemedelsanvändning, livskvalitet och välmående. Vidare saknas det ordentliga riktlinjer och ansvarsuppdelning vid läkemedelsgenomgångar. Studien visar även att ökad läkemedelsanvändning kan påverka miljö negativt samt att läkemedelsbiverkningar innebär onödiga kostnader för samhället och onödigt lidande för patienten.

79808182 4051 - 4084 av 4084
RefereraExporteraLänk till träfflistan
Permanent länk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • harvard-cite-them-right
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf