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  • 101.
    Ek, Kristina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Eriksson, Monika
    Skaraborg Hospital, Skövde, Sweden.
    Eriksson, Irene
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Healthcare providers’ experiences of assessing and performing oral care in older adults2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12189Article in journal (Refereed)
  • 102.
    Ek, Kristina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Westin, Lars
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Prahl, Charlotte
    Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden / Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden.
    Österlind, Jane
    Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden / Ersta Sköndal University College, Department of Health Care Sciences, Stockholm, Sweden.
    Strang, Susann
    Sahlgrenska Academy, University of Gothenburg, Institute of Health and Care Sciences, Göteborg, Sweden / Angered Local Hospital, Angered, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Henoch, Ingela
    Angered Local Hospital, Angered, Sweden / University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden / Ersta Sköndal University College and Ersta Hospital, Palliative Research Centre, Stockholm, Sweden.
    Hammarlund, Kina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Death and caring for dying patients: exploring first-year nursing students' descriptive experiences2014In: International Journal of Palliative Nursing, ISSN 1357-6321, E-ISSN 2052-286X, Vol. 20, no 10, p. 509-515Article in journal (Refereed)
    Abstract [en]

    Aim: To describe first-year nursing student`s expereinces of witnessing death and providing end-of-life care. Methods: This study is a part of a larger longitudial prject. Interviews (n=17) were conducted with nursing students at the end of their fisrt year of education. To analyse the interviews (lived-expereince description), a thematic analysis, "a search for meaning" (Van Manen, 1997) was applied. Result: The results are presented within the framework of four separate themes: (1) The thought of death is more frightening than the actual epereince, (2) Daring to approach the dying patient and offering something of oneself, (3) The expereince of not sufficing in the face of death and (4) being confronted with one`s own feelings. Conclusion: Nursing students require continous support and opportunity to reflect and discuss their experiences about caring for dying patients and confronting death throughout the entirety of their education. In addition, teachers and clinical superviosors need t give support using reflective practice to help students to devlo confidence in their capacity for caring dying patients.

  • 103.
    Ekman, Robert
    et al.
    Örebro University, Sweden.
    Stark Ekman, Diana
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Schyllander, Jan
    Swedish Civil Contingencies Agency, Sweden.
    Schelp, Lothar
    Karolinska Institutet, Sweden.
    Reducing visits to local health care by one third safety promotion efforts in Western Sweden2016In: Injury Prevention, ISSN 1353-8047, E-ISSN 1475-5785, Vol. 22, p. A85-A85Article in journal (Refereed)
  • 104.
    Ekström, Anette
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Abrahamsson, Hanna
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
    Eriksson, Rose-Marie
    Department of Obstetrics and Gynecology, Central Hospital, Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Women’s use of nipple shields - their influence on breastfeeding duration after a process-oriented education for health professionals2014In: Breastfeeding Medicine, ISSN 1556-8253, E-ISSN 1556-8342, Vol. 9, no 9, p. 458-466Article in journal (Refereed)
  • 105.
    Ekström, Anette C.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nilsson, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Apell, Caroline
    The Municipality of Alingsås, Sweden.
    Palmius, David
    Skaraborg Hospital Skövde, Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nurses challenges to support hospitalized patients regarding sexual-health issues2016In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 5, no 3, article id 1000344Article in journal (Refereed)
    Abstract [en]

    Background: The approach to nursing should be characterized by a holistic view of the human being which includes sexual health. From a nursing perspective, it is therefore of most importance to have a dialogue about factors associated with sexual health also among hospitalized patients. However, to our knowledge there is a lack of qualitative studies regarding nurses attitudes about dialogue with patients about sexual health.

    Objective: To investigate nurses attitudes towards dialogue with hospitalized patients about sexual health.

    Methods: A qualitative method was used and interviews were conducted which then were analyzed using a qualitative content analysis. Eleven registered nurses were included, the inclusion criteria was: at least one year of experience as a nurse and working on a medical or surgical ward in a hospital in the southwest of Sweden. The participants were in the ages 25-65 and had worked as nurses between 2 and 30 years. Nine of the participants were women. The data were collected during 2011.

    Results: The nurses experiences of and reflections on dialogue with patients about sexual health were presented as a single main theme: Nurses challenges to support hospitalized patients with sexual health issues. This theme had three categories: Feeling uncomfortable, Feeling inadequate and Task-oriented care with related subcategories respectively.

    Conclusions: Nurses attitudes towards their dialogues about sexual health with hospitalized patients were less challenging if they were initiated by the patients or if the patients were men with medical causes related to sexual health. Lack of knowledge and support from colleagues became reasons why nurses felt inadequate about discussing sexual health with their patients.

  • 106.
    Ekström, Anette
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nurses and midwives professional support increases with improved attitudes - design and effects of a longitudinal randomized controlled process-oriented intervention2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, no 1, article id 275Article in journal (Refereed)
    Abstract [en]

    Background: Becoming parents for the first time is challenging. Mothers need both social and professional support to handle these challenges. Professionals’ attitudes affect quality of care and support. So to improve professional support, an intervention consisting of a process-oriented training was performed. Due to the positive results of the intervention there is a need to illuminate the methodological approach further. The overall aim was therefore to describe a methodological approach to improve and evaluate health care professionals’ attitudes toward breastfeeding and parental support in order to improve quality of care in childbearing.

    Methods: This study was a longitudinal randomized control intervention study, in which groups of mothers received care in childbearing from midwives and child health nurses. These health professionals had gone through a process-oriented training, or not. In order to improve attitudes of health professionals the training was based on evidence, practical skills and reflective processes (both private and professional experiences) in relation to breastfeeding and parental support. Included in the longitudinal study were health professionals from five intervention municipalities n = 36 and health professionals from five control municipalities n = 45. All mothers who fulfilled the inclusion criteria were consecutively identified from the hospital register and asked to participate in the study. Mothers who accepted to participate were included in the interventions group (n = 206) or control groups (n = 162, n = 172 respectively) based on which municipality they belonged to.

    Results: The results of the process-oriented training improved the professionals’ attitudes toward breastfeeding and parental support. These improved attitudes in health professionals increased intervention-group mother’s satisfaction with professional and social support. Intervention-group mother’s relation to and feelings for their baby as well as breastfeeding was also improved.

    Conclusion: These results stress the importance of professionals’ attitude in quality of care during childbearing, as well as pointing to the possibility to improve professionals’ attitudes with a process-oriented training.

    Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR), trial registration:ACTRN12611000354987.

  • 107.
    Ekström, Anette
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Thorstensson, Stina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Validation of Measurement Scales in Health Care2015In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 4, no 2, article id 1000236Article in journal (Other academic)
  • 108.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar / Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Berg-Beckhoff, Gabriele
    Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
    Country and Gender-Specific Achievement of Healthy Nutrition and Physical Activity Guidelines: Latent Class Analysis of 6266 University Students in Egypt, Libya, and Palestine2017In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 9, no 7, p. 1-12, article id 738Article in journal (Refereed)
    Abstract [en]

    Research on healthy behaviour such as physical activity and healthy nutrition and their combination is lacking among university students in Arab countries. The current survey assessed healthy nutrition, and moderate/vigorous physical activity (PA) of 6266 students in Egypt, Libya, and Palestine. We computed a nutrition guideline achievement index using WHO recommendation, as well as the achievement of PA recommendations using guidelines for adults of the American Heart Association guidelines. Latent class regression analysis identified homogenous groups of male and female students, based on their achievements of both guidelines. We examined associations between group membership and achievement of guidelines. A three-class solution model best fitted the data, generating three student Groups: "Healthy Eaters" (7.7% of females, 10.8% of males), "Physically Active" (21.7% of females, 25.8% of males), and "Low Healthy Behaviour" (70.6% of females, 63.4% of males). We did not observe a latent class that exhibited combined healthy behaviours (physically active and healthy eaters), and there were no major differences between countries. We observed a very low rate of healthy nutrition (approximate to 10% of students achieved greater than four of the eight nutrition guidelines), with little gender differences across the countries. About 18-47% of students achieved the PA guidelines, depending on country and gender, more often among males. Few females achieved the PA guidelines, particularly in Libya and Palestine. Culturally adapted multi-behavioural interventions need to encourage healthy lifestyles, nutrition and PA behaviours. National policies need to promote active living while addressing cultural, geographic, and other barriers to young adults' engagement in PA.

  • 109.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar / College of Medicine, Qatar University, Doha, State of Qatar / Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Khalil, Khalid A.
    Faculty of Medical Technology, Misrata, Libya.
    Ssewanyana, Derrick
    Utrecht Centre for Child and Adolescent Studies, Utrecht University, Netherlands.
    Stock, Christiane
    Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
    Behavioral risk factor clusters among university students at nine universities in Libya2018In: AIMS Public Health, ISSN 2327-8994, Vol. 5, no 3, p. 296-311Article in journal (Refereed)
    Abstract [en]

    Objectives: This study identifies and describes the clustering of 5 behavioral risk factors (BRFs) among university students. We also investigated whether cluster membership is associated with the students' self-rated academic performance and self-rated health. Material and methods: A sample of 1300 undergraduates at 6 universities and 3 colleges in Libya completed a self-administered questionnaire that assessed BRFs (nutrition, physical activity, alcohol consumption, smoking, illicit drug use, inadequate sleep). A two-step cluster analysis generated student clusters with similar lifestyles. Results: Two contrasting clusters of almost even size emerged (after exclusion of alcohol and illicit drug use due to very low prevalence). Cluster 1 comprised students with higher engagement in all forms of physical activity, higher levels of health consciousness, greater daily fruit/vegetable intake and better sleep patterns than students in cluster 2. Only as regards the consumption of sweets, cluster 1 students had less favorable practices than cluster 2 students. The prevalence of smoking was equally low in both clusters. Students in cluster 2, depicting a less healthy lifestyle, were characterized by a higher proportion of women, of students with less income and of higher years of study. Belonging to cluster 2 was associated with lower self-rated health (OR: 0.46, p < 0.001) and with lower self-rated academic performance (OR: 0.66, p < 0.001). Conclusion: Preventive programs should not address BRFs in isolation and should particularly target students with clustering of BRFs using specifically tailored approaches.

  • 110.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar / School of Sports and Exercise, Faculty of Applied Sciences, University of Gloucestershire, Gloucester, England, United Kingdom.
    Samara, Anastasia
    Unit for Health Promotion, Institute of Public Health, University of Southern Denmark, Odense, Denmark.
    Adherence to Recommended Dietary Guidelines and the Relationships with the Importance of Eating Healthy in Egyptian University Students2018In: International Journal of Preventive Medicine, ISSN 2008-7802, E-ISSN 2008-8213, Vol. 9, no 1, article id 73Article in journal (Refereed)
    Abstract [en]

    Background: Little is known on the food consumption habits and adherence to dietary guidelines among young adults. We examined students' adherence to recommended guidelines, and the associations between importance of eating healthy and guidelines adherence. Methods: A total of 3271 undergraduates at 11 faculties, Assiut University, Egypt (2009-2010), completed a questionnaire reporting their consumption of 12 food groups; number of servings of fruits/vegetables/day; and how important it is for them to eat healthy. We employed the WHO guidelines for the Eastern Mediterranean region (WHO 2012) to compute students' adherence to dietary guidelines for the different food groups. Chi-square tested the differences for adherence to guidelines by gender, and the associations between the importance of healthy eating and guidelines adherence for the whole sample and by gender. Results: Except for cereal products, no food group had an adherence level >45%. Gender differences were observed (men had better adherence for sweets, cake/cookies, snacks, and raw vegetables but not for fast food/canned food or cooked vegetables, P < 0.001 for each). There was a significant positive trend between the increase of subjective importance of eating healthy and adherence to guidelines (P = 0.012-<0.001). However, this association was only for some food groups and gender dependent. Conclusions: Across the majority of food groups we examined, this sample exhibited low adherence levels to International Nutrition Guidelines. Healthier eating educational/intervention efforts should target foods exhibiting low adherence (most food groups, particularly salad/raw vegetables, fresh fruits, dairy/dairy products, meat/sausage products); consider gender differences (females reported lower adherence across most food groups); and note the relation between adherence and subjective importance of eating healthy by food groups and gender.

  • 111.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / University of Gloucestershire, Gloucester, United Kingdom / Qatar University, Doha, Qatar.
    Ssewanyana, Derrick
    Utrecht University, Netherlands.
    Stock, Christiane
    University of Southern Denmark, Esbjerg, Denmark.
    Behavioral Health Risk Profiles of Undergraduate University Students in England, Wales, and Northern Ireland: A Cluster Analysis2018In: Frontiers In Public Health, ISSN 2296-2565, Vol. 6, article id 120Article in journal (Refereed)
    Abstract [en]

    Background: Limited research has explored clustering of lifestyle behavioral risk factors (BRFs) among university students. This study aimed to explore clustering of BRFs, composition of clusters, and the association of the clusters with self-rated health and perceived academic performance. Method: We assessed (BRFs), namely tobacco smoking, physical inactivity, alcohol consumption, illicit drug use, unhealthy nutrition, and inadequate sleep, using a self-administered general Student Health Survey among 3,706 undergraduates at seven UK universities. Results: A two-step cluster analysis generated: Cluster 1 (the high physically active and health conscious) with very high health awareness/consciousness, good nutrition, and physical activity (PA), and relatively low alcohol, tobacco, and other drug (ATOD) use. Cluster 2 (the abstinent) had very low ATOD use, high health awareness, good nutrition, and medium high PA. Cluster 3 (the moderately health conscious) included the highest regard for healthy eating, second highest fruit/vegetable consumption, and moderately high ATOD use. Cluster 4 (the risk taking) showed the highest ATOD use, were the least health conscious, least fruit consuming, and attached the least importance on eating healthy. Compared to the healthy cluster (Cluster 1), students in other clusters had lower self-rated health, and particularly, students in the risk taking cluster (Cluster 4) reported lower academic performance. These associations were stronger for men than for women. Of the four clusters, Cluster 4 had the youngest students. Conclusion: Our results suggested that prevention among university students should address multiple BRFs simultaneously, with particular focus on the younger students.

  • 112.
    El Ansari, Walid
    et al.
    Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Public Health, University of Turku, Turku, Finland / Folkhälsan Research Center, Helsinki, Finland.
    Berg-Beckhoff, Gabriele
    Unit for Health Promotion Research, Institute of Public Health, University of Southern Denmark, Esbjerg, Denmark.
    Is Healthier Nutrition Behaviour Associated with Better Self-Reported Health and Less Health Complaints?: Evidence from Turku, Finland2015In: Nutrients, ISSN 2072-6643, E-ISSN 2072-6643, Vol. 7, no 10, p. 8478-8490Article in journal (Refereed)
    Abstract [en]

    We examined nutrition behaviour, self-reported health and 20 health complaints of undergraduates in Finland. Students at the University of Turku in Finland participated in a cross-sectional online survey (N = 1189). For nutrition behaviour, we computed two composite food intake pattern scores (sweets, cakes and snacks; and fruits and vegetables), a dietary guideline adherence index and the subjective importance of healthy eating. Multinomial logistic regression assessed the association of students' nutrition behaviour with three levels of self-reported health, controlling for many potential confounders (age, sex, living with partner, economic situation, moderate physical activity, Faculty and BMI). Factor analysis of the 20 health complaints revealed three components (psychological, pains/aches and circulatory/breathing symptoms). Multiple linear regression tested the association of students' eating habits with the three components of health complaints, controlling for the same confounders. Fruits and raw and cooked vegetable consumption, dietary guideline adherence index and subjective importance of healthy eating were highest among students with excellent/very good self-reported health, exhibiting a decreasing trend for those individuals with poor/fair self-reported health. High levels of psychological symptoms were associated with decreased consumption of fruits and vegetables, less dietary guideline adherence and less subjective importance of healthy eating. Pain/aches symptoms were associated with a higher consumption of sweets, cookies and snacks and a lower adherence to dietary guidelines. More healthy nutrition behaviour was consistently associated with better self-reported health and less health complaints. Of the four nutrition behaviour indicators we employed, the dietary guideline adherence index was the best indicator and exhibited the most consistent associations with self-reported health and health complaints.

  • 113.
    El Ansari, Walid
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Doha, Qatar / College of Medicine, Doha, Qatar / Faculty of Applied Sciences, University of Gloucestershire, Gloucester, United Kingdom.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. University of Turku, Department of Public Health, Turku, Finland.
    Draper, Steve
    University Centre Hartpury, Gloucester, United Kingdom.
    Correlates of achieving the guidelines of four forms of physical activity, and the relationship between guidelines achievement and academic performance: Undergraduate students in Finland2017In: Central European Journal of Public Health, ISSN 1210-7778, E-ISSN 1803-1048, Vol. 25, no 2, p. 87-95Article in journal (Refereed)
    Abstract [en]

    Objectives: We surveyed and compared, by gender, the levels and correlates of achieving the international guidelines of four forms of physical activity (PA): moderate PA (MPA), vigorous PA (VPA), moderate or vigorous PA (MVPA), and muscle strengthening PA (MSPA). The study assessed the associations between achieving the guidelines of the four PA forms and a range of socio-demographic, health and academic performance variables. Methods: Data was collected across the seven faculties of the University of Turku (2013-2014 from a representative sample of 1,189 undergraduates). An English language online self-administered questionnaire assessed frequency and duration of PA/week for each form of PA. We employed cut-offs for the guidelines in accordance with the American Heart Association. Chi-square statistic tested the differences in PA, socio-demographic variables and academic performance between males and females. Binary logistic regression examined the factors associated with achieving the four PA guidelines and linear regression examined the association between the frequency of PA and academic performance. Results: Achievement of PA guidelines was relatively low across the sample. Female students were less likely to achieve the VPA or MSPA guidelines, but were more health conscious and in generally exhibited better academic performace than males. High health awareness and excellent/very good self-rated health were the strongest predictors of achieving all forms of PA. Parents' education level was positively related to likelihood of achieving the VPA, MVPA and MSPA guidelines. Achieving the MPA guidelines (but not VPA or MSPA) was positively associated with subjective perceptions of better academic performance. Conclusions: Achievement of PA guidelines was generally low for this sample of Finnish students, and was associated with positive health status and high health awareness. Universities need a holistic approach to improve awareness of health and promote PA in students' lifestyles.

  • 114.
    Elbardisi, Haitham
    et al.
    Hamad Medical Corporation, Doha, Qatar.
    Majzoub, Ahmad
    Hamad Medical Corporation, Doha, Qatar.
    Al Said, Sami
    Hamad Medical Corporation, Doha, Qatar.
    Al Rumaihi, Khalid
    Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Hamad General Hospital, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Alattar, Alia
    Hamad Medical Corporation, Qatar.
    Arafa, Mohamed
    Hamad Medical Corporation, Doha, Qatar / Cairo University, Cairo, Egypt.
    Geographical differences in semen characteristics of 13 892 infertile men2018In: Arab Journal of Urology, ISSN 2090-598X, Vol. 16, no 1, p. 3-9Article in journal (Refereed)
    Abstract [en]

    Objective: To assess the relationship between geographical differences and all semen parameters, across 13,892 infertile men of 84 diverse nationalities, recruited at a specialised tertiary hospital that represents the main healthcare provider in Qatar. Male infertility is an important and global public health problem. Despite this, there is a significant scarcity of epidemiological male infertility and semen analysis research in the Middle East and North Africa (MENA) region, as well as geographical comparisons with other parts of the world. Patients and methods: Retrospective study of semen findings of 13 892 infertile men assessed at the Male Infertility Unit at Hamad Medical Corporation, in Qatar between January 2012 and August 2015. Based on country of origin, patients were categorised into those from the MENA region (n = 8799) and non-MENA patients (n = 5093). The two groups were compared across demographic features and semen characteristics: age, sperm volume, sperm total motility, sperm progressive motility (PMot), abnormal sperm forms (ABF), and sperm DNA fragmentation (SDF). Results: The whole sample's mean (SD) age was 35.7 (0.7) years, sperm concentration was 32.3 (0.25) × 106 sperm/mL, total motility was 45.4 (0.2)%, sperm PMot was 25.1 (0.2)%, and ABF was 79.9 (0.2)%. Overall, 841 patients had azoospermia (6.05%), 3231 had oligospermia (23.3%), 4239 had asthenospermia (30.5%) and 6772 had teratospermia (48.7%). SDF (1050 patients) was abnormal in 333 patients (31.7%). MENA patients were significantly younger than their non-MENA counterparts and had a greater semen volume. Non-MENA patients had significantly higher sperm counts, total motility and PMot, and lower ABF. SDF showed no statistical difference between the two groups. MENA patients had significantly higher prevalence of oligospermia, asthenospermia, and teratospermia; and lower prevalence of normal sperm concentration, normal motility, and normal morphology. Throughout the 4 years of the study, MENA patients constantly had significantly lower sperm counts; generally lower sperm total motility percentage and generally lower quality sperm morphology. We compared patients by age (≤40 and &gt;40 years): in the patients aged ≤40 years, the same results as for the overall study were reproduced; in the &gt;40-years group, the same results were reproduced with the exception of morphology, which was not significantly different between the MENA and non-MENA patients. Conclusion: Semen quality is generally lower in male infertility patients from the MENA region compared to non-MENA regions. © 2018 Arab Association of Urology

  • 115.
    Elfstrand Corlin, Tinna
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kajonius, Petri J.
    University of Skövde, School of Bioscience. University of Skövde, The Systems Biology Research Centre.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    The impact of personality on person-centred care: a study of care staff in Swedish nursing homes2017In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 12, no 2, article id e12132Article in journal (Refereed)
    Abstract [en]

    Aim and objective: In this study, we explore how personal and situational factors relate to the provision of person-centred care (PCC) in nursing homes. Specifically, we focus on the relationship between the care staff's personality traits and provision of PCC and to what extent perceptions of the working environment influences this relationship.

    Background: The ultimate goal of elderly care is to meet the older person's needs and individual preferences (PCC). Interpersonal aspects of care and the quality of relationship between the care staff and the older person are therefore central in PCC.

    Design and methods: A cross-sectional Swedish sample of elderly care staff (= 322) completed an electronic survey including measures of personality (Mini-IPIP) and person-centred care (Individualized Care Inventory, ICI). A principal component analysis was conducted on the ICI-data to separate the user orientation (process quality) of PCC from the preconditions (structure quality) of PCC.

    Results: Among the five factors of personality, neuroticism was the strongest predictor of ICI user orientation. ICI preconditions significantly mediated this relationship, indicating the importance of a supportive working environment. In addition, stress was introduced as a potential explanation and was shown to mediate the impact of neuroticism on ICI preconditions.

    Conclusions: Personality traits have a significant impact on user orientation, and the perception of a supportive and stress free working environment is an important prerequisite for achieving high-quality person-centred elderly care.

    Implications for practice: Understanding how personality is linked to the way care staff interacts with the older person adds a new perspective on provision of person-centred elderly care.

  • 116.
    Elfstrand Corlin, Tinna
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kazemi, Ali
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Accounting for job satisfaction: Examining the interplay of person and situation2017In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 58, no 5, p. 436-442Article in journal (Refereed)
    Abstract [en]

    In the present study, we investigate the interplay of personality traits (i.e., person) in frontline care staff in nursing homes and the way they relate to the residents (i.e., situation) to account for their job satisfaction. Participants completed a survey including Mini-IPIP tapping the five-factor model of personality, Individualized Care Inventory tapping four aspects of person-centered care and job satisfaction. The results revealed that staff scoring high on neuroticism experienced less job satisfaction. This relationship was partly accounted for by resident autonomy, suggesting that part of the adverse influence of neuroticism on job satisfaction may be mitigated by organizations providing a supportive care environment. In contrast, staff scoring high on agreeableness experienced higher job satisfaction. This relationship was accounted for by another aspect of person-centered care, that is, knowing the person. This suggests that agreeableness in a sense facilitated adjustment of acts of care toward the unique needs and preferences of residents and this partly explained why the more agreeable the staff was the more they felt satisfied at work. In sum, effects of personality traits on job satisfaction in care staff are partially mediated by the perception of working conditions and care policy and to the extent that a certain personality trait affects whether the staff have a positive or negative perception of the way they relate to the residents, they will experience, respectively, higher or a lower job satisfaction. This finding has implications for how to combine a focus on delivering person-centered care with improving personal job satisfaction.

  • 117.
    Elhag, Wahiba
    et al.
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar / College of Medicine, Qatar University, Doha, State of Qatar.
    Abdulrazzaq, Sama
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Abdullah, Ali
    Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Elsherif, Mohamed
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Elgenaied, Israa
    Department of Bariatric Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, State of Qatar.
    Evolution of 29 Anthropometric, Nutritional, and Cardiometabolic Parameters Among Morbidly Obese Adolescents 2 Years Post Sleeve Gastrectomy2018In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 28, no 2, p. 474-482Article in journal (Refereed)
    Abstract [en]

    Background Laparoscopic sleeve gastrectomy (LSG) is a popular treatment for adolescent morbid obesity. Research on LSG outcomes among adolescents assessed a narrow range of anthropometric, nutritional, or cardiometabolic parameters, leading to an incomplete picture of these changes. We examined a wide variety of anthropometric, nutritional, and cardiometabolic parameters among adolescents before and after LSG. Methods We retrospectively reviewed medical charts of all obese adolescents who underwent LSG at Hamad Medical Corporation, Qatar, between January 2011 and June 2015 (N = 102). We assessed preoperative levels and postoperative changes in 4 anthropometric, 15 nutritional, and 10 cardiometabolic parameters. Results The study sample comprised 79 patients with complete information (36 males, mean age 15.99 +/- 1.1 years). At a mean of 24.2 months post-LSG, we observed (1) significantly reduced mean weight and body mass index by 51.82 +/- 28.1 kg and 17 +/- 6.24 kg/m(2), respectively; (2) the highest prevalence of post-LSG deficiencies pertained to vitamin D, albumin, and ferritin (89.3, 38, and 33.3%, respectively); (3) low hemoglobin levels (29.3%) only in females; (4) trace elements were not deficient; (4) significant reductions in percentage of adolescents with elevated low-density lipoprotein (from 66.1 to 38.9%), alanine aminotransferase (from 45.3 to 10.9%), and aspartate aminotransferase (from 24.1 to 8.6%) levels; (5) 100% remission of prediabetes cases; and (6) 80% remission of type 2 diabetes cases. Conclusions LSG achieved significant weight loss and improvement of cardiometabolic risk factors among adolescents. However, the slight worsening of preexisting nutritional deficiencies warrants careful preoperative surveillance and appropriate postoperative nutritional supplementation.

  • 118.
    Elhag, Wahiba
    et al.
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar.
    Razaq, Sama
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
    Elsherif, Mohamed
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qata.
    Mustafa, Isra
    Department of Bariatric Surgery/Bariatric Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qata.
    Lorcaserin vs. Phentermine among non-surgical and surgical obese patients: Anthropometric, glycemic, lipid, safety and cost outcomes2019In: Annals of Medicine and Surgery, ISSN 2049-0801, Vol. 45, p. 75-81Article in journal (Refereed)
    Abstract [en]

    Background: To evaluate effectiveness, safety, and costs of Lorcaserin vs. phentermine among obese non–surgical and surgical patients (post bariatric surgery). Methods: This retrospective study retrieved charts of all patients (January 2013–June 2016) who received Lorcaserin or phentermine for 3 months. The study assessed anthropometric, glycemic, and lipid changes, as well as side effects and cost of medications among overweight and obese non-surgical (n = 83) and surgical patients (n = 46). These two patient groups were compared using Chi-square (χ2) and unpaired‘t’ test for qualitative and quantitative variables respectively. Results: At 3 months, among the non-surgical group, Phentermine patients had greater percentage of total weight loss (TWL%) (7.65 ± 8.26 vs. 2.99 ± 3.72%, P = 0.003), and greater BMI reduction (−3.16 ± 3.63 vs. −1.15 ± 1.53 kg/m2, P = 0.003) than Lorcaserin. Within the surgical group, Lorcaserin patients had significantly smaller TWL% (1.86 ± 5.06 vs. 7.62 ± 9.80%, P = 0.012), and smaller BMI reduction (−0.74 ± 1.80 vs. −3.06 ± 4.08 kg/m2, P = 0.012) than Phentermine. Lorcaserin exhibited significant total cholesterol and LDL improvements only among surgical patients with significant weight reduction (≥5% TW). Both medications were not associated with glycemic improvements among non-surgical and surgical groups. Phentermine had slightly more side effects but was less expensive. Conclusions: Among both patient groups, phentermine was more effective in achieving weight loss. Lorcaserin showed dyslipidemia improvements only among surgical patients who achieved significant weight reduction. Anti-obesity medications as part of weight management programs can result in weight loss among non-surgical and surgical patients, or halt weight regain among surgical patients. This is the first study to evaluate the effectiveness and safety of two anti-obesity medications (lorcaserin vs. phentermine) among two distinct obese patient groups, non-surgical and surgical patients. 

  • 119.
    Elmoghazy, Walid
    et al.
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar / Department of Surgery, Sohag University, Sohag, Egypt.
    Ahmed, Khalid
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
    Vijay, Adarsh
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
    Kamel, Yasser
    Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar.
    Elaffandi, Ahmed
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar / Department of Surgical Oncology, National Cancer Institute, Cairo University, Egypt.
    El Ansari, Walid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Surgery, Hamad Medical Corporation, Doha, Qatar .
    Kakil, Rasul
    National Center for Cancer Care and Research, Doha, Qatar.
    Khalaf, Hatem
    Department of Surgery, Hamad Medical Corporation, Doha, Qatar.
    Hepatocellular carcinoma in a rapidly growing community: Epidemiology, clinico-pathology and predictors of extrahepatic metastasis2019In: Arab Journal of Gastroenterology, ISSN 1687-1979, Vol. 20, no 1, p. 38-43Article in journal (Refereed)
    Abstract [en]

    Background and study aims: Hepatocellular carcinoma (HCC) with extrahepatic metastasis has been studied, however, data from the Middle East remain scarce. In this study, we assess epidemiology of HCC in Qatar, and identify predictors of the metastatic behaviour. Patients and methods: All newly-diagnosed HCC patients on top of liver cirrhosis between 2011 and 2015 were included in the study. Results: A total of 180 patients met our inclusion criteria. The mean age was 58.8 ± 10.5 years with a mean follow-up of 1.0 ± 1.1 years. There were 150 male patients and HCV was the most common cause of liver cirrhosis 108 (60%), and 22 (12.2%) patients were classified as Child-Pugh class C. The overall survival of 51.1%, and 47 (26%) had at least one extrahepatic metastasis at the time of diagnosis. Single site metastasis was diagnosed in 10 patients, whereas 37 patients had multiple sites metastases. We compared patients who had metastases with patients who did not have metastasis at the time of diagnosis of HCC regarding several variables, and analysis revealed that tumour diameter larger than 5 cm (OR = 6.10, 95% CI = 1.85–20.12) (p = 0.003), and bilobar liver involvement (OR = 5.49, 95% CI = 1.10–27.30) (p = 0.037) were independent predictors of metastatic behaviour of HCC. Conclusion: The incidence of HCC is rising in our population, extrahepatic metastasis is no longer rare and tumours larger than 5 cm and bilobar involvement are determinants of the extrahepatic metastasis. © 2019 Pan-Arab Association of Gastroenterology

  • 120.
    Engqvist, Inger
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Skaraborg Hospitals, Falköping, Sweden.
    Nilsson, Kerstin
    Institute of Health and Caring Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    The recovery process of postpartum psychosis from both the woman's and next of kin's perspective: An interview study in Sweden2014In: Open Nursing Journal, ISSN 1874-4346, E-ISSN 1874-4346, Vol. 8, no 1, p. 8-16Article in journal (Refereed)
    Abstract [en]

    Abstract: Objectives: The most serious type of psychiatric disorder in connection with childbirth is postpartum psychosis. With this disorder occasionally follows emotional rejection of the infant which has serious long term effect on mother and child. The aim of this study was to explore the experiences of the recovery process of postpartum psychosis from the women, from the partners of the women, and their next of kin.

    Methods: Interviews were conducted with seven women, who had previously suffered postpartum psychosis, and six of their next of kin. The interviews were transcribed verbatim and analysed using content analysis.

    Results: Two categories emerged: the recovery process and the circumstances of the support provided. The women and their next of kin spoke about the turning point in the illness, their own personal as well as their social recovery, the importance of support not only from relatives and friends, but also from professionals, and the use of medication. However, the key to recovery was an internal decision by the women themselves.

    Conclusion: Conclusion is that the recovery from this severe mental disorder requires hard work and the key to their recovery was the decision made by the women. This disorder causes a mental darkness to descend, but at the start of the recovery a dim light shines in the dark tunnel. The nursing staff must be made aware that good sleep is important for the psychiatric treatment and that recovery may take a long time. The nurse needs to provide hope and encouragement, as well as help the woman to recognise the strength that exists within her. To reduce the risk of a recurrence of the disorder, the staff needs to offer follow up visits.

  • 121.
    Enskär, Karin
    et al.
    Jönköping Univ, Sch Hlth Sci, Jönköping, Sweden / Jönköping Univ, CHILD Res Grp, Jönköping, Sweden.
    Björk, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Jönköping Univ, CHILD Res Grp, Jönköping, Sweden.
    Knutsson, Susanne
    Jönköping Univ, Sch Hlth Sci, Jönköping, Sweden / Univ Coll Borås, Dept Hlth Sci, Borås, Sweden.
    Granlund, Mats
    Jönköping Univ, Sch Hlth Sci, Jönköping, Sweden / Jönköping Univ, CHILD Res Grp, Jönköping, Sweden..
    Darcy, Laura
    Jönköping Univ, CHILD Res Grp, Jönköping, Sweden / Univ Coll Borås, Dept Hlth Sci, Borås, Sweden.
    Huus, Karina
    Jönköping Univ, Sch Hlth Sci, Jönköping, Sweden / Jönköping Univ, CHILD Res Grp, Jönköping, Sweden.
    A Swedish perspective on nursing and psychosocial research in paediatric oncology: A literature review2015In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 19, no 3, p. 310-317Article in journal (Refereed)
    Abstract [en]

    Purpose: A dramatic improvement in outcomes of survival rates of childhood cancer has been seen. Caring science research is central in providing skills and knowledge to the health care sector, but few overviews of the content of published research have been carried out. The aim of this review was to investigate the content and methodology of published studies in paediatric oncology relevant to caring science, and also to compare possible differences in content and method of the published studies from the nursing and psychosocial perspectives. Method: A systematic literature review was performed of 137 published articles on paediatric oncology relevant to caring science in Sweden. Results: The results show that most of the studies were descriptive or comparative ones with a quantitative design. Most of them focused on parents (43%) or children (28%). Most of the studies investigated wellbeing (88%), using questionnaires (54%) or interviews (38%). Several different measurement instruments had been used. While the results were often clearly presented, the clinical implications were more diffuse. The most acknowledged research fund was the Swedish Childhood Foundation (75%). Conclusions: To reflect the children' perspectives in paediatric oncology require that future researchers take on the challenge of including children (even young ones) in research. The use of a limited number of agreed measurement instruments is desirable. The biggest challenge for the future is to make a shift from explorative to intervention studies. There is an urgent need to transform research results into clinical practice. (C) 2014 Elsevier Ltd. All rights reserved.

  • 122.
    Enskär, Karin
    et al.
    School of Health Sciences, Jönköping University, Sweden / CHILD Research Group, Jönköping University, Sweden.
    Huus, Karina
    School of Health Sciences, Jönköping University, Sweden / CHILD Research Group, Jönköping University, Sweden.
    Björk, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. CHILD Research Group, Jönköping University, Sweden.
    Granlund, Mats
    School of Health Sciences, Jönköping University, Sweden / CHILD Research Group, Jönköping University, Sweden.
    Darcy, Laura
    CHILD Research Group, Jönköping University, Sweden / Institution of Health Science, University College of Borås, Sweden.
    Knutsson, Susanne
    School of Health Sciences, Jönköping University, Sweden / Institution of Health Science, University College of Borås, Sweden.
    An Analytic Review of Clinical Implications From Nursing and Psychosocial Research Within Swedish Pediatric Oncology2015In: Journal of Pediatric Nursing: Nursing Care of Children and Families, ISSN 0882-5963, E-ISSN 1532-8449, Vol. 30, no 4, p. 550-559Article in journal (Refereed)
    Abstract [en]

    The publisher regrets that this article has been temporarily removed. A replacement will appear as soon as possible in which the reason for the removal of the article will be specified, or the article will be reinstated. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

  • 123.
    Erichsen Andersson, Annette
    et al.
    The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden / Department of Anesthesia, Surgery, and Intensive Care, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
    Petzold, Max
    Akademistatistik - Centre for Applied Biostatistics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Bergh, Ingrid
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Karlsson, Jón
    Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden / The Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
    Eriksson, Bengt I.
    Department of Orthopedics, Sahlgrenska University Hospital, Gothenburg, Sweden / The Sahlgrenska Academy, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.
    Nilsson, Kerstin
    The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.
    Comparison between mixed and laminar airflow systems in operating rooms and the influence of human factors: Experiences from a Swedish orthopedic center2014In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 42, no 6, p. 665-669Article in journal (Refereed)
  • 124.
    Eriksson, Anita
    et al.
    Högskolan i Borås .
    Gustavsson, Susanne
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Krav, uppmaningar och frågor: en autoetnografisk reflektion över handledning av självständiga arbeten2016In: Utbildning och Lärande / Education and Learning, ISSN 2001-4554, Vol. 10, no 1, p. 70-87Article in journal (Refereed)
  • 125.
    Eriksson, Irene
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ek, Kristina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Jansson, Sofie
    Municipal Home Care, Jönköping, Sweden.
    Sjöström, Ulrika
    Psychiatric Clinic Ryhov, Jönköping, Sweden.
    Larsson, Margaretha
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    To feel emotional concern: A qualitative interview study to explore telephone nurses’ experiences of difficult calls2019In: Nursing Open, E-ISSN 2054-1058, Vol. 6, no 3, p. 842-848Article in journal (Refereed)
    Abstract [en]

    Aim: To describe telenurses’ experiences of difficult calls.

    Design: A qualitative approach with a descriptive design was used to gain a deeper understanding of the telenurses’ experiences.

    Methods: The data were collected in spring 2017 through semi-structured interviews with 19 telenurses at call centres and primary healthcare centres and were analysed with qualitative content analysis.

    Results: Becoming emotionally concerned is central to the telenurse’s experiences of difficult calls. Difficult calls are accompanied by feelings such as inadequacy, uncertainty and anxiety, which can be described as emotional tension. Emotional tension refers to situations when the caller’s expressed emotions were conveyed to the telenurses and altered their state of mind. The telenurses stated that difficult calls that cause them to become anxious remain in their thoughts and go through their minds repeatedly, making a deep impression.

  • 126.
    Eriksson, Irene
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Lindblad, Monica
    Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden.
    Möller, Ulrika
    Bräcke diakoni, Skara, Sweden.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. affilierad College of Nursing, University of Rhode Island, USA.
    Holistic health care: Patients' experiences of health care provided by an Advanced Practice Nurse2018In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 24, no 1, article id e12603Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION: Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system.

    AIM: To describe patients' experiences of health care provided by an APN in primary health care.

    METHODS: An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze.

    RESULTS: The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care.

    CONCLUSION: The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context.

  • 127.
    Eriksson, Irene
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Olofsson, Birgitta
    Department of Nursing Umeå University, Umeå, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Fagerström, Lisbeth
    Department of Health Sciences, University of Buskerud, Drammen, Norway.
    Older women's experiences of suffering from urinary tract infections2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 9-10, p. 1385-1394Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe and explore older women's experiences of having had repeated urinary tract infections (UTIs). Background: UTIs are one of the most common bacterial infections among older women. Approximately one-third of very old women suffer from at least one UTI each year. Despite the high incidence of UTI, little is known about the impact of UTI on health and daily life in older women. Design: A qualitative descriptive design. Methods: A qualitative study using semi-structured interviews was conducted with 20 Swedish women aged 67-96 years who suffered from repeated UTIs the preceding year. The data were analysed using qualitative content analysis. Results: Two main themes were identified: being in a state of manageable suffering and depending on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological health problems, struggling to deal with the illness and being restricted in daily life. Depending on alleviation was illustrated in terms of having access to relief but also receiving inadequate care. Conclusions: This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences. The women in this study described the physical and psychological health problems, struggling to deal with the illness, being restricted in daily life, depending on access to relief and receiving inadequate care. Relevance to clinical practice: It is important to improve the knowledge about how UTI affects the health of older women. This knowledge may help nurses develop strategies to support these women. One important part in the supportive strategies is that nurses can educate these women in self-care. © 2013 John Wiley & Sons Ltd.

  • 128.
    Ervasti, Jenni
    et al.
    Finnish Inst Occupat Hlth, Helsinki, Finland / Univ Helsinki, Clinicum, Helsinki, Finland.
    Airaksinen, Jaakko
    Finnish Inst Occupat Hlth, Helsinki, Finland.
    Pentti, Jaana
    Univ Helsinki, Clinicum, Helsinki, Finland.
    Vahtera, Jussi
    Univ Turku, Dept Publ Hlth, Finland / Turku Univ Hosp, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Univ Turku, Finland.
    Virtanen, Marianna
    Finnish Inst Occupat Hlth, Helsinki, Finland / Uppsala Univ, Dept Publ Hlth & Caring Sci, Uppsala, Sweden.
    Kivimaki, Mika
    Finnish Inst Occupat Hlth, Helsinki, Finland / Univ Helsinki, Clinicum, Finland / UCL, Dept Epidemiol & Publ Hlth, London, England.
    Does increasing physical activity reduce the excess risk of work disability among overweight individuals?2019In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 45, no 4, p. 376-385Article in journal (Refereed)
    Abstract [en]

    Objectives We examined the extent to which an increase in physical activity would reduce the excess risk of work disability among overweight and obese people (body mass index >= 25kg/m(2)).

    Methods We used counterfactual modelling approaches to analyze longitudinal data from two Finnish prospective cohort studies (total N=38 744). Weight, height and physical activity were obtained from surveys and assessed twice and linked to electronic records of two indicators of long-term work disability (>= 90-day sickness absence and disability pension) for a 7-year follow-up after the latter survey. The models were adjusted for age, sex, socioeconomic status, smoking, and alcohol consumption.

    Results The confounder-adjusted hazard ratio (HR) of long-term sickness absence for overweight compared to normal-weight participants was 1.43 [95% confidence interval (CI) 1.35-1.53]. An increase in physical activity among overweight compared to normal-weight individuals was estimated to reduce this HR to 1.40 (95% CI 1.31-1.48). In pseudo-trial analysis including only the persistently overweight, initially physically inactive participants, the HR for long-term sickness absence was 0.82 (95% CI 0.70-0.94) for individuals with increased physical activity compared to those who remained physically inactive. The results for disability pension as an outcome were similar.

    Conclusions These findings suggest that the excess risk of work disability among overweight individuals would drop by 3-4% if they increased their average physical activity to the average level of normal-weight people. However, overweight individuals who are physically inactive would reduce their risk of work disability by about 20% by becoming physically active.

  • 129.
    Ervasti, Jenni
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Epidemiology and Public Health, University College London, United Kingdom / Clinicum, University of Helsinki, Helsinki, Finland.
    Head, Jenny
    Department of Epidemiology and Public Health, University College London, United Kingdom.
    Goldberg, Marcel
    Population-based Cohorts Unit, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Research Unit 1168 Aging and Chronic Diseases—Epidemiological and Public Health Approaches, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
    Airagnes, Guillaume
    Université Paris Descartes, Sorbonne Paris Cité, Paris, France / Department of Psychiatry and Addictology, AP-HP, Hôpitaux Universitaires Paris Ouest, Paris, France.
    Pentti, Jaana
    Clinicum, University of Helsinki, Helsinki, Finland.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Psychology, University of Turku, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Jokela, Markus
    Medicum, University of Helsinki, Helsinki, Finland.
    Vahtera, Jussi
    University of Turku and Turku University Hospital, Turku, Finland.
    Zins, Marie
    Population-based Cohorts Unit, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Research Unit 1168 Aging and Chronic Diseases—Epidemiological and Public Health Approaches, French National Institute of Health and Medical Research (INSERM), Villejuif, France / Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Public Health and Caring Sciences, University of Uppsala, Uppsala, Sweden.
    Sickness absence diagnoses among abstainers, low-risk drinkers and at-risk drinkers: consideration of the U-shaped association between alcohol use and sickness absence in four cohort studies2018In: Addiction, ISSN 0965-2140, E-ISSN 1360-0443, Vol. 113, no 9, p. 1633-1642Article in journal (Refereed)
    Abstract [en]

    Aims To estimate differences in the strength and shape of associations between alcohol use and diagnosis-specific sickness absence. Design A multi-cohort study. Participants (n = 47 520) responded to a survey on alcohol use at two time-points, and were linked to records of sickness absence. Diagnosis-specific sickness absence was followed for 4-7 years from the latter survey. Setting and participants From Finland, we had population cohort survey data from 1998 and 2003 and employee cohort survey data from 2000-02 and 2004. From France and the United Kingdom, we had employee cohort survey data from 1993 and 1997, and 1985-88 and 1991-94, respectively. Measurements We used standard questionnaires to assess alcohol intake categorized into 0, 1-11 and > 11 units per week in women and 0, 1-34 and > 34 units per week in men. We identified groups with stable and changing alcohol use over time. We linked participants to records from sickness absence registers. Diagnoses of sickness absence were coded according to the International Classification of Diseases. Estimates were adjusted for sex, age, socio-economic status, smoking and body mass index. Findings Women who reported drinking 1-11 units and men who reported drinking 1-34 units of alcohol per week in both surveys were the reference group. Compared with them, women and men who reported no alcohol use in either survey had a higher risk of sickness absence due to mental disorders [rate ratio = 1.51, 95% confidence interval (CI) = 1.22-1.88], musculoskeletal disorders (1.22, 95% CI = 1.06-1.41), diseases of the digestive system (1.35, 95% CI = 1.02-1.77) and diseases of the respiratory system (1.49, 95% CI = 1.29-1.72). Women who reported alcohol consumption of > 11 weekly units and men who reported alcohol consumption of > 34 units per week in both surveys were at increased risk of absence due to injury or poisoning (1.44, 95% CI = 1.13-1.83). Conclusions In Finland, France and the United Kingdom, people who report not drinking any alcohol on two occasions several years apart appear to have a higher prevalence of sickness absence from work with chronic somatic and mental illness diagnoses than those drinking below a risk threshold of 11 units per week for women and 34 units per week for men. Persistent at-risk drinking in Finland, France and the United Kingdom appears to be related to increased absence due to injury or poisoning.

  • 130.
    Ervasti, Jenni
    et al.
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Kivimäki, Mika
    Finnish Institute of Occupational Health, Helsinki, Finland / Department of Epidemiology and Public Health, University College London, London, United Kingdom / Clinicum, University of Helsinki, Helsinki, Finland.
    Head, Jenny
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Goldberg, Marcel
    French National Institute of Health and Medical Research (INSERM), Population-based Cohorts Unit, INSERM, Paris, Villejuif, France / French National Institute of Health and Medical Research (INSERM), Research Unit 1168 Aging and Chronic Diseases—Epidemiological and Public Health Approaches, INSERM, Paris, Villejuif, France.
    Airagnes, Guillaume
    Faculty of Medicine, Universite Paris Descartes, Paris, France / Department of Psychiatry and Addictology, AP-HP, Hôpitaux Universitaires Paris Ouest, Paris, France.
    Pentti, Jaana
    Clinicum, University of Helsinki, Helsinki, Finland.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Finland / Finnish Institute of Occupational Health, Helsinki, Finland.
    Suominen, Sakari
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. University of Turku, Turku, Finland.
    Jokela, Markus
    Medicum, University of Helsinki, Helsinki, Finland.
    Vahtera, Jussi
    University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland.
    Zins, Marie
    French National Institute of Health and Medical Research (INSERM), Population-based Cohorts Unit, INSERM, Paris, Villejuif, France / French National Institute of Health and Medical Research (INSERM), Research Unit 1168 Aging and Chronic Diseases—Epidemiological and Public Health Approaches, INSERM, Paris, Villejuif, France / University Versailles Saint Quentin en Yvelines, Paris, France.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Finland.
    Sociodemographic Differences Between Alcohol Use and Sickness Absence: Pooled Analysis of Four Cohort Studies2018In: Alcohol and Alcoholism, ISSN 0735-0414, E-ISSN 1464-3502, Vol. 53, no 1, p. 95-103Article in journal (Refereed)
    Abstract [en]

    Aims: We examined differences in sickness absence in relation to at-risk drinking and abstinence, taking into account potential changes in consumption.& para;& para;Methods: We used individual-participant data (n = 46,514) from four prospective cohort studies from Finland, France and the UK. Participants responded to a survey on alcohol use at two time points 4-6 years apart, and were linked to records of sickness absence for an similar to 6-year follow-up after the latter survey. Abstainers were those reporting no alcohol use in either survey. At-risk drinkers at T1 were labelled as 'former', at-risk drinkers at T2 as 'current' and at-risk drinkers at both times as 'consistent' at-risk drinkers. The reference group was low-risk drinkers at both times. Study-specific analyses were stratified by sex and socioeconomic status (SES) and the estimates were pooled using meta-analysis.& para;& para;Results: Among men (n = 17,285), abstainers (6%), former (5%), current (5%) and consistent (7%) at-risk drinkers had an increased risk of sickness absence compared with consistent low-risk drinkers (77%). Among women (n = 29,229), only abstainers (12%) had a higher risk of sickness absence compared to consistent low-risk drinkers (74%). After adjustment for lifestyle and health, abstaining from alcohol was associated with sickness absence among people with intermediate and high SES, but not among people with low SES.& para;& para;Conclusions: The U-shaped alcohol use-sickness absence association is more consistent in men than women. Abstinence is a risk factor for sickness absence among people with higher rather than lower SES. Healthy worker effect and health selection may partly explain the observed differences.& para;& para;Short summary: In a pooled analysis from four cohort studies from three European countries, we demonstrated a U-shaped association between alcohol use and sickness absence, particularly among men. Abstinence from alcohol was associated with increased sickness absenteeism among both sexes and across socioeconomic strata, except those with low SES.

  • 131.
    Fejes, Andreas
    et al.
    Linköpings universitet.
    Olson, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Högskolan Dalarna, Stockholms universitet.
    Rahm, Lina
    Linköpings universitet.
    Dahlstedt, Magnus
    Linköpings universitet.
    Sandberg, Fredrik
    Linköpings universitet.
    Individualisation in Swedish adult education and the shaping of neo-liberal subjectivities2018In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170, Vol. 62, no 3, p. 461-473Article in journal (Refereed)
    Abstract [en]

    In this article we have analysed the ways a discourse on individualisation is taking shape within adult education in Sweden, how it operates, and what effects it has in terms of shaping student subjectivity. Drawing on a post-structural theorisation we analyse interviews with teachers and students in municipal adult education (MAE) and folk high schools (FHS). The analysis illustrates how both institutions contribute to the shaping of individualised subjectivities, although differently. At the end, a general question is raised about what happens with the democratic function of adult education in general, when a discourse on individualisation operates in the ways described, and more specifically, asks what is happening to FHS as an educational practice, that upholds its self-image as a last bastion of a collective notion of learning and subjectivity, and nurturing an educational practice of learning democracy?

  • 132.
    Fejes, Andreas
    et al.
    Linköpings universitet.
    Olson, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Högskolan Dalarna / Stockholms universitet.
    Rahm, Lina
    Linköpings universitet.
    Dahlstedt, Magnus
    Linköpings universitet.
    Sandberg, Fredrik
    Linköpings universitet.
    Individualisering genom det kollektiva i svensk folkhögskola2015Conference paper (Other academic)
    Abstract [en]

    The aim of this paper presentation is to identify how the principles of democracy and the market are played out in Swedish adult education. More specifically, we focus on how collective and individually oriented notions of what it means to be a citizen, shape student subjectivity. By focusing on both formal adult education (municipal adult education) and non-formal adult education (folk high schools) we wish to illustrate how these principles are mobilized differently, thus shaping different kinds of citizen subjectivities. Drawing on a post structural theorization inspired by the work of Michel Foucault, we analyse interviews with students and teachers at one school for municipal adult education, as well as one folk high school. Our analysis illustrates how an individually oriented citizen is shaped through discourses mobilized in both settings. However, in the folk highs school, individualization is shaped through discourses on collectivization. We argue that such shaping are in line with neoliberal forms of governance.

  • 133.
    Feo, Rebecca
    et al.
    University of Adelaide, Australia.
    Conroy, Tiffany
    University of Adelaide, Australia.
    Jangland, Eva
    Uppsala University, Sweden / Uppsala University Hospital, Uppsala, Sweden.
    Muntlin Athlin, Åsa
    Uppsala University, Sweden / Uppsala University Hospital, Uppsala, Sweden.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Parr, Jenny
    Counties Manukau District Health Board, Auckland, New Zealand / Auckland University of Technology, New Zealand.
    Blomberg, Karin
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kitson, Alison
    University of Adelaide, Australia / Flinders University, Australia.
    Towards a standardised definition for fundamental care: a modified Delphi study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2285-2299Article in journal (Refereed)
    Abstract [en]

    AIMS: To generate a standardised definition for fundamental care and identify the discrete elements that constitute such care.

    BACKGROUND: There is poor conceptual clarity surrounding fundamental care. The Fundamentals of Care Framework aims to overcome this problem by outlining three core dimensions underpinning such care. Implementing the Framework requires a standardised definition for fundamental care that reflects the Framework's conceptual understanding, as well as agreement on the elements that comprise such care (i.e., patient needs, such as nutrition, and nurse actions, such as empathy). This study sought to achieve this consensus.

    DESIGN: Modified Delphi study.

    METHODS: Three phases: (1) engaging stakeholders via an interactive workshop; (2) using workshop findings to develop a preliminary definition for, and identify the discrete elements that constitute, fundamental care; and (3) gaining consensus on the definition and elements via a two-round Delphi approach (Round 1 n=38; Round 2 n=28).

    RESULTS: Delphi participants perceived both the definition and elements generated from the workshop as comprehensive, but beyond the scope of fundamental care. Participants questioned whether the definition should focus on patient needs and nurse actions, or more broadly on how fundamental care should be delivered (e.g., through a trusting nurse-patient relationship), and the outcomes of this care delivery. There were also mixed opinions whether the definition should be nursing specific.

    CONCLUSIONS: This study has initiated crucial dialogue around how fundamental care is conceptualised and defined. Future work should focus on further refinements of the definition and elements with a larger, international group of practising nurses and service users. This article is protected by copyright. All rights reserved.

  • 134.
    Ferrie, Jane E.
    et al.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / School of Community and Social Medicine, University of Bristol, Bristol, United Kingdom.
    Virtanen, Marianna
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Jokela, Markus
    Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
    Madsen, Ida E. H.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Heikkilä, Katriina
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Batty, G. David
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
    Bjorner, Jakob B.
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Borritz, Marianne
    Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.
    Burr, Hermann
    Federal Institute for Occupational Safety and Health (Bundesanstalt für Arbeitsschutz und Arbeitsmedizin), Berlin, Germany.
    Dragano, Nico
    Institute for Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
    Elovainio, Marko
    National Institute for Health and Welfare, Helsinki, Finland.
    Fransson, Eleonor I.
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden / School of Health Sciences, Jönköping University, Jönköping, Sweden / Stress Research Institute, Stockholm University, Stockholm, Sweden.
    Knutsson, Anders
    Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden.
    Koskenvuo, Markku
    Department of Public Health, University of Helsinki, Helsinki, Finland.
    Koskinen, Aki
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Kouvonen, Anne
    Department of Social Research, University of Helsinki, Helsinki, Finland.
    Kumari, Meena
    Institute for Social and Economic Research, University of Essex, Colchester, United Kingdom.
    Nielsen, Martin L.
    Unit of Social Medicine, Frederiksberg University Hospital, Copenhagen, Denmark.
    Nordin, Maria
    Department of Psychology, Umeå University, Umeå, Sweden.
    Oksanen, Tuula
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Pahkin, Krista
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Pejtersen, Jan H.
    The Danish National Centre for Social Research, Copenhagen, Denmark.
    Pentti, Jaana
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Salo, Paula
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland / Department of Psychology, University of Turku, Turku, Finland.
    Shipley, Martin J.
    Department of Epidemiology and Public Health, University College London, London, United Kingdom.
    Tabák, Adam
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / 1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Hungary.
    Suominen, Sakari B.
    University of Skövde, Health and Education. University of Skövde, School of Health and Education. Department of Public Health, University of Turku, Turku, Finland / Folkhälsan Research Center, Helsinki, Finland.
    Theorell, Töres
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Väänänen, Ari
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Vahtera, Jussi
    Department of Public Health, University of Turku, Turku, Finland / Turku University Hospital, Turku, Finland.
    Westerholm, Peter J. M.
    Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
    Westerlund, Hugo
    Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
    Rugulies, Reiner
    National Research Centre for the Working Environment, Copenhagen, Denmark / Departments of Public Health and Psychology, University of Copenhagen, Copenhagen, Denmark.
    Nyberg, Solja T.
    Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland.
    Kivimäki, Mika
    Department of Epidemiology and Public Health, University College London, London, United Kingdom / Finnish Institute of Occupational Health, Helsinki, Tampere and Turku, Finland / Institute of Behavioural Sciences, University of Helsinki, Helsinki, Finland.
    Job insecurity and risk of diabetes: a meta-analysis of individual participant data2016In: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel: ECMAJ. ISSN 1488-2329, ISSN 0820-3946, E-ISSN 1488-2329, Vol. 188, no 17-18, p. E447-E455Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Job insecurity has been associated with certain health outcomes. We examined the role of job insecurity as a risk factor for incident diabetes.

    METHODS: We used individual participant data from 8 cohort studies identified in 2 open-access data archives and 11 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary risk estimate.

    RESULTS: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09-1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking), the association was slightly attenuated (adjusted OR 1.12, 95% CI 1.01-1.24). Heterogeneity between the studies was low to moderate (age- and sex-adjusted model: I(2) = 24%, p = 0.2; multivariable-adjusted model: I(2) = 27%, p = 0.2). In the multivariable-adjusted analysis restricted to high-quality studies, in which the diabetes diagnosis was ascertained from electronic medical records or clinical examination, the association was similar to that in the main analysis (adjusted OR 1.19, 95% CI 1.04-1.35).

    INTERPRETATION: Our findings suggest that self-reported job insecurity is associated with a modest increased risk of incident diabetes. Health care personnel should be aware of this association among workers reporting job insecurity.

  • 135.
    Fornes, Romina
    et al.
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
    Maliqueo, Manuel
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden / Endocrinology and Metabolism Laboratory, Department of Medicine, West Division, University of Chile, Santiago, Chile.
    Hu, Min
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hadi, Laila
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Jimenez-Andrade, Juan M.
    Unidad Académica Multidisciplinaria Reynosa Aztlán, Universidad Autónoma de Tamaulipas, Reynosa, Tamaulipas, Mexico.
    Ebefors, Kerstin
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Nyström, Jenny
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Labrie, Fernand
    Laval University Research Center in Molecular Endocrinology, Oncology and Human Genomics, CHUL Research Center, Quebec, Canada.
    Jansson, Thomas
    Department of Obstetrics & Gynecology, Division of Reproductive Sciences, University Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
    Benrick, Anna
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Stener-Victorin, Elisabet
    Department of Physiology and Pharmacology, Karolinska Institutet, 171 77, Stockholm, Sweden.
    The effect of androgen excess on maternal metabolism, placental function and fetal growth in obese dams2017In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, article id 8066Article in journal (Refereed)
    Abstract [en]

    Pregnant women with polycystic ovary syndrome (PCOS) are often overweight or obese. To study the effects of maternal androgen excess in obese dams on metabolism, placental function and fetal growth, female C57Bl6J mice were fed a control (CD) or a high fat/high sucrose (HF/HS) diet for 4-10 weeks, and then mated. On gestational day (GD) 15.5-17.5, dams were injected with dihydrotestosterone (CD-DHT, HF/HS-DHT) or a vehicle (CD-Veh, HF/HS-Veh). HF/HS dams had higher fat content, both before mating and on GD18.5, with no difference in glucose homeostasis, whereas the insulin sensitivity was higher in DHT-exposed dams. Compared to the CD groups, the livers from HF/HS dams weighed more on GD18.5, the triglyceride content was higher, and there was a dysregulation of liver enzymes related to lipogenesis and higher mRNA expression of Fitm1. Fetuses from HF/HS-Veh dams had lower liver triglyceride content and mRNA expression of Srebf1c. Maternal DHT exposure, regardless of diet, decreased fetal liver Pparg mRNA expression and increased placental androgen receptor protein expression. Maternal diet-induced obesity, together with androgen excess, affects maternal and fetal liver function as demonstrated by increased triglyceride content and dysfunctional expression of enzymes and transcription factors involved in de novo lipogenesis and fat storage.

  • 136.
    Fornes, Romina
    et al.
    Department of Physiology and Pharmacology, Karolinska Institutet, Solna.
    Manti, Maria
    Department of Physiology and Pharmacology, Karolinska Institutet, Solna.
    Qi, Xiaojuan
    Department of Physiology, Qiqihar Medical University, Qiqihar, China.
    Vorontsov, Egor
    Proteomics Core Facility, University of Gothenburg, Gothenburg.
    Sihlbom, Carina
    Proteomics Core Facility, University of Gothenburg, Gothenburg.
    Nyström, Jenny
    Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Jerlhag, Elisabet
    Department of Pharmacology, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Maliqueo, Manuel
    Endocrinology and Metabolism, Faculty of Medicine, West division, University of Chile, Santiago, Chile.
    Hirschberg, Angelica Lindén
    Division of Obstetrics and Gynecology, Karolinska University Hospital, Solna.
    Carlström, Mattias
    Department of Physiology and Pharmacology, Karolinska Institutet, Solna.
    Benrick, Anna
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg.
    Stener-Victorin, Elisabet
    Department of Physiology and Pharmacology, Karolinska Institutet, Solna.
    Mice exposed to maternal androgen excess and diet-induced obesity have altered phosphorylation of catechol-O-methyltransferase in the placenta and fetal liver2019In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 43, p. 2176-2188Article in journal (Refereed)
    Abstract [en]

    Background/objectives: Maternal obesity together with androgen excess in mice negatively affects placental function and maternal and fetal liver function as demonstrated by increased triglyceride content with dysfunctional expression of enzymes and transcription factors involved in de novo lipogenesis and fat storage. To identify changes in molecular pathways that might promote diseases in adulthood, we performed a global proteomic analysis using a liquid-chromatography/mass-spectrometry system to investigate total and phosphorylated proteins in the placenta and fetal liver in a mouse model that combines maternal obesity with maternal androgen excess. Methods: After ten weeks on a control diet (CD) or high fat/high sugar-diet, dams were mated with males fed the CD. Between gestational day (GD) 16.5 and GD 18.5, mice were injected with vehicle or dihydrotestosterone (DHT) and sacrificed at GD 18.5 prior to dissection of the placentas and fetal livers. Four pools of female placentas and fetal livers were subjected to a global proteomic analysis. Total and phosphorylated proteins were filtered by ANOVA q < 0.05, and this was followed by two-way ANOVA to determine the effect of maternal obesity and/or androgen exposure. Results: In placenta, phosphorylated ATP-citrate synthase was decreased due to maternal obesity, and phosphorylated catechol-O-methyltransferase (COMT) was differentially expressed due to the interaction between maternal diet and DHT exposure. In fetal liver, five total proteins and 48 proteins phosphorylated in one or more sites, were differentially expressed due to maternal obesity or androgen excess. In fetal liver, phosphorylated COMT expression was higher in fetus exposed to maternal obesity. Conclusion: These results suggest a common regulatory mechanism of catecholamine metabolism in the placenta and the fetal liver as demonstrated by higher phosphorylated COMT expression in the placenta and fetal liver from animals exposed to diet-induced maternal obesity and lower expression of phosphorylated COMT in animals exposed to maternal androgen excess. © 2019, Springer Nature Limited.

  • 137.
    Forsberg Ahlcrona, Mirella
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Pramling Samuelsson, Ingrid
    Department of Education, Communication and Learning, University of Gothenburg, Sweden.
    Mathematics in preschool and problem solving: Visualizing Abstraction of balance2014In: Creative Education, ISSN 2151-4755, E-ISSN 2151-4771, Vol. 5, no 6, p. 427-434Article in journal (Refereed)
  • 138.
    Forsberg, Anna
    et al.
    Department of Health Sciences at Lund University, Lund, Sweden / Skåne University Hospital, Department of Transplantation and Cardiology, Sweden.
    Flodén, Anne
    School of Health Sciences, Jönköping University, Jönköping, Sweden.
    Lennerling, Annette
    The Transplant Center, Sahlgrenska University Hospital, Gothenburg, Sweden / Institute of Health and Care Sciences, University of Gothenburg, Sweden.
    Karlsson, Veronika
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nilsson, Madeleine
    Queen Silvia’s Children Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.
    Fridh, Isabell
    Institute of Health and Care Sciences, University of Gothenburg,Sweden / School of Health Sciences, University of Borås, Sweden.
    The core of after death care in relation to organ donation: A grounded theory study2014In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 30, no 5, p. 275-282Article in journal (Refereed)
  • 139.
    Forsberg, Anna
    et al.
    Department of Health Sciences, Lund University, Sweden / Department of Transplantation and Cardiology, Skåne University Hospital, Sweden.
    Karlsson, Veronika
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Anaesthesia and Intensive Care, Sahlgrenska University Hospital, Sweden.
    Cavallini, Josefin
    The Transplant Centre, Sahlgrenska University Hospital, Sweden.
    Lennerling, Annette
    The Transplant Centre, Sahlgrenska University Hospital, Sweden / The Sahlgrenska Academy Institute of Health and Care Sciences, University of Gothenburg, Sweden.
    The meaning of social adaptation after solid organ transplantation2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 2, p. 62-67Article, review/survey (Refereed)
  • 140.
    Forsberg, Anna
    et al.
    Lund University, Lund, Sweden / Skåne University Hospital, Lund, Sweden.
    Lennerling, Anette
    Sahlgrenska University Hospital, Gothenburg, Sweden / University of Gothenburg, Göteborg, Sweden.
    Fridh, Isabell
    University of Gothenburg, Göteborg, Sweden / University of Borås, Borås, Sweden.
    Karlsson, Veronika
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nilsson, Madeleine
    Sahlgrenska University Hospital, Gothenburg, Sweden.
    Understanding the Perceived Threat of the Risk of Graft Rejections: A Middle-Range Theory2015In: Global Qualitative Nursing Research, ISSN 2333-3936, Vol. 2, article id 2333393614563829Article in journal (Refereed)
    Abstract [en]

    From a clinical viewpoint, graft rejection is one of the greatest threats faced by an organ transplant recipient (OTR). We propose a middle-range theory (MRT) of Perceived Threat of the Risk of Graft Rejection (PTRGR) as a contribution to the practice of transplant nursing. It could also apply to the detection of risky protective behavior, that is, isolation, avoidance, or non-adherence. The proposed MRT covers the following concepts and the relationship between them: transplant care needs, threat reducing interventions, intervening variables, level of PTRGR, protective strategies, and evidence-based practice. Parts of this theory have been empirically tested and support the suggested relationship between some of the concepts. Further tests are needed to strengthen the theoretical links. The conceptual framework might serve as a guide for transplant nurses in their efforts to promote post-transplant health and reduce threat-induced emotions.

  • 141.
    Franx, Bart A. A.
    et al.
    Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
    Arnoldussen, Ilse A. C.
    Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
    Kiliaan, Amanda J.
    Department of Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
    Gustafson, Deborah R.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Neurology, Section for NeuroEpidemiology, State University of New York, Downstate Medical Center, USA / Neuropsychiatric Epidemiology Unit (EPINEP), Institute for Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
    Weight Loss in Patients with Dementia: Considering the Potential Impact of Pharmacotherapy2017In: Drugs & Aging, ISSN 1170-229X, E-ISSN 1179-1969, Vol. 34, no 6, p. 425-436Article, review/survey (Refereed)
    Abstract [en]

    Unintentional body weight loss is common in patients with dementia and is linked to cognitive impairment and poorer disease outcomes. It is proposed that some dementia medications with market approval, while aiming to improve cognitive and functional outcomes of a patient with dementia, are associated with reported body weight or body mass index loss. This review presents evidence in the published literature on body weight loss in dementia, describes selected theories behind body weight loss, evaluates the potential impact of approved dementia pharmacotherapies on body weight, considers the potential role for medical foods, understands the potential influence of treatments for neuropsychiatric symptoms and signs, and finally, summarizes this important area.

  • 142.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. College of Nursing, University of Rhode Island, USA.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Reflective STRENGTH-Giving Dialogue Developed to Support Older Adults in Learning to Live with Long-Term Pain: A Method and a Study Design2014In: Journal of Gerontology & Geriatric Research, ISSN 2167-7182, Vol. 3, no 5, article id 187Article in journal (Refereed)
    Abstract [en]

    Background: Long-term musculoskeletal pain is a major health problem that significantly impacts quality of life among older adults. Many lack professional guidance and must learn on their own to live with pain. This calls for a holistic method that addresses older adults’ needs in their situations. The developed method has its foundation in the didactic model: “The challenge – to take control of one’s life with long-term illness.

    Aim: The aim was to describe the method, Reflective STRENGTH-Giving Dialogue, and present a study design where the method is learned and used by health care providers to support older adults in learning to live their lives with long-term pain at home in a way that promotes health, well-being, meaning and strength in life.

    Methods: The pilot study design consists of an educational program including continuous supervision to health care providers during the accomplishment of dialogues with community dwelling older adults. The key dimensions in Reflective STRENGTH-Giving Dialogue are:

    Situation: Confront and ascertain the facticity in the current situation; Transition from “one to I” and Take charge in the situation; Reflect upon possibilities and choices; Engagement in fulfilling small and large life projects that gives joy and meaning in life; Get inner strength and courage; Tactful and challenging approach and Holistic perspective. Data will be collected through interviews and questionnaires. Qualitative and quantitative methods (NRS, BPI-SF, GDS, KASAM, MSQ) will be used for analysis. A control-group will be enrolled.

    Discussion and Relevance of Study: STRENGTH can be used to secure and enhance the quality of personcentered care. The method for dialogues can be a way to holistically and individually guide and support older adults in finding ways to live a meaningful life despite pain and to fulfill their desire to remain at home as long as possible .

  • 143.
    Gustafson, Deborah R.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. State University of New York, NY, United States / University of Gothenburg.
    McFarlane, Samy I
    State University of New York, NY, United States.
    Epidemiology of Type 2 Diabetes and Dementia2018In: Type 2 Diabetes and Dementia / [ed] Velandai Srikanth and Zoe Arvanitakis, Elsevier, 2018, p. 5-27Chapter in book (Other academic)
    Abstract [en]

    Type 2 diabetes (T2D) has been associated with dementia in countless observational epidemiology studies. The expansion of epidemiologic research on T2D and dementia is due to scientific recognition of the roles of metabolic and vascular factors as etiologic players in dementia, as well as ominous global demographic shifts in aging, obesity, and dementia. This chapter addresses epidemiologic studies evaluating the association between T2D and late-onset dementias with foci on (1) T2D and dementia as syndromes; (2) T2D and mild cognitive impairment or cognition and cognitive decline; (3) vascular and metabolic risk factors and comorbidities; (4) genetic influences on the T2D-dementia association; (5) ethnoracial considerations; (6) T2D and brain outcomes and biological markers; and (7) clinical trials of T2D medications and cognition and dementia. © 2018 Elsevier Inc. All rights reserved.

  • 144.
    Gustafsson, Margareta
    et al.
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Kullén Engström, Agneta
    School of Health, University of Borås, Sweden.
    Ohlsson, Ulla
    School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Sundler, Annelie Johansson
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. School of Health, Care and Social Welfare, Mälardalens University, Västerås, Sweden.
    Bisholt, Birgitta
    Department of Nursing, Karlstad University, Karlstad, Sweden.
    Nurse teacher models in clinical education from the perspective of student nurses: A mixed method study2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 12, p. 1289-1294Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    The aim was to describe and compare the clinical teacher's role in different models of clinical practice from the perspective of student nurses.

    DESIGN AND SETTINGS:

    The study took place in collaboration with two Swedish universities that applied different educational models in clinical practice. A mixed method approach was used. The quantitative part had a comparative design and the qualitative part had a descriptive design.

    PARTICIPANTS:

    The study group consisted of 114 student nurses (response rate 87%). Fifty-three of them had met clinical teachers employed at the university and not participating in the daily clinical work (University Nurse Teachers, UNTs), whilst 61 had met clinical teachers dividing their time between teaching and nursing (Clinical Nurse Teachers, CNTs). Eight students participated in the qualitative part of the study.

    METHODS:

    A questionnaire including the CLES+T scale was used to ascertain the students' perception of the clinical teacher's role, complemented by interviews directed towards an enrichment of this perception.

    RESULTS:

    Students meeting CNTs agreed more strongly than those meeting UNTs that the teacher had the ability to help them integrate theory and practice. Whilst spontaneous meetings between students and CNTs occurred, students mostly met UNTs in seminars. Students meeting UNTs felt alone but did appreciate having someone outside the clinical environment to provide support if they did not get along with their preceptor.

    CONCLUSIONS:

    In the case of UNTs, it is important that they keep their knowledge of clinical issues updated and visit the clinical placement not only for seminars but also to give students emotional support. In the case of CNTs, it is important that they are members of the faculty at the university, take part in the planning of the clinical courses and are able to explain the learning goals to the students.

  • 145.
    Gustavell, Tina
    et al.
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden / Karolinska University Hospital, Gastrocentrum, Stockholm, Sweden.
    Sundberg, Kay
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
    Frank, Catharina
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
    Wengström, Yvonne
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden / Karolinska University Hospital, Breast and Sarcoma Unit, Radiumhemmet, Stockholm, Sweden.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
    Segersvärd, Ralf
    Karolinska University Hospital, Gastrocentrum, Stockholm, Sweden / Karolinska Institutet, Department of Clinical Science, Intervention and Technology, Division of Surgery, Stockholm, Sweden.
    Langius-Eklöf, Ann
    Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Stockholm, Sweden.
    Symptoms and self-care following pancreaticoduodenectomy: Perspectives from patients and healthcare professionals - Foundation for an interactive ICT application2017In: European Journal of Oncology Nursing, ISSN 1462-3889, E-ISSN 1532-2122, Vol. 26, p. 36-41Article in journal (Refereed)
    Abstract [en]

    PurposePoor prognosis and a problematic recovery period after pancreaticoduodenectomy means that patients may benefit from early detection of symptoms and support for self-management. Interactive Information and Communication Technology tools can be used for this purpose, but the content needs to be relevant to patients as well as healthcare professionals. To facilitate development of the content of an application for this purpose, the aim of this study was to explore common symptoms and self-care in the first six months after pancreaticoduodenectomy, as identified by patients and healthcare professionals.

    MethodData were collected through individual interviews with patients (n = 14), along with two focus group interviews and one individual interview with healthcare professionals (n = 10). Data were analysed using qualitative content analysis.

    ResultsCommon symptoms after surgery were those related to eating, bowel function and emotional wellbeing, along with fatigue and pain. Some self-care activities and advice were mentioned in the interviews. The patients often experienced a lack of advice on self-care at discharge.

    ConclusionsThe results render knowledge of the symptoms it is important to be aware of and to assess regularly after pancreaticoduodenectomy. The results also contribute to knowledge about specific self-care related to these symptoms, even though it was not extensively described, and further research is needed to define evidence-based self-care advice.

  • 146.
    Gustavsson, Susanne
    et al.
    Department of Education and Special Education, University of Gothenburg, Göteborg, Sweden.
    Andersén, Annelie
    Department of Educational Studies, Karlstad University, Karlstad, Sweden.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    To challenge and to be challenged – teachers collective learning in higher education2019In: Reflective Practice, ISSN 1462-3943, E-ISSN 1470-1103, Vol. 20, no 3, p. 339-354Article in journal (Refereed)
    Abstract [en]

    Critical analyzing and reflective competence are essential objectives in all higher education. In academic professional education, it is a challenge for the teacher to support and develop the student´s critical reflection of both academic and placement studies. The aim of this study is to identify the characteristics of the teacher role and the challenges of the reflective seminar within higher education. Data were gathered through group interviews and analyzed with a phenomenological hermeneutic approach. The result shows four themes; the experience of control and uncertainty, building trust and challenging ideas, the alternation between closeness and distance, and the parallel processes of supervising learning and being in a learning state. One conclusion is that the seminar teaching practice stimulates a collegial learning environment. This practice promotes the teachers pedagogical and didactical competence and an open attitude to each other´s teaching practice.

  • 147.
    Gustavsson, Susanne
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Eriksson, Anita
    Högskolan i Borås.
    Blivande lärares frågor vid handledning - Gör jag en kvalitativ studie med kvantitativa inslag?2015In: Pedagogisk forskning i Sverige, ISSN 1401-6788, E-ISSN 2001-3345, Vol. 20, no 1-2, p. 79-99Article in journal (Refereed)
  • 148.
    Gånedahl, Hanna
    et al.
    University of Skövde, School of Health and Education.
    Zsaludek Viklund, Pernilla
    University of Skövde, School of Health and Education.
    Carlén, Kristina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kylberg, Elisabeth
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekberg, Joakim
    Unit for Health Analysis, Centre for Healthcare Development, County Council of Östergötland, Linköping, Sweden / Unit of Community Medicine, Department of Medicine and Health, Linköping University, Sweden.
    Work-site wellness programmes in Sweden: a cross-sectional study of physical activity, self-efficacy, and health2015In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 129, no 5, p. 525-530Article in journal (Refereed)
    Abstract [en]

    In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate.

    OBJECTIVES: The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme.

    STUDY DESIGN: A cross-sectional study design was used.

    METHODS: An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden.

    RESULTS: Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity.

    CONCLUSIONS: Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme.

  • 149.
    Göransson, Carina
    et al.
    Halmstad University, Sweden / Örebro University, Sweden.
    Eriksson, Irene
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ziegert, Kristina
    Halmstad University, Sweden.
    Wengström, Yvonne
    Karolinska University Hospital, Stockholm, Sweden / Karolinska Institutet, Stockholm, Sweden.
    Langius-Eklöf, Ann
    Karolinska Institutet, Stockholm, Sweden.
    Brovall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kihlgren, Annica
    Örebro University, Sweden.
    Blomberg, Karin
    Örebro University, Sweden.
    Testing an app for reporting health concerns-Experiences from older people and home care nurses2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12181Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the experiences of using an app among older people with home-based health care and their nurses.

    BACKGROUND: Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed.

    DESIGN: Explorative qualitative design.

    METHODS: For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis.

    RESULTS: The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement.

    CONCLUSIONS: The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future.

    IMPLICATIONS FOR PRACTICE: The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care.

  • 150.
    Göransson, Carina
    et al.
    School of Health and Welfare, Halmstad University, Halmstad, Sweden / Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Wengström, Yvonne
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
    Ziegert, Kristina
    School of Health and Welfare, Halmstad University, Halmstad, Sweden.
    Langius-Eklöf, Ann
    Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, Irene
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kihlgren, Annica
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Blomberg, Karin
    Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
    Perspectives of health and self-care among older persons-To be implemented in an interactive information and communication technology-platform2017In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 26, no 23-24, p. 4745-4755Article in journal (Refereed)
    Abstract [en]

    AIM AND OBJECTIVES: To acquire knowledge regarding the contents to be implemented in an interactive information and communication technology-platform perceived to be relevant to health and self-care among older persons based on the literature, healthcare professionals and the older persons themselves.

    BACKGROUND: The growing ageing population places demands on the healthcare system to promote healthy ageing and to strengthen the older person's self-care ability. This requires innovative approaches to facilitate communication between the older person and healthcare professionals, and to increase the older person's participation in their care. An information and communication technology-platform could be used for this purpose, but the content needs to be relevant to both the older persons and the healthcare professionals.

    DESIGN: Descriptive qualitative design.

    METHODS: This study was based on three samplings: a scoping review of the literature (n = 20 articles), interviews with healthcare professionals (n = 5) and a secondary analysis of interviews with older persons (n = 8) and nursing assistants (n = 7). The data were analysed using qualitative content analysis.

    RESULTS: Four areas were identified to be of relevance to older persons' perceived health: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care. Self-care was described in the literature and by the healthcare professionals more than by the older persons.

    CONCLUSIONS: The results show a concordance in the data samplings that give a clear indication of the areas relevant to older persons' health and self-care that can be integrated in an interactive information and communication technology-platform for use in regular daily care assessments. Descriptions of self-care were limited indicating a possible gap in knowledge that requires further research.

    RELEVANCE TO CLINICAL PRACTICE: Areas relevant to older persons' health and self-care could be used for regular assessment to support and promote healthy ageing.

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