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  • 201.
    Barrsten, Petra
    et al.
    University of Skövde, School of Health and Education.
    Malmborg, Johanna
    University of Skövde, School of Health and Education.
    Palliativ vård i hemmet: Närståendes erfarenheter - En litteraturbaserad studie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Palliativ vård bygger på ett förhållningsätt som innebär att öka livskvalitén för både patienten och dess närstående. Palliativ vård handlar om god symtom kontroll och lindring. Den palliativa vården i hemmet lägger stort ansvar på de närstående, inte bara när det kommer till kontrollera symtomen men att organisera vården för patienten 24 timmar/dygnet. Sjuksköterskan måste se patienten och närståendes livssituation för att ge bra stöd i hemmet. Syfte: Syftet med denna studie var att belysa närståendes erfarenheter av att vårda den sjuke palliativt i hemmet. Metod: Som metod valdes en litteraturbaserad studie. Datamaterialet bestod av nio kvalitativa vetenskapliga artiklar. Resultat: Tre kategorier identifierades såsom: Ny roll, behov av hjälp från kunniga och behålla det egna livet med sex underkategorier. Närståendes erfarenheter, att ha ett stort ansvar är svårt och krävande men även meningsfullt. Brist på stöd från sjukvården påverkar närståendes förmåga att vårda den sjuke. Slutsats: När närstående vårdar den sjuke i hemmet är tiden både tung och meningsfull. Det beror på vilket stöd och information de får från sjuksköterskorna samt om de själva får möjligheten att distansera sig till vårdandet för att behålla det egna livet.

  • 202.
    Basic, Anesa
    et al.
    University of Skövde, School of Life Sciences.
    Johnsson, Sofia
    University of Skövde, School of Life Sciences.
    BVC-SJUKSKÖTERSKORS ERFARENHETER AV ATT GE STÖD TILL NYBLIVNA FÖRÄLDRAR FÖR ATT FRÄMJA AMNINGEN2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
  • 203.
    Bays, Harold E.
    et al.
    Louisville Metabolic and Atherosclerosis Research Center Inc., Louisville, KY, USA.
    Sartipy, Peter
    University of Skövde, School of Bioscience. University of Skövde, The Systems Biology Research Centre. Global Medicines Development, CVMD, AstraZeneca, Gothenburg, Sweden.
    Xu, John
    Biometrics and Information Sciences, AstraZeneca, Gaithersburg, MD, USA.
    Sjöström, Carl David
    Global Medicines Development, CVMD, AstraZeneca, Gothenburg, Sweden.
    Underberg, James A.
    Department of Medicine, NYU School of Medicine & NYU Center for Prevention of Cardiovascular Disease, New York, NY, USA.
    Dapagliflozin in patients with type II diabetes mellitus, with and without elevated triglyceride and reduced high-density lipoprotein cholesterol levels2017In: Journal of Clinical Lipidology, ISSN 1933-2874, E-ISSN 1876-4789, Vol. 11, no 2, p. 450-458Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Dapagliflozin is a selective sodium-glucose cotransporter 2 inhibitor that improves glycemic control in patients with type II diabetes mellitus (T2DM) by reducing renal glucose reabsorption.

    OBJECTIVE: The aim was to evaluate the lipid effects of dapagliflozin 10 mg or placebo in patients with T2DM with/without baseline elevated triglyceride and reduced high-density lipoprotein (HDL) cholesterol levels.

    METHODS: This was a post hoc analysis of 10 phase 3, placebo-controlled studies of dapagliflozin 10 mg (N = 2237) or placebo (N = 2164) administered for 24 weeks in patients with T2DM. Patients with elevated triglyceride (>= 150 mg/dL [1.69 mmol/L]) and reduced HDL cholesterol levels (<40 mg/dL [1.04 mmol/L] in men; <50 mg/dL [1.29 mmol/L] in women) were included (group A). The reference group (group B) included patients who did not meet the defined lipid criteria.

    RESULTS: The effects of dapagliflozin on fasting lipid profiles were generally similar in the 2 lipid groups (ie, groups A and B) and, compared with placebo, were associated with minor increases in non-HDL cholesterol, low-density lipoprotein, and HDL cholesterol levels. The effects on triglyceride levels were inconsistent. The incidence of adverse events (AEs)/serious AEs, and AEs of genital infection, urinary tract infection, volume reduction, renal function, and hypoglycemia were similar in the 2 lipid groups.

    CONCLUSION: Patients with T2DM treated with dapagliflozin experienced minor changes in lipid levels; the changes were generally similar in the 2 lipid groups. The clinical significance of these changes in lipids is unclear, especially in view of the positive effects of dapagliflozin on other cardiovascular disease risk factors. 

  • 204.
    Bazargan-Hejazi, Shahrzad
    et al.
    University of California, Los Angeles.
    Medeiros, Sarah
    University of California, Los Angeles.
    Mohammadi, Reza
    Karolinska Institutet.
    Lin, Johnny
    University of Los Angeles.
    Dalal, Koustuv
    University of Skövde, School of Life Sciences.
    Patterns of Intimate Partner Violence: a study of female victims in Malawi2012In: Journal of Injury and Violence Research, ISSN 2008-2053, E-ISSN 2008-4072, Vol. 5, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The term “intimate partner violence” (IPV) encompasses physical, sexual and psychological violence, or any combination of these acts, and globally is the most common type of violence against women. This study aims to examine the lifetime prevalence of different types of intimate partner violence (IPV) among Malawi women ages 15 to 49, and its association with age, education, and living in rural versus urban areas. METHODS: Data was obtained from a cross-sectional study of data as part of the 2004 Malawi Demographic and Health Survey.  Women were eligible for the study if they met the following criteria: 1) lived in one of the 15,041 households randomly selected from 522 rural and urban clusters located in 10 large districts of Malawi; 2) were married or cohabitating; and 3) were between the ages of 15 and 49 years.  Consenting, eligible women responded to a comprehensive questionnaire covering demographic factors, health issues, as well as items related to physical, emotional and sexual IPV.  To assess bivariate associations, chi-squared tests and multivariate logistic regressions were conducted. RESULTS: Among the 8291 respondents, 13% reported emotional violence; 20% reported being pushed, shaken, slapped or punched; 3% reported experiencing severe violence, such as being strangled or burned, threatened with a knife, gun or with another weapon; and 13% reported sexual violence.  Data showed women ages 15 to 19 were significantly less likely to report emotional IPV, women ages 25 to 29 were significantly more likely to report being pushed or shaken, slapped or punched (OR 1.35; CI: 1.05-1.73), and women ages 30 to 34 were significantly more likely to report sexual IPV, compared to women ages 45 to 49 (OR 1.40; CI: 1.03-1.90).  Finally, women who had no ability to read were less likely to report sexual IPV than their counterparts who could read a full sentence (OR 0.76; CI: 0.66-0.87). CONCLUSIONS: The prevalence of different types of IPV in Malawi appears slightly lower than that reported for other countries in sub-Saharan Africa.  Further studies are needed to assess the attitudes and behaviors of Malawi women towards acceptability and justification of IPV as well as their willingness to disclose it.

  • 205.
    Beetz, Andrea
    et al.
    Univ Rostock, Dept Special Educ, D-18055 Rostock, Germany .
    Kotrschalt, Kurt
    Univ Vienna, Dept Behav Biol, A-1010 Vienna, Austria .
    Turner, Dennis C.
    Univ Zurich Irchel, IEMT Switzerland & Anim Behav, Zurich, Switzerland .
    Hediger, Karin
    Univ Rostock, Dept Special Educ, D-18055 Rostock, Germany .
    Uvnäs-Moberg, Kerstin
    University of Skövde, School of Life Sciences.
    Julius, Henri
    Univ Rostock, Dept Special Educ, D-18055 Rostock, Germany .
    The Effect of a Real Dog, Toy Dog and Friendly Person on Insecurely Attached Children During a Stressful Task: An Exploratory Study2011In: Anthrozoos, ISSN 0892-7936, E-ISSN 1753-0377, Vol. 24, no 4, p. 349-368Article in journal (Refereed)
    Abstract [en]

    The regulation of stress by an attachment figure is a key feature of attachment relationships. Previous research suggests that in some cases animal companionship may be regarded as an attachment relationship. This may be particularly important for persons with an insecure or disorganized attachment pattern who may find it more difficult than securely attached individuals to accept social support from humans. In our study, we investigated whether 31 boys (aged 7-12 years) with insecure/disorganized attachment would profit more from the presence of a dog (n = 11) than of a friendly human (n = 11) or a toy dog (n = 9) as support during a socially stressful situation (Trier Social Stress Test for Children, TSST-C). Stress levels were assessed via salivary cortisol recorded five times before, during, and after the TSST-C. The behavior of the children was coded from video recordings. Self-reported stress levels did not significantly differ between the groups before and after the TSST-C. Salivary cortisol, however, was significantly lower in the real dog condition than in the other two conditions (Kruskal-Wallis H test on area under the curve increase (AUCi): chi(2) = 15.17, df = 2, p = 0.001). Also, the more the children stroked the dog, the less pronounced was their stress reaction (r(s) = -0.818, p = 0.002). Our data suggest an important role of physical contact in the stress reducing effect. We conclude that the children investigated profited more from interacting with a friendly dog than with either a human or a toy dog in a stressful situation. We discuss the relevance of our findings for animal-assisted interventions.

  • 206.
    Behboudi, A.
    et al.
    Univ Gothenburg, Inst Biomed, Gothenburg, Sweden.
    Nordlander, C.
    Univ Gothenburg, Inst Cell & Mol Biol, Gothenburg, Sweden.
    Klinga-Levan, Karin
    University of Skövde, School of Life Sciences.
    Karlsson, S.
    Evidence for a tumor suppressor locus distal to Tp53 - a study in experimental endometrial adenocarcinoma2007In: European Journal of Cancer Supplements, ISSN 1359-6349, E-ISSN 1878-1217, Vol. 5, no 4, p. 62-62Article in journal (Other academic)
  • 207.
    Behnsen, Pia
    et al.
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Buil, Joanne M.
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Koot, Susanne
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Huizink, Anja
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Van Lier, Poul
    Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Netherlands.
    Heart rate (variability) and the association between relational peer victimization and internalizing symptoms in elementary school children2019In: Development and psychopathology (Print), ISSN 0954-5794, E-ISSN 1469-2198, p. 1-9, article id 29 aprilArticle in journal (Refereed)
    Abstract [en]

    Relational victimization typically emerges first during the elementary school period, and has been associated with increased levels of internalizing symptoms in children. Individual differences in autonomic nervous system functioning have been suggested as a potential factor linking social stressors and internalizing symptoms. The aim of this study was therefore to examine whether heart rate and heart rate variability mediated the association between relational victimization and internalizing symptoms in 373 mainstream elementary school children. Children were assessed in 2015 (T 0 ; Grades 3-5, M age = 9.78 years, 51% boys) and reassessed in 2016 (T 1 ). Heart rate and heart rate variability were assessed during a regular school day at T 1 . A multi-informant (teacher and peer report) cross-time measure of relational victimization, and a multi-informant (self- and teacher report) measure of internalizing problems at T 1 was used. Results showed that heart rate variability, but not heart rate, mediated the association between relational victimization and internalizing symptoms. This study provides tentative support that in children from a general population sample, a psychobiological factor may mediate the association of relational victimization with internalizing symptoms.

  • 208.
    Bel-Serrat, Silvia
    et al.
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Mouratidou, Theodora
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Pala, Valeria
    Fondaz IRCSS Ist Nazl Tumori, Nutrit Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Huybrechts, Inge
    Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium.
    Boernhorst, Claudia
    Univ Bremen, Inst Epidemiol & Prevent Res, BIPS, D-28359 Bremen, Germany.
    Fernandez-Alvira, Juan Miguel
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Hadjigeorgiou, Charalampos
    Res & Educ Inst Child Hlth, Strovolos, Cyprus.
    Eiben, Gabriele
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Hebestreit, Antje
    Univ Bremen, Inst Epidemiol & Prevent Res, BIPS, D-28359 Bremen, Germany.
    Lissner, Lauren
    Univ Gothenburg, Dept Publ Hlth & Community Med, Gothenburg, Sweden.
    Molnar, Denes
    Univ Pecs, Fac Med, Dept Pediat, Pecs, Hungary.
    Siani, Alfonso
    Inst Food Sci, Unit Epidemiol & Populat Genet, CNR, Avellino, Italy.
    Veidebaum, Toomas
    Natl Inst Hlth Dev, Ctr Hlth & Behav Sci, Tallinn, Estonia.
    Krogh, Vittorio
    Fondaz IRCSS Ist Nazl Tumori, Nutrit Epidemiol Unit, Dept Prevent & Predict Med, Milan, Italy.
    Moreno, Luis A.
    Univ Zaragoza, Fac Hlth Sci, Growth Exercise Nutr & Dev GENUD Res Grp, E-50009 Zaragoza, Spain.
    Relative validity of the Children's Eating Habits Questionnaire- food frequency section among young European children: the IDEFICS Study2014In: Public Health Nutrition, ISSN 1368-9800, E-ISSN 1475-2727, Vol. 17, no 2, p. 266-276Article in journal (Refereed)
    Abstract [en]

    Objective: To compare, specifically by age group, proxy-reported food group estimates obtained from the food frequency section of the Children's Eating Habits questionnaire (CEHQ-FFQ) against the estimates of two non-consecutive 24h dietary recalls (24-HDR). Design: Estimates of food group intakes assessed via the forty-three-food-group CEHQ-FFQ were compared with those obtained by a computerized 24-HDR. Agreement on frequencies of intakes (equal to the number of portions per recall period) between the two instruments was examined using crude and de-attenuated Pearson's correlation coefficients, cross-classification analyses, weighted kappa statistics (kappa(w)) and Bland-Altman analysis. Setting: Kindergartens/schools from eight European countries participating in the IDEFICS (Identification and prevention of Dietary- and lifestyle-induced health EFfects In Children and infantS) Study cross-sectional survey (2007-2008). Subjects: Children aged 2-9 years (n 2508, 50.4% boys). Results: The CEHQ-FFQ provided higher intake estimates for most of the food groups than the 24-HDR. De-attenuated Pearson correlation coefficients ranged from 0.01 (sweetened fruit) to 0.48 (sweetened milk) in children aged 2-<6 years (mean = 0.25) and from 0.01 (milled cereal) to 0.44 (water) in children aged 6-9 years (mean = 0.23). An average of 32 % and 31 % of food group intakes were assigned to the same quartile in younger and older children, respectively, and classification into extreme opposite quartiles was <= 12 % for all food groups in both age groups. Mean kappa(w) was 0.20 for 2-<6-year-olds and 0.17 for 6-9-year-olds. Conclusions: The strength of association estimates assessed by the CEHQ-FFQ and the 24-HDR varied by food group and by age group. Observed level of agreement and CEHQ-FFQ ability to rank children according to intakes of food groups were considered to be low.

  • 209.
    Bengtsson, Emelie
    et al.
    University of Skövde, School of Health and Education.
    Tysk, Lina
    University of Skövde, School of Health and Education.
    Patienters upplevelser av att leva med kronisk njursvikt i väntan på njurtransplantation: En litteraturbaserad studie.2015Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Njurarna har en central funktion i kroppen och sviktar dessa innebär det en stor påverkan på det dagliga livet samt en kontinuerlig kontakt med sjukvården. Sjukdomen och dess behandling påverkar inte bara kroppen fysiskt utan även psykiskt och socialt. Njurtransplantation är en kostnadseffektiv och väletablerad behandlingsform vilken ger god prognos för patienten. Dock är efterfrågan på organ större än tillgången vilket i många fall innebär en väntan på obestämd tid för patienten. Syfte: Syftet med studien var att beskriva patienters upplevelser av att leva med kronisk njursvikt i väntan på transplantation. Metod: Litteraturbaserad studie baserad på tio vetenskapliga artiklar med kvalitativ ansats. Resultat: Ur analysen framkom tre kategorier; Livet begränsas, en oviss väntan samt stöd från omgivningen med nio underkategorier. Diskussion: Livet i väntan på transplantation medför många begränsningar som i sin tur innebär lidande. Detta skapar ett behov av stöd från omgivningen, däribland sjuksköterskan. För att sjuksköterskan ska kunna ge stöd åt patienten är det viktigt att förstå hur patienter upplever livet i väntan på transplantation.  

  • 210.
    Bengtsson, Emily
    et al.
    University of Skövde, School of Health and Education.
    Larsson, Lisa
    University of Skövde, School of Health and Education.
    Patienters upplevelse av hälsa och välbefinnande under långvarig behandling av hemodialys: En litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Många patienter lever med kronisk njursjukdom som påverkar det dagliga livet. En försämring av njurfunktionen innebär att en kronisk njursvikt uppstår som kan leda till att behovet av dialys uppstår. En behandlingsform av dialys är hemodialys vilket innebär att blodet renas utanför kroppen. En förståelse för hur patienter upplever hälsa och välbefinnande är av vikt för att sjuksköterskorna ska kunna arbeta främjande för patienterna. Syfte: Beskriva patienters upplevelser av hälsa och välbefinnande under långvarig behandling av hemodialys. Metod: En litteraturöversikt som byggde på 10 kvalitativa artiklar. Resultat: Patienterna upplevde att hemodialysbehandlingarna medförde flera begränsningar i livet som påverkade deras hälsa och välbefinnande. Det skapade känslor av förlust och att vara beroende av andra människor. När patienterna upplevde ett stöd från andra människor gav det kraft och energi. Upplevelsen av att vara begränsad i tid och rum skapade existentiella frågor. Hoppet om en ny njure blev avgörande för patienternas hälsa och välbefinnande. Konklusion: För att skapa hälsa och välbefinnande för patienterna är det av stor vikt att sjuksköterskorna visar ett intresse och en ödmjukhet för patienternas existentiella tankar. Sjuksköterskorna behöver uppmuntra till känslor av hopp hos patienterna för att upplevelsen av hälsa och välbefinnande ska kunna uppstå.

  • 211.
    Bengtsson, Felicia
    University of Skövde, School of Health and Education.
    SJUKSKÖTERSKORS NEGATIVA ATTITYDER GENTEMOT PATIENTER MED PSYKISK OHÄLSA - En litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aim: The purpose of this study was to describe nurses’ negative attitudes towards patients with mental illness. Method: A literature review made on eleven studies of which seven were qualitative and four quantitative. Articles were selected based on inclusion criteria which were that the articles would be relevant on the basis of the study's purpose, that they were published between the years 2004-2014, that they were out of good quality and that they were peer-rewieved. Quality inspection and analysis was done using qualitative method. Key results: Three categories emerged: attitudes based on lack of knowledge, attitudes based on fear and attitudes based on uncertainty. The result shows that the main attitudes are negative and depends primarily on lack of knowledge, fears and uncertainty. Lack of knowledge contributed to fears and uncertainty and considered the cornerstone of attitudes. Conclusions: Nurses need more education and knowledge, and it can contribute to the fears and uncertainty also decreases.

  • 212.
    Bengtsson, Josefine
    et al.
    University of Skövde, School of Health and Education.
    Hansson, Emma
    University of Skövde, School of Health and Education.
    Sjuksköterskors uppfattningar och erfarenheter av att närstående till patienter närvarar vid HLR: en litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Hjärtstopp drabbar cirka 10 000 människor i Sverige årligen och få av dem överlever. Påbörjas hjärt- och lungräddning omedelbart ökar chansen för överlevnad markant. Sjuksköterskan har en betydande roll vid hjärtstopp i samband med hjärt- och lungräddning ska de också ta hand om de närstående som ser det som sin rättighet att närvara. De närstående uttrycker att det ökar lidandet om de inte får tillräckligt med stöd vid HLR. Syfte: Att beskriva sjuksköterskors uppfattningar och erfarenheter av att närstående till patienter närvarar vid HLR i sjukhusmiljö Metod: En litteraturöversikt gjordes där tio artiklar ligger till grund för resultatet. Resultat: Resultatet presenteras i fyra kategorier: Patientens önskningar ska vara i fokus, En känslomässig upplevelse för närstående, Emotionellt krävande moment för sjuksköterskor och Det krävs resurser i situationen. Slutsats: Sjuksköterskorna uppfattar fördelar för alla inblandade men önskar mer utbildning i kommunikation med närstående vid HLR.

  • 213.
    Bengtsson, Katarina
    et al.
    University of Skövde, School of Life Sciences.
    Broxe, Camilla
    University of Skövde, School of Life Sciences.
    Upplevelsen att vårda sin make/maka som genomgått en stroke2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Stroke is one of the most common diseases in Sweden and every year 30 000 individuals are affected. Today it is possible for these persons to continue to live in their homes. Informal caregivers are often the ones who take over the caring responsibility. The aim of this literature study was to describe the spouse´s experience of being an informal carer to a person affected by stroke. The method used was a descriptive synthesis. The material consists of nine scientific research articles. In this study four themes emerged: The experience of change; The experience of loss of freedom and leisure time; The experience of gratefulness, hope and support; The experience of the future, anxiety and guilt and finally The experience of responsibility and control. The result of this study contributes to the nursing practice by highlighting the importance of awareness of these people’s experiences. Prevention is included in the nursing profession and as a nurse it is most important to prevent informal cares from being patients.

  • 214.
    Bengtsson, Katarina
    et al.
    University of Skövde, School of Health and Education.
    Qorri, Mirjeta
    University of Skövde, School of Health and Education.
    Min välsignelse och min börda: att vara närstående till en person med demenssjukdom2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Dementia is a widespread disease, of which relatives are affected and experience suffering.People with dementia live longer at home with support from relatives. By providingrelatives with support, unhealthiness can be prevented, and the health of the person withdementia can be promoted. The aim was to describe relatives experiences of living with aperson affected by dementia. The method consisted of a literature review with 11qualitative articles. The results were presented in four main themes, “Fighting against thewind”, “Changed relationships”, “The constant presence of feelings” and “The need ofsupport”. Relatives described changes, struggles and grief over the life-partner or parentthey once had, which no longer was present. Relatives experienced poor treatment fromhealth care and a need of support which wasn’t met. Nurses can prevent the sufferingexperienced by relatives with the right resources and knowledge. Nurses should also leadand instruct fellow employees to better be equipped to meet relatives and their needs.Nurses can also provide relatives with information regarding different facilities of support.

  • 215.
    Bengtsson, Margareta
    et al.
    University of Skövde, School of Life Sciences.
    Gosende, Martina
    University of Skövde, School of Life Sciences.
    Anhörigas upplevelser av att vårda en familjemedlem som insjuknat i demens: en analys av självbiografier2008Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    Being the relative of a person with dementia is a life changing experience. The relatives often find themselves in a complex situation, which requires that the nurse, can identify needs among the relatives. It‘s also important that the nurse has a broad knowledge about the role of the relative as a caregiver, to be able to give support to them in this situation. The purpose of this study was to describe the relative’s experiences of taking care of a familymember with dementia in the home. Six autobiographies were studied to emerge in the experiences of the family caregivers. Burnards (1991) content analysis and Graneheims & Lundmans (2004) qualitative content analysis was used to analyze the data and the result reveals 3 main categories and 10 categories. The main categories were: Suffering, desperation and isolation. The situation of the caregiving relatives involves experiences of mental distress as well as having to cope with several difficulties. Their new role as a family caregiver is characterized by feelings of isolation which increases as the sickness proceeds.

  • 216.
    Bennedsen, Svetlana
    et al.
    University of Skövde, School of Life Sciences.
    Nilsson, Annlouise
    University of Skövde, School of Life Sciences.
    Att vara föräldrar till barn med Duchennes muskeldystrofi: Litteratutöversikt2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Every year approximately ten boys in Sweden get a disease called Duchenne muscular ystrophy. Duchenne muscular dystrophy is a genetically determined, progressive and incurable neuromuscular disease that generally causes that a child will be physical disability and death in early adulthood. To have a disabled child that suffers for an incurable disease is big responsibility and a major change. The aim of this study is to illustrate parents´ experiences of living with a child with Duchenne muscular dystrophy Literature review. Eight qualitative and four quantitative articles were included in this and the articles were examined and analyzed. The result was combined into three themes. Which are Emotional kaos, Need for support and knowledge and Acceptable and planning for the future. The whole amily experienced feelings of grief, needs of family support and emotional chaos. Nursing staff should know how important it is with adequate information about Duchenne muscular dystrophy. By understanding a situation in the family nursing staff can meet the parent’s needs and requirements.

  • 217.
    Bennet, Sean M. P.
    et al.
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Böhn, Lena
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Störsrud, Stine
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Liljebo, Therese
    Department of Nutrition, Karolinska University Hospital, Stockholm, Sweden.
    Collin, Lena
    Department of Gastroenterology, Sabbatsbergs Hospital, Stockholm, Sweden.
    Lindfors, Perjohan
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Department of Gastroenterology, Sabbatsbergs Hospital, Stockholm, Sweden / Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden.
    Törnblom, Hans
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Öhman, Lena
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Simrén, Magnus
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Multivariate modelling of faecal bacterial profiles of patients with IBS predicts responsiveness to a diet low in FODMAPs2018In: Gut, ISSN 0017-5749, E-ISSN 1468-3288, Vol. 67, no 5, p. 872-881Article in journal (Refereed)
    Abstract [en]

    Objective The effects of dietary interventions on gut bacteria are ambiguous. Following a previous intervention study, we aimed to determine how differing diets impact gut bacteria and if bacterial profiles predict intervention response. Design Sixty-seven patients with IBS were randomised to traditional IBS (n=34) or low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) (n=33) diets for 4 weeks. Food intake was recorded for 4 days during screening and intervention. Faecal samples and IBS Symptom Severity Score (IBS-SSS) reports were collected before (baseline) and after intervention. A faecal microbiota dysbiosis test (GA-map Dysbiosis Test) evaluated bacterial composition. Per protocol analysis was performed on 61 patients from whom microbiome data were available. Results Responders (reduced IBS-SSS by >= 50) to low FODMAP, but not traditional, dietary intervention were discriminated from non-responders before and after intervention based on faecal bacterial profiles. Bacterial abundance tended to be higher in non-responders to a low FODMAP diet compared with responders before and after intervention. A low FODMAP intervention was associated with an increase in Dysbiosis Index (DI) scores in 42% of patients; while decreased DI scores were recorded in 33% of patients following a traditional IBS diet. Non-responders to a low FODMAP diet, but not a traditional IBS diet had higher DI scores than responders at baseline. Finally, while a traditional IBS diet was not associated with significant reduction of investigated bacteria, a low FODMAP diet was associated with reduced Bifidobacterium and Actinobacteria in patients, correlating with lactose consumption. Conclusions A low FODMAP, but not a traditional IBS diet may have significant impact on faecal bacteria. Responsiveness to a low FODMAP diet intervention may be predicted by faecal bacterial profiles.

  • 218.
    Bennet, Sean M. P.
    et al.
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Polster, Annikka
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Törnblom, Hans
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Isaksson, Stefan
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Capronnier, Sandrine
    Department of Life Science, Danone Nutricia Research, Palaiseau, France.
    Tessier, Aurore
    Department of Life Science, Danone Nutricia Research, Palaiseau, France.
    Le Nevé, Boris
    Department of Life Science, Danone Nutricia Research, Palaiseau, France.
    Simrén, Magnus
    Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Center for Functional GI and Motility Disorders, University of North Carolina, Chapel Hill, North Carolina, USA.
    Öhman, Lena
    University of Skövde, School of Health and Education. Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Department of Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Global Cytokine Profiles and Association With Clinical Characteristics in Patients With Irritable Bowel Syndrome2016In: American Journal of Gastroenterology, ISSN 0002-9270, E-ISSN 1572-0241, Vol. 111, no 8, p. 1165-1176Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Evidence suggests that patients with irritable bowel syndrome (IBS) have an altered cytokine profile, although it is unclear whether cytokines are linked with symptom severity. We aimed to determine whether global serum and mucosal cytokine profiles differ between IBS patients and healthy subjects and whether cytokines are associated with IBS symptoms.

    METHODS: Serum from 144 IBS patients and 42 healthy subjects was analyzed for cytokine levels of interleukin (IL)-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-17A, interferon (IFN)-γ, and tumor necrosis factor (TNF) by MSD MULTI-ARRAY. In total, 109 IBS and 36 healthy sigmoid colon biopsies were analyzed for mRNA expression of IL-8, IL-10, TNF, and FOXP3 by quantitative reverse transcription PCR. Multivariate discrimination analysis evaluated global cytokine profiles. Rectal sensitivity, oroanal transit time, and psychological and gastrointestinal symptom severity were also assessed.

    RESULTS: Global cytokine profiles of IBS patients and healthy subjects overlapped, but cytokine levels varied more in IBS patients. Serum levels of IL-6 and IL-8 tended to be increased and levels of IFN-γ tended to be decreased in IBS patients. Mucosal mRNA expression of IL-10 and FOXP3 tended to be decreased in IBS patients. Within both the full study cohort and IBS patients alone, serum level of TNF was associated with looser stool pattern, while subjects with more widespread somatic symptoms had increased serum levels of IL-6. Although neither IBS bowel habit subgroups nor patients with possible post-infectious IBS were associated with distinct cytokine profiles, a small cluster of IBS patients with comparatively elevated immune markers was identified.

    CONCLUSIONS: Global cytokine profiles did not discriminate IBS patients from healthy subjects, but cytokine profiles were more varied among IBS patients than among healthy subjects, and a small subgroup of patients with enhanced immune activity was identified. Also, association of inflammatory cytokines with some clinical symptoms suggests that immune activation may be of importance in a subset of IBS patients.

  • 219.
    Benrick, Anna
    et al.
    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.
    Chanclón, Belén
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Micallef, Peter
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Wu, Yanling
    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.
    Shelton, John M.
    Molecular Pathology Core, University of Texas Southwestern Medical Center, Dallas, TX, USA.
    Stener-Victorin, Elisabet
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden / Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden.
    Wernstedt Asterholm, Ingrid
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Adiponectin protects against development of metabolic disturbances in a PCOS mouse model2017In: Proceedings of the National Academy of Sciences of the United States of America, ISSN 0027-8424, E-ISSN 1091-6490, Vol. 114, no 34, p. E7187-E7196, article id 201708854Article in journal (Refereed)
    Abstract [en]

    Adiponectin, together with adipocyte size, is the strongest factor associated with insulin resistance in women with polycystic ovary syndrome (PCOS). This study investigates the causal relationship between adiponectin levels and metabolic and reproductive functions in PCOS. Prepubertal mice overexpressing adiponectin from adipose tissue (APNtg), adiponectin knockouts (APNko), and their wild-type (WT) littermate mice were continuously exposed to placebo or dihydrotestosterone (DHT) to induce PCOS-like traits. As expected, DHT exposure led to reproductive dysfunction, as judged by continuous anestrus, smaller ovaries with a decreased number of corpus luteum, and an increased number of cystic/atretic follicles. A two-way between-groups analysis showed that there was a significant main effect for DHT exposure, but not for genotype, indicating adiponectin does not influence follicle development. Adiponectin had, however, some protective effects on ovarian function. Similar to in many women with PCOS, DHT exposure led to reduced adiponectin levels, larger adipocyte size, and reduced insulin sensitivity in WTs. APNtg mice remained metabolically healthy despite DHT exposure, while APNko-DHT mice were even more insulin resistant than their DHT-exposed littermate WTs. DHT exposure also reduced the mRNA expression of genes involved in metabolic pathways in gonadal adipose tissue of WT and APNko, but this effect of DHT was not observed in APNtg mice. Moreover, APNtg-DHT mice displayed increased pancreatic mRNA levels of insulin receptors, Pdx1 and Igf1R, suggesting adiponectin stimulates beta cell viability/hyperplasia in the context of PCOS. In conclusion, adiponectin improves metabolic health but has only minor effects on reproductive functions in this PCOS-like mouse model.

  • 220.
    Benrick, Anna
    et al.
    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.
    Kokosar, Milana
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Hu, Min
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Larsson, Martin
    Department of Physiology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Maliqueo, Manuel
    Endocrinology and Metabolism Laboratory, West Division, School of Medicine, University of Chile, Santiago, Chile.
    Marcondes, Rodrigo Rodrigues
    Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden / Disciplina de Ginecologia, Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
    Soligo, Marzia
    Institute of Translational Pharmacology, Consiglio Nazionale delle Ricerche, Rome, Italy.
    Protto, Virginia
    Institute of Translational Pharmacology, Consiglio Nazionale delle Ricerche, Rome, Italy.
    Jerlhag, Elisabet
    Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Sazonova, Antonina
    Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Behre, Carl Johan
    Department of Cardiology, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Højlund, Kurt
    Department of Endocrinology, Odense University Hospital, Odense, Denmark.
    Thorén, Peter
    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, Stockholm, Sweden.
    Autonomic nervous system activation mediates the increase in whole-body glucose uptake in response to electroacupuncture2017In: The FASEB Journal, ISSN 0892-6638, E-ISSN 1530-6860, Vol. 31, no 8, p. 3288-3297Article in journal (Refereed)
    Abstract [en]

    A single bout of low-frequency electroacupuncture (EA) causing muscle contractions increases whole-body glucose uptake in insulin-resistant rats. We explored the underlying mechanism of this finding and whether it can be translated into clinical settings. Changes in glucose infusion rate (GIR) were measured by euglycemic-hyperinsulinemic clamp during and after 45 min of low-frequency EA in 21 overweight/obese women with polycystic ovary syndrome (PCOS) and 21 controls matched for age, weight, and body mass index (experiment 1) and in rats receiving autonomic receptor blockers (experiment 2). GIR was higher after EA in controls and women with PCOS. Plasma serotonin levels and homovanillic acid, markers of vagal activity, decreased in both controls and patients with PCOS. Adipose tissue expression of pro-nerve growth factor (proNGF) decreased, and the mature NGF/proNGF ratio increased after EA in PCOS, but not in controls, suggesting increased sympathetic-driven adipose tissue metabolism. Administration of alpha-/beta-adrenergic receptor blockers in rats blocked the increase in GIR in response to EA. Muscarinic and dopamine receptor antagonist also blocked the response but with slower onset. In conclusion, a single bout of EA increases whole-body glucose uptake by activation of the sympathetic and partly the parasympathetic nervous systems, which could have important clinical implications for the treatment of insulin resistance.

  • 221.
    Berg, Angela
    et al.
    University of Skövde, School of Health and Education.
    Mattsson, Jenny
    University of Skövde, School of Health and Education.
    Att leva med fibromyalgi - en sjukdom som drabbar hela familjen: En litteraturbaserad studie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: From the beginning fibromyalgia was classified as rheumatism, but now we know it is caused by central nervous system (CNS) disorder. The symptoms are diffuse but most common are constant pain and fatigue. There are no specific tests to establish the diagnose and no satisfying medication. The disease is not visible outside the body and many experiences misbelieve from care staff and relatives, which affects their wellbeing negatively. Aim: The aim of this study is to describe how patients and their family are affected by fibromyalgia. Method: A literature based study was used to identify the knowledge that already existed in the topic. Results: Fibromyalgia is an invisible disease that affects the individual and their family significantly. Because the complicity of establishing the diagnose and the fact that fibromyalgia can not be seen outside the body, these patients are often met with distrust from both doctors and acquaintances. The lack of information is apparent, which can affect the disease negatively. Four main themes emerged, The changed lift, To be misbelieved, Changed rolls and the vague knowledge. Conclusion: Nurses have an important function, to listen to and inform individuals with fibromyalgia, and their relatives. To be able to inform, a higher knowledge and understanding is necessary. To get information can be the difference between coping with the disease, or not.

  • 222.
    Berg, Helena
    et al.
    University of Skövde, School of Life Sciences.
    Hjortman, Ingela
    University of Skövde, School of Life Sciences.
    Omvårdnad vid bensår: En litteraturöversikt2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BAKGRUND: Patienter med bensår återfinns inom hela sjukvården. Detta innebär att många sjuksköterskor kommer att möta dessa patienter i sitt arbete oberoende av var de arbetar. Distriktssköterskor kan ägna upp till hälften av sin arbetstid till bensårsbehandling. Patienter med bensår lider ofta av smärtor. Såren påverkar deras livskvalité och begränsar deras liv. SYFTE: Denna studies syfte var att belysa omvårdnaden vid smärtsamma bensår, ur såväl ett sjuksköterske- som patientperspektiv. METOD: En litteraturöversikt baserad på vetenskapliga artiklar. Resultatet grundas på 14 artiklar, med både kvalitativ och kvantitativ metod. RESULTAT: Fyra huvudtema framkom; Smärtkontroll, Interaktion mellan sjuksköterska och patient, Social gemenskap och Kunskapsutveckling. Många patienter med bensår hade smärtor som inte uppmärksammades av sjuksköterskan, då patienterna inte alltid påtalade detta. Sjuksköterskor har ett viktigt arbete i att kontinuerligt smärtskatta och följa upp smärtlindringen. Optimal sårbehandling förutsätter ett gott samarbete mellan patient och sjuksköterska. Den sociala gemenskapen är en viktig del i patientens välbefinnande och främjar sårläkning och minskar smärta. Både patienter och sjuksköterskor saknar tillräckliga kunskaper om bensår.

  • 223.
    Berg, Helena
    et al.
    University of Skövde, School of Health and Education.
    Kjellberg, Kristina
    University of Skövde, School of Health and Education.
    Inget går upp mot distriktssköterskor: Distriktssköterskans roll inom projektet Samverkande sjukvård2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The number of elderly in Sweden is increasing. They are often fragile and sickly, needing more care and support. To meet an increased need of healthcare, a collaboration project, Collaborative Healthcare, was established to ensure that patients are treated at the right place. Research shows that the elderly often fall ill from hospital admission, and after visits to the emergency department, they are more often admitted because of their complex medical history. Aim: To investigate whether the district nurse's profession within the project Collaborative Healthcare leads to a reduction in the use of other healthcare resources. Method: This study is retrospective with a quantitative approach. Data collected by others within the project were used. The analysis was performed with descriptive and correlation analysis. The results are presented in tables, figures and text. Results: The district nurse's efforts often lead to nursing in the home, preventing visits to health centers and emergency rooms as well as hospital admissions. Conclusion: Cooperation between different healthcare authorities leads to benefits for both patients and staff.

  • 224.
    Berg, Lars-Erik
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Neurovetenskaplig psykiatri2018In: Psykoterapi, ISSN 2001-5836, no 2, p. 47-49Article, book review (Other academic)
  • 225.
    Berg Marklund, Erik
    et al.
    University of Skövde, School of Life Sciences.
    Rönnberg, Karolina
    University of Skövde, School of Life Sciences.
    Sjuksköterskors upplevelse av hur arbetsmiljön påverkar omvårdnadsarbetet: En intervjustudie2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Studies have shown that nurses work environment can affect them in their nursing care. This study aimed to interview nurses about their perception of how their work environment affects nursing care. Interviews were conducted with seven registered nurses at a hospital in western Sweden. The interviews were analyzed and manifest content linked to the aim of the study was identified and then condensed. The results showed that there are many different aspects in nurses work environment that they feel affect them in their nursing care. Nurses experienced that a good social climate could help them in their nursing care. At the same time work related stress and lack of time for patients, mostly due to time consuming administrative work, had a negative impact on nursing care. The conclusion of this study is that nurses experience that their work environment can have both a positive and a negative effect on nursing care. Future research on nurses work environment is needed to better serve the needs of nursing care.

  • 226.
    Bergelind, Sandra
    et al.
    University of Skövde, School of Life Sciences.
    Mohamad, Rondik
    University of Skövde, School of Life Sciences.
    Patienters upplevelser av sjuksköterskors bemötande: En litteraturöversikt2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    BACKGROUND: Being a nurse requires medical knowledge as well as knowledge about nursing science. Nursing is among other things about how to respond to patients in a proper manner to avoid unnecessary suffering in the care. For nurses to be able to respond to patients in a way that the patients experience as good the nurses have to know how the patients experience the approach.

    AIM: To illustrate how the patients who are receiving hospital treatment experience the care of nurses.

    METHOD: Literature overview as described by Friberg (2006), where 14 articles were analyzed.

    RESULT: The result is divided into five themes: The importance of the encounter for patients, The significance of humor, Patients´ need for communication and information, The need for acknowledgement/confirmation, and Factors that affect patients trust in nurses.

    CONCLUSION: The result shows how patients experience the nursing situation and what their notion of a good approach is. The result can be used as evidence of the importance of the quality of the nursing and is urgent knowledge to nurses who daily meet patients at work. The knowledge that the study has contributed with can be used to improve the care relationship between patients and nurses in practice.

  • 227.
    Bergendahl, Jessica
    et al.
    University of Skövde, School of Health and Education.
    Östman, Evelina
    University of Skövde, School of Health and Education.
    Ortorexia nervosa: Hälsa som blir ohälsa2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    ABSTRACT

    Title: Orthorexia Nervosa- Healthy turning unhealthy

    Department: School of Life Sciences, University of Skövde

    Course: University Diploma Project in Public Health Science,15 ECTS

    Author: Bergendahl, Jessica; Östman, Evelina

    Supervisor: Ekberg, Joakim

    Pages: 23

    Month and year: 06/2014

    Keywords: Orthorexia Nervosa, Health, Mental illness, Media influences

    Background: A healthier way of life often starts out with good intentions, but sometimes people take their healthy lifestyle too far. Orthorexia nervosa was meant to be a description for a group of people with similar problems, until it was clear that there might be more behind it. A person with orthorexia is obsessed with healthy dieting and takes it to the extreme.

    Aim: To investigate what orthorexia is and if there are clear guidelines about treatment.

    Method: We have studied literature, scientific articles, and completed interviews with people qualified in the fields of orthorexia. A qualitative study based on a content analysis was performed.

    Results: Orthorexia nervosa has no status of diagnosis. It is difficult to determine exactly what triggers orthorexia, however, it is likely that it is a need of control. Using an extremely healthy diet creates the feeling of being in control. Media seems to influence this.

    Conclusion: The conclusion was that more research is needed in order to decide what orthorexia nervosa actually stands for. Orthorexia nervosa is considered when a person tries to live as healthy as possible but by strictly controlling their diet illness occurs.

  • 228.
    Berggren, Beatrice
    et al.
    University of Skövde, School of Health and Education.
    Hultman, Veronica
    University of Skövde, School of Health and Education.
    Sjuksköterskors erfarenheter av att vårda patienter med HIV i utvecklingsländer: En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: HIV är en kronisk sjukdom som innebär att immunförsvaret försvagas. Symtom som förekommer kan liknas vanliga infektionssjukdomar, exempelvis feber och halsont. Idag lever 30–50 miljoner människor i världen med sjukdomen. Sjukdomen är en av de ledande orsakerna till mortalitet i utvecklingsländer. Syfte: Att undersöka sjuksköterskors erfarenheter av att vårda patienter med HIV i utvecklingsländer. Metod: En litteraturöversikt som baseras på kvalitativa (n=10) och kvantitativa artiklar (n=1) samt kombinerat kvalitativ och kvantitativt (n=2). Resultat: Ur analysen framkom två kategorier; Bygga ömsesidig tillit och Brister i organisationen med fem underkategorier. Konklusion: Sjuksköterskor i utvecklingsländer upplever en utmanande arbetsmiljö kring patienter med HIV. De upplever känslor av stress, otillräcklighet och maktlöshet. Trots mycket negativitet upplevdes glädje i att vårda patienter med HIV.

  • 229.
    Berggren, Elisabeth
    University of Skövde, School of Life Sciences.
    Daily life after Subarachnoid Haemorrhage: Identity construction, patients' and relatives' statements about patients' memory, emotional status and activities of living2012Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this thesis was to describe patients’ experience and reconstruction regarding the onset of, and events surrounding being struck by a Subarachnoid Haemorrhage (SAH), and to describe patients’ and relatives’ views of patients’ memory ability, emotional status and activities of living, in a long-term perspective.

    Methods: Both inductive and deductive approaches were used. Nine open interviews were carried out in home settings, in average 1 year and 7 seven months after the patients’ onset, and discourse analysis was used to interpret the data. Eleven relatives and 11 patients, 11 years after the onset, and 15 relatives and 15 patients, 6 years after the onset, participated in two studies. Interviews using a questionnaire with structured questions and memory tests were used to collect data. Fischer’s exact test and Z-scores were used for the statistical analysis.

    Results: Patients with experience of a SAH were able to judge their own memory for what happened when they became ill. The reconstruction of the illness event may be interpreted as an identity creating process. The process of meaning-making is both a matter of understanding SAH as a pathological event and a social and communicative matter, where the SAH is construed into a meaningful life history, in order to make life complete (I). Memory problems, changes in emotional status and problems with activities of living were common (II-IV). There was correspondence between relatives’ and patients’ statements regarding the patients’ memory in general and long-term memory. Patients judged their own memory ability better than relatives, compared with results on memory tests. Relatives stated that some patients had meta-memory problems (II). The episodic memory seemed to be well  reserved, both concerning the onset and in the long-term perspective (I, II). There were more problems with social life than with P- and I-ADL (III), and social company habits had changed due to concentration difficulties, mental fatigue, and  patients’ sensitivity to noisy environments and uncertainty (IV). Relatives rated the patients’ ability concerning activities of living and emotional status, and in a similar manner to patients’ statements (III-IV).

    Conclusions: The reconstruction of the illness event can be used as a tool in nursing for understanding the patient’s identity-construction. Relatives and patients stated the patients’ memory, emotional status and activities of living in a similar manner, and therefore both patients’ and relatives’ statements can be used as a tool in nursing care, in order to support the patient. However, the results showed: meta-memory problems (relatives’ statements) and that the patients’ judged their own memory ability better than relatives in comparison with results on memory tests. Nevertheless, there was a high degree of concordance between relatives’ and patients’ evaluations concerning patients´ memory ability, emotional status, emotional problems, social company habits and activities of living. Therefore both relatives’ and patients’ statements can be considered to be reliable. However, sometimes the patients and the relatives judge the patients’ memory differently. Consequently, memory tests and formalized dialogues between the patient, the relative and a professional might be required, in order to improve the mutual family relationship in a positive way. Professionals however, must first assume that patients can judge their own memory, emotional status and ability in daily life.

  • 230.
    Berggren, Elisabeth
    University of Skövde, School of Life Sciences.
    Identity construction and memory after Subarachnoid Haemorrhage: Patients' accounts and relatives' and patients' statements in relation to memory tests2010Licentiate thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: A Subarachnoid haemorrhage (SAH) is a complex pathophysiological event and most patients have, before the onset, felt completely well. Being stricken by a SAH is a dramatic event, often followed by unconsciousness and memory problems. This may influence the adjustment to daily life. Supporting patients and relatives in nursing care therefore requires knowledge concerning patients' experience of the onset of the SAH event, and knowledge concerning patients' memory after a SAH.

    Aim: The general aim of this thesis was to study patients' experiences and reconstruction of the onset of, and events surrounding, a SAH and to study patients' and relatives' experience of patients' memory ability, in a long-term perspective.

    Specific aims:

    (I) The aim of this study was to analyse people's accounts of SAH, and to describe how they initiate and create meaning for the onset and events surrounding the SAH. The specific questions were : (i) What is highlighted in the accounts of SAH? (II) How is the illness reconstructed? (iii) How is meaning created through communicative interaction with others about SAH?

    (II) The aim was to describe memory after a SAH from the perspective of relatives and patients in two cohorts. In this study, the researchers also aimed to evaluate the application of relatives' statements as a tool in nursing care and rehabilitation, in order to support the patients. This was achieved by comparing: (i) Relatives' statements with patients' statements and (ii) Relatives' and patients' statements with the patients' memory test results.

    Methods: Both an inductive and a deductive approach were used. Nine open interviews were carried out in home settings, 1 year and 7 months (ranging 14-24 months) after the patients' onset and discourse analysis was used to interpret the data (I). Eleven relatives and 11 patients, 11 years and 15 relatives and 15 patients, 6 years after the onset participated in two studies. Interview questions and memory tests were used to collect data. Fischer's exact test was used for the statistical analysis (II).

    Findings:Patient with experience of a SAH were able to judge their own memory for what happened when they became ill. Both conscious irrational and rational actions were expressed in relation to experienced sensations. Critical events related to SAH were "existential insights" and "time as waiting and time as structuring meaning". The reconstruction of the illness event may be interpreted as an identity ceating process. The process of meaning-making is both a matter of understanding SAH as a pathological event, and a social and communicative matter, where the SAH is constructed into a meaningful life history, in order to make life complete (I). Memory problems were common according to relatives' and patients' statements and from memory test results. There was correspondence between relatives' and patients' statements regarding the patients' memory in general and long-term memory. Patients judged their own memory ability better than relatives, compared with results on memory tests. Both relatives and patients underestimated older patients' memory ability and underrated younger patients' memory problems, when compared with results on memory tests. Relatives stated that some patients had meta-memory problems (II). The episodic memory seemed to be well preserved, both concerning the onset (I) and in the long-term perspective (II).

    Conclusions: The reconstruction of the illness is a tool in nursing for understanding the patient's self-positioning and identity-construction. (I) Relatives' and patients' statements regarding patients' memory can also be used as tools in nursing care. However, the results showed: meta-memory problems (relatives' statements); that patients' judged their own memory ability better than relatives in comparison with results on memory tests. Consequently, memory tests and formalized dialogues, between the patient, the relative and a professional are required in order to prevent complications in the patient's mutual family relationships. However, professionals must assume that patients can judge their own memory (II). Dialogues between the patient, the relative and a professional, with focus on how to manage daily life in patients' home context, due to the patient's experience of the onset of the SAH and possible memory problems after the SAH, will probably improve the mutual family relationship in a positive way (I,II).

  • 231.
    Berggren, Elisabeth
    et al.
    University of Skövde, School of Life Sciences.
    Sidenvall, Birgitta
    Jönköping University.
    Hellström Muhli, Ulla
    University of Skövde, School of Life Sciences.
    Identity construction and meaning-making after subarachnoid haemorrhage2010In: British Journal of Neuroscience Nursing, ISSN 1747-0307, E-ISSN 2052-2800, Vol. 6, no 2, p. 86-93Article in journal (Refereed)
    Abstract [en]

    Aim: The aim was to analyse people's accounts of subarachnoid haemorrhage (SAH) and to describe how they initiate and create meaning for the onset and events surrounding the SAH.

    Background: Being struck by a SAH is a dramatic event, often followed by unconsciousness. There is therefore a special need for a patient to try to create some kind of meaning for the event during recovery and afterwards.

    Method: Nine interviews were carried out in home settings and discourse analysis was used to interpret the data.

    Findings: People stricken by SAH seem to be able to judge from memory for when they were becoming ill. Critical events related to SAH were existential threats and existential insights; and time as 'waiting' and time as 'structuring meaning'. The reconstruction of the illness event may be interpreted as an identity-creating process.

    Conclusion: The reconstruction of the illness is a tool that can be used by nurses and other health professionals to understand a patient's self-positioning and identity-construction.

  • 232.
    Berggren, Elisabeth
    et al.
    University of Skövde, School of Life Sciences.
    Sidenvall, Birgitta
    Jönköping University.
    Larsson, Dennis
    University of Skövde, The Systems Biology Research Centre. University of Skövde, School of Life Sciences.
    Subarachnoid haemorrhage has long-term effects on social life2011In: British Journal of Neuroscience Nursing, ISSN 1747-0307, E-ISSN 2052-2800, Vol. 7, no 1, p. 429-435Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of this study was to describe memory after a subarachnoid haemorrhage (SAH) from the perspective of relatives and patients in two cohorts and also to evaluate the application of relatives' statements as a tool in nursing care and rehabilitation, in order to support the patient. Background: Cognitive sequelae due to SAH are a large disability and may influence the adjustment to daily life. Supporting patients and relatives requires knowledge concerning the patients' memory both from the perspective of patients and relatives. Method: Eleven relatives and 11 patients (Cohort 1), 11 years after the onset of an SAH and 15 relatives and 15 patients (Cohort 2) 6 years after the onset of an SAH, participated in the study. Interview questions and memory tests were used to collect data. Findings: Problems with memory, including meta-memory problems regarding relatives' statements, were common. Relatives and patients stated patients' menory in a similar manner. However, patients' statements concerning their memory corresponded in higher degree with memory test results, in comparison with relatives' statements. Conclusions: Relatives' and patients' statements are useful as tools in nursing care and rehabilitation. However, from results showing meta-memory problems and that patients' statements concerning their memory corresponded better with memory test results (in comparison with relatives' statements), it is vital to offer patients memory tests in order to prevent complications in mutual family relationships.

  • 233.
    Berggren, Emma
    et al.
    University of Skövde, School of Life Sciences.
    Lundin, Sabina
    University of Skövde, School of Life Sciences.
    Barn och ungas psykosomatiska besvär: Hur tar de sig uttryck och vilka är de bakomliggande orsakerna? - en litteraturstudie2012Independent thesis Basic level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    The purpose of this study was to examine psychosomaticsymptomsissuesamongst children and adolescents between the ages of 0-18 years and to clarify the underlying factors.Method: Literature study based on 10 scientific articles.Results: Psychosomatic issues amongst children and adolescents, due to stress, were common in Europe and Scandinavia. The symptoms varied between gender and age. The underlying factors were mainly school environmental issues, home conditions, socio-economic situations and disputes with teachers and peers. The symptoms varied from headache, gastro intestinal problems and insomnia to eating disorders, depression and pounding heart.               Conclusion: The future of children’s psychosomatic health depends on interventions on all levels of society since they are affected by everything from school environment and home conditions to unemployment and recession.

  • 234.
    Berggren, Johan
    et al.
    University of Skövde, School of Health and Education.
    Palmqvist, Mikael
    University of Skövde, School of Health and Education.
    Sjuksköterskors erfarenheter vid vård av vuxna i livets slutskede: En litteraturbaserad studie2016Independent thesis Basic level (degree of Bachelor), 12 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Sjuksköterskan arbetar nära vuxna patienter i livets slutskede där försök till läkande behandling gått över till en palliativ behandling. Många av dessa patienter har en komplicerad symtombild som kräver kunskaper i symtomhantering och de har också ofta oro, ångest och funderingar kring existentiella frågor som sjuksköterskan kan behöva hantera.Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av att vårda vuxna patienter i livets slutskedeMetod: Metoden som valdes var en litteraturbaserad studie grundat på kvalitativ forskning, baserat på tolv vetenskapliga artiklar. 

    Resultat: Ur analysen framträdde tre kategorier såsom Frustration, skicklig kommunikatör, få till ett nära samarbete med åtta underkategorier.

    Slutsats: Sjuksköterskors erfarenheter vid vård i livets slutskede påvisar betydelsen av att relationer mellan patienten, anhöriga och vårdpersonal skapas. 

  • 235.
    Berggren, Malin
    et al.
    University of Skövde, School of Health and Education.
    Berglund, Johanna
    University of Skövde, School of Health and Education.
    När hjärtat slutat slå: patientens upplevelse att överleva ett hjärtstopp. En litteraturbaserad studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: To suffer from cardiac arrest can be experienced as a dramatic event that affects both the health and life world. All of the patients have an existential coherency that affects the health, life and the patient itself. As a nurse you will be able to see the patient's life world and understand how different contexts affects the patient's experienced health. Purpose: The purpose was to describe the patient’s experience of surviving cardiac arrest. Method: The chosen method was a literature based study with a qualitative approach that included 11 articles that was analyzed using a method described by Friberg. Results: Through analysis of the data material three main themes was generated with associated sub themes. From the analysis of the data emerged three main themes a new every day life, a changed life and a life changing limitation with an inoperable defibrillator with ten undertheme. Conclusion: The majority of the patients experienced worry, fear and anxiety in their everyday life. They needed to develop new strategies to cope with their new life with the help of routines and planning to decrease stress in their everyday life.

  • 236.
    Bergh, Ingrid
    University of Skövde, School of Life Sciences.
    Pain in the elderly: rating scales, prevalence and verbal expression of pain and pain relief2003Doctoral thesis, comprehensive summary (Other academic)
  • 237.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Björk, Maria
    University of Skövde, School of Life Sciences.
    Sense of coherence over time for parents with a child diagnosed with cancer2012In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 12, p. Article number 79-Article in journal (Refereed)
    Abstract [en]

    Background: When a child is diagnosed with childhood cancer this creates severe stress in the parents. The aim of the study was to describe the sense of coherence and its change over time in a sample of parents of children diagnosed with cancer.

    Methods: The Swedish version of SOC (29 items) was used to measure the parents’ (n = 29) sense of coherence. Data were collected at four time-points: Time-point 1 at the time of diagnosis; time-point 2 during the treatment; time-point 3 after the child had completed their treatment and time-point 4 when the child had been off treatment for some years or had died.

    Results: The results showed that SOC in the investigated population is not stable over time. The parents decreased in total SOC between time-points 1, 2 and 3. Mothers had significantlyweaker total SOC score including the components Manageability and Meaningfulness at time-points 1 as well time-point 2 compared to the fathers. However, for the component Comprehensibility no significant differences were shown between mothers and fathers. This study indicates that mothers’ and fathers’ SOC scores change over time during the child’s cancer trajectory. However, the pattern in these changes varies between mothers and fathers.

    Conclusions: This study indicates that mothers and fathers may have different support needs during their child’s cancer trajectory.

  • 238.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Gunnarsson, Magnus
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Allwood, Jens
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Descriptions of pain in elderly patients following orthopaedic surgery2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 2, p. 110-118Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate what words elderly patients, who had undergone hip surgery, used to describe their experience of pain in spoken language and to compare these words with those used in the Short-Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The study was carried out at two orthopaedic and two geriatric clinical departments at a large university hospital in Sweden. Altogether, 60 patients (mean age =77) who had undergone orthopaedic surgery took part in the study. A face-to-face interview was conducted with each patient on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and one structured interview. The results show that a majority of the elderly patients who participated in this study verbally stated pain and spontaneously used a majority of the words found in the SF-MPQ and in the POM. The patients also used a number of additional words not found in the SF-MPQ or the POM. Among those patients who did not use any of the words in the SF-MPQ and the POM, the use of the three additional words 'stel' (stiff), 'hemsk' (awful) and 'räd(d)(sla)' (afraid/fear) were especially marked. The patients also combined the words with a negation to describe what pain was not. To achieve a more balanced and nuanced description of the patient's pain and to make it easier for the patients to talk about their pain, there is a need for access to a set of predefined words that describe pain from a more multidimensional perspective than just intensity. If the elderly patient is allowed, and finds it necessary, to use his/her own words to describe what pain is but also to describe what pain is not, by combining the words with a negation, then the risk of the patient being forced to choose words that do not fully correspond to their pain can be reduced. If so, pain scales such as the SF-MPQ and the POM can create a communicative bridge between the elderly patient and health care professionals in the pain evaluation process.

  • 239.
    Bergh, Ingrid H. E.
    et al.
    University of Skövde, School of Life Sciences.
    Ek, Kristina
    University of Skövde, School of Life Sciences.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Midwifery students attribute different quantitative meanings to "hurt", "ache" and "pain": A cross-sectional survey2013In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 26, no 2, p. 143-146Article in journal (Refereed)
    Abstract [en]

    Background: Assessment of women's labor pain is seldom acknowledged in clinical practice or research. The words "aching" and "hurting" are frequently used by women to describe childbirth pain. The aim of this study was to determine the quantitative meanings midwifery students attribute to the terms "hurt", "ache" and "pain". Data was collected by self-administered questionnaire from students at seven Swedish midwifery programs. A total of 230 filled out and returned a completed questionnaire requesting them to rate, on a visual analog scale, the intensity of "hurt", "ache" or "pain" in the back, as reported by a fictitious parturient. Results: The midwifery students attributed, with substantial individual variation, different quantitative meanings to the studied pain descriptors. Conclusions: To be able to communicate about pain with a woman in labor, it is essential that the midwife be familiar with the value of different words and what they mean to her as this may affect her assessment when the woman describes her pain. © 2012.

  • 240.
    Bergh, Ingrid H. E.
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Johansson, Anna
    Univ Hosp Örebro, Dept Obstet, Örebro, Sweden.
    Bratt, Annelie
    Skaraborgs Hosp, Dept Obstet & Gynecol, Skövde, Sweden.
    Ekström, Anette
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Mårtensson, Lena B.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards2015In: Women and Birth, ISSN 1871-5192, E-ISSN 1878-1799, Vol. 28, no 2, p. E14-E18Article in journal (Refereed)
    Abstract [en]

    Background: A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. Methods: This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. Results and conclusion: The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.

  • 241.
    Bergh, Ingrid H. E.
    et al.
    Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg.
    Stener-Victorin, Elisabet
    Institute of Neuroscience and Physiology/Endocrinology, Sahlgrenska Academy, University of Gothenburg.
    Wallin, Gunnar
    Institute of Clinical Sciences, Department of Obstetrics and Gynaecology, Sahlgrenska Academy, University of Gothenburg.
    Mårtensson, Lena
    University of Skövde, School of Life Sciences.
    Comparison of the PainMatcher and the Visual Analogue Scale for assessment of labour pain following administered pain relief treatment2011In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 1, p. E134-E139Article in journal (Refereed)
    Abstract [en]

    Objective: during childbirth, it is necessary to assess and monitor experienced pain and to evaluate the effect of pain relief treatment. The aim of this study was to compare the PainMatcher® (PM) with the Visual Analogue Scale (VAS) for the assessment of labour pain and the effect of pain relief treatment.Design: randomised controlled trial.Setting: labour ward with approximately 2500 childbirths per year in western Sweden.Participants: 57 women with labour pain treated with acupuncture or sterile water injections scored their electrical pain threshold and pain intensity with the PM. Pain intensity was also assessed with the VAS. Electrical pain threshold and pain intensity were assessed immediately after a uterine contraction before and 30, 60, 90, 120, 150 and 180 minutes after treatment.Measurements and findings: the results showed a weak correlation (r=0.13, p<0.05) between the pain intensity scores on the PM and the VAS. The PM detected changes (decrease) in pain intensity to a lower degree than the VAS. Surprisingly, in over 10% of sessions, women scored their pain intensity during a uterine contraction lower than their electrical pain threshold with the PM. However, electrical pain thresholds with the PM correlated well throughout all measurements.Conclusions: the PM is a reliable tool for the assessment of electrical pain threshold; however, the VAS is more sensitive than the PM for recording changes in pain intensity when assessing the effects of treatment on labour pain.Implications for practice: the PM and the VAS are not interchangeable in the case of labour pain, and there is still a need for research in this area to find a more suitable assessment instrument for the evaluation of labour pain.

  • 242.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Jakobsson, Eva
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Worst experiences of pain and conceptions of worst pain imaginable among nursing students2008In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 61, no 5, p. 484-491Article in journal (Refereed)
    Abstract [en]

    This paper is a report of a study to explore nursing students' own worst experiences of pain as well as their conceptions of the worst pain imaginable. Background.

    Pain is a personal experience, often assessed using a visual analogue scale. The endpoints of this scale are labelled with the extremes for pain experience (e.g. no pain to worst pain imaginable). People may understand the meaning of `no pain', but it is unclear what meaning they assign to `worst pain imaginable'. This indicates that a rating along the Visual Analogue Scale-line is dependent on the individual's previous experiences. Methods. Data were collected during the autumn of 2002. In total, 549 nursing students completed a questionnaire focusing on two main questions: `What is the worst experience of hurt, ache or pain you have had?' and `What is the worst pain imaginable for you?' Content analysis was used for data analysis. Results. The students' worst experience of pain was mostly related to acute or traumatic painful conditions, pain associated with female physiology, inflicted pain, psychological suffering and chronic painful conditions. The worst pain imaginable was described as condition-related pain, overwhelming pain, experiences of losses, deliberately inflicted pain, psychological suffering and as vicarious pain. Conclusion. The findings imply that nursing students, when they are imagining pain, include dimensions such as hope of relief, grief, control over the situation, powerlessness and empathy for and suffer with other people's pain. Further research is needed to explore why professional experience as a nurse diminishes the ability to imagine patients' pain.

  • 243.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Jakobsson, Eva
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Steen, Bertil
    University of Skövde, School of Life Sciences.
    Ways of talking about experiences of pain among older patients following orthopaedic surgery2005In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 52, no 4, p. 351-359Article in journal (Refereed)
    Abstract [en]

    Aim. The aim of this study was to examine how older patients who had undergone hip surgery described their experience of pain.

    Background. A verbal report of pain is considered to be the single most reliable indicator of a person's pain experience. When assessing pain, healthcare professionals must be able to interpret the content of pain reports in order to understand older patient's pain experiences.

    Methods. The study was carried out in two orthopaedic and two elder care wards in a large university hospital in Sweden in 2000. Altogether, 38 patients with hip replacement (mean age = 75) and 22 patients with hip fracture (mean age = 81) took part. A face-to-face interview was conducted with each patient on the second day after operation. Data were transcribed and analysed using descriptive qualitative content analysis.

    Findings. Participants expressed their pain in a nuanced and detailed way in everyday language. Four main themes with sub-themes emerged: (a) objectification (localizing; quantifying; characterizing; temporalizing); (b) compensating (substitution; picturing); (c) explaining (functionalizing pain and its relief; externalizing pain and its relief); (d) existentializing (present pain orientation; future pain orientation).

    Conclusions. Exploring the ways older patients talk about pain is expected to result in a better understanding of the older patient's need of empathic individualized care and in the optimization of pain management.

  • 244.
    Bergh, Ingrid
    et al.
    Department of Geriatric Medicine, Göteborg University, Sweden.
    Sjöström, Björn
    Department of Geriatric Medicine, Göteborg University, Sweden.
    A comparative study of nurses' and elderly patients' ratings of pain and pain tolerance1999In: Journal of Gerontological Nursing, ISSN 0098-9134, E-ISSN 1938-243X, Vol. 25, no 5, p. 30-36Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to compare elderly patients' and nurses' ratings of pain and pain tolerance. Data were collected through structured interviews with the patients. The attending nurses completed a questionnaire after conducting a pain assessment. Independent of each other, patients and nurses were asked to rate on a VAS when pain should be treated (pain tolerance) and pain intensity. The VAS has been used both by patients and nurses. The initial selection consisted of 43 patients; however, 9% (n = 4) were unable to complete the VAS. These patients were not significantly older than those who completed the study (n = 39). The results shows that nurses tend to overestimate mild pain and underestimate severe pain. Nurses rated pain tolerance significantly lower than patients. The results also suggest that nurses with training beyond basic nursing education tend to assess patients' pain more accurately than those without additional training. For patients who reported that they had pain prior to hospitalization, the nurses' pain ratings showed a higher agreement than for those who reported that they did not have pain before being hospitalized. At the time of the interviews, 21% (n = 8) of patients felt that their pain was so great they needed treatment. Those patients also were recognized by the attending nurses as being in pain. To improve elderly patients' pain management, practicing nurses must collaborate with researchers to develop specific empirical research nursing knowledge within geriatric pain management. This research-based knowledge should be incorporated into nurses' clinical practice regarding pain management. Specific guidelines must be developed for the assessment, treatment, and documentation of elderly patients' pain.

  • 245.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Quantification of the pain terms hurt, ache and pain among nursing students2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 2, p. 163-168Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to determine the quantitative meaning nursing students ascribe to the pain terms hurt (ont), ache (värk) and pain (smärta). In total, 549 nursing students filled in a questionnaire including questions about age, gender, and health care work experience. The students were also requested to rate response using a Visual Analogue Scale (VAS) rating for different statements about hurt, ache and pain. The results show that there were significant differences (p < 0.001) between rated intensity of the statements of hurt, ache and pain. There were, however, large variations in the students’ ratings of the pain terms; hurt ranged from 3 to 97 mm, ache from 7 to 97 mm and pain from 27 to 100 mm. There were no significant differences between male and female students regarding their ratings of hurt and ache when they were used to describe the worst self-experienced pain. Female students rated their experience of pain significantly higher (p < 0.001) on the VAS compared with male students. There was no significant correlation between previous experience of health care work and rated intensity of hurt, ache and pain. In conclusion, this study shows that there exist significant differences between the pain terms hurt, ache and pain according to a rating on a VAS. However, the results also demonstrate that there are large individual variations in how the students quantify the fictitious patient statements of hurt, ache and pain.

  • 246.
    Bergh, Ingrid
    et al.
    University of Skövde, Department of Health Sciences. Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Göteborg.
    Sjöström, Björn
    Department of Health Care Pedagogics, Göteborg University, Göteborg.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Göteborg.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Göteborg.
    An application of pain rating scales in geriatric patients2000In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 12, no 5, p. 380-387Article in journal (Refereed)
    Abstract [en]

    This study examined the applicability of three different pain rating scales, the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the Numeric Rating Scale (NRS), in geriatric patients. Data collection was performed in a geriatric clinic at a university hospital. A structured interview was conducted with 167 patients (mean age = 80.5 years). Patients rated their current experience of pain twice with a 5-minute pause in-between on the VAS, GRS and NRS, and were then asked if they experienced pain, ache or hurt (PAH) or other symptoms. The correlations were high and significant both between the ratings of the VAS, GRS and NRS (r = 0.78-0.92; p < 0.001) (alternative-forms reliability), and between the test and retesting (r = 0.75-r = 0.83; p < 0.001) (test-retest reliability). A logistic regression analysis showed that the probability to accomplish a rating on the pain scales decreased with advancing age of the patient, and this was especially marked for the VAS. The probability of agreement between the patients' ratings of pain and the verbal report of PAH tended to decrease with advancing age; this was especially so for the VAS. Patients who verbally denied PAH but reported pain on the scales rated it significant lower (p < 0.001) than those who verbally reported PAH and rated the pain as well. Eighteen percent of patients who denied pain but rated a pain experience verbally expressed suffering or distress. The study suggests that pain rating scales such as the VAS, GRS and NRS can be used to evaluate pain experience in geriatric patients. However, agreement between verbally expressed experience of PAH, and the rated experience of pain tended to decrease with advancing age. This indicates that the pain-evaluating process will be substantially improved by an additional penetration supported by a wide variety of expression of hurt, ache, pain, discomfort and distress.

  • 247.
    Bergh, Ingrid
    et al.
    University of Skövde, Department of Health Sciences. Department of Geriatric Medicine, Göteborg University.
    Sjöström, Björn
    University of Skövde, Department of Health Sciences.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University.
    Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales2001In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 13, no 5, p. 355-361Article in journal (Refereed)
    Abstract [en]

    Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected. In connection with the administration of analgesics, the patients were asked to "Mark the point that corresponds to your experience of pain just now at rest" on the VAS, GRS and NRS. This was repeated after 1.5-2 hours, and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. Two comparisons were conducted with each patient. The results show that the probability of accomplishing a rating on the VAS, GRS, NRS, and PRS was lower with advancing age in these elderly fracture patients. The correlations between the ratings of the VAS, GRS and NRS were strong and significant (r=0.80-0.95; p<0.001) both at the initial assessments and at the re-assessments. However, the verbally reported effects of the analgesics were often directly opposite to the changes in rated pain. Therefore, application of the VAS, NRS, GRS and PRS for the purpose of assessing pain relief must be combined with supplementary questions that allow the patient to verbally describe possible experience of pain relief.

  • 248.
    Bergh, Ingrid
    et al.
    University of Skövde, Department of Health Sciences. Avdelningen för geriatrik, Göteborgs universitet.
    Sjöström, Björn
    University of Skövde, Department of Health Sciences.
    Steen, Bertil
    Avdelningen för geriatrik, Göteborgs universitet.
    Smärta hos äldre: Skattningsskalor – förekomst och verbala uttryck för smärta och smärtlindring2003In: Incitament: för en hälso- & sjukvård i förvandling, ISSN 1103-503X, Vol. 12, no 7, p. 642-644Article in journal (Other (popular science, discussion, etc.))
    Abstract [en]

    Smärta är inte en del av det normala åldrandet, men många äldre drabbas av sjukdomar som leder till smärta. Smärta är en subjektiv sensorisk och emotionell obehagsupplevelse med faktisk eller potentiell vävnadsskada. Varje person upplever smärta på sitt sätt och denna uppfattning får avgörande betydelse för hur hälso- och sjukvårdspersonal kan förhålla sig till människor med smärta.

    Utgångspunkten för denna avhandling var att studera smärtförekomst bland äldre och att evaluera användandet av smärtskalor. Våra resultat visar att skattningsskalor kan vara till hjälp.

    Artikeln baserad på Ingrid Berghs avhandling: Pain in the elderly - Rating scales, prevalence and verbal expression of pain relief

  • 249.
    Bergh, Ingrid
    et al.
    University of Skövde, Department of Health Sciences. Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Steen, Gunilla
    Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Waern, Magda
    Institute of Clinical Neuroscience, Section of Psychiatry, Göteborg University, Gothenburg.
    Johansson, Boo
    Department of Psychology, Göteborg University, Gothenburg.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Sjöström, Björn
    University of Skövde, Department of Health Sciences. Department of Health Care Pedagogics, Göteborg University, Gothenburg.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Pain and its relation to cognitive function and depressive symptoms: A Swedish population study of 70-year-old men and women2003In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 26, no 4, p. 903-912Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the prevalence of pain and its characteristics, and to examine the association of pain with cognitive function and depressive symptoms, in a representative sample of 70-year-old men and women. Data were collected within the gerontological and geriatric population studies in Göteborg, Sweden (H-70). A sample of 124 men and 117 women living in the community took part in the study. A questionnaire was applied which included four different aspects of pain experience: prevalence, frequency of episodes of pain, duration and number of locations. In close connection to this, depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. The prevalence of pain during the last 14 days was higher in women (79%; n = 91) than in men (53%; n = 65) (P<0.001). Women (68%; n = 78) also reported pain that had lasted for >6 months to a greater extent than men (38%; n = 46) (P<0.001). The frequency of episodes of pain was also higher among women, 64% (n = 74) reporting daily pain or pain several days during the last 14 days while 37% of the men (n = 45) did so (P<0.001). Women (33%, n = 38) also reported pain experience from ≥3 locations more often than men (11%; n = 13) (P<0.001). On the other hand, the association between depressive symptoms and pain experience was more evident in men than in women. Women were taking significantly more antidepressants compared to men (P<0.03). The results show that pain is common in 70-year-old people and especially in women. However, associations between depressive symptoms and the four aspects of pain experience were more pronounced among men. 

  • 250.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Söderlund, Tina
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, SE-541 85 Skövde, Sweden.
    Vinterskog, Linda
    Department of Obstetrics and Gynaecology, Skaraborg Hospital, SE-541 85 Skövde, Sweden.
    Mårtensson, Lena B.
    University of Skövde, School of Life Sciences.
    Reliability and validity of the Acceptance Symptom Assessment Scale in assessing labour pain2012In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 5, p. e684-e688Article in journal (Refereed)
    Abstract [en]

    Objective: to investigate the reliability and validity of the Acceptance Symptom Assessment Scale (ASAS) in assessing labour pain.

    Design: a test-retest approach was used to assess reliability and validity.

    Setting: labour ward with approximately 2,400 deliveries annually in western part of Sweden.

    Participants: forty-seven pregnant women in the latent or active phase of labour.

    Methods: a total of five pain assessments with both the ASAS and the VAS were conducted in three sessions.

    Main outcome measures: correlation between ASAS and VAS.

    Findings: both scales demonstrated high and significant test–retest correlations (r=0.83–0.92; p<0.001). High and significant alternative-form reliability correlations (r=0.76–0.93, p<0.001) were found between ASAS and VAS ratings at all five assessments. Construct validity was established when both the ASAS and the VAS identified a pain reduction(p<0.001) 2 hrs after birth, compared to the previous assessment. Over two-thirds of the women preferred the ASAS to the VAS ,mainly(n=30) because the ASAS provided more choices relating to the pain experience, making it possible to label pain acceptable/unacceptable.

    Conclusions: the ASAS is interchangeable with the VAS for assessing labour pain. Over two-thirds of the women preferred it to the VAS.

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