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  • 251.
    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.

  • 252.
    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.

  • 253.
    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.

  • 254.
    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.

  • 255.
    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.

  • 256.
    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.

  • 257.
    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.

  • 258.
    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.

  • 259.
    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.

  • 260.
    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.

  • 261.
    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.

  • 262.
    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

  • 263.
    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. 

  • 264.
    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.

  • 265.
    Bergkvist, Krister
    et al.
    University of Skövde, School of Life Sciences.
    Lundberg, Pär
    University of Skövde, School of Life Sciences.
    Icke-farmakologiska Smärtlindrande Omvårdnadsåtgärder Inom Prehospital Akutsjukvård: En Kvalitativ Beskrivning av olika tillvägagångssätt2007Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    One of the most common complaints of patient’s in need of prehospital emergency care is pain of some sort. Since November 1 2005 a big portion of the ambulance personnel is no longer allowed to administer drugs of any kind. Hence it is reasonable to assume that pain treatment nowadays is carried out with both pharmacological and non-pharmacological methods. Therefore the authors saw an interest in investigating how the ambulance personnel look at the concept of, and treatment of pain.

    The aim of this study was to, with focus on non-pharmacological measures, describe how Swedish ambulance personnel treat the patient in pain.

    The study was conducted with 5 interviews with ambulance personnel. The interviews were transcribed verbatim and analyzed. The analysis revealed four main themes with a number of sub themes. The theme opinions of pain disclose the informant’s view of pain as an individual phenomenon and what changes the patients perception of pain. Refuting and behavior in tending patients describes the informant’s opinions that a calm refuting and a good relationship with the patient could divert the patient’s thoughts about the pain. Assessment and treatment describes the need for individual adaptation when treating patients in pain. Combination therapy is successful revealed the informants thoughts that a combination of both pharmacological and non-pharmacological gives the best result.

  • 266.
    Berglund Kristiansson, Elisabeth
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Källman, Ulrika
    Research Department, Region Västra Götaland, South Älvsborg Hospital, Borås, Sweden.
    Healthcare staff's views on the patients' prerequisites to be co-creator in preventing healthcare-associated infections2019In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712Article in journal (Refereed)
    Abstract [en]

    Background Every year, patients are affected by suffering and death caused by adverse events in connection with health care and the most common adverse events are healthcare-associated infections (HAI). The Swedish Patient Act from 2015 strengthens the patient's position in health care; however, there is lack of knowledge of how healthcare staff experience the possibilities to make the patient involved in the preventive work of HAI. Aim To describe healthcare professionals' views on the patient's prerequisites to be co-creator in preventing HAI in connection with hospital care. Method This study had a qualitative descriptive design with semi-structured individual interviews. Qualitative inductive content analysis was used to analyse the transcribed interview data. The study setting was a hospital in Sweden in 2015. Interviews were carried out among six healthcare professionals. Results In the analysis, 5 themes and 14 categories were identified in three different domains: Organisation, Healthcare staff and Patient. The result indicates an obstacle in each domain for the patient to become co-creator in preventing HAI. In Organisation domain, a lack of organizational structure such as elaborated working methods to involve the patient was pointed out. In the domain Healthcare staff, it showed that the professionals allocate the responsibility of preventing HAI to the patient but only if they had to or if they trusted the patient. In the Patient domain, the result states that the patient was perceived as passive; they did not take own initiatives to get involved. Conclusion The patient has an important role in successful HAI prevention work and should be considered as an obvious co-creator. Nevertheless, this study shows that neither organisation nor healthcare staff are sufficiently prepared for this. The organisation must make an anchored, structured and systematic work centred on the patient's needs and give more support both to healthcare professionals and patients.

  • 267.
    Berglund, Mia
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Att lära sig stödja patienters lärande2015In: Reflektion i lärande och vård: En utmaning för sjuksköterskan / [ed] Mia Berglund & Margaretha Ekebergh, Lund: Studentlitteratur AB, 2015, 1, p. 187-198Chapter in book (Refereed)
  • 268.
    Berglund, Mia
    University of Skövde, School of Life Sciences.
    Att ta rodret i livet med långvarig sjukdom2011In: CF-bladet - Medlemsblad för Riksförbundet Cystisk Fibros i Sverige, no 3, p. 18-19Article in journal (Other (popular science, discussion, etc.))
  • 269.
    Berglund, Mia
    University of Skövde, School of Life Sciences.
    Att ta rodret i livet med långvarig sjukdom: Lärande utmaningar vid långvarig sjukdom2011In: Dialäsen, ISSN 1104-4616, no 5, p. 37-40Article in journal (Other (popular science, discussion, etc.))
  • 270.
    Berglund, Mia
    University of Skövde, School of Life Sciences.
    Att ta rodret i sitt liv: Lärande utmaningar vid långvarig sjukdom2011Doctoral thesis, monograph (Other academic)
    Abstract [en]

    A starting point for this thesis is that patients’ learning has not received sufficient attention and thus has not featured in the study programmes in the field of caring. Focus has instead been placed on patients being given information and advice about their illness and treatment, advice that they are then expected to comply with. Too little attention has been paid to the individual who lives with his/her illness and who should be considered to have significant experiences. The overall aim has been to analyze and describe the phenomenon of learning to live with long-term illness as well as to develop a didactic model that can help carers to support patients’ learning processes.

    The theoretical perspective in the thesis is lifeworld theory, which permeates ontological, epistemological and methodological standpoints and also the view on learning. The design and carrying out of the research is based on a reflective lifeworld approach. The empirical study consists of interviews with people who live with different types of long-term illnesses.

    The learning that follows life with a long-term illness is generated in such a way as to respond to the will to live the well-known everyday life. A greater understanding of the empirical results has been achieved by a lifeworld philosophical elucidation, with a particular focus on learning turning points and the importance of reflection. Based on the empirical results, the lifeworld philosophical elucidation and the caring science lifeworld didactics a didactic model has been formulated. This model is entitled: The challenge – to take charge of one’s life with long-term illness. The model contains four theses: 1) Confronting one’s life situation and challenging to make a change, 2) Positioning oneself at a distance when creating a new whole, 3) Developing self-consciousness and taking responsibility, 4) Making learning visible with the aim of providing development and balance in life.

    The results in the thesis show that a genuine learning is something that differs from the learning of information and that the learning must be supported at an existential level based on the sufferer’s situation and for a long period of time.

  • 271.
    Berglund, Mia
    University of Skövde, School of Life Sciences.
    Lärande vid långvarig sjukdom: Utmaningar för patient och vårdare2012 (ed. 1)Book (Other academic)
  • 272.
    Berglund, Mia
    University of Skövde, School of Life Sciences.
    Senaste nytt från Skövde2011In: Medlemsbladet, Handledning i omvårdnad, no 2, p. 7-7Article in journal (Other (popular science, discussion, etc.))
  • 273.
    Berglund, Mia
    University of Skövde, School of Life Sciences.
    Utmaningen - att ta rodret i livet med långvarig sjukdom2012In: Njurfunk, ISSN 0347-1365, Vol. 1, no 39, p. 36-38Article in journal (Other (popular science, discussion, etc.))
  • 274.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Andersson, Susanne
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Kjellsdotter, Anna
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Att drabbas av långvarig sjukdom2017In: Vägen till patientens värld och personcentrerad vård: Att bli lyssnad på och förstådd / [ed] Karin Dahlberg, Inger Ekman, Stockholm: Liber, 2017, 1, p. 93-116Chapter in book (Refereed)
  • 275.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ek, Kristina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Att förstå de didaktiska redskapen i utbildningen2015In: Reflektion i lärande och vård: En utmaning för sjuksköterskan / [ed] Mia Berglund & Margaretha Ekebergh, Lund: Studentlitteratur AB, 2015, 1, p. 47-68Chapter in book (Refereed)
  • 276.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Ekebergh, MargarethaHögskolan i Borås.
    Reflektion i lärande och vård: En utmaning för sjuksköterskan2015Collection (editor) (Refereed)
  • 277.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Reflekterande KRAFT-givande samtal2017In: Vägen till patientens värld och personcentrerad vård: Att bli lyssnad på och förstådd / [ed] Karin Dahlberg, Inger Ekman, Stockholm: Liber, 2017, 1, p. 317-334Chapter in book (Refereed)
  • 278.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Reflekterande KRAFT-givande samtal i vården av äldre som lever med långvarig smärta i hemmet2015In: Ä. Riksföreningen för Sjuksköterskan inom äldrevård, ISSN 2001-1164, no 1, p. 14-16Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Reflekterande KRAFT-givande samtal är en metod utvecklad för att användas som ett verktyg i vården. Syftet är att stärka människors hälsa och välbefinnande samt den egna förmågan att bemästra sin situation på ett sätt som ger glädje och mening i livet. För den äldre kan det innebära en möjlighet att kunna bo kvar längre i det egna hemmet. Metoden har utvecklats utifrån resultaten av två avhandlingar, en om hemmets betydelse och att leva med långvarig smärta samt en om lärande vid långvarig sjukdom.

  • 279.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. College of Nursing, University of Rhode Island, USA.
    Svanström, Rune
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Keys to person-centred care to persons living with dementia: Experiences from an educational program in Sweden2019In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 18, no 7-8, p. 2695-2709Article in journal (Refereed)
    Abstract [en]

    Growing old entails an increased risk of disabilities and illnesses such as dementia. The orientation in Sweden on national level is that individuals remain in their own homes if desired and receive person-centred home care. The aim of this study was to describe the experience of an educational program and its influence on daily provision of care to persons with dementia. A lifeworld approach was used. Data were collected through group interviews with care providers in the context of home. The findings are presented in five themes: Increased knowledge about dementia and treatment, Relationship-building in order to provide good care, Open and flexible approach conveys calm, Continuity and flexibility are cornerstones in the care and Perceived improvements. This person-centred educational intervention resulted in a care that was based on each individual’s personality, preferences and priorities in life. Education given with continuity over time is key to improving provision of care to person with dementia.

  • 280.
    Berglund, Mia
    et al.
    University of Skövde, School of Life Sciences.
    Källerwald, Susanne
    University of Skövde, School of Life Sciences.
    The Movement to a New Understanding: A Life-World-Based Study about How People Learn to Live with Long-Term Illness2012In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 1, no 6Article in journal (Refereed)
    Abstract [en]

    Objective: The objective of the present study was to analyze and describe the phenomenon of learning to live with long-term illness.

    Method: The design and implementation of the research was based on a reflective lifeworld approach. The study consisted of interviews with people who live with different types of long-term illness.

    Results: Learning to live with a long-term illness happens in such a way as to respond to the will to live everyday life. The essential meaning of learning to live with long-term illness is constituted by the following elements: learning to know and live with a stranger, the driving forces of learning, learning methods are a balancing act, making the illness visible, as well as seeking knowledge and understanding. The result of the learning process can be understood as movement to a new understanding that is shown in the way the person with the illness acts and gives herself with the illness more space in life.

    Conclusion: The results show that genuine learning is something that differs from learning information and that the learning must be supported by the sufferer’s situation for a long period of time at an existential level.

  • 281.
    Berglund, Mia M. U.
    University of Skövde, School of Health and Education.
    Learning turning points - in life with long-term illness - visualized with the help of the life-world philosophy2014In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 9, article id 22842Article in journal (Refereed)
    Abstract [en]

    A long-term illness is an occurrence that changes one’s life and generates a need to learn how to live with it. This article is based on an empirical study of interviews on people living with different long-term illnesses. The results have shown that the learning process is a complex phenomenon interwoven with life as a whole. The essential meaning of learning to live with long-term illness concerns a movement toward a change of understanding of access to the world. In this movement, in which everyday lives as well as relationships with oneself and others are affected, a continual renegotiation is needed. Texts from existential/lifeworld philosopher, Heidegger and Gadamer, have been used to get a greater understanding of the empirical results. These texts have been analysed with particular focus on learning turning points and the importance of reflection. The results are highlighted under the following themes: Pursuit of balance*the aim of learning, The tense grip*the resistance to learning, To live more really*the possibilities of the learning, Distancing*the how of the learning, and The tense of the learning*the whole of the learning. In those learning turning points are present. Knowledge from this study has been used to make a didactic model designed to give caregivers a tool to support patients’ learning. The didactic model is called: The challenge to take charge of life with a long-term illness.

  • 282.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nässén, Kristina
    Academy of Care, Working Life and Social Welfare, University of Borås, Borås, Sweden.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education. College of Nursing, University of Rhode Island, Kingston, USA.
    Fluctuation between Powerlessness and Sense of Meaning: A Qualitative Study of Health Care Professionals’ Experiences of Providing Health Care to Older Adults with Long-Term Musculoskeletal Pain2015In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, article id 96Article in journal (Refereed)
    Abstract [en]

    Background: There is an increasing number of older adults living with long-term musculoskeletal pain and related disabilities. These problems are frequently unrecognized, underreported, and inadequately treated. Since many older adults desire to remain at home for as long as possible, it is important that individualized and holistically tailored care is provided in these settings. However, there is a complexity in providing care in this context.

    The aim of this study was to describe health care professionals’ experiences of providing health care to older adults living with long-term musculoskeletal pain at home.

    Methods: The phenomenon, “To provide health care to older adults living with long-term musculoskeletal pain at home”, was studied using reflective lifeworld research (RLR) which is based on phenomenological epistemology. Ten health care providers (nurse, physiotherapists, and occupational therapists) were interviewed and data was analysed.

    Results: The health care professional’s emotions fluctuated between powerlessness and meaningfulness. Needs, opportunities, understanding and respect had to be balanced in the striving to do good in the provision of health care in differing situations. Caring for older adults with long-term pain required courage to remain in the encounter despite feelings of insecurity and uncertainty about the direction of the dialogue. The essence of caring for older adults with long-term pain consisted of the following constituents: Sense of powerlessness; striving to provide good health care; and understanding and respect.

    Conclusions: The findings indicated that the health care professionals strived to do good and to provide health care that was holistic and sensitive to the older adults’ needs. A significant sense of powerlessness in the situation was experienced by the health care professionals. These findings address and support the need to develop methods that can be used to guide health care providers who support older adults in the context of their homes.

  • 283.
    Berglund, Mia
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Nässén, Kristina
    Academy of Care, Working Life and Social Welfare, University of Borås, Sweden.
    Hedén, Lena
    Academy of Care, Working Life and Social Welfare, University of Borås, Sweden.
    Gillsjö, Catharina
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study2016In: Journal of Gerontology & Geriatric Research, ISSN 2167-7182, Vol. 5, no 3, article id 1000304Article in journal (Refereed)
    Abstract [en]

    Background: A major health problem that frequently accompanies old age is long-term pain, but pain must be acknowledged by older adults and health care providers. Interventions are needed to alleviate pain and suffering’ while holistically providing health care that promotes wellbeing. The intervention project, Reflective STRENGTHGiving Dialogues© (STRENGTH) was implemented to increase health and wellbeing among community dwelling older adults living with long-term musculoskeletal pain at home.

    Aim: The aim of this study was to describe the older adults’ experiences of the intervention Reflective STRENGTH-Giving Dialogue.

    Method: A life world hermeneutic approach was used in collection and analysis of data. Twenty community dwelling older adults participated were interviewed in their homes after the intervention.

    Findings: The findings consisted of five themes and showed that the older adults experienced the Reflective STRENGTH-Giving Dialogues as a continuous and trusting relationship that alleviates the pain and breaks the loneliness. They expressed it as a new way to talk about life with pain. The dialogues supported reflection and memory and resulted in a transition in orientation in life.

    Conclusion: The Reflective STRENGTH-Giving Dialogues helped the older adults to increase their intellectual, emotional, and physical engagement in daily living. The dialogues facilitated a transition in orientation from past to present, to the future, and from obstacles to opportunities. The dialogues were oriented towards enjoyments, meaning, courage and strength in life as a whole which promoted the older adults’ sense of well-being and vitality. The dialogues also facilitated carrying out small and large life projects. The Reflective STRENGTH-Giving Dialogues created a deepened caring relationship that contributed to an increased sense of security, strength and courage, all of which enhanced the potential for better health and wellbeing.

  • 284.
    Berglund, Mia
    et al.
    University of Skövde, School of Life Sciences.
    Sjögren, Reet
    School of Health Care and Social Welfare, Mälardalen University, Västerås/Eskilstuna, Sweden.
    Ekebergh, Margaretha
    Department of Health and Caring Sciences, Linnéuniversitetet, Växjö, Sweden.
    Reflect and learn together - when two supervisors interact in the learning support process of nurse education2012In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 20, no 2, p. 152-158Article in journal (Refereed)
    Abstract [en]

    Aim  To describe the importance of supervisors working together in supporting the learning process of nurse students through reflective caring science supervision.

    Background  A supervision model has been developed in order to meet the need for interweaving theory and practice. The model is characterized by learning reflection in caring science. A unique aspect of the present project was that the student groups were led by a teacher and a nurse.

    Method  Data were collected through interviews with the supervisors. The analysis was performed with a phenomenological approach.

    Results  The results showed that theory and practice can be made more tangible and interwoven by using two supervisors in a dual supervision. The essential structure is built on the constituents ‘Reflection as Learning Support’, ‘Interweaving Caring Science with the Patient’s Narrative’, ‘The Student as a Learning Subject’ and ‘The Learning Environment of Supervision’.

    Conclusion  The study concludes that supervision in pairs provides unique possibilities for interweaving and developing theory and practice.

    Implications for nursing management  The supervision model offers unique opportunities for cooperation, for the development of theory and practice and for the development of the professional roll of nurses and teachers.

  • 285.
    Berglund, Mia
    et al.
    University of Skövde, School of Life Sciences.
    Westin, Lars
    University of Skövde, School of Life Sciences.
    Svanström, Rune
    University of Skövde, School of Life Sciences.
    Johansson Sundler, Annelie
    University of Skövde, School of Life Sciences.
    Suffering caused by care - Patients' experiences from hospital settings2012In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 7, article id 18688Article in journal (Refereed)
    Abstract [en]

    Suffering and well-being are significant aspects of human existence; in particular, suffering and well-being are important aspects of patients’ experiences following diseases. Increased knowledge about existential dimensions of illness and healthcare experiences may be needed in order to improve care and reduce unnecessary suffering. Therefore, the aim of this paper is to illuminate the phenomenon of suffering experienced in relation to healthcare needs among patients in hospital settings in Sweden. In this study, we used a reflective lifeworld approach. The data were analysed with a focus on meanings. The results describe the essential meaning of the phenomenon of suffering in relation to healthcare needs. The patients were suffering during care-giving when they felt distrusted or mistreated and when their perspective on illness and health was overlooked. Suffering was found to arise due to healthcare actions that neglected a holistic and patient-centred approach to care. Unfortunately, healthcare experiences that cause patients to suffer seem to be something one needs to endure without being critical. The phenomenon can be described as having four constituents: to be mistreated; to struggle for one’s healthcare needs and autonomy; to feel powerless; and to feel fragmented and objectified. The study concludes that there are problems associated with patients experiencing suffering at the hands of healthcare providers, even if this suffering may not have been caused deliberately to the patient. Consequently, conscious improvements are needed to lessen the suffering caused by care-giving, as are strategies that promote more patient-centred care and patient participation.

  • 286.
    Bergman, Johanna
    et al.
    University of Skövde, School of Health and Education.
    Simonsen, Lene-Therese
    University of Skövde, School of Health and Education.
    Kvinnors upplevelser av att leva med urininkontinens: en litteraturöversikt2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Urinary incontinence is a common problem among women where prevalence increases with age. There are three types of urinary incontinence: urge, stress and mixed urinary incontinence. Existing treatment methods focus on decreasing suffering. Urinary incontinence in women affects their well-being, increases suffering and decreases autonomy.

    Aim: To describe women’s experiences living with urinary incontinence

    Method: General literature review, where ten articles were basis for the result.

    Results: Women generally experience that their daily lives are affected and changed by living with urinary incontinence. They describe how they create their own strategies to recapture control over their daily lives. Living with urinary incontinence causes impaired well-being because of the experience of shame and embarrassment which affect their relationships and social life with others.

    Conclusion: To cope with everyday life, the women create their own strategies, which include always being aware of where the nearest toilet is or to bring extra clothes when leaving home. The strategies mean that women experience reduced stress and worry about urinary leakage. Involuntary urinary retention affects women physically and mentally, which means that it is important that healthcare professionals have good knowledge and insight into the life of patients with urinary incontinence living daily.

  • 287.
    Bergman, Karin
    et al.
    Skaraborg Primary Health Care, Skövde, Sweden.
    Perhed, Ulla
    Skaraborg Primary Health Care, Skövde, Sweden.
    Eriksson, Irene
    University of Skövde, School of Life Sciences.
    Lindblad, Ulf
    Department of Public Health and Community Medicine/Primary Health Care, University of Gothenburg, Gothenburg, Sweden.
    Fagerström, Lisbeth
    Faculty of Health Sciences, Buskerud University College, Drammen, Norway.
    Patients' satisfaction with the care offered by advanced practice nurses: A new role in Swedish primary care2013In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 19, no 3, p. 326-333Article in journal (Refereed)
    Abstract [en]

    The aim of this study is to describe patients' satisfaction with the new role of advanced practice nurses (APNs) in Swedish primary care. A questionnaire pertaining to patient satisfaction with the care offered by APNs was sent to respondents. Descriptive statistics, a chi-squared test and manifest qualitative content analysis were used during analysis. Although the results show an overall high level of patient satisfaction as regards APN-led care, those patients informed of the APN role prior to a consultation were significantly more satisfied. Respondents' comments indicate that professional treatment and competence are characteristic of the care offered by APNs and also relate the concepts of increased availability of and continuity in health care to the APN role. In order to guarantee the positive development of the APN role in Sweden, continued research is needed from patient, organizational and interprofessional perspectives, including intervention studies of cost effectiveness and the quality of care.

  • 288.
    Bergquist, Marie
    et al.
    University of Skövde, School of Health and Education.
    Larsson, Sanna
    University of Skövde, School of Health and Education.
    Skolsköterskans arbete med sex- och samlevnadsundervisning2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Research has shown that it is varies in the methods and the contents in the sexual- and interpersonal relation education. Students consider the sexual education need to improve. School nurses work to promote sexual health. It’s important to understand how school nurses work with education on sexuality- and interpersonal relations. Purpose: Describe how school nurses work with sex and social education. Method: Nine e-mail interviews were conducted. School nurses working with adolescents ages 12-18. Data analyzed with a qualitative meaning. Results: Demonstrated five themes; Knowledge and competence contribute to security with the sexual- and interpersonal relation education; Supportive environment and time for the school nurse´s work on the sexual- and interpersonal relation education; The school nurse´s diversity in teaching structure is adapted to the students’ knowledge; Teaching immigrants and refugees new students requires more preparation; The school nurse´s treatment and approach is important for questions about HBTQ. Conclusion: Difficulty for school nurses in their work is the lack of time, which implies limited teaching. The cooperation of teaching is perceived as positive and desirable. The sexual- and interpersonal relation education is of importance to the students. Challenge of teaching students from other cultures, school nurses lacking in deeper knowledge. 

  • 289.
    Bergqvist, Johan
    et al.
    University of Skövde, School of Health and Education.
    Stenman Josefsson, Märta
    University of Skövde, School of Health and Education.
    Sjuksköterskors erfarenheter av att vårda personer med demens på akutvårdsavdelningar: En litteraturbaserad studie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The diagnoses of dementia increases in line with the aging population of the earth. Symptoms vary between different dementia diagnoses and for some, a diagnosis might be a relief and confirmation of what’s really going on for both the patient and their relatives. Person centered care aims to empower a person's self-esteem and involvement in their own care. It urges healthcare professionals to look beyond the diagnosis of the patient, which makes this the form of care advocated for patients with dementia. Despite the fact that long waiting times is an acknowledged problem, nurses are still obliged to pursue nursing on equal standardse. Aim: The aim was to acknowledge nurses' experiences of caring for patients with dementia in acute care settings Method: A literature-based study with nine qualitative articles were chosen. Results: The analysis identified three main categories; lack of knowledge, structural deficiencies and relatives as a co-actor of the caring process, and eight subcategories. Conclusion: Dedication and education are central aspects regarding the care of patients with dementia. It becomes apparent that regardless of context, caring for patients with dementia is often mired in complexity. Nurses claim that lack of time and education combined with structural deficiencies constitutes an obstacle for nurses providing what they would consider sufficient care. These deficiencies may also negatively affect attitudes and perceptions and consequently the care of patients with dementia can be stigmatized.

  • 290.
    Bergqvist, Lisen
    et al.
    University of Skövde, School of Health and Education.
    Johansson, Sofie
    University of Skövde, School of Health and Education.
    ATT BLI FÅNGE I SIN EGEN KROPP: En litteraturstudie om patienters upplevelser av välbefinnande vid ALS2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 291.
    Bergsten, Niklas
    University of Skövde, School of Life Sciences.
    1,25(OH)2D3 and Prostate Cancer: The Effects on cAMP/PKA-dependent Gene Expression in LnCaP cells2010Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Prostate cancer is the leading male cancer form i Sweden and maybe worldwide as well. Vitamin D is synthesized in the skin following the exposure to sunlight. Researcers have long been aware of the positive effect that vitamin D3 has on prostate tumour growth. 1,25(OH)2D3 have for a long time been the target of these studies and have shown good results. The steroid hormone induces cAMP accumulation and activiates the cAMP dependent protein kinaseA (PKA). PKA is then able to activate a transcription regulating protein. 1,25(OH)2D3 is known to cause LNCaP cells to accumulate in the G1 phase ofthe cell cycle. It has also been shown that 1,25(OH)2D3 is under negativefeedback control via 24-hydroxylase. In this study, PKA activity was observed by transfecting LNCaP cells with a viral vector carrying firefly and Renillaluciferase genes. The successfully transfected LNCaP cells would then express luciferase as a response to PKA gene expression. The LNCaP cells were then treated with 1,25(OH)2D3 and GDP-β-S (100μM), a G-protein coupled receptorinhibitor, in order to examine if 1,25(OH)2D3 regulate PKA dependent gene expression through a G-protein coupled receptor. The study could show that 1,25(OH)2D3 regulate gene expression in LNCaP cells through a PKAdependent pathway. Furthermore, the PKA dependent gene expression was demonstrated to be independent of G-protein coupled recpetor activation.

  • 292.
    Bergsten, Niklas
    University of Skövde, School of Life Sciences.
    PDIA3 and Prostate Cancer: Do changes in nucleotidesequence correspond tomalignancy?2012Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    PDIA3 interacts with the lectin chaperons; calnexin and calreticulin to surveythe folding of newly synthesized glycoproteins by the addition of N-linkedglycans. PDIA3 is also involved in transcaltachia signaling cascades andimmunogenicity. The purpose was to determine if there were any changespresent in the nucleotide sequence of the Pdia3 gene. To study this, fourprostate cell lines were examined by Sanger sequencing, two malignant(LNCaP, PC3) and two normal (PNT1A, PNT2). These were to be compared tothe nucleotide sequence from nine formalin fixed paraffin-embedded (FFPE)samples of different Gleason score and the sequence from three FFPE samplesof normal prostate tissue chosen from the Örebro Radical Cohort. The obtainedsequences were then analysed with several bioinformatics tools to determine ifthere were any changes present. The nucleotide sequence obtained from thesequencing indicated that none of the cell lines expressed the most redundantisofrom; CRA_c, but instead CRA_a and CRA_b. Surprisingly, the two normalcell lines (PNT1A and PNT2) produced similar scores in BLAST search forboth the CRA_a and the CRA_b isoforms. Software analysis of the translatedsequences predicted that LNCaP expressed a membrane bound form PDIA3while PC3 expressed a cytoplasmic variant of the protein. To confirm this,another sequencing reaction was performed. The second results indicated thatall cell lines expressed the same isoform, but that the isoforms were localizedto different intracellular compartments.

  • 293.
    Bergström, Evelyn
    et al.
    University of Skövde, School of Life Sciences.
    Bega, Arijana
    University of Skövde, School of Life Sciences.
    Upplevelser av att leva med lungcancer: En litteraturbaserad studie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Lung cancer is a disease with poor prognosis, with many people that falls ill each year. It is a disease which leads to numerous and severe symptoms that create much suffering. Aim: The aim of this study was to describe patients' experiences of living with lung cancer in daily life. Methods: A literature study was conducted with a qualitative approach. Twelve scientific articles were reviewed and analyzed according to a model for a literature study. Results: Six categories were identified: live with uncertainty, stigma and guilt, experience of disease-related symptoms, a changed self-esteem, to get support and be confirmed and thrown between hope and despair. Discussion: There was a need for patients to live as independent as possible, social support and the support from health professionals was crucial for them to cope with it. Support overall was important for patients to be able to handle most situations. By acquiring knowledge about patients' with lung cancers experiences the nurse can be a better support for the patient in order to alleviate patients suffering.

  • 294.
    Bergström, Henrik
    et al.
    University of Skövde, School of Health and Education.
    Hammar, Andreas
    University of Skövde, School of Health and Education.
    ANHÖRIGAS UPPLEVDA SITUATION NÄR EN NÄRSTÅENDE VÅRDAS PÅ EN INTENSIVVÅRDSAVDELNING: -En litteraturöversikt2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: The intensive care unit is a department where critically and acute sick patients are being treated. The department has specialized routines, equipment to treat and screening. Nurses on a intensive care unit are responsible for the treatment of patients as well as the leadership of the workforce. The nurses are also responsible to acknowledge the patient’s relatives. Therefore, it is of great importance for the nurses to understand relatives’ experiences in this situation, to be able to give treatment of good quality to relatives too. Aim: To describe the experience of relatives to patients who are being treated at the intensive care unit. Method: A literature review of scientific articles with a qualitative standpoint, aimed towards the experiences of relatives to intensive care unit patients. Results: Relatives experienced that a lot of factors affected them negatively. Routines, equipment and treatment were experienced as unfamiliar and confusing. The situation made it hard for the relatives to experience being close to the patient. Relatives experienced that good communication and information made the situation positive. Relatives experienced that being a part and having a say in the patients’ treatment were important. Conclusion: To be a relative at the intensive care unit can feel unfamiliar and differ from other kinds of departments. There are rules, equipment and situations that makes it difficult for the relatives to see the context of the situation. It is of great importance that the healthcare is attentive and give the relatives the possibility to understand the context.

  • 295.
    Bergström, Marina
    et al.
    University of Skövde, School of Health and Education.
    Wiklander, Shaghayegh
    University of Skövde, School of Health and Education.
    Unga kvinnors användande av sexualitet som självskadebeteende: En kvalitativ studie2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Young girls that self-harm themselves have recent years been in focus. Thosewho earlier in life have been sexually abused are overrepresented among these women thatself-harm themselves through their sexuality.Aim: The aim of this study was to illustrate young women’s experiences of sexuality as aself-harm behavior.Method: A qualitative study with a phenomenological approach of own written stories.Result: Young women that harm themselves with their sexuality seek acknowledgement forinstance by publishing pictures on the internet to receive positive feedback on theirappearance. Further they use their sexuality to achieve a rush and a sense of suffice and bythat mitigate their anxiety. These women need a lot of support from their surroundings inorder to understand and process their self-harm behavior.Conclusion: School nurses need to pay attention that sexuality as a self-harm behavior existsin all social classes. The school nurse can through continuity and a trustworthy attitude createa good relation that is based on a genuine interest of wanting to understand these youngwomen from a life-world perspective. To be able to offer these young women the supportthey are in need of it is important that the school nurse dare to be present, listen and ask the question.

  • 296.
    Bergström, Natalie
    University of Skövde, School of Bioscience.
    The neural correlates of cognitive reappraisal stress resilience2018Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
    Abstract [en]

    Resilience refers to the fact that some individuals cope well with stressful experiences. Many factors contribute to this sort of resilience, such as the early environment, the serotonin transporter gene (5-HTTPLR), the hypothalamic-pituitaryadrenal (HPA) axis, the sympathetic-adrenal medullary (SAM) axis, and emotion regulation techniques. The aim of this thesis is to investigate which factors contribute to resilience, with a particular focus on the emotion regulation technique of cognitive reappraisal. The results show that the prefrontal cortex (PFC) and amygdala each play a crucial role when it comes to stress regulation. Studies have found that the PFC inhibits the amygdala response, but that the PFC is vulnerable to exposure to chronic stress. As a result, the PFC might fail to inhibit the amygdala response. Individuals who use cognitive reappraisal techniques – which has been associated particularly with frontal and parietal brain activity – seem to be less prone to this sort of problem, and, as a result, more resilient to stress.

  • 297.
    Bernanker Lundaahl, Sara
    et al.
    University of Skövde, School of Health and Education.
    Klint Carlander, Anna-Karin
    University of Skövde, School of Health and Education.
    Ungdomars syn på sex- och samlevnadsundervisningen i skolan2019Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Sex och samlevnad är en av många faktorer som har betydelse för hälsa och välbefinnande hos såväl vuxna som ungdomar. Alla elever har rätt att få sex- och samlevnadsundervisning i skolan. I arbetet med att stärka ungdomars förmåga att göra medvetna och ansvarstagande val som rör sexualitet och relationer är sex- och samlevnadsundervisningen en viktig del.

    Syfte: Att beskriva hur förstaårselever på gymnasiet upplever den sex- och samlevnadsundervisning som de hade i högstadiet.

    Metod: Studien genomfördes med kvalitativ metod med induktiv ansats och data analyserades med innehållsanalys. Fyra fokusgrupper genomfördes med totalt 20 deltagare. 

    Resultat: Analysen resulterade i tre kategorier; Eleverna beskriver att sex- och samlevnadsundervisning är av stor betydelse, Att ha erfarenhet av en undervisning som upplevs bristfällig samt elevernas önskemål om förändring i undervisningen.

    Slutsats: Ungdomarna upplever att sex- och samlevnadsundervisning är viktig men att undervisningen i detta ämne också har brister. Det finns behov av att lyssna på och respektera unga människors åsikter gällande undervisningen i sex- och samlevnad. Detta för att anpassa undervisningen utifrån ungdomars livsvärld och deras behov och därmed bidra med betydelsefull kunskap i ämnet. Skolsköterskors omvårdnadsperspektiv kan tänkas bidra till den öppenhet och följsamhet för individens unika behov vilket efterfrågas av deltagarna. 

  • 298.
    Bernhard, Pauline
    University of Skövde, School of Bioscience.
    Neurala korrelat till medkänsla med speciellt fokus på självmedkänsla2019Independent thesis Basic level (degree of Bachelor), 15 credits / 22,5 HE creditsStudent thesis
  • 299.
    Bernvik, Erika
    et al.
    University of Skövde, School of Health and Education.
    Jakobsson van Stam, Ebba
    University of Skövde, School of Health and Education.
    Blivande förstagångspappors förväntningar inför förlossningen2018Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Childbirth is part of the transition to parenthood. The transition is eased by support from midwives. It’s within the midwives area of responsibility to offer support to parents. Childbirth experiences are affected by received support and expectations of labour. Fathers’ childbirth experiences affect their well-being and parenting.

    Aim: Describe expecting first-time fathers’ expectations of the labour.

    Method: Qualitative individual semi-structured interviews with six expecting first-time fathers, whose women were in gestational week 29 to 35. The interviews were analyzed using qualitative content analysis.

    Results: Expecting fathers’ find it hard to imagine what will happen during childbirth. They expect that after the delivery they will be able to have a quiet moment alone with their families to adjust to their new life-situation. Besides this, fathers expect that they will have an important supportive role during childbirth. Midwives are expected to support both the labouring mother and the father during childbirth.

    Conclusion: Midwives should support parental couples based on their individual needs of support. Support to expecting fathers enables them to be supportive during childbirth. First-time fathers expects support to be important during childbirth to create a feeling of security for themselves.

  • 300.
    Bernvik, Erika
    et al.
    University of Skövde, School of Health and Education.
    Jakobsson van Stam, Ebba
    University of Skövde, School of Health and Education.
    Kvinnors upplevelse av lidande relaterat till cytostatikabehandlingen vid bröstcancer: En litteraturöversikt2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Breast cancer is the most common cancer among women and a common treatment is chemotherapy, which comes with side effects. Suffering can be categorized in three different forms. Ethical principles are used to motivate choice of treatment. Aim: To describe women's experience of suffering related to chemotherapy during breast cancer. Method: The study is a literature review based on qualitative research. Eleven articles were reviewed and summarized by using Friberg (2012). Results: Women with breast cancer experience suffering when undergoing chemotherapy. They feel loss of their identity when their looks changes. People around them treat them differently and they are not able to do the same things as before in the role of mother, wife, friend and colleague. Suffering also consists of physical symptoms related to the treatment and the illness period, but some of the symptoms do not go away after treatment. Discussion: Physical side effects lead to psychological side effects as women experiences loss of identity, guilt and shame. Health care professionals have an important role in informing and to counter women in a good way to reduce suffering. Chemotherapy leads to suffering due to the illness and treatment, but it is also related to their existence. 

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