Utskrift från Malmö högskola - mah.se
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Browsing Department of Care Science by Issue Date
Now showing items 1-20 of 114
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Insulin pens dribble from the tip of the needle after injection 
Annersten, Magdalena; Frid, Anders
Journal article in Practical Diabetes International;4 : John Wiley & Sons (2000)peer-reviewed 
scientific
ARTICLE
English abstract: Aim. To study different insulin pens regarding leakage from the tip of the needle after injection. Patients and method. Six pens were tested; Saline Pen 3.0 ml (Lilly), B-D Pen 3.0 ml, NovoLet 1.5 and 3.0 ml, NovoPen 1.5 and 3.0 ml. Twenty volunteers were injected with sterile saline and the needle was withdrawn after 1, 3, 5, or 7 s respectively. Any dribble was collected on a filter paper and weighed. The procedure was videotaped. Results. There was a minimum of dribbling from the 1.5 ml pens. Eight out of 20 NovoPen 3.0 ml and B-D Pen 3.0 ml, 16 out of 20 NovoLet 3.0 ml, and 19 out of 20 Saline Pen (Lilly) dribbled after a 7 s hold-in time. The 8 B-D Pen 3.0 ml had leaked 4.0 mg (2.4±18.8), the 8 NovoPen 3.0 ml 4.7 mg (3.8±6.7), the 16 NovoLet 3.0 ml 5.0 mg (3.1±16.6) and the 19 Saline Pen 3.0 ml had leaked 9.2 mg (4.9±19.1). Conclusion. There is a clinically significant leakage of fluid from the needle tip even after 7 s hold-in time. Patients should be taught to hold the needle in for at least 10 s to be assured they get the intended dose. 
insulin pens dribble.pdf
(140.9Kb)
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Transferrin receptor in children and its correlation with iron status...
Bramhagen, Ann-Cathrine; Virtanen, M; Siimes, MA; Axelsson, Irene
Journal article in Acta Paediatrica;6 : Taylor & Francis (2003)peer-reviewed
scientific
ARTICLE
English abstract: Aim: This study compared transferrin receptor (TfR) concentrations with iron parameters relative to a child´s intake of cow´s milk and follow-on formula. Methods: TfR, β-Haemoglobin, serum ferritin and mean corpuscular volume (MCV) of red blood cells were analyzed in a study population of 263 children aged 2.5 y. The amount of cow´s milk and follow-on formula consumed were recorded. Results: There was a significant difference of TfR/log. ferritin between children whose milk intake was < 500 ml and those with a milk intake of > 500 ml (p=0.003). There were significantly higher values of TfR/log. ferritin in children whose MCV of red blood cells was < 75fL than those with > 75fL (p=<0.0001). The TfR concentrations were significantly lower after iron treatment. Conclusion: Higher concentrations of TfR were correlated with lower concentrations of haemoglobin and MCV of red blood cells. Milk consumption increases the risk of higher ratio of TfR/log. ferritin. TfR concentrations were significantly lower after iron treatment. Swedish abstract: Syfte: Denna studie jämförde koncentrationen av transferrin receptor (TfR) med järnstatus parametrar i relation till barnets intag av komjölk och välling. Metod: TfR, β-Haemoglobin, serum ferritin och medelcellsvolumen (MCV) på de röda blodkropparna analyserades i en population av 263 barn i åldern 2.5 år. Mängden komjölk och välling som barnet drack registrerades. Resultat: Det fanns en signifikant skillnad i TfR/log. ferritin mellan barn vars intag av komjölk var < 500 ml respektive barn med intag av mjölk > 500 ml (p= 0.003). Där fanns ett signifikant högre värde av TfR/log. ferritin bland barn med en medelscellsvolum av de röda blodkropparna på < 75fL jämfört med de som hade > 75fL (p=<0.0001). Koncentrationen av TfR var signifikant högre efter järnbehandling. Konklusion: Högre koncentrationer av TfR var korrelerade med lägre koncentrationer av haemoglobin och MCV av röda bloda kroppar. Mjölk konsumtion ökade risken för högre kvot av TfR/log ferritin. TfR koncentrationen var signifikant lägre efter järnbehandling.
Transferrin receptor in children.pdf
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Evaluating psychiatric nurses' awareness of evidence-based nursing pu... Bahtsevani, Christel; Khalaf, Azzam; Willman, Ania
Journal article in Worldviews on Evidence-based Nursing;4 : Blackwell (2005)peer-reviewed
scientific
ARTICLE -
Performing subcutaneous injections : a literature review
Annersten, Magdalena; Willman, Ania
Journal article in Worldviews on Evidence-Based Nursing;3 : Sigma Theta Tau International (2005)review
ARTICLE
English abstract: Background: Persons using daily subcutaneous injections to administer medicine perform them in different ways and thereby increase the risk of skin complications related to the injection. It is often part of nurses’ role to administer medicine and educate the patient in injection technique. Course literature in nursing education, commercial patient education pamphlets, and instructional leaflets do not give consistent advice regarding subcutaneous injection technique. Aim: The aim of this review was to identify the scientific foundation for the technical performance of subcutaneous injections. The question to be answered was: How should a subcutaneous injection be administered to achieve the right dose in the right place with minimum complications? Method: The review included a search in three databases, a screening process at abstract level, followed by a quality assessment of included articles. The quality assessment was done independently by two people and followed specific protocols. Result: A total of 38 articles were assessed for quality and covered information on dose, location, and complications of subcutaneous injection. The assessed studies are heterogeneous in design and describe different aspects of the subcutaneous injection technique. Therefore, the scientific foundation for technical performance is weak. However, several studies indicate that the amount of subcutaneous fat and appropriate needle length are of high importance for the drug to reach the target tissue. Conclusion: More research regarding effective subcutaneous injection technique needs to be done.
Performing subcutraneous injections.pdf
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Pain in connection with capillary blood test at different sites in th...
Grill-Wikell, Heidi; Annersten, Magdalena; Frid, Anders
Journal article in European Diabetes Nursing;2 : Wiley-Blackwell (2005)peer-reviewed
scientific
ARTICLE
English abstract: There are studies suggesting that fear of blood and injury is associated with less frequent self-testing; by reducing pain when measuring blood glucose the number of measurements can probably increase. The aim of this study was to investigate whether or not there were any differences regarding pain at different test sites in the palm. Twenty type 1 diabetes subjects pricked themselves at four different sites in the palm in the non-dominant hand in a randomised order with the Freestyle® punction device loaded with BD Microfine+ lancets. Pain was evaluated by the subjects using the Pain-O-Meter®. The result (n=80) showed no statistically significant difference in pain score between the investigated sites. The level of sensory pain was reported: shooting (n=36), no pain (n=27), searing (n=8), soaring (n=5), pressing (n=2), aching (n=1) and burning (n=1); 86% (n=69) of the pricked sites were experienced as no pain at all. This study shows that pain in connection with capillary blood test is low as measured by the Pain-O-Meter. There are no significant differences in the pain experienced at different sites in the palm. More studies need to be done using different punction devices and more sites need to be investigated
Pain in connection.pdf
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Olycksfallsrisker i barnets hemmiljö : fokus på skållskador
Carlsson, Anna : Malmö högskola, Hälsa och samhälle
FoU-rapport;1 Malmö studies in Nursing Sciences;1 (2005)LICENTIATE
THESIS
English abstract: The overall aim of this licentiate thesis was to increase the knowledge about children’s (0–6 years old) exposure to accidents in the home environment through parents’ opinions about accidents and parents’ self-reported compliance with precautions. Data were collected from parents of 10-month-old children who answered a questionnaire. The questionnaire prompted responses related to parents’ background and socio-economic factors as well as questions about precautions they had taken to decrease hazards in their home. The questions focused on actions parents had taken upon receipt of preventive advice given to them during the eight-month Child Health Care nurse assessment. Thirty-two percent of the parents complied with less than half of the suggested precautions. Univariate odds ratios (OR) and 95% confidence intervals (95% C I) were calculated to investigate the associations between compliance and parents’ different background/socio-economic characteristics. The variables foreign born, low occupational level, 12 years’ education or less, rented housing and information provided at Child Health Care clinics proved to be statistically significant for the non-compliant group. Multiple logistic regression analysis was performed in order to adjust the estimated odds ratios for the influence of potential confounders such as parents’ nationality, educational and occupational level, place of information and habitation. After the adjustment the variable nationality and educational level stayed significant (Ι). Data in article ΙΙ were collected from medical records, in a retrospectively designed study. Burn-injured children (0–6 years old) consulting the University Hospital or the health centres (21) during 1998 and 2002 were included. Chi-squared test was used to analyse differences in nominal data and cross-tabulation was used to analyse the proportions between the characteristics of the injuries and sex, age and nationality. There were 148 burn injuries, 80% of which were scalds caused by hot liquid (71%) or hot food (29%). The majority were to boys between one and two years old. Children of foreign-born parents were more frequently affected and the extent of injuries often larger. The data collection method in article ΙΙΙ was tape-recorded interviews, analysed by content analysis, with parents of 20 children (0–6 years old) recently suffering from scalds. Parents told their perceptions about causes of the scalds. The analysis resulted in eight categories and two themes. One theme was ‘Deviation from the normal’, which could be when something unusual happened, such as a sudden visit by a friend or when a family member was tired, stressed or ill. The tiredness could be due to fever, a cold, other illnesses or mental stress. It could also be when something was broken in the kitchen and routines were changed. ‘Misjudgement of the child’s capacity’ was the other theme, which it concerned the children’s preventive capacity, rapidity and reach. It was hard for the parents to keep up with the fast development of the small children (9 months–2 years). The parents said that they often did not realise the child’s capacities until the accident occurred. Key words: accident, burns, child, compliance, intervention, prevention and scalds Swedish abstract: Denna licentiatavhandling syftar till att beskriva barns (0-6 år) utsatthet för olycksfallsrisker i hemmiljön genom att fokusera på omfattningen av bränn- och skållskador, föräldrars uppfattningar om påverkande faktorer till olyckshändelser samt föräldrars uppgifter om egen följsamhet till olycksförebyggande råd och anvisningar. I barnhälsovården (BHV) ges råd och anvisningar kring olika åtgärder lämpliga i förhållande till barns utveckling. Dessa råd ges kontinuerligt och under barnens 6 första år. Innehållet i råden är reglerat i det basprogram som föräldrar till alla barn i Sverige erbjuds fram till skolstart. Få studier beskriver i vilken utsträckning föräldrar följer dessa råd och vilka faktorer som påverkar dels föräldrarnas följsamhet till råden dels faktorer som påverkar risken för barnolycksfall. I denna licentiatavhandling är exemplet skållskador (ΙΙ, ΙΙΙ) beskrivet som ett av flera möjliga olycksfall i hemmiljö som barn drabbas av.
annaslic.pdf
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Mothers' experiences of feeding situations : an interview study. Bramhagen, Ann-Cathrine; Axelsson, Irene; Hallström, Inger
Journal article in Journal of Clinical Nursing .;1 : Blackwell (2006)peer-reviewed
scientific
ARTICLE
English abstract: AIM: The aim of the study was to describe parents' experiences concerning feeding situations and their contact with the nurse at the Child Health Service (CHS). BACKGROUND: Some of the most important tasks for the nurse at the CHS are to monitor growth, detect feeding difficulties and give advice concerning food intake and feeding practices. METHOD: Eighteen mothers differing in age, education, ethnicity and number of children and recruited from different CHS were interviewed. The narratives were transcribed verbatim and analysed by content analysis at manifest and latent levels. RESULT: All mothers' described that food and feeding were essential parts of their lives requiring a great deal of time and involvement. Two major categories of mothers' attitudes in feeding situations were identified - a flexible attitude and a controlling attitude. Mothers with a flexible attitude were sensitive to the child's signals and responded to them in order to obtain good communication. Mothers who expressed a need for control established rules and routines regarding the feeding situations. Mothers with a controlling attitude expressed receiving inadequate support from the nurse at the CHS. CONCLUSION AND CLINICAL IMPLICATION: This study shows that some mothers experience inadequate support from the nurse at the CHS. Knowledge about mothers' experiences of feeding situations and their different attitudes towards the child during feeding might improve the CHS nurses' knowledge and help them understand and more adequately support mothers who experience feeding difficulties. Swedish abstract: SYFTE: Syftet med studien var att beskriva föräldrars upplevelser av matsituationerna och kontakten med sjuksköterskan inom barnhälsovården (BHV). BAKGRUNDEN: Några av de viktigaste uppgifterna för sjuksköterskan inom BHV är att följa tillväxten, identifiera uppfödningsproblem och att ge råd om kost och uppfödningsrutiner. METOD: Arton mödrar med varierande ålder, utbildning etnicitet och antal barn och rekryterades från olika barnavårdscentraler blev intervjuade. Berättelserna skrevs ut ordagrant och analyserades med innehållsanalys på manifest och latent nivå. RESULTAT: Alla mödrar beskrev att kost och uppfödning var väsentliga delar i deras liv vilka krävde en hel del tid och engagemang. Två huvudkategorier avseende mödrars förhållningssätt kunde identifieras - ett flexibel förhållningssätt ett kontrollerande förhållningssätt. Mödrar som uttryckte ett flexibelt förhållningssätt var mer öppna för sina barns signaler och svarade på dem för att skapa en god kommunikation. Mödrar som uttryckte ett behov av kontroll skapade regler och rutiner kring matsituationerna. Mödrar med ett kontrollerande förhållningssätt uttryckte att de fick otillräckligt stöd från sjuksköterskan inom BHV. KONKLUSION AND KLINISKA IMPLIKATION: Denna studie visade att några mödrar beskrev otillräckligt stöd från sjuksköterskan inom BHV. Kunskap kring mödrars upplevelser av matsituationerna och deras olika förhållningssätt gentemot sitt barn i samband med måltider kan öka kunskapen hos sjuksköterskorna inom BHV och bidra till ökad förståelse och adekvat stöd till mödrar som upplever uppfödningsproblematik. -
Structured diabetes education in Sweden : a national inquiry involvin...
Annersten, Magdalena; Frid, Anders; Dahlberg, Gunnel; Högberg, Margareta; Apelqvist, Jan
Journal article in Practical Diabetes International;3 : John Wiley and Sons (2006)peer-reviewed
scientific
ARTICLE
English abstract: The overall goals for the treatment of diabetes are to prevent acute and long-term complications and maintain a good quality of life. The St Vincent Declaration and the Swedish National Guidelines for the Treatment of Diabetes Mellitus describe patient education in self-treatment as a prerequisite for the achievement of these goals. This survey aimed to evaluate the presence of structured patient education (in advance planned education), its organisation, staffing and goals, and the results in out-patient diabetes care in Sweden.A questionnaire consisting of 35 open and closed questions was mailed to 1250 diabetes educated nurses working in hospitals and primary health care in the entire country.Responses were received from 583 (47%) nurses. Structured diabetes patient education was performed by 486 nurses. It was usually organised by nurses and performed in co-operation with doctors (55%), dietitians (38%), chiropodists (36%), and social workers (9%). The sessions took place individually at pre-scheduled visits (80%), or as group education (26%). Fifty-one percent described explicit goals for the education, most commonly: general knowledge about diabetes, improved metabolic control and increased safety. The structured education was evaluated by 51% of which the HbA[1]c level at the next scheduled visit was the most frequently used evaluation method (44%), followed by home monitored blood glucose values (37%) and a structured evaluation form (17%). The goals had been achieved to a great or quite great extent by 67% of the responding nurses.To the extent that structured patient education takes place, nurses are usually responsible for its performance. It takes place individually as well as in groups. Many nurses lack evident goals for the education and sufficient evaluation methods.It was concluded that there is confusion about the content of structured education vs information activity.
Structured ptedu_Annersten[1].pdf
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How to write a research proposal
Annersten, Magdalena; Wredling, Regina
Journal article in European Diabetes Nursing;2 : John Wiley and Sons (2006)scientific
ARTICLE
English abstract: A structured written research proposal is a necessary requirement when making an application for research funding or applying to an ethics committee for approval of a research project. A proposal is built up in sections of theoretical background; aim and research questions to be answered; a description and justification of the method chosen to achieve the answer; awareness of the ethical implications of the research; experience and qualifications of the team members to perform the intended study; a budget and a timetable. This paper describes the common steps taken to prepare a written proposal as attractively as possible to achieve funding
How to write a research proposal.pdf
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Evaluation of a modified interview version and of a self-rating versi...
Niméus, Anders; Hjalmarsson Ståhlfors, Fredrik; Sunnqvist, Charlotta; Stanley, Barbara; Träskman-Bendz, Lil
Journal article in European Psychiatry;7 : Elsevier (2006)peer-reviewed
scientific
ARTICLE
English abstract: The Suicide Assessment Scale (SUAS) was constructed to be sensitive to change of suicidality. It was recently found to be predictive of suicide in a group of suicide attempters. The aim of the present study was to evaluate the reliability and validity of a modified interview version of SUAS with defined scores and also a new self-rating version (SUAS-S). The subjects consisted of former inpatients, 42 persons who had been admitted because of a suicide attempt about 12 years ago and 22 control patients. The subjects were rated according to the SUAS, the SUAS-S, as well as the Montgomery Asberg Depression Rating Scale (MADRS). The interrater reliability was found to be high. The SUAS correlated significantly with the MADRS, but the concordance was not consistent, which indicates that the SUAS measures something different from depression. The SUAS-S correlated significantly with the interview-rated SUAS, thus exhibiting good concurrent validity. In summary, both the modified interview version of SUAS and the SUAS-S seem to be valid, reliable and easily used suicide assessment instruments. © 2006 Elsevier Masson SAS. All rights reserved.
SUAS-S.pdf
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Sjuksköterskors kliniska beslutsfattande med fokus på perifera venkat...
Eiman Johansson, Maria : Malmö university, Faculty of Health and Society
FoU-rapport;3 (2007)LICENTIATE
THESIS
English abstract: Every working shift nurses make several decisions, including decisions about management of peripheral venous catheters (PVC). Peripheral catheterisation is a common procedure, which affects numerous patients in health care today. PVC are for example used for intravenous infusions with antibiotics, nutrients and blood components. Having PVC in situ may lead to complications such as thrombophlebitis. Clinical guidelines have been developed within the area to assist nurses in their decision-making, but clinical guidelines are not always adhered to. There are several reasons why clinicians do not always adhere to clinical guidelines, although such adherence may lead to fewer complications. Choices for decisions regarding PVC management have been investigated in previous studies, but not in a naturalistic setting. The overall aim of this licentiate thesis was to describe nurses’ clinical decision-making through focusing on their adherence to clinical guidelines and their clinical reasoning concerning decisions of PVC. Two studies have been conducted and data were collected during a six-month period, from December 2004 to June 2005. Study I investigated nurses’ adherence to national and local PVC guidelines by focusing on time in situ, site, size and documentation at the dressing. The thrombophlebitis frequency associated with PVC in situ was also investigated. Structured observations through two protocols were carried out and data about 343 PVC were analysed. Study II investigated nurses’ clinical reasoning regarding PVC management and cues and factors of importance in the decision10 making process were analysed. Nurses were observed in their daily work with focus on PVC management. They were interviewed both about the PVC decisions made in the observed situations and about factors influencing their reasoning regarding PVC management in general. The observations facilitated the interviews. Transcribed interview texts were analysed with content analysis. The results in study I showed that thrombophlebitis frequency was 7.0% and the nurses seemed to replace or remove PVC before any severe complications arose in accordance with clinical guidelines. Nurses partly adhered to national and local guidelines concerning site, size, documentation at the dressing and time in situ. Differences in guideline adherence were observed for wards with local or national guidelines, as well as for wards with different specialities. The results indicate that local guidelines may have an impact on guideline adherence but these results need further exploration. Analysis of interview texts in study II resulted in a category system with three main categories describing cues and factors of importance in the nurses’ clinical reasoning about PVC: the individual patient situation, the nurse’s work situation, and experience of PVC management. An overall theme was also revealed in the interview texts and the nurses balance in their clinical reasoning between avoiding or minimizing discomfort and pain for the patient and preventing complications from the PVC. The results from this licentiate thesis have implications for the education of nurses as well as during implementation of clinical guidelines. Swedish abstract: För att kunna ge vård av säker och god kvalitet krävs att sjuksköterskor har kunskap inom många områden, eftersom de har ansvar för såväl bedömning, planering och genomförande, som utvärdering och dokumentation av omvårdnadsarbetet. Ett av flera ansvarsområden för sjuksköterskor i deras dagliga arbete är beslutsfattande om insättning och skötsel av perifera venkatetrar (PVK). En PVK är en tunn plastkateter som sätts in i ett blodkärl via en kanyl. PVK används vid intravenös behandling med till exempel antibiotika och andra läkemedel, blodkomponenter eller näringslösningar. En stor andel av alla patienter inom hälsooch sjukvård kommer någon gång i kontakt med en PVK och riskerar då också att utsättas för komplikationer. En vanlig komplikation i samband med PVK är tromboflebit. Tromboflebit förekommer i olika svårighetsgrader och innebär att inflammation har uppstått i blodkärlet i kombination med samtidig blodpropp. Symtom som kan uppstå är rodnad, svullnad, smärta, hårdhet i kärlet och varig infektion. Det finns kliniska riktlinjer om PVK framtagna både på nationell och på lokal nivå som fungerar som ett stöd i beslutsfattandet. Tidigare forskning har visat att kliniskt verksamma ibland inte följer riktlinjer. Anledningar till att inte riktlinjer följs kan till exempel vara att de kliniskt verksamma inte håller med om det som rekommenderas, inte känner till rekommendationerna, inte har tid eller möjlighet att påverka de beslut som fattas eller att det finns individuella faktorer att ta hänsyn till för den enskilda patienten. 52 Frågan kan ställas om sjuksköterskor använder sig av kliniska riktlinjer i sitt dagliga arbete eller om det är andra faktorer och aspekter som har betydelse och påverkar beslutsfattandet. Denna licentiatavhandling syftade till att beskriva sjuksköterskors kliniska beslutsfattande genom att fokusera på deras följsamhet till riktlinjer och beslutsresonemang om PVK. Två studier har genomförts inom ramen för denna licentiatavhandling. Studie I undersökte i vilken utsträckning sjuksköterskor följer nationella och lokala riktlinjer om PVK. PVKns placering och storlek, tiden som PVKn varit placerad i blodkärlet, dokumentation vid PVKns förband samt om det fanns tecken på tromboflebit vid PVKn var variabler som undersöktes i relation till de rekommendationer som fanns. Utifrån två protokoll samlades strukturerad data in och analyserades. Totalt 343 PVK ingick i analysen. I studie II undersöktes de tecken och påverkande faktorer som har betydelse när sjuksköterskor fattar beslut om skötsel av PVK. I studien observerades 43 sjuksköterskor i sitt dagliga arbete. Sjuksköterskorna intervjuades också dels om PVK-besluten som de fattade under observationerna, dels om deras beslutsfattande om PVK-skötsel i allmänhet. Studie I visade att sjuksköterskor delvis följer riktlinjer. Det fanns skillnader mellan de vårdavdelningar som hade nationella riktlinjer och de som hade lokala riktlinjer, i hur de olika avdelningarna valde placering, storlek och dokumenterade vid PVKns förband. PVKn hade suttit längre tid än rekommenderat i varierande utsträckning. Andelen tromboflebiter var låg (7.0%) och tromboflebiterna var milda. Det tyder på att sjuksköterskor är noga med att ta bort PVK vid tecken på komplikationer. Studie II visade att sjuksköterskor i sitt kliniska resonemang om PVK-skötsel tar hänsyn till den individuella patientsituationen, sjuksköterskans arbetssituation och erfarenhet av PVK-skötsel. Det framkom även att sjuksköterskor balanserar mellan att undvika eller minimera obehag och smärta för patienten och samtidigt förebygga komplikationer från PVKn. Resultaten från denna licentiatavhandling kan få betydelse för undervisning av sjuksköterskestudenter och även när kliniska riktlinjer ska införas på vårdavdelningar. -
Time geography: a model for psychiatric life charting?
Sunnqvist, Charlotta; Persson, Ulla; Lenntorp, Bo; Träskman-Bendz, Lil
Journal article in Journal of Psychiatric and Mental Health Nursing; : Blackwell Publishing (2007)peer-reviewed
scientific
ARTICLE
English abstract: Since many years, life charting has been used to describe the life course and life events of psychiatric patients. The aim of the present study was to describe and evaluate time geographic life charts of 11 former psychiatric patients in order to promote systematic descriptions of their life events over time. Information on all events which was gathered from the life charts was analysed by manifest content analysis and reduced to four categories: information received by asking only about moves, social capacity, predisposing life events and/or stressful as well as precipitating life events. Our findings showed that this kind of life charts offered a comprehensive and structured picture. They describe a detailed life situation from one time period to another, where geographical sites serve as anchors. The patients expressed satisfaction with this method of combining an interview with a time geographic life line.
Time-geography.pdf
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Translating fear and abuse into Arabic/Islamic concepts: process and ... Wangel, Anne-Marie; Ouis, Pernilla; Östman, Margareta : 2nd Conference of Migrant Health in Europe, (2008) conference
POSTER
English abstract: Background: To study sexual and reproductive health issues, an understanding of cultural and language bound concepts is needed. Scandinavian studies of native speaking women show a relation between history of partner violence, sexual abuse and fear of delivery. In Malmo the third largest city of Sweden, 36% of the population has a foreign background. The proportion of Arabic speaking women within maternity care is increasing in Sweden. Islamic concepts are often based in the Arabic language and are of importance for non-Arabic speaking Muslim women as well. To enable participation in a prospective study on history of abuse and fear and delivery outcome, the validated instruments needed translation into Arabic language. Aim: To describe challenges in translating instruments, on fear and abuse, developed for westernized societies into an Arabic questionnaire. Method: Interviews and face validity testing of translated instruments from Western language to develop an Arabic questionnaire were conducted. Results: In order to validate translated instruments of concepts related to sexual and reproductive health, an understanding of cultural and religious ideas, meaning of words for sexuality, violence, abuse, fear and “destiny” needs to be addressed and considered. Examples of international approaches to these issues will be presented. Conclusion: Translation of cultural concepts for questionnaire development requires more than understanding and interpretation. Ethical approval 2006/354-31; 2007/1360-32. PhD-studies by faculty funding -
Suicide attempters:biological stressmarkers and adverse life events
Sunnqvist, Charlotta; Westrin, Åsa; Träskman-Bendz, Lil
Journal article in European Archives of Psychiatric and Clinical Neurosciences;8 : EAPCN (2008)peer-reviewed
scientific
ARTICLE
English abstract: Risk factors for suicidal behaviour include adverse life events as well as biochemical parameters acting, e.g. within the hypothalamic–pituitary– adrenal axis and/or monoaminergic systems. The aim of the present investigation was to study stressful life events and biological stress markers among former psychiatric inpatients, who were followed up 12 years after an index suicide attempt. At the time of the index suicide attempt, and before treatment, cerebrospinal fluid (CSF) samples were taken, and 24 h (h) urine (U) was collected. 3-Methoxy-4-hydroxyphenylglycole (MHPG) in CSF and 24 h urinary samples of cortisol and noradrenaline/adrenaline (NA/A) were analysed. Data concerning stressful life events were collected retrospectively from all participants in the study through semi-structured interviews at follow-up. We found that patients who reported sexual abuse during childhood and adolescence had significantly higher levels of CSF-MHPG and U-NA/A, than those who had not. Low 24 h U-cortisol was associated with feelings of neglect during childhood and adolescence. In conclusion, this study has shown significant and discrepant biological stress-system findings in relation to some adverse life events.
Suicide attempters.pdf
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Outcome analysis of a research-based didactic model for education to ... Gebru, Kerstin; Khalaf, Azzam; Willman, Ania
Journal article in Scandinavian Journal of Caring Sciences;22 (2008)peer-reviewed
scientific
ARTICLE
English abstract: Aims and objectives: To describe and analyse to what extent the goals of the education in promoting culturally competent nursing care have been achieved from a student perspective. Background: As Sweden has transformed into a multicultural society over the past 50 years, there is a need to specify, at all levels of the nursing programme, transcultural concepts for the success of integration. A research-based didactic model was designed for the nursing programme at Malmö University and this was followed by investigations of its outcome. Design and methods: The study is a prospective cohort study with an outcome analysis. A descriptive research study with a longitudinal design was performed, with the focus on Swedish nursing students' experiences of transcultural nursing knowledge and their attitudes before and after implementation of the didactic model. The students evaluate highly their competence to meet demands of multicultural health and medical service. Additionally, their ability to recognise and understand the consequences of international migration on health also received a high mean. Conclusions: The study revealed the knowledge and experience acquired by Swedish students in transcultural nursing. The assumption was that a visible development of knowledge should occur during the three years of education. Interpreting the findings, such effectiveness can be found and hopefully the students will be able to give holistic nursing care based on a person's individual culture. -
Developing an instrument for evaluating implementation of clinical pr... Bahtsevani, Christel; Willman, Ania; Khalaf, Azzam; Östman, Margareta
Journal article in Journal of Evaluation in Clinical Practice;xx : Blackwell Publishing Ltd. (2008)peer-reviewed
scientific
ARTICLE
English abstract: Rationale and aims: This study focuses on the development of an instrument for the evaluation of clinical practice guidelines and is one part of a research project about the implementation and use of such guidelines among hospitals in the southern region of Sweden. The aim of the present paper was to investigate the test-retest reliability of a questionnaire. Method: A questionnaire was designed to gather data about guidelines that have been implemented as well as information about factors, which, according to the Promoting Action on Research Implementation in Health Service (PARIHS)-model, influence the success of implementation. Thirty-nine professionals at one of the hospitals included in the survey completed the questionnaire on two occations within a mean time of 5.5 weeks. The test-retest reliability was analyzed by means of Cohen's Kapps and percentage concordance. Results: Eight items had good agreement in terms of strength and high percentage concordance. With regard to the Kappa values 13 items show moderate and two fair agreement. Conclusions: The test-retest reliability scores show mainly acceptable results indicating a reasonable stability, thus suggesting the possibility of further developing the instrument. The factors described in the PARIHS-model seem relevant for use in evaluating implementation and use of guidelines. The instrument could benefit from a revision of the language in order to enhance clarity and make it less abstract. -
Utveckling och samstämmighet avseende bedömningskriterier i de vetens... Bengtsson, Mariette; Wann-Hansson, Christine; Gebru, Kerstin; Falk, Solvig; Dejin-Karlsson, Elisabeth; Sjöblom, Ingela (2008)
NU2008 Lärande i ny tid 7-9 maj 2008, Kalmarother
Swedish abstract: BAKGRUND Idag sker den vetenskapliga metodskolningen i huvudämnet omvårdnad i kurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola. Studenter har visat i utvärderingar att det inte fanns någon kontinuitet och progression mellan de vetenskapliga metodkurserna på sjuksköterskeprogrammet, vilket också uppmärksammats av undervisarna. Enligt förvaltningslagen är det en myndighetsutövning gentemot en enskild person när en examinator sätter ett betyg. Därför måste betygssättning hanteras rättsäkert och konsekvent vilket kräver väl förankrade betygskriterier (Ekecrantz, 2007). För att säkra kvalitet och kontinuitet mellan kurserna 1, 4, 8 och 9 på sjuksköterskeprogrammet på Malmö Högskola och för att EU-anpassa betygsgraderingen enligt ECTS-skalan (ECTS USERS`GUIDE) behövdes nya bedömningskriterier baserade på nya lärandemål enligt Bologna processen utarbetas. För att successivt öka kunskapsstegringen mellan de vetenskapliga metodkurserna har i ett tidigare projekt nya lärandemål enligt Bologna modellen för respektive kurs utarbetats. SYFTE Syftet med projektet är att identifiera och formulera bedömningskriterier baserade på en successiv kunskapsstegring inom forskningsområdet omvårdnad både avseende metod och ett kritiskt förhållningssätt. GENOMFÖRANDE Arbetet påbörjades i augusti 2007 och projektgruppen består av sex undervisande och examinerande lärare i de berörda kurserna. Litteratur i ämnet studerades och gruppen samlade in information om hur andra universitet och högskolor tillämpat ECTS-skalan. Arbetsgrupper för respektive kurs bildades som utarbetade förslag för bedömningskriterier A till F för respektive kurs. Därefter strålade arbetsgrupperna samman för att gemensamt fastställa samstämmighet samt progression mellan kurserna. Gruppen har också diskuterat examinationsformer, undervisningsmetoder, litteratur och begreppsdefinitioner relaterade till betygskriterier. Arbetet har också lett till att lärandemålen för respektive kurs har fått korrigeras och anpassat för att kunna vara utvärderingsbara. För att få studenternas synpunkter kommer de utarbetade förslagen att presenteras för studenter i respektive kurs för att få deras syn på bedömningskriterierna. Studenter i kurs 4 och 8/9 kommer under läsåret 08/09 att få vara delaktiga i utvecklingsprocessen av bedömningskriterierna. Implementering av resultatet kan tidigast ske VT09 och kommer därefter att utvärderas. Betygskriterierna kan ses i bilaga 1-5. DISKUSSION Dessa kriterier skall vara ett stöd för betygsättning av examensarbete såväl som seminarier och enskilda uppgifter dock utan att minska examinatorns ansvar för bedömningen. Bedömningskriterierna bör också ge utrymme för examinatorns egen bedömning (Boij m.fl., 2007). Betygskriterierna skall fungera som ett stöd för examinatorn så väl som för studenten, som kan inspireras att sträva efter ett högre betyg. Eftersom ECTS-graderingen är målrelaterad så finns det inget krav på att en viss del av studenterna skall få ett visst betyg. Det är dock viktigt att kraven för E skall vara likvärdiga med betyget GODKÄND. Det finns både fördelar och nackdelar med betyg i många grader. Enligt Ekecrantz (2007) ger det större precision och rättvisa samt en bättre feedback till studenterna på deras prestationer. Ekecrantz menar dock att många grader kan leda till ökad stress för studenten och ge en ökad arbetsbelastning för läraren samt att examinationsformerna kan försämras. Arbetsgruppen håller inte riktigt med om detta. Visserligen kan examinationsformerna behöva förändras men det behöver nödvändigtvis inte leda till en försämring. En intressant aspekt som Boij m.fl. (2007) tar upp i sin rapport från Kungliga Tekniska Högskolan är att bedömning av t.ex. examensarbete kan göras utifrån flera perspektiv såsom process, vetenskapligt innehåll och prestation för att examinatorn skall kunna skaffa ett bra underlag för att sätta betyg. Studentinflytande är viktigt och det är en utmaning att få studenterna delaktiga i processen, vilket inte har varit så lätt inom alla verksamheter (Åkesson 2006). -
Identifying markers for mental ill-health during pregnancy in registr... Wangel, Anne-Marie; Molin, Johan; Östman, Margareta : 2nd Conference of Migrant Health in Europe (2008) conference
POSTER
English abstract: Background: Population based studies report increasing mental ill- health levels of women in reproductive ages. The antenatal routine care program in Sweden consists of 8-10 visits with a nurse midwife. Data from these visits, delivery and postnatal care has been collected with the National Delivery Register since 1973. No variables however exist for identifying mental health. A computerized perinatal patient record system has been in use for12 years at the University Hospital in Malmö, Sweden. It consists of some 2,500 variables possible to use for follow-up studies, as well as searchable free-text. The record system is used by all clinical staff involved with the pregnant woman. Aim: To identify markers for mental ill-health in pregnancy in registry data to predict delivery outcome. Method: Patient records from six consecutive years with 22,000 pregnancies were selected. Theoretical markers of mental ill-health related words were identified and tested in a sub-sample. A free-text-search among all patient records was performed to identify the occurrence of each of the selected markers. Results: Twenty words relating to mental ill-health instruments were chosen for the free-text database search. Presence of reported words as "panic", “anxiety” and “stress” showed an increase OR for instrumental delivery, ruptured sphincter and caesarian section. The phrase "anti-depressive" seem to lower the OR for these outcomes. Conclusion: Preliminary data seems to indicate an increased risk of obstetric complications at delivery associated with some of the markers for ill-health. Further analyses could assist in developing variables for the identification of words predicting mental ill-health and increased obstetric risks. Ethical approval 350/2007. PhD-studies by faculty funding -
Platsens betydelse för dementa : en studie av demensvården i tre skån...
Rämgård, Margareta : Kommunförbundet Skåne
FoU Skriftserie;2009:8 (2009)REPORT
Swedish abstract: Projektet har genomförts i tre kommunla boende för dementa och berör platsers betydelse för dementa boendes sociala välbefinnande. Några av frågeställningarna i projektet är: Kan socialt välmående för de dementa boende relateras till specifika platser? Har förändringar i den fysiska miljön någon påverkan på de dementa boende? Materialet består av fokusgrupper tillsammans med personalen i de tre särskilda boendena, djupintervjuer med anhöriga samt dagböcker som följer trettio dementa boende under tre månader. Förutom de spatiala frågorna tar rapporten upp behovet av kontinuitet i arbetet med de dementa boende och hur det kan minska oro och därmed reducera medicinförbrukningen. Den pekar även på att om de dementa boende skall uppleva mening i boendet så måste de utveckla sociala aktiviteter i mindre grupper, olika konstellationer och miljöer som de känner igen sedan tidigare. Rapporten visar att när dementa boende får komma till platser där de utövat sociala aktiviteter (och som är förknippade med stark positiva känsloupplevelser) förstärks deras kognition och minnesfunktion.
Skriftserie Fou-platsens.pdf
(3.589Mb)
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Elimination Bengtsson, Mariette; Stenzelius, Karin
Book chapter in Omvårdnadens grunder. Hälsa och ohälsa : Studentlitteratur (2009)BOOK CHAPTER
Swedish abstract: Intag av mat och dryck liksom elimination av kroppens avfallsprodukter tillhör månniskans grundläggande fysiologiska behov.Att drabbas av urin- och avföringsproblem av skiftande slag kan upplevas integritets-kränkande för den drabbade. Att prata om det kan vara svårt och ännu mer besvärande att vara i behov av hjälp med sina toalettbestyr. den friska individen har dåliga kunskaper om sina kroppsliga funktionerså länge han/hon är frisk. Först när något kroppsligt fel tillstöter söker individen kunskap. detta gäller i ännu högre grad normal urin och tarmfunktion eftersom detta område är omgärdat av tabu.Sjuksköterskans viktigaste uppgift är att dela med sig av sin kunskap.
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