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Eklund, C., Elfström, M., Eriksson, Y. & Söderlund, A. (2019). User experiences from a web-based, self-management programme: struggling with what I need when stress management is about me. European Journal of Physiotherapy, 39-48
Open this publication in new window or tab >>User experiences from a web-based, self-management programme: struggling with what I need when stress management is about me
2019 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, p. 39-48Article in journal (Refereed) Published
Abstract [en]

Objectives: To explore users’ experiences of a tailored, interactive web application that supports behaviour change in stress management and to identify if and in that case what in the web-based programme that needed further development or adjustment to be feasible in a randomised controlled trial.

Method: The design of this study was explorative with a qualitative approach. Nine individuals were recruited among the staff at a university. Semi-structured individual interviews were conducted and analysed using qualitative content analysis, after the participants had completed the web-based stress management programme.

Results: One theme was identified, Struggling with what I need when stress management is about me, describing the paradox in having a programme that is perceived as supporting stress management while also being perceived as extensive and time consuming. The theme was divided in two categories: Defining the needs, where the users expressed what they needed from the programme and their everyday environment, to be able to use the programme, and It is about me, where the programme was described as helping the users understand their own stress.

Conclusion: The participants expressed acceptance of using a web-based programme for stress related problems. The perceived extensiveness of the programme must be considered in further development.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
stress management, behaviour change, behaviour medicine, content analysis, e-health
National Category
Medical and Health Sciences Other Medical Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-40273 (URN)10.1080/21679169.2018.1468814 (DOI)000470063000008 ()2-s2.0-85046429289 (Scopus ID)
Available from: 2018-07-20 Created: 2018-07-20 Last updated: 2019-06-20Bibliographically approved
Yuwanich, N., Akhavan, S., Nantsupawat, W., Martin, L., Elfström, M. & Sandborgh, M. (2018). Development and psychometric properties of the stressor scale for emergency nurses. International Emergency Nursing, 39, 77-88
Open this publication in new window or tab >>Development and psychometric properties of the stressor scale for emergency nurses
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2018 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 39, p. 77-88Article in journal (Refereed) Published
Abstract [en]

Introduction: Emergency department nurses are exposed to specific stressors and report higher stress levels than nurses in other hospital departments. This study aimed to develop and test the psychometric properties of a questionnaire-based instrument for identifying stressors for emergency department nurses. Methods: The instrument's content and face validities were examined by five experts and nurses in emergency nursing field. The test-retest reliability was examined on 30 emergency department nurses. The construct validity, including an exploratory and a confirmatory factor analysis, was tested on 405 emergency department nurses. Cronbach's alpha values and intra-class coefficients were calculated. Results: The instrument's content and face validities were satisfactory. The exploratory factor analysis provided a five-factor solution, whereas the confirmatory factor analysis provided a final four-factor solution with 25 items distributed among the factors Life and death situations, Patients' and families' actions and reactions, Technical and formal support, and Conflicts. The Cronbach's alpha values ranged from 0.89 to 0.93 per factor, and the intra-class correlation coefficient was 0.89, indicating good homogeneity and stability. Conclusions: The instrument's content, face, and construct validities were satisfactory, and the internal consistency and test-retest reliability were good. This instrument can be useful in the management of emergency departments.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2018
Keywords
Emergency room nursing, Instrument development, Occupational stress, Questionnaire, Validation
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40256 (URN)10.1016/j.ienj.2018.01.005 (DOI)000436593800012 ()29409734 (PubMedID)2-s2.0-85041302081 (Scopus ID)
Available from: 2018-07-19 Created: 2018-07-19 Last updated: 2018-09-14Bibliographically approved
Eklund, C., Elfström, M., Eriksson, Y. & Söderlund, A. (2018). Development of the web application My Stress Control—Integrating theories and existing evidence. Cogent Psychology, 5(1), 1-19
Open this publication in new window or tab >>Development of the web application My Stress Control—Integrating theories and existing evidence
2018 (English)In: Cogent Psychology, Vol. 5, no 1, p. 1-19Article in journal (Refereed) Published
Abstract [en]

Aim: To describe the systematic development of an evidence-based, tailored, interactive web application for self-management of work-related stress, and to test usability issues regarding how to proceed through the programme. Methods: Evidence from the fields of stress management, behaviour change and web-based interventions was the foundation for the theoretical framework and content. The next step was the development process of the web application and validation among experts and one possible end user. Last, a usability test with 14 possible end users was conducted. Results: The web-application, My Stress Control (MSC), was built on a solid theoretical framework. It consists of 12 modules including: introduction, psychoeducation, ambivalence, stress management strategies, lifestyle change, and maintenance. Self-monitoring, goal-setting, re-evaluating goals, feedback, and prompting formulation of intention to change are central techniques supporting behaviour change. The usability test revealed difficulties in understanding how to proceed through the programme. Conclusion: The development contributes to filling a gap in the literature regarding development of complex web-based interventions. MSC is dissimilar to existing programs in the field, considering the tailoring and multi-tracked opportunities. Although developed from the evidence in multiple fields, the web application would benefit from further development to support users in reaching the end module.

Place, publisher, year, edition, pages
Cogent OA, 2018
Keywords
behaviour change, health promotion, internet, occupational stress, stress management, stress prevention
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40238 (URN)10.1080/23311908.2018.1489457 (DOI)000436962900001 ()2-s2.0-85049310511 (Scopus ID)
Funder
AFA Insurance, 130263
Available from: 2018-07-12 Created: 2018-07-12 Last updated: 2018-12-10Bibliographically approved
Eklund, C., Elfström, M., Eriksson, Y. & Söderlund, A. (2018). Evaluation of a Web-Based Stress Management Application: A Feasibility Study. Journal of Technology in Behavioral Science, 3(3), 150-160
Open this publication in new window or tab >>Evaluation of a Web-Based Stress Management Application: A Feasibility Study
2018 (English)In: Journal of Technology in Behavioral Science, ISSN 2366-5963, Vol. 3, no 3, p. 150-160Article in journal (Refereed) Published
Abstract [en]

The aim of the current study was to investigate the feasibility of a Web-based program that promotes behavior change for stress-related problems in terms of the program’s acceptability, practicability, and any possible effects. In addition, the aim was also to study how appropriate and realistic the study’s process and resource management would be for conducting a randomized controlled trial. A convenience sample consisting of 14 individuals was recruited from a university in Sweden. The participants had access to the program for a duration of 9 weeks. Questionnaires were answered before accessing, during use of, and after completing the program. Both qualitative and quantitative data were collected and analyzed. The program was considered acceptable and practically feasible, though small adjustments have to be made. The program was considered time-consuming, extensive, and in need of some clarifications. Regarding process and resource management, the study participants required minimum support. It was difficult to identify the time point when to send out the process measures because the participants worked at their own pace. Also, one of the process measurements, the motivation to change, remained stable. With some adjustments to the instructions to the study participants and minor changes in the program, the intervention and study’s procedure were considered as feasible and can be carried out in a randomized controlled trial.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
stress, internet, behaviour change, occupational stress, health promotion, feasibility
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-40272 (URN)10.1007/s41347-018-0044-8 (DOI)30238058 (PubMedID)
Funder
AFA Insurance, 130263
Available from: 2018-07-20 Created: 2018-07-20 Last updated: 2019-06-18Bibliographically approved
Östlund, G., Zander, V., Elfström, M. L., Gustafsson, L.-K. & Anbäcken, E.-M. (2018). ´Nothing to do about it, simply hang on´ - Older women´s experiences of social and existential health after a reablement intervention. In: : . Paper presented at European Conference for Social Work Research 2018.
Open this publication in new window or tab >>´Nothing to do about it, simply hang on´ - Older women´s experiences of social and existential health after a reablement intervention
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2018 (English)Conference paper, Oral presentation only (Other academic)
National Category
Social Sciences Other Social Sciences
Identifiers
urn:nbn:se:mdh:diva-41519 (URN)
Conference
European Conference for Social Work Research 2018
Available from: 2018-12-09 Created: 2018-12-09 Last updated: 2018-12-10Bibliographically approved
Östlund, G., Zander, V., Elfström, M., Gustafsson, L.-K. & Anbäcken, E.-M. (2017). “It gets easier when the sun is shining”: a follow-up study after a reablement intervention. In: : . Paper presented at Nationell forskarkonferens i socialt arbete, Umeå, 2017.
Open this publication in new window or tab >>“It gets easier when the sun is shining”: a follow-up study after a reablement intervention
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2017 (English)Conference paper, Oral presentation only (Refereed)
National Category
Social Sciences Health Sciences
Research subject
Social Work
Identifiers
urn:nbn:se:mdh:diva-36091 (URN)
Conference
Nationell forskarkonferens i socialt arbete, Umeå, 2017
Available from: 2017-07-10 Created: 2017-07-10 Last updated: 2017-10-16Bibliographically approved
Anbäcken, E.-M., Gustafsson, L.-K., Elfström, M., Zander, V. & Östlund, G. (2016). A holistic way ofworking interprofessionally in home care with and for older people. In: : . Paper presented at Joint Conference of Home Care & Gerontology, Tokyo, 2016.
Open this publication in new window or tab >>A holistic way ofworking interprofessionally in home care with and for older people
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2016 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-36092 (URN)
Conference
Joint Conference of Home Care & Gerontology, Tokyo, 2016
Projects
Intensiv hemrehabilitering
Available from: 2017-07-10 Created: 2017-07-10 Last updated: 2017-10-17Bibliographically approved
Nahlen Bose, C., Persson, H., Björling, G., Ljunggren, G., Elfström, M. & Saboonchi, F. (2016). Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure: a randomized controlled trial. European Journal of Cardiovascular Nursing, 15(7), 537-548, Article ID S1-S1.
Open this publication in new window or tab >>Evaluation of a Coping Effectiveness Training intervention in patients with chronic heart failure: a randomized controlled trial
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2016 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, no 7, p. 537-548, article id S1-S1Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Impaired emotional well-being has detrimental effects on health outcomes in patients with chronic heart failure (CHF).

AIMS:

To evaluate a nurse-led Coping Effectiveness Training (CET) group intervention for patients with CHF. It was hypothesized that CET would increase emotional well-being (primary outcome) and health-related quality (HRQoL) of life and improve clinical outcomes. Furthermore, changes in appraisal and coping as mediators of the intervention effect were examined.

METHODS:

Participants were randomized to either control group (n=51) receiving standard health care or CET intervention group (n=52). Self-assessments of positive affect, negative affect, depression, anxiety, HRQoL, illness perception, coping strategies and social support were performed pre- and post-intervention and after six weeks, six months and 12 months. Time to death and hospitalizations were measured during the entire follow-up (median 35 months, interquartile range 11 months).

RESULTS:

No significant improvements for emotional well-being and HRQoL in the intervention group compared with the control group were found. After excluding patients with clinical anxiety and depression at baseline the intervention group had significantly lower negative affect (p = 0.022). There were no significant differences regarding cardiovascular events between the groups. The intervention group had greater sense of control over their illness in the short-term (p = 0.036).

CONCLUSION:

CET intervention was found to increase sense of control over the illness in the short term. Psychosocial support programmes, like CET, for patients with CHF is currently lacking evidence for implementing in clinical practice. However, the results provide a basis for future studies with a modified CET intervention design and increased study size.

Keywords
Heart failure, intervention, randomized controlled trial, follow-up, sense of control, affect
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:mdh:diva-30702 (URN)10.1177/1474515115625033 (DOI)000389893500009 ()26733462 (PubMedID)2-s2.0-85001022114 (Scopus ID)
Available from: 2016-01-12 Created: 2016-01-12 Last updated: 2018-02-05Bibliographically approved
Nahlen Bose, C., Björling, G., Elfström, M., Persson, H. & Saboonchi, F. (2015). Assessment of Coping Strategies and Their Associations With Health Related Quality of Life in Patients With Chronic Heart Failure: the Brief COPE Restructured. Cardiology Research, 6(2), 239-248
Open this publication in new window or tab >>Assessment of Coping Strategies and Their Associations With Health Related Quality of Life in Patients With Chronic Heart Failure: the Brief COPE Restructured
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2015 (English)In: Cardiology Research, ISSN 1923-2829, E-ISSN 1923-2837, Vol. 6, no 2, p. 239-248Article in journal (Refereed) Published
Abstract [en]

Background: Individuals with chronic heart failure (CHF) need to cope with both the physical limitations and the psychological impacts of the disease. Since some coping strategies are beneficial and others are linked to increased mortality and worse health-related quality of life (HRQoL), it is important to have a reliable and valid instrument to detect different coping styles. Brief COPE, a self-reporting questionnaire, has been previously used in the context of CHF. There is, however, currently a lack of consensus about the theoretical or empirical foundations for grouping the multiple coping strategies assessed by Brief COPE into higher order categories of coping. The main purpose of this study was to examine the structure of Brief COPE, founded on the higher order grouping of its subscales in order to establish an assessment model supported by theoretical considerations. Furthermore, the associations between these higher order categories of coping and HRQoL were examined to establish the predictive validity of the selected model in the context of CHF.

Method: One hundred eighty-three patients diagnosed with CHF were recruited at a heart failure outpatient clinic or at a cardiac ward. Self-reported questionnaires were filled in to measure coping strategies and HRQoL. Confirmatory factor analyses were performed to investigate different hierarchical structures of Brief COPE found in the literature to assess coping strategies in patients with CHF. Regression analyses explored associations of aggregated coping strategies with HRQoL.

Results: A four factorial structure of Brief COPE displayed the most adequate psychometric properties, consisting of problem focused coping, avoidant coping, socially supported coping and emotion focused coping. Avoidant coping was associated with worse HRQoL in CHF.

Conclusions: This study provides support for a four-factor model of coping strategies in patients with CHF. This could facilitate assessment of coping both in clinical and research settings.

Keywords
Heart failure; Factor analysis; Statistical; Adaption; Psychological; Quality of life; Self-report
National Category
Nursing Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:mdh:diva-30701 (URN)10.14740/cr385w (DOI)000359639600001 ()28197233 (PubMedID)
Available from: 2015-05-13 Created: 2016-01-12 Last updated: 2019-01-10Bibliographically approved
Bose, C. N., Bjorling, G., Elfström, M., Persson, H. & Saboonchi, F. (2015). Implementation of coping effectiveness training in patients with chronic heart failure: participants evaluations indicate psychosocial benefits. European Journal of Cardiovascular Nursing, 14, S10-S10
Open this publication in new window or tab >>Implementation of coping effectiveness training in patients with chronic heart failure: participants evaluations indicate psychosocial benefits
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2015 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, p. S10-S10Article in journal, Meeting abstract (Refereed) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-28619 (URN)000356411700016 ()
Available from: 2015-07-16 Created: 2015-07-16 Last updated: 2017-05-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5098-8489

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