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Publications (10 of 19) Show all publications
Rudberg, I., Olsson, A., Thunborg, C. & Salzmann-Erikson, M. (2024). Adjustments in Interprofessional Communication: A Focus Group Study in Psychiatric Outpatient Units. Issues in Mental Health Nursing
Open this publication in new window or tab >>Adjustments in Interprofessional Communication: A Focus Group Study in Psychiatric Outpatient Units
2024 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673Article in journal (Refereed) Published
Abstract [en]

Communication in healthcare extends beyond patient care, impacting the work environment and job satisfaction. Interprofessional communication is essential for fostering collaboration, but challenges arise from differences in training, roles, and hierarchies. The study aimed to explore psychiatric outpatient clinicians' experiences of interprofessional communication and their perceptions of how the communication intersects the organizational and social work environment of healthcare. Qualitative research involved focus group interviews with clinicians from five psychiatric outpatient units in Central Sweden, representing diverse professions. The authors analyzed semi-structured interview data thematically to uncover clinicians' perspectives on interprofessional communication. An overarching theme, "Adjustment of communication," with subthemes "Synchronized communication" and "Dislocated communication," emerged. Clinicians adapted communication strategies based on situations and needs, with synchronized communication promoting collaboration and dislocated communication hindering it. Communicating with each other was highly valued, as it contributed to a positive work environment. The study underscores the importance of an open, supportive environment that fosters trust, and respect among healthcare clinicians. Consistent with prior research, collaboration gaps underscore the urgent need to improve interprofessional communication.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS INC, 2024
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-66404 (URN)10.1080/01612840.2024.2308556 (DOI)001195473700001 ()38564368 (PubMedID)
Available from: 2024-04-10 Created: 2024-04-10 Last updated: 2024-04-10Bibliographically approved
Larsson, L. E., Wang, R., Cederholm, T., Wiggenraad, F., Rydén, M., Hagman, G., . . . Thunborg, C. (2023). Association of Sarcopenia and Its Defining Components with the Degree of Cognitive Impairment in a Memory Clinic Population. Journal of Alzheimer's Disease, 96(2), 777-788
Open this publication in new window or tab >>Association of Sarcopenia and Its Defining Components with the Degree of Cognitive Impairment in a Memory Clinic Population
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2023 (English)In: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908, Vol. 96, no 2, p. 777-788Article in journal (Refereed) Published
Abstract [en]

Background: Sarcopenia and cognitive impairment are two leading causes of disabilities. Objective: The objective was to examine the prevalence of sarcopenia and investigate the association between sarcopenia diagnostic components (muscle strength, muscle mass, and physical performance) and cognitive impairment in memory clinic patients. Methods: 368 patients were included (age 59.0±7.25 years, women: 58.7%), displaying three clinical phenotypes of cognitive impairments, i.e., subjective cognitive impairment (SCI, 57%), mild cognitive impairment (MCI, 26%), and Alzheimer's disease (AD, 17%). Sarcopenia was defined according to diagnostic algorithm recommended by the European Working Group on Sarcopenia in Older People. Components of sarcopenia were grip strength, bioelectrical impedance analysis, and gait speed. They were further aggregated into a score (0-3 points) by counting the numbers of limited components. Multi-nominal logistic regression was applied. Results: Probable sarcopenia (i.e., reduced grip strength) was observed in 9.6% of the patients, and 3.5% were diagnosed with sarcopenia. Patients with faster gait speed showed less likelihood of MCI (odds ratio [OR]: 0.24, 95% confidence interval [CI]: 0.06-0.90) and AD (OR: 0.12, 95% CI: 0.03-0.60). One or more limited sarcopenia components was associated with worse cognitive function. After adjusting for potential confounders, the association remained significant only for AD (OR 4.29, 95% CI 1.45-11.92). Conclusion: The results indicate a connection between the sarcopenia components and cognitive impairments. Limitations in the sarcopenia measures, especially slow walking speed, were related to poorer cognitive outcomes. More investigationsare required to further verify the causal relationship between sarcopenia and cognitive outcomes.

Place, publisher, year, edition, pages
IOS Press BV, 2023
Keywords
Alzheimer's disease, body composition, cognitive function, gait speed, hand grip strength, outpatients, sarcopenia, Aged, Cognitive Dysfunction, Female, Hand Strength, Humans, Muscle Strength, Walking Speed, cognitive defect, complication, human, physiology
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-64853 (URN)10.3233/JAD-221186 (DOI)001099536400028 ()2-s2.0-85176971451 (Scopus ID)
Available from: 2023-11-29 Created: 2023-11-29 Last updated: 2023-12-20Bibliographically approved
Rudberg, I., Olsson, A., Thunborg, C. & Salzmann-Erikson, M. (2023). Interprofessional communication in a psychiatric outpatient unit – an ethnographic study. BMC Nursing, 22(1), Article ID 286.
Open this publication in new window or tab >>Interprofessional communication in a psychiatric outpatient unit – an ethnographic study
2023 (English)In: BMC Nursing, E-ISSN 1472-6955, Vol. 22, no 1, article id 286Article in journal (Refereed) Published
Abstract [en]

Background: Communication in healthcare has been extensively studied, but most research has focused on miscommunication and the importance of communication for patient safety. Previous research on interprofessional communication has mainly focused on relationships between physicians and nurses in non-psychiatric settings. Since communication is one of the core competencies in psychiatric care, more research on interprofessional communication between other clinicians is needed, and should be explored from a broader perspective. This study aimed to explore and describe interprofessional communication in a psychiatric outpatient unit. Method: During spring 2022, data consisting of over 100 h of fieldwork were collected from observations, formal semi-structured interviews and informal conversations inspired by the focused ethnography method. Data was collected at an outpatient unit in central Sweden, and various clinicians participated in the study. The data analysis was a back-and-forth process between initial codes and emerging themes, but also cyclical as the data analysis process was ongoing and repeated and took place simultaneously with the data collection. Results: We found that a workplace’s history, clinicians´ workload, responsibilities and hierarchies influence interprofessional communication. The results showed that the prerequisites for interprofessional communication were created through the unit’s code of conduct, clear and engaging leadership, and trust in the ability of the various clinicians to perform new tasks. Conclusion: Our results indicate that leadership, an involving working style, and an environment where speaking up is encouraged and valued can foster interprofessional communication and respect for each other´s professional roles is key to achieving this. Interprofessional communication between different clinicians is an important part of psychiatric outpatient work, where efficiency, insufficient staffing and long patient queues are commonplace. Research can help shed light on these parts by highlighting aspects influencing communication.

Place, publisher, year, edition, pages
BioMed Central Ltd, 2023
Keywords
Code of conduct, Focused ethnography, Interprofessional communication, Psychiatric outpatient care, adult, article, conversation, data analysis, ethnography, field work, human, interpersonal communication, leadership, outpatient care, outpatient department, patient safety, professional standard, responsibility, semi structured interview, speech, spring, Sweden, trust, workload, workplace
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-64175 (URN)10.1186/s12912-023-01446-y (DOI)001088254300003 ()2-s2.0-85169145954 (Scopus ID)
Available from: 2023-09-06 Created: 2023-09-06 Last updated: 2024-07-04Bibliographically approved
Lagerlund, H., Thunborg, C. & Sandborgh, M. (2022). Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study. BMC Geriatrics, 22(1), Article ID 261.
Open this publication in new window or tab >>Behaviour-directed interventions for problematic person transfer situations in two dementia care dyads: a single-case design study
2022 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 22, no 1, article id 261Article in journal (Refereed) Published
Abstract [en]

Background: Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads. Methods: This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection. Results: Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved. Conclusions: The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The small number of cases and observations limits the generalizability, and the results should be interpreted in consideration of the piloting approach of the study. 

Place, publisher, year, edition, pages
BioMed Central Ltd, 2022
Keywords
Dementia, Functional behaviour analysis, Person transfer situation, Physiotherapy, Single-case design, Special care unit
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-58031 (URN)10.1186/s12877-022-02952-5 (DOI)000774866300002 ()35351026 (PubMedID)2-s2.0-85127250990 (Scopus ID)
Available from: 2022-04-13 Created: 2022-04-13 Last updated: 2024-07-04Bibliographically approved
Fallahpour, M., Fritz, H., Thunborg, C., Akenine, U. & Kivipelto, M. (2022). Experiences of Active Everyday Life Among Persons with Prodromal Alzheimer’s Disease: A Qualitative Study. Journal of Multidisciplinary Healthcare, 15, 1921-1932
Open this publication in new window or tab >>Experiences of Active Everyday Life Among Persons with Prodromal Alzheimer’s Disease: A Qualitative Study
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2022 (English)In: Journal of Multidisciplinary Healthcare, E-ISSN 1178-2390, Vol. 15, p. 1921-1932Article in journal (Refereed) Published
Abstract [en]

Introduction: Identifying strategies to prevent or delay cognitive decline among the rising numbers of elderly is acknowledged as a global public health priority. Research suggests that an active lifestyle in terms of participation in activities has the potential to reduce the risk of later-life cognitive decline. The concept of “active everyday life”, however, needs to be further explored. Aim: The study aimed to explore and describe the active everyday lives of persons with prodromal Alzheimer’s disease (AD) in terms of quality of participation in activities and perceived restrictions. Methods: This qualitative study was part of a larger project, the MIND-ADMINI trial. Nine in-depth interviews were conducted with seven participants (2 males, 5 females; mean age of 72.3) at baseline before the intervention. The data were collected from January to October 2018 and analyzed using the grounded theory approach. Results: Four categories emerged from the analysis: (i) active body and mind; (ii) doing desired meaningful activities to feel engaged, contented, and satisfied; (iii) doing in the context of being connected to others; (iv) ability in making decisions and taking actions. From these categories, which presented the key elements of an active everyday life, a core category was identified: Living a complete life in flow. Conclusion: The findings suggest key elements of participation quality that contribute to an active life. The identified elements are important to be considered in rehabilitation to provide opportunities and possibilities for participation to enable and improve the quality of participation among persons with cognitive impairments. 

Place, publisher, year, edition, pages
Dove Medical Press Ltd, 2022
Keywords
activity, Alzheimer’s disease, everyday life, participation, prevention, qualitative method
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-59940 (URN)10.2147/JMDH.S369878 (DOI)000853889900001 ()2-s2.0-85137083382 (Scopus ID)
Available from: 2022-09-14 Created: 2022-09-14 Last updated: 2024-07-04Bibliographically approved
Akenine, U., Thunborg, C., Kivipelto, M. & Fallahpour, M. (2022). Experiences of Participation in a Multimodal Preventive Trial MIND-AD(MINI) Among Persons with Prodromal Alzheimer's Disease: A Qualitative Study: A Qualitative Study. Journal of Multidisciplinary Healthcare, 15, 219-234
Open this publication in new window or tab >>Experiences of Participation in a Multimodal Preventive Trial MIND-AD(MINI) Among Persons with Prodromal Alzheimer's Disease: A Qualitative Study: A Qualitative Study
2022 (English)In: Journal of Multidisciplinary Healthcare, E-ISSN 1178-2390, Vol. 15, p. 219-234Article in journal (Refereed) Published
Abstract [en]

Introduction: Alzheimer's disease (AD) is one of the world's leading public health challenges. One-third of AD cases are attributable to modifiable vascular and lifestyle related risk factors. The Multimodal Preventive Trial for Alzheimer's Disease, MINDADMINI a 6-month multinational parallel-group randomized controlled trial (RCT), targeted persons with prodromal AD and built on the positive outcomes from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial. The intervention consisted of four main components of (i) physical exercise training program, (ii) nutrition guidance, (iii) cognitive training, and (iv) social stimulation, as well as (iv) monitoring of metabolic/vascular risk factors.

Aim: The study aimed to explore and describe the experiences of participation in MINDADMINI among persons with prodromal AD.

Methods: This qualitative study was part of the larger MIND-ADMINI project. Eight participants were interviewed twice, before and after the intervention. The data was analyzed using qualitative content analysis.

Results: The results are presented as categories of (i) knowledge of AD and prevention, (ii) motives for study participation, (iii) experiences of the received information about the study, (iv) taking the decision to participate, (v) expectations on study participation, (vi) experiences of study participation and (vii) internal and external factors influencing study participation.

Conclusion: The MIND-ADMINI was well-tolerated by the participants. At the beginning of the study, the number of tasks and visits was perceived as burdensome but was later well tolerated. The participant' knowledge about AD and prevention increased during the trial. Their motives for participating in MIND-ADMINI were described as both altruistic and self beneficial. Health benefits from the study components, access to specialized medical care were identified as benefits. Managing the intensive flow of information was described a major challenge. The participants' needs for personalized support during the trial stress the importance of applying a person-centered approach providing the preventive trials.

Place, publisher, year, edition, pages
Dove Press, 2022
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-57432 (URN)10.2147/JMDH.S345607 (DOI)000753875100002 ()2-s2.0-85123960198 (Scopus ID)
Available from: 2022-02-16 Created: 2022-02-16 Last updated: 2024-07-04Bibliographically approved
Nelson, D. W., Granberg, T., Andersen, P., Jokhadar, E., Kahlin, J., Granstrom, A., . . . Eriksson, L. I. (2022). The Karolinska NeuroCOVID study protocol: Neurocognitive impairment, biomarkers and advanced imaging in critical care survivors. Acta Anaesthesiologica Scandinavica, 66(6), 759-766
Open this publication in new window or tab >>The Karolinska NeuroCOVID study protocol: Neurocognitive impairment, biomarkers and advanced imaging in critical care survivors
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2022 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 66, no 6, p. 759-766Article in journal (Refereed) Published
Abstract [en]

Background: This is the study plan of the Karolinska NeuroCOVID study, a study of neurocognitive impairment after severe COVID-19, relating post-intensive care unit (ICU) cognitive and neurological deficits to biofluid markers and MRI. The COVID-19 pandemic has posed enormous health challenges to individuals and health- systems worldwide. An emerging feature of severe COVID-19 is that of temporary and extended neurocognitive impairment, exhibiting a myriad of symptoms and signs. The causes of this symptomatology have not yet been fully elucidated. Methods: In this study, we aim to investigate patients treated for severe COVID-19 in the ICU, as to describe and relate serum-, plasma- and cerebrospinal fluid-borne molecular and cellular biomarkers of immune activity, coagulopathy, cerebral damage, neuronal inflammation, and degeneration, to the temporal development of structural and functional changes within the brain as evident by serial MRI and extensive cognitive assessments at 3-12 months after ICU discharge. Results: To date, we have performed 51 3-month follow-up MRIs in the ICU survivors. Of these, two patients (similar to 4%) have had incidental findings on brain MRI findings requiring activation of the Incidental Findings Management Plan. Furthermore, the neuropsychological and neurological examinations have so far revealed varying and mixed patterns. Several patients expressed cognitive and/or mental concerns and fatigue, complaints closely related to brain fog. Conclusion: The study goal is to gain a better understanding of the pathological mechanisms and neurological consequences of this new disease, with a special emphasis on neurodegenerative and neuroinflammatory processes, in order to identify targets of intervention and rehabilitation.

Place, publisher, year, edition, pages
WILEY, 2022
Keywords
biomarkers, brain injury, COVID-19, critical care, magnetic resonance imaging, neurocognitive disorders, patient outcome assessment
National Category
Clinical Medicine
Identifiers
urn:nbn:se:mdh:diva-58050 (URN)10.1111/aas.14062 (DOI)000777175900001 ()35332517 (PubMedID)2-s2.0-85127407309 (Scopus ID)
Available from: 2022-04-20 Created: 2022-04-20 Last updated: 2022-08-29Bibliographically approved
Lagerlund, H. H., Thunborg, C. & Sandborgh, M. (2021). Dyadic intervention for complex person transfer situations in dementia care: A single-case replication study. International Journal of Behavioral Medicine, 28(SUPPL 1), S122-S123
Open this publication in new window or tab >>Dyadic intervention for complex person transfer situations in dementia care: A single-case replication study
2021 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 28, no SUPPL 1, p. S122-S123Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
SPRINGER, 2021
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-55361 (URN)000660029800367 ()
Available from: 2021-07-01 Created: 2021-07-01 Last updated: 2022-11-17Bibliographically approved
Eklund, C., Elfström, M., von Heideken Wågert, P., Söderlund, A., Gustavsson, C., Cederborn, S., . . . Lööf, H. (2021). The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement: An Empirical Phenomenological Study. Physical Therapy, 101(8), Article ID pzab117.
Open this publication in new window or tab >>The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement: An Empirical Phenomenological Study
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2021 (English)In: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 101, no 8, article id pzab117Article in journal (Refereed) Published
Abstract [en]

Objective

Sedentary behavior (SB) is defined as a mean of >6 hours of daytime sitting or lying down. SB has been shown to increase with older age and is a risk factor for disease. During the transition from working life to retirement, changes in daily life activities occur, risking increased SB. The aim of the present study was to gain a deeper understanding of SB in relation to the transition from working life to retirement as experienced by persons in retirement.

Methods

The study was grounded in a phenomenological life-world perspective. Fourteen semi-structured interviews were conducted with participants aged 64–75. Data were analyzed using the empirical phenomenological psychological method.

Results

The participants described that voluntary sedentary time was positively related to general health and well-being, while involuntary sedentary time was negatively related to health. Increased sedentary time was described as natural when aging. Retirement was expressed as a time for rest after hard work and the ability to choose a slower pace in life. Internal and external demands and daily routines interrupted SB, whereas loneliness was perceived to increase SB. Participants strived to find a balance between physical activity and sedentary time. The variations in the participants’ descriptions formed three typologies: in light of meaningful sedentary behavior, in the shadow of involuntary sedentary behavior, and a dual process – postponing sedentary behavior with physical activity.

Conclusions

Increased SB was perceived as natural when aging, but something that may be postponed by conscious choices. SB was perceived as associated with health, rest and recovery but also with the risk of deteriorating health.

Impact

This knowledge of the experienced meaning of SB could guide the design of health promotion interventions and may be helpful in targeting those in need of support and individualizing interventions to decrease SB in retirement.Lay SummaryThis study reveals how persons in retirement describe sedentary behavior as something healthy but also as unhealthy and that sedentary behavior is natural in aging and can be postponed by physical activity.

Keywords
Healthy Aging, Lifestyle, Phenomenology, Physical Activity, Sedentary
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-54120 (URN)10.1093/ptj/pzab117 (DOI)000736132800010 ()2-s2.0-85115445763 (Scopus ID)
Available from: 2021-05-10 Created: 2021-05-10 Last updated: 2022-10-31Bibliographically approved
Thunborg, C., Salzman-Erikson, M. & Olsson, A. (2021). The Swedish translation of Perceptions of Restraint Use Questionnaire (PRUQ): A test-retest reliability study in two dementia nursing homes. BMC Geriatrics, 21(1)
Open this publication in new window or tab >>The Swedish translation of Perceptions of Restraint Use Questionnaire (PRUQ): A test-retest reliability study in two dementia nursing homes
2021 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 21, no 1Article in journal (Refereed) Published
Abstract [en]

Background The Perceptions of Restraint Use Questionnaire measures perception of restraint in a 17-item questionnaire. The aim of this study was to assess the test-retest reliability of the PRUQ as a measure of staff attitudes to restraint in elderly older persons care for people with dementia from two different nursing homes, and its ability to produce reliable results. Methods Twenty-six staff members from two different nursing homes completed the 17-item PRUQ twice with 14-21 days between time points. As the questionnaire has already been translated in another study, the current study evaluated total item scores, mean, internal consistency, and intraclass correlation for reliability purposes. Results The internal consistency Cronbach's Alpha were > >= 0.726. The Intraclass correlation (ICC) between test and retest was moderate to good for the three subscales, with ICC (A,1) and ICC (C,1) values approximately equal and in the range 0.480-0.962. A Bland-Altman plot of the PRUQ total mean scores illustrates no systematic change in the mean. Conclusions The Swedish version of the PRUQ shows mainly good reliability. Therefore, we suggest that researchers continue to develop the PRUQ to be an even higher reliable questionnaire of health care professionals' perceptions of measure for restraint use in nursing homes for persons with dementia.

Place, publisher, year, edition, pages
Springer Nature, 2021
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-56333 (URN)10.1186/s12877-021-02486-2 (DOI)000710133300002 ()2-s2.0-85117711718 (Scopus ID)
Available from: 2021-11-04 Created: 2021-11-04 Last updated: 2024-07-04Bibliographically approved
Organisations
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ORCID iD: ORCID iD iconorcid.org/0000-0003-0964-1747

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