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  • 101.
    Renbro, Gunnar
    Mälardalen University, School of Health, Care and Social Welfare.
    Palpationsömhet i perifer nerv och känseltest med sporre på friska försökspersoner2010Independent thesis Basic level (university diploma), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Background: Leg pain is common and neuropathy (nerve disease) is one reason which probably is under diagnosed. Bimanual (bilateral) nerve palpation and sensory test with spurs has been shown to be quite reliable. Furthermore, the tests are straight forward detecting nerve disease but have not been tested on a healthy population.

    Purpose: The purpose was to investigate whether peripheral nerve palpation in fossa poplitea induces pain/discomfort, and if side difference exists in a sensibility test with spurs on the lower leg in healthy subjects.

    Method: A bimanual palpation test of the tibial and peroneal nerve in fossa poplitea and also a bimanual sensibility test with spurs of dermatome L4, L5 and S1 on the lower leg were carried out. In order to find healthy subjects a purposive sampling was made. A total of 37 subjects between 20 and 57 years with a median age of 23 participated in the study.

    Results: At the palpation test the intensity of pain/discomfort had a median of 1 (range 3) in the 11 degrees of pain scale. A large part estimated differences between the sides in both the palpation test (11 of 37) and the sensibility test with spur (25 of 37). There was no significant difference between the sexes.

    Conclusion: When performing these nerve tests it is important to keep in mind that even healthy individuals might perceive some pain/discomfort as well as side difference. However, we need more studies to confirm these results.

  • 102.
    Rossen, Jenny
    et al.
    Sophiahemmet Högskola.
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Lööf, Helena
    Sophiahemmet Högskola.
    Hagströmer, Maria
    Yngve, Agneta
    Exploration of study participants experiences following Sophia Step Study: A two-year physical activity intervention2016Conference paper (Other academic)
  • 103.
    Rossen, Jenny
    et al.
    Sophiahemmet Högskola.
    Lööf, Helena
    Sophiahemmet Högskola.
    Yngve, Agneta
    Sophiahemmet Högskola.
    Hagströmer, Maria
    Brismar, Kerstin
    Johansson, Unn-Britt
    Sophiahemmet Högskola.
    Using pedometers for self-management of physical activity: Participants' experiences from Sophia Step Study: A physical activity promotion intervention in pre- and type 2 diabetes2017Conference paper (Other academic)
  • 104.
    Rubertsson, Christine
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Wickberg, B.
    University of Göteborg, Sweden.
    Gustafsson, P.
    Karolinska Institutet, Stockholm, Sweden.
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences.
    Depressive symptoms in early pregnancy two months and one year postpartum-prevalence and risk factors in a national Swedish sample2005In: Archives of Women’s Mental Health, ISSN 1434-1816, Vol. 8, no 2, p. 97-104Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Depression and other psychiatric disorders during pregnancy and postpartum is an important health problem, especially if the symptoms are recurrent or sustained. METHODS: All Swedish speaking women attending their first antenatal care visit during three predestined weeks were invited to participate. Depressive symptoms were evaluated using the Edinburgh Postnatal Depression Scale (EPDS) in early pregnancy, two months and one year postpartum. RESULTS: In all, 2430 women completed three questionnaires. A dose-effect relation was found between the numbers of stressful life events experienced in the year prior to pregnancy and mean EPDS score in pregnancy. The prevalence of recurrent or sustained depressive symptoms (EPDS> or =12 on all three evaluations) was 3% (79/2430). Three factors were associated with depressive symptoms, two or more stressful life events in the year prior to pregnancy, native language other than Swedish and unemployment. CONCLUSIONS: Apart from questions about psychiatric history, a psychosocial history in early pregnancy including stressful life events, native language and employment status could help the health professionals to identify women at risk for recurrent or sustained depression during pregnancy and the year after giving birth.

  • 105.
    Rådestad, Ingela
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Rubertsson, Christine
    Karolinska Institutet, Stockholm, Sweden .
    Ebeling, M.
    Mälardalen University, Department of Caring and Public Health Sciences.
    Hildingsson, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences. Karolinska Institutet, Stockholm, Sweden .
    What factors in early pregnancy indicate that the mother will be hit by her partner during the year after childbirth2004In: Birth, ISSN 0730-7659, Vol. 31, no 2, p. 84-92Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: To be hit by one's intimate partner during the first year after childbirth may affect a woman's health and ability to take care of her newborn. The purpose of this study was to document the prevalence and indicators in early pregnancy of a woman being hit by her partner during the year after childbirth. METHOD: Information was collected by a postal questionnaire in early pregnancy and 12 months after childbirth from the approximately 5,550 women in Sweden who visited an antenatal care clinic for the first time during one of three chosen weeks in 1999 and 2000. RESULTS: Of the 3,266 recruited women, 2,563 returned the follow-up questionnaire. Being hit during the first year after childbirth was reported by 52 of the 2,563 (2%) women: 32 (61%) had been hit by their partner once, 12 (23%) twice, and 8 (15%) three or more times. Risk increased in women who were age 24 years or younger (3.9% had been hit), unmarried (7.1%), born in countries outside Europe (6.8%), with a partner born outside Europe (5.4%), had a low level of education (8.9%), and were unemployed (5.0%). In early pregnancy, women with back pain (4.0%), a chronic illness (4.1%), coital pain (6.1%), frequent depression-related symptoms (8.1%), stomach pain (3.8%), or a urinary tract problem (6.3%) were hit more often than others after childbirth. CONCLUSIONS: At least 2 percent of Swedish women giving birth in 2000 were hit by their partner during the year after childbirth. Using identified predictors during antenatal care may increase the likelihood of finding women at risk, thereby enhancing the possibility of interventions to prevent this crime and health hazard.

  • 106.
    Sjöö, Emmalisa
    Mälardalen University, School of Health, Care and Social Welfare.
    Att lämna intensivvården: En kvalitativ litteraturstudie2018Independent thesis Advanced level (professional degree), 5 credits / 7,5 HE creditsStudent thesis
    Abstract [en]

    A patient who has been critically ill and starts to recover, will be discharged from the intensive care unit (ICU) to a general ward. A high demand of intensive care facilities can result in quick discharges causing higher risk of inadequate planning and preparation. This may result with negative consequences for the patient including readmission to the ICU, longer hospital stays and increased mortality. The intensive care nurse has the responsibility to fulfill a safe and coherent discharge. A transition is the way people respond and react to change from one place to another. The aim of this study was to describe patients experiences of their discharge from ICU to general ward. A qualitative literature study with descriptive synthesis was chosen as method. The results showed that inadequate information and preparation can create anxiety. The patients who received good support during the discharge experienced, found that it was a positive step in the right direction. The conclusion is that patients who are going to be discharged from ICU need individual information and preparation. There’s a need for routines to reduce patient concerns, facilitating communication and information and ensuring patient safety.

  • 107.
    Skoglund, Karin
    et al.
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    Hillered, Lars
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    Tsitsopoulos, Parmenion
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    Engquist, Henrik
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    Purins, Karlis
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    Lewén, Anders
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    Enblad, Per
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    Marklund, Niklas
    Uppsala Universitet, Institutionen för neurovetenskap, Sweden.
    The Neurological Wake-up Test Does not Alter Cerebral Energy Metabolism and Oxygenation in Patients with Severe Traumatic Brain Injury2014In: Neurocritical Care, ISSN 1541-6933, E-ISSN 1556-0961, Neurocritical Care, ISSN 1541-6933, Vol. 2014, no 20, p. 413-426, article id 3Article in journal (Other academic)
    Abstract [en]

    Background: The neurological wake-up test (NWT) is used to monitor the level of consciousness in patients with traumatic brain injury (TBI). However, it requires interruption of sedation and may elicit a stress response. We evaluated the effects of the NWT using cerebral microdialysis (MD), brain tissue oxygenation (PbtiO2), jugular venous oxygen saturation (SjvO2), and/or arterial-venous difference (AVD) for glucose, lactate, and oxygen in patients with severe TBI.Methods: Seventeen intubated TBI patients (age16–74 years) were sedated using continuous propofol infusion. All patients received intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring in addition to MD, PbtiO2and/or SjvO2 . Up to 10 days postinjury, ICP, CPP, PbtiO2 (51 NWTs), MD (49 NWTs), and/or SjvO2 (18 NWTs) levels during propofol sedation (baseline) and NWT were ompared. MD was evaluated at a flow rate of 1.0 µL/min (28 NWTs) or the routine 0.3 µL/min rate (21 NWTs). Results: The NWT increased ICPandCPP levels (p<0.05). Compared to baseline, nterstitial levels of glucose, lactate, pyruvate, glutamate, glycerol, and the actate/pyruvate ratio were unaltered by the NWT. Pathological SjvO2(<50 % or >71 % ;n=2 NWTs) and PbtiO2(<10 mmHg; n=3 NWTs) values were rare at baseline and did not change following NWT. Finally, the NWT did not alter the AVD of glucose, lactate, or oxygen. Conclusions: The NWT-induced stress response resulted in increased ICP and CPP levels although it did not negatively alter focal neurochemistry or cerebral oygenation in TBI patients.

  • 108.
    Stenvall, M.
    et al.
    Umeå University, Sweden.
    Elinge, E.
    Umeå University, Sweden.
    von Heideken Wågert, Petra
    Umeå University, Sweden.
    Lundström, M.
    Umeå University, Sweden.
    Gustafson, Y.
    Umeå University, Sweden.
    Nyberg, L.
    Umeå University, Sweden.
    Having had a hip fracture – association with dependency among the oldest old2005In: Age and ageing, ISSN 0002-0729, Vol. 34, no 3, p. 294-297Article in journal (Refereed)
  • 109.
    Strömsöe, Anneli
    Högskolan Dalarna.
    .: .2010In: Nationella kvalitetsregister och nationellt kvalitetsregister för hjärtstopp utanför sjukhus: Befolkningstäthet och dess karakteristik och utfall vid hjärtstopp utanför sjukhus, 2010Conference paper (Other academic)
  • 110.
    Strömsöe, Anneli
    Högskolan Dalarna.
    .: .2010In: Befolkningstäthet och dess karakteristik och utfall vid hjärtstopp utanför sjukhus, 2010Conference paper (Other academic)
  • 111.
    Strömsöe, Anneli
    Högskolan Dalarna, Sweden.
    Cardiopulmonary resuscitation in Sweden – yesterday, today and tomorrow2015Conference paper (Other (popular science, discussion, etc.))
  • 112.
    Strömsöe, Anneli
    Högskolan Dalarna.
    Cardiopulmonary resuscitation in Sweden – yesterday, today and tomorrow2014Conference paper (Other academic)
  • 113.
    Strömsöe, Anneli
    Högskolan Dalarna.
    Cardiopulmonary resuscitation in Sweden – yesterday, today and tomorrow2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    In Sweden, the reported incidence and outcome of out-of-hospital cardiac arrest (OHCA) vary between counties. In the mid -1980s, a national programme in cardiopulmonary resuscitation (CPR) was developed and rescuers have been educated in CPR. Since 1990, Swedish OHCA data are to be reported to the Swedish Cardiac Arrest Register (SCAR). The aim of this thesis was to describe and analyse the incidence and outcome of OHCA and the amount of national training in CPR from data reported to the SCAR and to the CPR training register. The data on OHCAs were related to a variety of epidemiological and quality indicators. Methods: this thesis is based on register data from both the SCAR and the CPR training register. The inclusion criteria were treated OHCAs (I-IV), witnessed treated OHCAs (V) and rescuers educated in CPR (I).The number of participants were: I: CPR training register, 1983-2007, n=2 million rescuers, and SCAR, 1990-2007, n=45,775, II: SCAR, 2008-2009, n=6,457 registered manually or on the web and n=3,522 registered on the web, III: SCAR, 2008-2010, n=2,398 prospectively registered and n=800 retrospectively registered, IV: SCAR, 1992-2011, n=59,926, V: SCAR, 2008-2010, n=11,005. Results: since 1983, 5,000 instructor-trainers have trained more than 50,000 instructors who have trained almost two million of Sweden’s nine million inhabitants to perform adult CPR. The number of bystander CPR attempts for OHCA in Sweden increased from 31% (1992) to 55% (2007) (I). In 2008-2009, the number of reported OHCAs varied between 13 and 52 per 100,000 inhabitants and year. Bystander CPR, cardiac aetiology and longer emergency medical service (EMS) response times were more frequent in less populated areas, but survival was not associated with population density (II). A validation process showed that, there was a 25% missing rate between 2008 and 2010 of OHCAs reported to the SCAR. In the non-reported OHCAs, patients were older and had less frequently received bystander CPR, but, despite this, they also had a higher survival rate (III). From 1992 to 2011, the OHCAs reported to the SCAR increased from 27 to 52 per 100,000 inhabitants and year. Survival to one month increased from 4.8% (1992) to 10.7% (2011), particularly among patients found in a shockable rhythm. This increase in survival was associated with signs of improvement in all four links of the chain of survival (IV). Furthermore, estimates indicate that, if the delay from collapse to 1) calling for an ambulance, 2) the start of CPR, and 3) the time to defibrillation is reduced to <2 min, <2min and <8 min respectively, approximately 300-400 additional lives could be saved (V). Conclusions: there has been an impressive development in the preparedness for and treatment of patients suffering from OHCAs in Sweden during the last 30 years. Improvements in various links in the chain of survival have resulted in a marked increase in survival after OHCA. It suggests that this figure will increase further if the delay to the start of treatment can be reduced still further.

  • 114.
    Strömsöe, Anneli
    Högskolan Dalarna.
    Education in cardiopulmonary resuscitation in Sweden and its clinical consequences.2010In: ResuscitationArticle in journal (Refereed)
  • 115.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Education in cardiopulmonary resuscitation in Sweden and its clinical consequences2009In: XXII Nordic-Baltic Congress of Cardiology, Reykjavik, 2009Conference paper (Other academic)
  • 116.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Förbättrade resultat för patienter som drabbats hjärtstopp utanför sjukhus – en uppföljning från 1992 till 20112013Conference paper (Refereed)
    Abstract [sv]

    Syfte: Att beskriva patienter som drabbats av hjärtstopp utanför sjukhus och dess resultatsförändringar i behandling och överlevnad.

    Metod: Patienter (n=59 926) som drabbats av hjärtstopp utanför sjukhus i samtliga Sveriges län och som rapporterats till Svenska hjärt-lungräddningsregistret från 1992 till 2011.

    Resultat: Antalet rapporterade hjärtstopp utanför sjukhus ökade från 27 (1992) till 52 (2011) per 100 000 invånare och år. Vidare så ökade bevittnandegraden av hjärtstopp utanför sjukhus av ambulanspersonalen, en ökad förekomst av hjärtlungräddning innan ambulansen kom fram till patienten samt att tiden ökade från larm till dess att ambulansen kom fram till patienten.

    1-månads-överlevnad ökade från 4,8% (1992) till 10,7% (2011). De som framförallt överlevde 1 månad eller mer var de patienter som levde vid ankomst till sjukhus. Av de patienter som drabbats av hjärtstopp utanför sjukhus mellan 2008 till 2010, var det 41% som genomgick kylbehandling på sjukhus samt 28% som behandlades med ballongvidgning av hjärtats kranskärl. De patienter som överlevde (2008-2011), hade 94% en god eller relativ god hjärnfunktion.

    Sammanfattning: De patienter som drabbats av hjärtstopp utanför sjukhus 1992-2011, påvisar en fördubblad överlevnad. De patienter som framförallt överlever, är de som lever vid ankomst till sjukhus och som senare läggs in på vårdavdelning.   

  • 117.
    Strömsöe, Anneli
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Mälardalens högskola.
    Kvalitetsindikatorer i det svenska hjärt-lungräddningsregistret2015Conference paper (Other academic)
  • 118.
    Strömsöe, Anneli
    Högskolan Dalarna, Sweden.
    Långsiktigt förbättrade resultat hos patienter som drabbats av hjärtstopp utanför sjukhus2015Conference paper (Other academic)
  • 119.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Utbildning i HLR i Sverige och dess kliniska konsekvenser2008In: HLR kongressen, Stockholm, 2008Conference paper (Other academic)
  • 120.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Validity of reported data in the out-of-hospital cardiac arrest register in chosen parts in Sweden2012Conference paper (Refereed)
    Abstract [en]

    Aim: To describe differences and similarities between reported and non reported data in the out-of-hospital cardiac arrest (OHCA) register in Sweden.

    Methods: Prospective and retrospective data of treated OHCA patients in Sweden, 2008-2010 were compared in the Swedish OHCA register. Data were investigated in 4 Swedish counties with various recording models. Prospective data are those reported by the ambulance crew and retrospective data those missed by the ambulance crew but discovered afterwards by crosschecking with the local ambulance register.

    Result: In 2008-2010, the number of prospective reported cases was n=2398 and retrospective cases n=3198 which indicates a 30% missing rate.

    When comparing the two groups, the mean age was higher in patients who were reported retrospectively (69 years versus 67 years; p=0.003). There was no difference between groups with regard to sex, time of day and year of OHCA, witnessed status or initial rhythm.

    However, bystander CPR was more frequent among patients in who were reported prospectively (65% versus 60%; p= 0.023) where as survival to 1 month was higher among patients who were reported retrospectively (9,2% versus 11,9%;p=0.035)

     

    Conclusion: Among 3198 cases of OHCA in 4 regions in Sweden 800 (30%) were not reported prospectively by the ambulance crew but retrospectively when discovered as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, less frequently receiving bystander CPR but having a higher survival. Our data suggest that patients who suffer OHCA and are prospectively reported to a quality register may be influenced by selection bias.

  • 121.
    Strömsöe, Anneli
    Högskolan Dalarna, Medicinsk vetenskap.
    Validity of reported data in the out-of-hospital cardiac arrest register in chosen parts in Sweden: [HLR-registrets tillförlitlighet]2013Conference paper (Refereed)
    Abstract [en]

    Aim: To describe differences between reported and non reported data in the out-of-hospital cardiac arrest (OHCA) register in Sweden.

    Methods: Prospective and retrospective data of treated OHCA patients in Sweden, 2008-2010 were compared in the Swedish OHCA register. Data were investigated in three Swedish counties with various recording models. Prospective data are those reported by the ambulance crew and retrospective data those missed by the ambulance crew but discovered afterwards by crosschecking with the local ambulance register.

    Result: In 2008-2010, the number of prospective reported cases was n=2, 398 and retrospective cases n=3, 198 which indicates a 25% missing rate.

    When comparing the two groups, the mean age was higher in patients who were reported retrospectively (69 years versus 67 years; p=0.003). There was no difference between groups with regard to sex, time of day and year of OHCA, witnessed status or initial rhythm.

    However, bystander CPR was more frequent among patients in who were reported prospectively (65% versus 60%; p= 0.023) where as survival to 1 month was higher among patients who were reported retrospectively (9,2% versus 11,9%;p=0.035)

     

    Conclusion: Among 3, 198 cases of OHCA in three regions in Sweden 800 (25%) were not reported prospectively by the ambulance crew but retrospectively when discovered as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, less frequently receiving bystander CPR but having a higher survival. Our data suggest that patients who suffer OHCA and are prospectively reported to a quality register may be influenced by selection bias.

  • 122.
    Strömsöe, Anneli
    et al.
    Högskolan Dalarna, Medicinsk vetenskap.
    Afzelius, S.
    Axelsson, C.
    Kallestedt, M. L. Sodersved
    Enlund, M.
    Svensson, L.
    Herlitz, J.
    Improvements in logistics could increase survival after out-of-hospital cardiac arrest in Sweden2013In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796, Vol. 273, no 6, p. 622-627Article in journal (Refereed)
    Abstract [en]

    Objectives. In a review based on estimations and assumptions, to report the estimated number of survivors after out-of-hospital cardiac arrest (OHCA) in whom cardiopulmonary resuscitation (CPR) was started and to speculate about possible future improvements in Sweden.

    Design. An observational study. Setting All ambulance organisations in Sweden. Subjects Patients included in the Swedish Cardiac Arrest Registry who suffered an OHCA between January 1, 2008 and December 31, 2010. Approximately 80% of OHCA cases in Sweden in which CPR was started are included. Interventions None

    Results. In 11005 patients, the 1-month survival rate was 9.4%. There are approximately 5000 OHCA cases annually in which CPR is started and 30-day survival is achieved in up to 500 patients yearly (6 per 100000 inhabitants). Based on findings on survival in relation to the time to calling for the Emergency Medical Service (EMS) and the start of CPR and defibrillation, it was estimated that, if the delay from collapse to (i) calling EMS, (ii) the start of CPR, and (iii) the time to defibrillation were reduced to <2min, <2min, and <8min, respectively, 300400 additional lives could be saved.

    Conclusion. Based on findings relating to the delay to calling for the EMS and the start of CPR and defibrillation, we speculate that 300400 additional OHCA patients yearly (4 per 100000 inhabitants) could be saved in Sweden.

  • 123.
    Strömsöe, Anneli
    et al.
    Högskolan Dalarna, Medicinsk vetenskap.
    Svensson, L.
    Axelsson, A. B.
    Goransson, K.
    Todorova, L.
    Herlitz, J.
    Validity of reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden2013In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 84, no 7, p. 952-956Article in journal (Refereed)
    Abstract [en]

    Aim: To describe differences and similarities between reported and non-reported data in the Swedish Cardiac Arrest Register in selected parts in Sweden. 

    Methods: Prospective and retrospective data for treated OHCA patients in Sweden, 2008-2010, were compared in the Swedish Cardiac Arrest Register. Data were investigated in three Swedish counties, which represented one third of the population. The recording models varied. Prospective data are those reported by the emergency medical service (EMS) crews, while retrospective data are those missed by the EMS crews but discovered afterwards by cross-checking with the local ambulance register. 

    Result: In 2008-2010, the number of prospectively (n = 2398) and retrospectively (n = 800) reported OHCA cases was n = 3198, which indicates a 25% missing rate. When comparing the two groups, the mean age was higher in patients who were reported retrospectively (69 years vs. 67 years; p = 0.003). There was no difference between groups with regard to gender, time of day and year of OHCA, witnessed status or initial rhythm. Bystander cardiopulmonary resuscitation (CPR) was more frequent among patients who were reported prospectively (65% vs. 60%; p = 0.023), whereas survival to one month was higher among patients who were reported retrospectively (9.2% vs. 11.9%; p = 0.035). 

    Conclusion: Among 3198 cases of OHCA in three counties in Sweden, 800 (25%) were not reported prospectively by the EMS crews but were discovered retrospectively as missing cases. Patients who were reported retrospectively differed from prospectively reported cases by being older, having less frequently received bystander CPR but having a higher survival rate. Our data suggest that reports on OHCA from national quality registers which are based on prospectively recorded data may be influenced by selection bias. 

  • 124.
    Strömsöe, Anneli
    et al.
    Högskolan Dalarna, Medicinsk vetenskap.
    Svensson, L.
    Axelsson, Å.
    Göransson, K.
    Todorova, L.
    Herlitz, J.
    Kvalitetsbedömning - nationella hjärtstoppsregistret 2008-20102012Conference paper (Other academic)
  • 125.
    Strömsöe, Anneli
    et al.
    Högskolan Dalarna, Medicinsk vetenskap.
    Svensson, L.
    Claesson, A.
    Lindkvist, J.
    Lundström, A.
    Herlitz, J.
    Association between population density and reported incidence, characteristics and outcome after out–of–hospital cardiac arrest in Sweden2011In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 82, no 10, p. 1307-1313Article in journal (Refereed)
    Abstract [en]

    Aim. To describe the reported incidence of out of hospital cardiac arrest (OHCA) and the characteristics and outcome after OHCA in relation to population density in Sweden. Methods All patients participating in the Swedish Cardiac Arrest Register between 2008 and 2009 in (a) 20 of 21 regions (n = 6457) and in (b) 165 of 292 municipalities (n = 3522) in Sweden, took part in the survey.

    Results. The regional population density varied between 3 and 310 inhabitants per km2 in 2009. In 2008–2009, the number of reported cardiac arrests varied between 13 and 52 per 100,000 inhabitants and year. Survival to 1 month varied between 2% and 14% during the same period in different regions. With regard to population density, based on municipalities, bystander CPR (p = 0.04) as well as cardiac etiology (p = 0.002) were more frequent in less populated areas. Ambulance response time was longer in less populated areas (p < 0.0001). There was no significant association between population density and survival to 1 month after OHCA or incidence (adjusted for age and gender) of OHCA.

    Conclusion. There was no significant association between population density and survival to 1 month after OHCA or incidence (adjusted for age and gender) of OHCA. However, bystander CPR, cardiac etiology and longer response times were more frequent in less populated areas.

  • 126.
    Strömsöe, Anneli
    et al.
    Högskolan Dalarna, Sweden.
    Svensson, Leif
    Södersjukhuset, Stockholm, Sweden.
    Axelsson, Åsa B.
    Sahlgrenska Academy at Gothenburg University, Sweden.
    Claesson, Andreas
    Prehospen University College of Borås, Borås; Sweden.
    Göransson, Katarina E.
    Karolinska University Hospital, Stockholm; Sweden.
    Nordberg, Per
    Södersjukhuset, Stockholm, Sweden.
    Herlitz, Johan
    Sahlgrenska University Hospital, Sweden.
    Improved outcome in Sweden after out-of-hospital cardiac arrest and possible association with improvements in every link in the chain of survival2015In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, no 14, p. 863-871Article in journal (Refereed)
    Abstract [en]

    Aims: To describe out-of-hospital cardiac arrest (OHCA) in Sweden from a long-term perspective in terms of changes in outcome and circumstances at resuscitation.

    Methods and results: All cases of OHCA (n = 59 926) reported to the Swedish Cardiac Arrest Register from 1992 to 2011 were included. The number of cases reported (n/100 000 person-years) increased from 27 (1992) to 52 (2011). Crew-witnessed cases, cardiopulmonary resuscitation prior to the arrival of the emergency medical service (EMS), and EMS response time increased (P < 0.0001). There was a decrease in the delay from collapse to calling for the EMS in all patients and from collapse to defibrillation among patients found in ventricular fibrillation (P< 0.0001). The proportion of patients found in ventricular fibrillation decreased from 35 to 25% (P < 0.0001). Thirty-day survival increased from 4.8 (1992) to 10.7% (2011) (P < 0.0001), particularly among patients found in a shockable rhythm and patients with return of spontaneous circulation (ROSC) at hospital admission. Among patients hospitalized with ROSC in 2008–2011, 41% underwent therapeutic hypothermia and 28% underwent percutaneous coronary intervention. Among 30-day survivors in 2008–2011, 94% had a cerebral performance category score of 1 or 2 at discharge from hospital and the results were even better if patients were found in a shockable rhythm.

    Conclusion: From a long-term perspective, 30-day survival after OHCA in Sweden more than doubled. The increase in survival was most marked among patients found in a shockable rhythm and those hospitalized with ROSC. There were improvements in all four links in the chain of survival, which might explain the improved outcome.

  • 127.
    Svindseth, Marit F.
    et al.
    Department of Psychiatry, Sunnmore Hospital, 6026 Aalesund, Norway, and National University of Science and Technology, 7440 Trondheim, Norway.
    Nøttestad, Jim Aage
    Department of Forensic Psychiatry, Broset, St. Olav’s Hospital, National University of Science and Technology, 7440 Trondheim, Norway. .
    Wallin, Juliska
    Mälardalen University, School of Sustainable Development of Society and Technology.
    Roaldset, John Olav
    Department of Psychiatry, Sunnmore Hospital, 6026 Aalesund, Norway, and National University of Science and Technology, 7440 Trondheim, Norway. .
    Dahl, Alv A.
    The Cancer Clinic, Rikshospitalet-Radiumhospitalet Medical Center, University of Oslo, Montebello, 0310 Oslo, Norway..
    Narcissism in patience admitted to psychiatric acute wards: its relation to violence, suicidality and other psychopathology2008In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 8, no 13Article in journal (Refereed)
    Abstract [en]

    Background

    The objective was to examine various aspects of narcissism in patients admitted to acute psychiatric wards and to compare their level of narcissism to that of an age- and gender-matched sample from the general population (NORM).

    Methods

    This cross-sectional study interviewed 186 eligible acute psychiatric patients with the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF). The patients filled in the Narcissistic Personality Inventory-21 item version (NPI-21), The Hospital Anxiety and Depression Scale (HADS) and the Rosenberg Self-Esteem Scale. High and low narcissism was defined by the median of the total NPI-21 score. An age- and gender-matched control sample from the general population also scored the NPI-21 (NORM).

    Results

    Being male, involuntary admitted, having diagnosis of schizophrenia, higher self-esteem, and severe violence were significantly associated with high narcissism, and so were also low levels of suicidality, depression, anxiety and GAF scores. Severe violence and high self-esteem were significantly associated with high narcissism in multivariable analyses. The NPI-21 and its subscales showed test-retest correlations ≥0.83, while the BPRS and the HADS showed lower correlations, confirming the trait character of the NPI-21. Depression and suicidality were negatively associated with the NPI-21 total score and all its subscales, while positive association was observed with grandiosity. No significant differences were observed between patients and NORM on the NPI-21 total score or any of the NPI subscales.

    Conclusion

    Narcissism in the psychiatric patients was significantly associated with violence, suicidality and other symptoms relevant for management and treatment planning. Due to its trait character, use of the NPI-21 in acute psychiatric patients can give important clinical information. The similar level of narcissism found in patients and NORM is in need of further examination.

  • 128.
    Svindseth, Marit
    et al.
    National University of Science and Technology.
    Sørebø, Øystein
    Buskerud University College.
    Nøttestad, Jim Aage
    National University of Science and Technology.
    Roaldset, John Olav
    National University of Science and Technology.
    Wallin, Juliska
    Mälardalen University, School of Sustainable Development of Society and Technology.
    Dahl, Alv A.
    University of Oslo.
    Psychometric examination and normative data for the Narcissistic Personality Inventory 29 item version: Personality and Social Sciences2009In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 50, no 2, p. 151-159Article in journal (Refereed)
    Abstract [en]

    The Narcissistic Personality Inventory (NPI) is commonly used in empirical studies of narcissism. Few population-based studies have been published. Our aim was to do a confirmatory factor analysis (CFA) of the NPI 29 item version with a four-factor structure, in two population-based samples and in a patient sample, and present normative population-based data. The NPI-29 was filled in by 324 respondents from the Norwegian population, 231 from the Swedish population and 167 Norwegian psychiatric patients. The four-factor structure of the NPI-29 with Leadership/Power, Exhibitionism/Self-admiration, Superiority/Arrogance and Uniqueness/Entitlement was reproduced in these samples. The CFA models showed good fit indices in all samples. Mean scores on the NPI-29 and four subscales hardly differed between the samples. For the NPI-29 total score and factors, few significant differences were observed. CFA of the samples supported the factor structure of the NPI-29 formerly identified by principal component analysis of the Swedish population sample.

  • 129. Söderbäck, Maja
    Encountering Parents: Professional Action Styles among Nurses in Pediatric care1999Doctoral thesis, monograph (Other scientific)
  • 130.
    Söderbäck, Maja
    Mälardalen University, Department of Caring and Public Health Sciences.
    Nurses' empowering of Parents in Pediatric settings: A conceptual analysis1996Report (Refereed)
  • 131.
    Söderbäck, Maja
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare.
    Care of hospitalized children in Mozambique: nurses' beliefs and practice regarding family involvement2007In: Journal of Child Health Care, ISSN 1367-4935, E-ISSN 1741-2889, Vol. 11, no 1, p. 53-69Article in journal (Refereed)
    Abstract [en]

    This study aims to describe nurses' beliefs and practice regarding family involvement in the care of hospitalized children in Mozambique. Ethnographic fieldwork was used. The data production consisted of field descriptions from observations and interviews with 36 nurses. Through qualitative content analysis the findings show that nurses' practice of family involvement reflects a society that is poor, hierarchical, family-oriented but at the same time still adaptive. Four themes are identified: family members' presence in order to assist the nurses in care; nurses' support and education of family members to be involved in care; nurses' shielding of family members from family involvement; difficulties and conditional dilemmas in the nurses' involvement of families. It is concluded that emphasizing culturally congruent nursing care is necessary if families' way of life is to be accommodated. However, to empower family involvement in everyday practice, the Mozambican nurses themselves need to be empowered.

  • 132.
    Tham, Vibeke
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Christensson, Kyllike
    Karolinska Institutet, Stockholm, Sweden.
    Ryding, Elsa Lena
    Karolinska Institutet, Stockholm, Sweden.
    Sense of coherence and symptoms of post-traumatic stress after emergency caesarean section2007In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 86, no 9, p. 1090-1096Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In this study of women who had undergone an emergency caesarean section (EmCS), the aim was to examine the associations between, on the one hand, the new mother's sense of coherence (SOC) and obstetric and demographic variables a few days postpartum, and on the other hand, post-traumatic stress symptoms 3 months' postpartum. METHODS: In a prospective study, 122 Swedish- or English-speaking new mothers completed 2 self-assessment questionnaires, at 2 days and 3 months after an EmCS. To measure SOC, we used the Sense of Coherence Scale (SOC-13), and to measure reactions to traumatic events, the Impact of Event Scale (IES-15). RESULTS: Independent risk factors associated with post-traumatic stress symptoms were: imminent fetal asphyxia as an indication for the operation, and low SOC in the woman. The group of women with low SOC were those with an intense fear of childbirth during pregnancy, immigrants, and socially underprivileged women. CONCLUSIONS: Symptoms of post-traumatic stress following EmCS are associated both with the new mother's personal coping style and with the circumstances of the event. We recommend that women who belong to groups who more often report a low SOC or who had imminent asphyxia as an indication for the operation should be offered support and follow-up.

  • 133.
    Thirugnanam, Vasanthakumar
    Mälardalen University. Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Sustainable Development of Society and Technology.
    Effect of combined treatment with R-(+)-methanandamide and chemotherapeutic drugs in mantle cell lymphoma and chronic lymphocytic leukemia: MCLIndependent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Mantle cell lymphoma (MCL) is a non-Hodgkin B-cell lymphoma with very bad prognosis. The genetic hallmark of MCL, is the translocation t(11;14)(q13;q32) which leads to overexpression of cyclin D1, a D-type cyclin that is not usually expressed at high levels in normal B lymphocytes.

     

    Previous studies indicate that cannabinoid receptors are expressed in lymphoma and have shown that lymphoma cell death is induced as a result of exposure to cannabinoids (ligands).

     

    The aim of this diploma work was to combined cytostatics with the cannabinoid receptor ligand R (+)-Methanandmide (R-MA). Our data suggest that combination treatment with cytostatics and R-MA induces synergistic effects in most cases.

  • 134.
    Torres, Sandra
    et al.
    Linköping University, Sweden.
    Hammarström, Gunhild
    Uppsala University, Sweden.
    Speaking of 'limitations' while trying to disregard them:: A qualitative study of how diminished everyday competence and aging can be regarded2006In: Journal of Aging Studies, ISSN 0890-4065, E-ISSN 1879-193X, Journal of aging studies, Vol. 20, no 4, p. 291-302Article in journal (Refereed)
    Abstract [en]

    Research shows that there is a difference between being old and feeling old. The way in which the experience of growing into advanced old age is regarded has also been found to play an important role for well-being in old age. One central aspect of this experience - i.e. diminished everyday competence - remains relatively under-researched. This article explores, through 21 qualitative interviews, how a group of elders regard declines in everyday competence. Three distinctive categories were found: (a) diminished everyday competence is regarded as a 'fact of life' that cannot be overcome and must therefore be accepted; (b) as something that could be overcome - in the long run - but must be 'temporarily' accepted and (c) as a matter of fact that can neither be overcome nor accepted. In addition, these categories were found to come hand in hand with specific ways of regarding limitations; being in need of assistance from others and how the process of growing into old age is regarded as a whole.

  • 135.
    Trulsson, O.
    et al.
    Ullevåls University Hospital, Oslo, Norway.
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences.
    The silent child -: Mother´s experiences before, during and after stillbirth2004In: Birth, ISSN 0730-7659, Vol. 31, no 3, p. 189-195Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The quality of care received by a woman who gives birth to a dead baby is crucial for her long-term well-being, and limiting the period between diagnosis of intrauterine death and induction of delivery decreases her anxiety risk. The primary objective of this study was to explore why induction of delivery for most women should not be delayed more than 24 hours from the diagnosis of intrauterine death. A secondary objective was to determine how the time between diagnosis and delivery should be spent. METHODS: Twelve women were interviewed about their experience before and during the diagnosis of their baby's death and the event of birth. Interviews took place 6 to 18 months after the delivery and were analyzed using a phenomenological methodology. RESULTS: Women experienced premonition, difficulty communicating their worry, cessation of verbal communication with staff, unreality and numbing, desire to get rid of the dead child immediately, going through childbirth, and total silence. Many women believed that they were not respected as a human being during the process of diagnosing the intrauterine death. Themes emerged indicating caregivers should not reduce to zero the time between diagnosis of intrauterine death and induction of delivery. Time may be needed to obtain medical information about the delivery and to prepare the woman for meeting with and saying goodbye to her long-awaited but now silent baby. CONCLUSION: The period between diagnosis of intrauterine death and induction of delivery may give health professionals a major opportunity to improve a woman's ability to cope with the event of stillbirth and prepare her to meet with her loved but now silent baby. Further clinical research can identify supportive mechanisms for parents, and sources of iatrogenic psychological trauma that should be eliminated.

  • 136.
    Tulviste, Tiia
    et al.
    University of Tartu, Estonia.
    Mizera, Luule
    University of Tartu, Estonia.
    De Geer, Boel
    Södertörn University College, Sweden .
    Tryggvason, Marja-Terttu
    Södertörn University College, Sweden .
    Child-rearing goals of Estonian, Finnish, and Swedish mothers2007In: Scandinavian Journal of Psychology, ISSN 0036-5564, Vol. 48, no 6, p. 487-497Article in journal (Refereed)
    Abstract [en]

    In the present study, the child-rearing goals of mothers of 4- to 6-year-old children from Estonia, Finland, and Sweden were compared. The developedChild-Rearing Goals Questionnaire consisted of three different tasks: open-ended questions, item rating, and item ranking. All mothers were similar in valuing highly self-maximization, but differed in emphasis on traditional child-rearing goals (e.g., conformity, obedience, politeness, being hard-working, etc.). The Swedish mothers tended to stress the characteristics connected with self-maximization as well as self-confidence and children's happiness, but did not value the traditional child-rearing goals. The Estonian mothers attached a great significance both to the traditional characteristics and to self-maximization. The Finnish mothers also stressed both traditional and non-traditional values, but to a lesser extent than the Estonians. The Swedish andFinnish mothers' child-rearing goals were relatively homogeneous. In contrast, the Estonian mothers were generally less focused on any specific goal.Mothers with a lower level of education stressed traditional goals more than mothers with a higher level of education. The results are discussed in the light of the possible effect different cultural contexts have on maternal child-rearing goals: bringing up children in stable welfare societies (such as Sweden and Finland) in contrast to a rapidly changing society (such as Estonia).

  • 137.
    Tydén, Tanja
    et al.
    Uppsala universitet, Sweden.
    Aneblom, Gunilla
    Uppsala universitet, Sweden.
    von Essen, Louise
    Uppsala universitet, Sweden.
    Häggström-Nordin, Elisabet
    Mälardalen University, School of Health, Care and Social Welfare. Uppsala universitet, Sweden.
    Larsson, Margareta
    Uppsala universitet, Sweden.
    Odlind, Viveca
    Uppsala universitet, Sweden.
    Trots lättillgängliga akut-p-piller sjunker inte antalet aborter. Studier av kvinnors kunskaper, attityder och erfarenheter av metoden.2002In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 99, no 47, p. 4730-4735Article in journal (Refereed)
    Abstract [sv]

    Despite the fact that emergency contraceptive pills (ECP) have become easily available across the country during recent years, abortion numbers continue to rise in Sweden, especially in the young age groups (< 25). In a series of studies, we have investigated knowledge, attitudes and experience of ECP among young women. Our results show that, whereas most women are aware of the method, many lack knowledge about the mechanism of action and time frames for best use, which could explain why ECPs are not used by more than a fraction of women who might have had benefit from their use. Since half of the women requesting a termination of pregnancy stated that they would have used ECP if they had had them available at home at the time of the unprotected intercourse which led to an unintended pregnancy, it seems reasonable to encourage women to keep ECPs at home, in case the need should arise. It is important that ECPs are available without prescription, but beyond that, much more information about ECP is necessary in order for the method to be widely accepted and used as a back-up after failure with other contraceptives.

  • 138.
    von Heideken Wågert, Petra
    et al.
    Institutionen för Samhällsmedicin och Rehbilitering, Umeå Universitet.
    Gustafson, Yngve
    Geriatrik, Institutionen för Samhällsmedicin och Rehbilitering, Umeå Universitet.
    Kallin, Kristina
    Geriatrik, Institutionen för Samhällsmedicin och Rehbilitering, Umeå Universitet.
    Jensen, Jane
    Sjukgymnastik, Institutionen för Samhällsmedicin och Rehbilitering, Umeå Universitet.
    Lundin-Olsson, Lillemor
    Sjukgymnastik, Institutionen för Samhällsmedicin och Rehbilitering, Umeå Universitet.
    Falls in very old people: The population-based Umeå 85+ Study in Sweden2009In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 49, no 3, p. 390-396Article in journal (Refereed)
    Abstract [en]

     

     The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total population aged 90 and ≥95 (-103), in Umeå, Sweden. Of the 253 people interviewed, 220 (87%) were followed up for falls for 6 months, of whom 109 lived in ordinary and 111 in institutional housing. A comprehensive geriatric baseline assessment was made through interviews and testing during home visits. Forty percent of the participants did fall a total 304 times, corresponding to 2.17 falls per Person Year (PY). It occurred 0.83 injuries per PY, including 0.14 fractures per PY. In a Cox regression analysis, the independent explanatory risk factors for time to first fall were dependency in activities of daily living (ADL), thyroid disorders, treatment with selective serotonin reuptake inhibitors (SSRIs) and occurrence of falls in the preceding year. It could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture within 1 year. ADL, thyroid disorders and treatment with SSRIs should be considered in fall prevention programmes.

     

    The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total population aged 90 and ³ 95 (-103), in Umeå, Sweden. Of the 253 people interviewed, 220 (87%) were followed up for falls for six months, of whom 109 lived in ordinary and 111 in institutional housing. A comprehensive geriatric baseline assessment was made through interviews and testing during home visits. Forty percent of the participants did fall a total 304 times, corresponding to 2.17 falls per Person Year (PY). It occurred 0.83 injuries per PY, including 0.14 fractures per PY. In a Cox regression analysis, the independent explanatory risk factors for time to first fall were dependency in activities of daily living (ADL), thyroid disorders, treatment with selective serotonin reuptake inhibitors (SSRIs) and occurrence of falls in the preceding year. It could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture within one year. ADL, thyroid disorders and treatment with SSRIs should be considered in fall prevention programmes.

     

  • 139.
    von Heideken Wågert, Petra
    et al.
    Umeå University, Umeå, Sweden.
    Gustafson, Yngve
    Umeå University, Umeå, Sweden.
    Lundin-Olsson, Lillemor
    Umeå University, Umeå, Sweden.
    Large variations in walking, standing up from a chair, and balance in women and men over 85 years: An observational study2009In: Australian Journal of Physiotherapy, ISSN 0004-9514, Vol. 55, no 1, p. 39-45Article in journal (Refereed)
    Abstract [en]

    Question: How do three different age groups of women and men >85 years perform in tests of gait speed, chair stands, and balance?

    Design: A population-based cross-sectional observational study.

    Participants: Half the 85-year-old population, and the total population aged 90 and ³95 (-103) in Umeå, Sweden were assessed in the Umeå 85+ Study (n=238).

    Outcome measures: Usual and fastest gait speed (m/s) over 2.4 meters (8 feet), three consecutive chair stands (s), the Berg Balance Scale and ability to perform the tests (yes/no).

    Results: The median (10th-90th percentile) usual gait speed was 0.49 m/s (0.23-0.75), time to perform the chair stands test 12.6 seconds (8.5-20.2), and median Berg Balance Scale scores 45 (0-54). An age-related decline in physical ability was seen in women, but not in men. Men had greater physical ability than women. The Berg Balance Scale showed no floor or ceiling effects, but the gait speed and chair stands tests resulted in a floor effect especially for women.

    Conclusion: There were large variations in physical ability in these very old people. These data provide valuable reference values for physical ability in the oldest age groups for commonly used clinical measurements.

  • 140.
    von Heideken Wågert, Petra
    et al.
    Mälardalen University, Department of Caring and Public Health Sciences. Umeå University, Umeå, Sweden .
    Gustavsson, JM
    Umeå University, Umeå, Sweden .
    Kallin, K
    Umeå University, Umeå, Sweden .
    Nygren, B
    Umeå University, Umeå, Sweden .
    Lundman, B
    Umeå University, Umeå, Sweden .
    Norberg, A
    Umeå University, Umeå, Sweden .
    Gustafson, Y
    Umeå University, Umeå, Sweden .
    Health status in the oldest old. Age and sex differences in the Umeå 85+ Study.2006In: Aging Clinical and Experimental Research, ISSN 1670-2780, Vol. 18, no 2, p. 116-26Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: With an increasing population aged 85 years and over, the aim of this study was to describe health status and living conditions in the oldest old and to estimate age and sex differences in a Northern European population. METHODS: A population-based cross-sectional study, The Umeå 85+ Study, was carried out in the municipality of Umeå in northern Sweden. Out of 319 eligible participants aged 85, 90 and 95 years and over, 253 participated. Structured interviews and assessments were conducted with the participants in their homes, and data were also collected from relatives, caregivers and medical charts. Cognition was screened with the Mini-Mental State Examination (MMSE), depressive symptoms with the Geriatric Depression Scale-15 (GDS-15) and nutritional status with the Mini Nutritional Assessment (MNA). Activities of daily living (ADL) were assessed applying the Staircase of ADL (including Katz' Index of ADL) and morale with the Philadelphia Geriatric Center Morale Scale (PGCMS). Participants also rated their own health. RESULTS: Over half of the participants had hypertension, one out of four was depressed, and the same proportion had had a hip fracture; the mean number of drugs taken was 6.4+/-4.0. Younger participants had lower rates of diagnoses and prescribed drugs, and were less dependent in ADL and other functional variables; men had lower rates of diagnoses and reported symptoms. The majority of participants rated their general health and morale as good. CONCLUSIONS: There were large variations in social, medical and functional variables within and between age and sex groups. This northern population of the oldest old seems to have a very high prevalence of hypertension, depression, hip fractures, and many prescribed drugs.

  • 141.
    von Heideken Wågert, Petra
    et al.
    Umeå University, Sweden.
    Rönnmark, B.
    Umeå University, Sweden.
    Rosendahl, E.
    Umeå University, Sweden.
    Lundin-Olsson, L.
    Umeå University, Sweden.
    Gustavsson, J.M.C.
    Umeå University, Sweden.
    Nygren, B.
    Umeå University, Sweden.
    Lundman, B.
    Umeå University, Sweden.
    Norberg, A.
    Umeå University, Sweden.
    Gustafson, Y.
    Umeå University, Sweden.
    Morale in the oldest old: the Umeå 85+ Study2005In: Age and Ageing, ISSN 0002-0729, Vol. 34, no 3, p. 249-255Article in journal (Refereed)
    Abstract [en]

    Objective: to describe morale among the oldest old, and to investigate which social, functional and medical factors are associated with morale in this population. Design: a cross-sectional study. Setting: a population-based study in the municipality of Umea, a city in Northern Sweden. Subjects: half of the 85-year-old population, and the total population of 90-year-olds and >= 95-year-olds (95-103) were asked to participate (n = 319) and 238 were interviewed. Methods: structured interviews and assessments during home visits, interviews with relatives and caregivers and review of medical charts. The 17-item Philadelphia Geriatric Center Morale Scale (PGCMS) was used to measure morale. Participants were assessed with the Barthel Activities of Daily Living (ADL) Index, Geriatric Depression Scale (GDS-15), Mini-Mental State Examination (MMSE), Mini Nutritional Assessment (MNA), and a symptom questionnaire. Multiple regression analyses were conducted to find independent factors to explain the variation in the PGCMS score. Results: eighty-four per cent (n = 199) of those interviewed answered the PGCMS. Three-quarters had middle range or high morale. GDS score, type of housing, previous stroke, loneliness and number of symptoms, adjusted for age group and sex, explained 49.3% of the variance of total PGCMS score. Conclusions: a large proportion of the oldest old had high morale. The most important factors for high morale were the absence of depressive symptoms, living in ordinary housing, having previously had a stroke and yet still living in ordinary housing, not feeling lonely and low number of symptoms. The PGCMS seems applicable in the evaluation of morale among the oldest old.

  • 142.
    Waldenström, U.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Hildingsson, Ingegerd
    Mälardalen University, Department of Caring and Public Health Sciences.
    Rubertsson, Christine
    Karolinska Institutet, Stockholm, Sweden.
    Rådestad, Ingela
    Mälardalen University, Department of Caring and Public Health Sciences.
    A negative birth experience: prevalence and risk factors in a national sample2004In: Birth, ISSN 0730-7659, Vol. 31, no 1, p. 17-27Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A woman's dissatisfaction with the experience of labor and birth may affect her emotional well-being and willingness to have another baby. The aim of this study was to investigate the prevalence and risk factors of a negative birth experience in a national sample. METHODS: A longitudinal cohort study of 2541 women recruited from all antenatal clinics in Sweden during 3 weeks spread over 1 year was conducted. Data were collected by three questionnaires, which measured women's global experience of labor and birth 1 year after the birth, and obtained information on possible risk factors during pregnancy and 2 months after the birth. RESULTS: Seven percent of the women had a negative birth experience. The following risk factors were found: (1) factors related to unexpected medical problems, such as emergency operative delivery, induction, augmentation of labor, and infant transfer to neonatal care; (2) factors related to the woman's social life, such as unwanted pregnancy and lack of support from partner; (3) factors related to the woman's feelings during labor, such as pain and lack of control; and (4) factors that may be easier to influence by the caregivers, such as insufficient time allocated to the woman's own questions at antenatal checkups, lack of support during labor, and administration of obstetric analgesia. CONCLUSIONS: Many risk factors were related to unexpected medical problems and participants' social background. Of the established methods to improve women's birth experience, childbirth education and obstetric analgesia seemed to be less effective, whereas support in labor and listening to the woman's own issues may be underestimated

  • 143.
    Walve, Rebecka
    Mälardalen University, School of Health, Care and Social Welfare.
    "ANDAS SKA MAN ÄNDÅ GÖRA": - Föräldrars förlossningsupplevelser då psykoprofylax använts som förlossningsförberedelse2013Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Several factors can affect the childbirth experience among parents. Previous research showed that parental education was insufficient. Parents who participated in both regular parental classes and psychoprophylaxis education were more satisfied with the psychoprophylaxis education compared to those who participated in only traditional parental classes. Psychoprophylaxis should be more considered as it could help the woman to handle her pain and contribute to increased self-esteem. The aim was to describe and illustrate the parents' childbirth experiences when psychoprophylaxis was used as childbirth preparation. The material for the study was collected through seven semi-structured interviews analyzed by qualitative content analysis. Three self-rated scales were used to illustrate the experiences of childbirth, pain in childbirth and psychoprophylaxis. The results showed that childbirth experience with psychoprophylaxis was individual. The psychoprophylaxis was a help when coping with labor pains for the mothers but also for the fathers to manage the mothers labor pain. Parental cooperation and midwifery support was important when using the psychoprophylaxis. Complicated deliveries with interventions and separation between child and parents contributed to a negative birth experience, despite using psychoprophylaxis and support from the midwife. The parents meant that there was a need for psychoprophylaxis and several mothers could not imagine giving birth without the use of psychoprophylaxis.

  • 144.
    Öjmyr-Joelsson, Maria
    et al.
    Karolinska University Hospital, Sweden.
    Nisell, Margret
    Karolinska University Hospital, Sweden.
    Frenckner, Björn
    Karolinska University Hospital, Sweden.
    Rydelius, Per-Anders
    Karolinska University Hospital, Sweden.
    Christensson, Kyllike
    Mälardalen University, School of Health, Care and Social Welfare. Karolinska University, Sweden.
    High and intermediate imperforate anus: psychosocial consequences among school-aged children2006In: Journal of Pediatric Surgery, ISSN 0022-3468, E-ISSN 1531-5037, Vol. 41, no 7, p. 1272-1278Article in journal (Refereed)
    Abstract [en]

    BACKGROUND/PURPOSE: Imperforate anus is an unusual malformation, which, even after surgical intervention, usually entails constipation and fecal incontinence. This study aimed to evaluate ongoing psychosocial effects of this birth defect in school-aged children. METHODS: Twenty-five children born with high and intermediate imperforate anus participated in the study, along with their parents and classroom teachers. One group of healthy children and 1 group of children with juvenile chronic arthritis, along with their parents, served as controls. Children and parents individually answered a questionnaire devised for this study. Parents filled out the Child Behavior Checklist and the children's teacher filled out the Teacher's Report Form. RESULTS: According to test results, children with imperforate anus were happy and optimistic. They liked school better and reported better relationships with schoolmates than the other children. The index group reported statistically significantly more frequent constipation. According to parental responses, the imperforate-anus children suffered from fecal incontinence and odor, as well as constipation (P < .001). Index-group parents reported on the Child Behavior Checklist that their children had more emotional and behavioral problems. On the Teacher's Report Form, teachers reported few problems for the same children. CONCLUSIONS: Patients with imperforate anus did not experience psychosocial impairment despite significant functional problems.

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