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Supporting someone after their stroke : family members' views and experiences of self-management
No full textPURPOSE: Self-management has increased in recognition in stroke research and rehabilitation along with growing trends of shorter hospital stays and more patient-centred care. Family members are key persons in the self-management process, but their views and experiences of self-management have not been studied in detail. This study aimed to explore family members' understanding of self-management, the strategies they use and the challenges they face when providing support. METHODS: For this descriptive study, semi-structured interviews with family members (n = 27) were conducted. Data were analysed using inductive content analysis. RESULTS: The analysis resulted in three main categories and eight subcategories. Most family members saw self-management as performing practical tasks, such as daily living activities and rehabilitation training. However, family members described a broad range of actions to support self-management, including emotional and motivational support. They found it challenging to give the right amount of support and expressed a need of more information after discharge. CONCLUSIONS: Family members' conceptualisations of self-management differ from the strategies they use to provide support. A clearer understanding of self-management as a collective process can benefit the development and delivery of efficient self-management support
Techno-economic assessment of electric vehicle-based decentralized electricity delivery for enhanced power resilience during outages
No full textThe integration of electric vehicles (EVs) into power systems offers a promising pathway to enhance energy resilience during grid outages. Most of the existing studies treat EV outage support as a short-term, technical problem, with limited attention to economics, business models (e.g., ownership and stakeholders), or long-term outages. To bridge the gap, this study presents a comprehensive framework to evaluate the techno-economic feasibility of using EV mobility as a decentralized electricity delivery solution during both short-term and long-term outages. A rule-based control strategy is developed to operate EVs under realistic operational constraints, with the primary objective of maximizing energy delivery and minimizing unmet demand during outages. The framework incorporates real-world data, including household and critical load profiles, EV battery capacities, ownership types, outage durations, travel distances, and seasonal variations. Scenario-based simulations are performed to compare various technical and economical key performance indicators. Results show that EVs with personal ownership type and large capacity (100 kWh) can effectively meet residential energy needs during short-term outages. In long-term outages, expanding the EV fleet effectively reduce unmet demand, and higher solar generation in summer and spring significantly improves energy availability compared to winter, where unmet load is more than twice as high under identical conditions. The findings offer practical insights for stakeholders and policymakers in developing EV-based resilience strategies for future energy systems. Furthermore, the study highlights the importance of designing appropriate business models to support the integration of mobile energy services into resilience planning. © 2025 The Authors
Pain assesment in people with dementia : A literature review
No full textBakgrund Demenssjukdom gör att man får en nedsatt förmåga att uttrycka sina behov och känslor, vilket gör att smärta kan vara svår att upptäcka och bedöma. Vanligt förekommande i denna grupp är smärta och obehandlad smärta kan leda till ökat lidande, beteendeförändringar och försämrad livskvalitet. Detta innebär för sjuksköterskor en särskild utmaning, de olika smärtbedömningsintrumenten bygger på att kunna smärtskatta baserad på sin egen förmåga att uttrycka sig. Sjuksköterskans kliniska blick och erfarenheter samt användning av olika bedömningsinstrument blir centrala för att kunna identifiera och lindra smärta hos personer med demenssjukdom. Syfte Att beskriva sjuksköterskors erfarenheter av att bedöma smärta hos personer med demenssjukdom. Metod En litteraturöversikt med kvalitativ ansats baserad på 15 vetenskapligt granskade artiklar. Datainsamlingen genomfördes i databaserna CINAHL och PubMed. Artiklarna kvalitetsgranskades med Nilssons (2017a, 2017b) granskningsmallar och analyserades genom innehållsanalys enligt Graneheim och Lundman (2004). Resultat Tre huvudkategorier identifierades: (1) Utmaningar i smärtbedömning hos personer med demenssjukdom, (2) Sjuksköterskors erfarenheter, kunskap och attityder samt (3) Strategier och förbättringsområden i smärthantering. Resultaten visade att bristande kommunikation, begränsad utbildning och brist på tid försvårar smärtbedömningen, medan erfarenhet, empati och användning av strukturerade bedömningsinstrument underlättar arbetet. Slutsats Sjuksköterskors kliniska erfarenhet och personcentrerade förhållningssätt är avgörande för en god smärtbedömning. För att förbättra vårdkvaliteten behövs kontinuerlig utbildning, gemensamma rutiner och tvärprofessionellt samarbete.Background Dementia causes a reduced ability to express one's needs and feelings, which makes pain difficult to detect and assess. Pain is common in this group, and untreated pain can lead to increased suffering, behavioral changes, and a reduced quality of life. This poses a particular challenge for nurses, as the various pain assessment instruments are based on being able to assess pain based on one's own ability to express oneself. The nurse's clinical perspective and experiences as well as the use of various assessment instruments are central to being able to identify and relieve pain in people with dementia. Aim To describe nurses' experiences of assessing pain in people with dementia. Method A qualitative literature review based on 15 peer-reviewed articles. Data collection was conducted in the CINAHL and PubMed databases. The articles were quality-reviewed using Nilsson's (2017a, 2017b) review templates and analyzed through content analysis according to Graneheim and Lundman (2004). Results Three main categories were identified: (1) Challenges in pain assessment in people with dementia, (2) Nurses' experiences, knowledge and attitudes, and (3) Strategies and areas for improvement in pain management. The results showed that poor communication, limited training and lack of time make pain assessment difficult, while experience, empathy and the use of structured assessment instruments facilitate the work. Conclusions Nurses' clinical experience and person-centered approach are crucial for good pain assessment. Continuous education, shared routines, and interprofessional collaboration are needed to improve the quality of care
Autonomous language-image generation loops converge to generic visual motifs
No full textAutonomous AI-to-AI creative systems promise new frontiers in machine creativity, yet we show that they systematically converge toward generic outputs. We built iterative feedback loops between Stable Diffusion XL (SDXL; image generation) and Large Language and Vision Assistant (LLaVA; image description), forming autonomous text → image → text → image cycles. Across 700 trajectories with diverse prompts and 7 temperature settings over 100 iterations, all runs converged to nearly identical visuals—what we term ‘‘visual elevator music.’’ Quantitative analysis revealed just 12 dominant motifs with commercially safe aesthetics, such as stormy lighthouses and palatial interiors. This convergence persisted across model pairs, indicating structural limits in cross-modal AI creativity. The effect mirrors human cultural transmission, where iterated learning amplifies cognitive biases, but here, diversity collapses entirely as AI loops gravitate to high-probability attractors in training data. Our findings expose hidden homogenizing tendencies in current architectures and underscore the need for anti-convergence mechanisms and sustained human-AI interplay to preserve creative diversity
Don't charge while you heat! The social potential for flexibility and coordination of energy-intensive technologies in single-family houses
No full textThis study explores the social potential for flexibility and coordination of energy-intensive technologies, specifically electric vehicles and heat pumps – an increasingly common combination in Swedish single-family homes with diverse needs and motivations. As electrification rises and power peaks grow more concerning, the research examines flexibility in everyday EV charging and heating practices, focusing on enabling and hindering conditions. Drawing on 21 household interviews and social practice theory, the study found that flexibility potential was influenced by temporal, geographical, and material conditions, along with values, expectations, and experiences. Alternative charging strategies and frugal heating practices demonstrated flexibility, especially among households valuing environmental care. Foreseeability supported flexibility, while rigid schedules and high comfort expectations posed challenges. Practices centred around care were important but could reduce flexibility, and unfavourable combinations of geographical and material conditions further constrained it, but instead shaped fragility and awareness. Coordinating EV charging with heat pump use and adapting to new power tariffs proved complex. The study highlights the importance of understanding the social dimensions of energy flexibility and offers insights for policymakers and energy providers to support households in managing and coordinating practices related to multiple energy-intensive technologies in response to price signals and power demands
Potential and feasibility of preoptimisation in ventral hernia repair- a focus group study
No full textAIM: The aim of this study was to explore patients' experiences of participation in a preoptimisation programme prior to ventral hernia repair, focusing on the programme's feasibility and patient-perceived potential. INTRODUCTION: Preoptimisation of modifiable risk factors has received growing attention, but little is known about ventral hernia patients' perspectives on such programmes. Understanding patient motivation and perceived barriers is critical for designing effective interventions. METHOD: Eight ventral hernia patients participated in a home-based preoptimisation programme lasting at least three weeks. Focus group interviews were conducted and analysed using reflexive thematic analysis. RESULTS: Participants generally perceived the preoptimisation programme positively. Clear and structured advice was valued, with participants appreciating straightforward instructions on physical activity and lifestyle change. Reported barriers included everyday life circumstances, orthopaedic comorbidities, and in some cases the hernia itself. Patients described perceived positive health effects, including improved fitness, weight loss, and better diabetes control. No adverse effects were raised during the interviews. CONCLUSION: This is, to our knowledge, the first qualitative study of pre-optimisation programmes in ventral hernia surgery. As an exploratory, hypothesis-generating study, its findings are shaped by sample size and setting but provide novel insights that complement quantitative research by highlighting patient perspectives. Pre-optimisation programmes appear feasible and meaningful to ventral hernia patients, particularly when supported by clear guidance, structured follow-up, and surgeon involvement. The findings are discussed in the light of Self-Determination Theory, which emphasises internalisation of motivation through autonomy, competence, and relatedness
"Not only has she survived, but she lives a happy life” – Parents’ perspectives and experiences of a novel disease-modifying therapy for spinal muscular atrophy in Sweden
No full textThe objective of this prospective cohort study was to explore parents' perspectives of patients' experiences of the first available novel disease-modifying therapy for SMA in Sweden. Patients with SMA and their parents/legal guardians were identified in the National Patient Register and the Multi-Generation Register. Data was recorded using an electronic questionnaire administered at baseline, and after 6, 12, and 18 months. In total, 47 parents to 33 children with SMA (mean patient age: 9 years, 59% female; 27% with SMA type I, 33% with type II, and 39% with type III) participated. All parents reported that they wished their child to be treated with nusinersen and most parents (81%) reported that they had sufficient information to make an informed treatment decision. Across follow-up, almost all parents reported having a positive experience of nusinersen. Our study provides unique insights into caregivers' real-world experiences of a novel disease-modifying therapy for SMA
Parenthood after neonatal care -parenting sense of competence and coparenting three years after discharge
No full textMany parents of infants in neonatal intensive care units (NICUs) experience trauma and a loss of their parental role, which may affect their parenting following discharge. This study aimed to compare parenting competence and coparenting between parents of NICU and non-NICU infants three years postpartum. We also examined factors influencing parenting among NICU parents. We used a comparative cohort design to collect data from 561 parents who completed a set of questionnaires, including measures of parenting sense of competence, coparenting, dyadic relationship quality, social support, and depressive symptoms. Three years postpartum, no differences were found in parenting sense of competence or coparenting between NICU parents and non-NICU parents. For both NICU mothers and fathers, a higher parenting sense of competence in satisfaction and efficacy was associated with a higher quality in the couple relationship. Mothers reported higher parenting satisfaction if they had not experienced a traumatic birth. Fathers reported higher parenting satisfaction if they had no depressive symptoms, and higher parenting efficacy if they had a longer couple relationship, received greater social support, had a shorter infant hospital stay, or were rooming-in with their partner and infant during hospitalization. Factors associated with more coparenting problems among NICU parents included lower couple relationship quality, a 7-14-day hospitalization for mothers, and lower social support for fathers. This study highlights that early possibilities for parents to initiate parenthood together and receive adequate mental and social support during and after NICU hospitalization should be a priority for enhancing parents' sense of competence and coparenting
Being seen in crisis : Patients’ experiences of encounters in ambulance care - A literature review
No full textBakgrund Ambulansen är till för att ge akutsjukvård till personer som saknar möjlighet att ta sig till sjukhus på egen hand eller att deras vårdbehov är av sådant slag att de kan behöva vård på vägen till rätt vårdinstans. Patienterna som befinner sig i denna typ av situation, har alla olika känslomässiga upplevelser och kan befinna sig i olika stadier av till exempel kris eller chock då deras hälsa och livssituation plötsligt förändras. Ambulanspersonalen som arbetar tillsammans kan ha olika arbetslivserfarenhet och utbildning, men också olika känslomässiga mognad och säkerhet i den egna personen när det kommer till att möta olika situationer och sättet att bemöta patienterna på kan variera. Syfte Studiens syfte är att beskriva patienters upplevelser av bemötandet från ambulanspersonal i olika vårdsituationer. Metod Examensarbetet genomförs som en strukturerad litteraturstudie med inslag av den metodologi som används vid systematiska översikter. Resultat Resultatet utformades i två huvudkategorier och 7 underkategorier. Resultatet visade att patienters upplevelser av bemötande från ambulanspersonal var både positiva och negativa. Slutsats Patienter inom ambulanssjukvården upplever bemötandet från ambulanspersonal som varierande. De upplevde både positiva och negativa upplevelser. Där bland annat kompetensen, trevligt och empatiskt bemötande, delaktighet, autonomi samt aktivt lyssnande och bekräftelse av patientens symtom och behov, var viktiga för att känna sig väl omhändertagen samt för ett bra bemötande.Background The ambulance is intended to give emergency care to patients who are unable to reach the hospital on their own or who require medical care during transportation to the appropriate health care facility. Patients who are in this type of situation have different emotional experiences and can be in different stages of, for example crisis or shock due to their sudden change of health and life circumstances. The ambulance staff who work together may have different work experience and education as well as differences in emotional maturity and self-confidence when it comes to handling different situations as well as the treatment and interactions with patients might differ. Aim The aim of this study is to describe patients experiences of being treated by ambulance staff in different care situations. Method This thesis is carried out as a structured literature study, applying aspects of the methodology used in systematic reviews. Results The results were organized into two main categories and seven subcategories. The results showed that patients’ experiences of ambulance personnel’s behavior and interactions were both positive and negative. Conclusions Patients within the ambulance care are experiencing the treatment from ambulance personnel as varying, reporting both positive and negative experiences. Important factors are the competence of the ambulance staff, a friendly and empathetic approach, patient participation, autonomy, and validation of the patients' needs and symptoms. These are all important for the patient to feel well cared for and for a good encounter
Even eagles struggle to fly : Matti Nykänen, Eddie the Eagle, and Jan Boklöv in the era of commercialisation, professionalisation, and mediatisation
No full textThis paper examines the professionalisation, mediatisation, and commodification of ski jumping, focusing on the careers of Matti Nykänen, Jan Boklöv, and Michael ‘Eddie the Eagle’ Edwards. We explore how the underdog who transformed the sport and the outsider who captivated the media competed against one of history’s most accomplished ski jumpers. Furthermore, we analyse why figures like Boklöv and Edwards have not reemerged, concentrating on their significance in the Winter Olympics. Through qualitative interviews with former ski jumpers and coaches, we examine the negotiation between the logic of sport, driven by competition and winning, commodification, driven by economic maximisation, and mediatisation, driven by narrative dramatization. Findings suggest that while performance sets professional standards, media narratives can elevate unconventional figures like Eddie the Eagle, who gained fame despite his limited success. In contrast, successful athletes like Nykänen experienced negative media commodification. Boklöv’s innovative V-style, meanwhile, exemplifies how such innovations can reshape the sport. Finally, we highlight the paradoxes of professionalisation and thus reveal that commercialisation and mediatisation are not necessarily tied to sporting success but remain crucial in defining public narratives