Publikationer från Sophiahemmets Högskola
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Patients’ experiences of sleep during hospital inpatient care : A non-systematic literature review
No full textBakgrund Sömn är livsviktigt för människor eftersom den gör det möjligt för kroppen och hjärnan att återhämta sig. Patienter som vårdas på sjukhus har behov av sömn för att kunna läka och återhämta sig. Olika faktorer i miljön och rutinerna på sjukhus kan påverka patienternas sömn negativt vilket orsakar ett onödigt lidande. Genom att sammanställa forskning om patienters upplevelser av sömn vid inneliggande vård på sjukhus kan vi öka förståelsen för patientperspektivet och hitta åtgärder för att främja patienters sömnupplevelse. Syfte Syftet var att beskriva patienters upplevelser av sömn vid inneliggande vård på sjukhus. Metod Denna examensuppsats skrevs i form av en icke-systematisk litteraturöversikt. Efter sökningar i databaserna Pubmed och CINAHL valdes 12 vetenskapliga artiklar utifrån uppställda urvalskriterier. Artiklarna baserades både på kvantitativ och kvalitativ metod. Artiklarna kvalitetsgranskades med stöd av Sophiahemmet Högskolas bedömningsunderlag för att därefter analyseras med integrerad analysmetod. Resultatet redovisades efter analysen genom att presenteras uppdelad i identifierade huvudkategorier med tillhörande underkategorier. Resultat Resultatet sammanställdes i tre identifierade huvudkategorier med tillhörande underkategorier. Till huvudkategorin upplevelse av miljöfaktorer identifierades underkategorierna ljud och buller, störande eller otillräcklig belysning samt obekväm säng och fysisk utformning av rummet. Till huvudkategorin upplevelse av psykiska och kroppsliga faktorer identifierades underkategorierna oro, stress och ångest över sjukdom, smärta och kroppsligt obehag samt ovisshet kring behandling och information. Till huvudkategorin upplevelser av vårdrelaterade strukturer och arbetssätt identifierades underkategorierna rutiner och kontroller under natten samt vårdpersonalens bemötande. Slutsats Flera faktorer i vårdmiljön på sjukhus påverkar patienters upplevelse av sömn. Resultatet visar att patienternas sömn ofta är något som förbises inom vården. Genom relativt enkla åtgärder i såväl den fysiska vårdmiljön som vårdpersonalens arbetssätt kan patientens upplevelse av sömn vid inneliggande vård på sjukhus förbättras. Genom ett personcentrerat arbetssätt kommer sjukvården långt i att förbättra patienternas sömnupplevelse vilket har en positiv effekt på välmåendet och återhämtningen.Background Sleep is vital for the body and brain to recover. Hospitalized patients need sufficient sleep to heal, but various factors in the hospital environment can negatively impact patients’ sleep and cause unnecessary suffering. By compiling research on patients’ experiences of sleep during hospital stays, we can gain a better understanding of their perspective and identify ways to improve sleep quality in inpatient hospital settings. Aim The aim was to describe inpatients’ experiences of sleep in hospitals. Method This thesis is a non-systematic literature review based on twelve original scientific articles from the databases PubMed and CINAHL. The articles, using both qualitative and quantitative methods, were quality-assessed using Sophiahemmet University’s evaluation tools and analyzed using an integrated analysis method. Results The results were compiled into three identified main categories with associated subcategories. The main category of experience of environmental factors was identified with the subcategories of sound and noise, disturbing or insufficient lighting, and uncomfortable bed and physical design of the room. The main category of experience of mental and physical factors was identified with the subcategories of worry, stress and anxiety about illness, pain and physical discomfort, and uncertainty about treatment and lack of information. The main category of experience of care-related structures and working methods was identified with the subcategories of routines and checks during the night, and the treatment of the care staff. Conclusions Sleep is often overlooked in healthcare, despite its importance for recovery. The findings show that both the physical hospital environment and the routines of healthcare staff influence how patients experience sleep. Through relatively simple adjustments and a more person-centred approach, healthcare providers can improve patients’ sleep experiences, leading to better recovery and overall well-being
Living with aphasia after stroke : A literature review based on people’s own experiences
No full textBakgrund Stroke drabbar många människor världen över och för vissa kan det leda till afasi, vilket är en språkstörning. Språkstörningen kan påverka en persons tal-, skriv- och kommunikationsförmåga. Det har visat sig att många människor inte vet vad afasi är. Därför kan information om personers upplevelse av att leva med afasi hjälpa vårdpersonalen men även samhället i stort att få en djupare kunskap om språkstörningen. Syfte Syftet med denna studie var att beskriva personers upplevelser av att leva med afasi efter en stroke. Metod Denna studiedesign var en icke-systematisk litteraturöversikt som innehöll 12 vetenskapliga artiklar med kvantitativa och kvalitativa ansatser. Artiklarna har genomsökts i databaserna PubMed och CINAHL och har granskats för kvalitet utifrån Sophiahemmets bedömningsunderlag. Resultaten analyserades genom en integrerad dataanalys. Resultat Resultatet delades upp i fyra huvudkategorier: betydelsen av meningsfull sysselsättning efter afasi, emotionella konsekvenser av afasi, sociala konsekvenser och relationella förändringar och praktiska och funktionella hinder efter afasi. Resultatet indikerade att efter att personer drabbas av afasi kan det förekomma många komplikationer som kan leda till förändring av sociala relationer, motoriska- och känslomässiga utmaningar samt kommunikations- och lässvårigheter. Familj, vänner, rehabiliteringstjänster samt social delaktighet/sysselsättning ansågs vara viktiga byggstenar som kunde påverka en person med afasi positivt. Slutsats Resultatet har visat att personer med afasi påverkas av sin språkstörning i det dagliga livet både känslomässigt och inom sociala relationer. Studier betonade vikten av sysselsättning och terapier för rehabilitering. I resultaten framkom upplevelser av bristande kunskap kring afasi vilket påverkade möten inom vården och i samhället negativt samt ett ökat behov av kunskap om språkstörningen.Background Stroke affects many people worldwide and for some it can lead to aphasia, which is a language disorder. The language disorder can affect a person's speaking, writing and communication skills. It has been shown that many people do not know what aphasia is. Therefore, information about people's experiences of living with aphasia can help healthcare professionals, but also society at large, to gain a deeper understanding of the language disorder. Aim The aim of this literature review was to describe people's experiences of living with aphasia after a stroke. Method This study design was a non-systematic literature review that contained 12 scientific articles with quantitative and qualitative approaches. Articles were searched in PubMed and CINAHL databases and were reviewed for quality based on Sophiahemmet's assessment documents. The results were analyzed through an integrated data analysis. Results The results were divided into four main categories: the importance of meaningful occupation after aphasia, emotional consequences of aphasia, social consequences and relational changes, and practical and functional barriers after aphasia. The results indicated that after people suffer from aphasia, there can be many complications that can lead to changes in social relationships, motor-and emotional challenges and communication-and reading difficulties. Family, friends, rehabilitation services and social participation/occupation were considered important building blocks that can positively affect a person with aphasia. Conclusions The results show that people with aphasia were affected by their language disorder in daily life both emotionally and in social relationships. Studies emphasized the importance of occupation and therapies for rehabilitation. The results revealed experiences of a lack of knowledge about aphasia, which negatively affected encounters in healthcare and in society, as well as an increased need for knowledge about the language disorder
Dynamic birth position, awareness and practice by midwives in Ethiopia : A parallel mixed-methods study
No full textBACKGROUND: Respectful maternity care, as recommended by the World Health Organization, includes allowing women to give birth in the position of their choice. Dynamic birth positions, which enable women to adopt various positions during labor and delivery, are associated with improved obstetric outcomes. However, the extent of knowledge and practice regarding dynamic birth positions among Ethiopian midwives remains poorly understood. OBJECTIVE: To assess midwives' awareness and practice of dynamic birth positions and explore their perspectives and experiences. METHODS: A convergent parallel mixed-methods design was employed to evaluate midwives' knowledge, attitudes, and practices regarding dynamic birth positions. Quantitative data were analyzed using stepwise backward elimination logistic regression to identify key predictors, while qualitative data were examined through thematic analysis. RESULTS: The study included 483 midwives, with 473 participating in the quantitative survey and 10 in the qualitative interviews. Fewer than half of the midwives demonstrated good levels of knowledge (45%) and attitude (49.5%), while only 22.6% reported regular practice of dynamic birth positions. Participation in training emerged as the strongest predictor of knowledge, attitude, and practice. Thematic analysis revealed six key themes: routine practices, awareness, clinical implementation, barriers, facilitators, and user needs. CONCLUSION: Awareness and practice of dynamic birth positions among Ethiopian midwives are notably low. Key barriers include limited awareness and suboptimal working conditions, whereas targeted training significantly enhances all assessed domains. To promote the adoption of dynamic birth positions, efforts should focus on increasing awareness, modifying delivery equipment, and improving the clinical environment
Prevention strategies and modifiable risk factors for upper extremity injury : A systematic review and meta-analysis for the Female, woman and/or girl Athlete Injury pRevention (FAIR) consensus
No full textOBJECTIVES: To examine injury prevention strategies and potentially modifiable risk factors (MRFs) for upper extremity (UE) injuries in female, woman and/or girl athletes (female/woman/girl). DESIGN: Systematic review with meta-analysis, semiquantitative analyses and Grading of Recommendations Assessment, Development and Evaluation in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. DATA SOURCES: MEDLINE (Medical Literature Analysis and Retrieval System Online), CINAHL (Cumulative Index to Nursing and Allied Health Literature), APA PsycINFO (American Psychological Association Psychological Information Database), SPORTDiscus (Sports Discus Database), EMBASE (Excerpta Medica Database), and ERIC (Education Resources Information Center) (30 October 2023) and Cochrane Systematic Review Database and the Cochrane Central Register of Controlled Trials (CENTRAL) (25 November 2023). ELIGIBILITY: Primary data studies with comparison group(s) assessing the association of prevention strategies and/or MRFs for sport-related UE injury, with ≥1 female/woman/girl in each study group. RESULTS: 55 studies (n=20 intervention, n=35 MRF) were included with 33 228 athletes (8642 female/woman/girl; 26%). Of these, 17 (31%) reported female/woman/girl-specific estimates and included five injury locations (n=3 general UE, n=12 shoulder, n=3 elbow, n=3 wrist/hand). One prevention strategy (n=5 shoulder-specific exercise programmes) and seven MRFs were identified, including less range of motion (n=6), less shoulder muscle strength (n=8), high training load (n=1), presence of scapular dyskinesis (n=3), high sport specialisation (n=2), equipment differences (n=1) and less sport-specific conditioning (n=1). Pooled data from three studies suggest that shoulder exercise programmes consisting of strength, stability/control and sport-specific exercises reduce shoulder injury rates by 51% (95% CI 0.30 to 079; I2 0.0%; very-low certainty evidence) across paediatric (≤18 years) and adult handball and volleyball players. CONCLUSIONS: Our understanding of female/woman/girl UE injury prevention is limited by heterogeneity across injury outcomes, interventions, MRFs and limited female/woman/girl athlete-specific data. Shoulder-specific strengthening and stability exercise programmes may be beneficial to reduce shoulder injury rates in female/woman/girl handball and volleyball players. Future research should prioritise female/woman/girl athletes to reduce the burden of UE injuries. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42024494967
Meals as a nursing intervention and its impact on dignity for people living with dementia : A non-systematic literature review
No full textBakgrund I en åldrande befolkning blir det allt vanligare med kognitiv svikt. Personer med kognitiv svikt förlorar successivt förmågan att utföra vardagssysslor, som att genomföra en måltid. Detta påverkar inte bara personens hälsa om det innebär ett otillräckligt närings- och vätskeintag, utan ett missat tillfälle för samvaro med andra och identitetsbyggande, vilket kan påverka känslan av värdighet. Måltiden för personer med kognitiv svikt skulle därför kunna utgöra en omvårdnadshandling, där sjuksköterskan ansvarar för att patientens värdighet inte går förlorad. Syfte Att beskriva hur måltidssituationen, som en omvårdnadshandling, kan främja värdighet hos personer med kognitiv svikt. Metod Icke-systematisk litteraturstudie, induktiv ansats, kvalitativ metod. Resultat I måltidssituationen som en omvårdnadshandling för främjandet av värdighet hos personer med kognitiv svikt kunde tre huvudkategorier identifieras: hur måltidsmiljön skapar förutsättningar för värdighet, hur stödjande handlingar i måltidssituationen främjar värdighet och hur bemötande stärker känslan av värdighet. Resultatet visar vikten av en igenkännande och harmonisk miljö, måltiden som en struktur som ger trygghet i vardagen, betydelsen av personcentrerade insatser och valmöjligheter, vikten av självbestämmande och autonomi samt betydelsen av att få vara socialt delaktig. Slutsats Måltidssituationen kan ses som en central arena för värdighet hos personer med kognitiv svikt. En trygg och hemlik miljö, ett respektfullt bemötande samt möjlighet att bevara identitet och delaktighet framträder som viktiga aspekter. Med stöd i Nordenfelts teori om värdighet kan både människovärde och identitetsvärdighet identifieras i måltidssituationen. För omvårdnadspersonal innebär detta ett ansvar och en möjlighet att se måltiden som en omvårdnadshandling som kan stärka värdighet.Background In an aging population, dementia is becoming increasingly common. People living with dementia gradually lose the ability to manage daily living activities, such as eating. This does not only affect the person's health if it leads to insufficient nutritional and fluid intake, but also a missed opportunity for socializing and identity building, which in turn can affect the sense of dignity. Mealtimes for people living with dementia could become an act of nursing – where the nurse ensure that the person’s sense of dignity is held intact. Aim To describe how the mealtime situation, as an act of nursing, can promote dignity in people living with dementia. Method A non-systematic literature study with inductive approach and a qualitative method. Results Mealtime situations for people living with dementia, as a nursing act for maintaining the sense of dignity, appear to boil down to three main factors: how the mealtime environment can contribute to dignity, how supportive actions can promote dignity and how respectful treatment can strengthen the sense of dignity. The results show the importance of a harmonious environment, the meal as a structure that provides a sense of safety in everyday life, the importance of person-centred interventions and choices, self-determination and autonomy, as well as and the importance of being able to participate in a social context. Conclusions The mealtime situation can be seen as a central arena for dignity in people living with dementia. A safe and homelike environment, respectful treatment and the opportunity to preserve identity and participation emerge as important aspects. With support from Nordenfelt's dignity theory, dignity can be identified in mealtime situations. For nurses, this means a responsibility and an opportunity to treat mealtimes as a nursing act that can strengthen dignity
Make My Day - stroke prevention grounded in engaging everyday activities in primary healthcare : A single-blinded randomised controlled trial
No full textLifestyle habits significantly impact health, including stroke risk, and structured approaches in primary healthcare are needed to address risk factors and promote healthy lifestyles. Make My Day, a multifactorial activity-focussed and lifestyle-based stroke prevention programme, was developed to address the rising challenges of increasingly unhealthy lifestyle habits and stroke risk factors. This study evaluated the effect of the Make My Day intervention to reduce stroke risk at 12 months in primary healthcare. In this single-blinded randomised controlled trial, 122 individuals at risk for stroke were randomised to intervention group (n = 63) or control group (n = 59). Inferential statistics and a longitudinal mixed-effect logistic regression model were used to analyse the primary outcome. Inferential statistics were applied to analyse secondary outcomes, that is, goal achievement. At 12 months, the odds for high stroke risk (adjusted OR (CI) = 0.390 (0.156; 0.971), P = .043), was found significantly lower in the intervention group, compared to the control group. Both groups showed significant improvements in several stroke risk factors and goal fulfilment at 12 months. The Make My Day intervention trial indicates a reduction in stroke risk, and the potential of individual goals and engaging everyday activities to support lifestyle change. Make My Day can be a valuable means to address stroke prevention within primary healthcare. The study is registered at ClinicalTrials.gov, Identifier: NCT05279508. Protocol ID: KI2020-00175
Poor association between clinical characteristics and seropositivity in children with suspected long COVID : A single-centre study
No full textAIM: We aimed to compare characteristics and clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody positive or negative children attending a specialist outpatient clinic for suspected paediatric long COVID. METHODS: A cross-sectional study was conducted of 113 children and adolescents enrolled between 1 December 2020 to 14 September 2021 in a multidisciplinary programme. Clinical and epidemiological data were collected with standardised interviews and laboratory tests including SARS-CoV-2 spike antibody measurement. RESULTS: A serological link to SARS-CoV-2 infection was found in 52%. Most patients (94.7%) reported several symptoms. Fatigue, post-exertional malaise, dizziness, nausea, headache, and concentration difficulties were the most common. Seronegative children had a higher number of individual symptoms. School absence and drop-out from leisure activities was substantial in both groups with higher numbers for the seronegative group. Self-reported health was low in both groups. CONCLUSION: Children attending a specialist paediatric long COVID clinic experienced multiple symptoms and poor self-reported health. The symptomatology was similar regardless of serological status, implying multifactorial causes. A multidisciplinary assessment of this cohort was essential considering the broad spectrum of symptoms displayed and their substantial impact on everyday functioning
Psychological distress, skipped meals, and insufficient sleep, and the occurrence of back pain in adolescent female soccer players : The Karolinska football Injury Cohort study
No full textBACKGROUND: There is growing awareness that back pain in adolescent soccer (European football) players is not always related to local tissue damage. Approaches taking into consideration lifestyle factors are needed. This study aimed to investigate the association between psychological distress, skipped meals, and insufficient sleep, and the occurrence of back pain among adolescent female soccer players. HYPOTHESIS: Psychological distress, skipped meals, and insufficient sleep are associated with the occurrence of back pain. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: Swedish adolescent female soccer players aged 12 to 17 years, without back pain at baseline, were included. The exposures psychological distress, skipped meals, and insufficient sleep were assessed at baseline. The players were followed for 1 year with a weekly web-based survey, where back pain intensity was measured on a numeric rating scale (NRS) ranging from 0 to 10. The outcome back pain was defined as reporting low back pain and/or upper back/neck pain intensity of ≥4 on the NRS. Multivariable Cox proportional hazard regression analyses were performed to estimate the hazard rate ratio (HRR) with 95% CI for the association between each exposure and the outcome back pain, adjusted for age at baseline and parents' education. RESULTS: In total, 351 players were included, and 141 players reported back pain at some point during the 1-year follow-up. The adjusted HRR for back pain was 1.79 (95% CI, 1.11-2.91) for insufficient sleep, 1.45 (95% CI, 0.97-2.17) for psychological distress, and 0.98 (95% CI, 0.61-1.59) for skipped meals. CONCLUSION: Insufficient sleep and psychological distress are associated with the occurrence of back pain among female adolescent soccer players. CLINICAL RELEVANCE: Our results contribute to the understanding of what may influence the occurrence of back pain in adolescence, offering potential strategies for the prevention of back pain in adolescent female soccer players
Patients' experience of care relationship in the prehospital emergency care : A litterature review
No full textBakgrund: Alla patienter har rätt till en högkvalitativ vård med hög patientsäkerhet. Vårdrelationen är inom omvårdnadsforskningen kärnan i vårdandet och en nödvändig utgångspunkt för att kunna utföra omvårdnad. En god vårdrelation kan leda till att patienten blir mer delaktig i sin vård och får möjligheten att kunna ta adekvata beslut som främjar den egna hälsan. När en obalans uppstår i vårdrelationen försvårar det patientens möjlighet att vara delaktig i sin vård. I den prehospitala akutsjukvården är vårdrelationen en central del i mötet mellan ambulanspersonalen och patienten. Det bidrar till en helhetsbild av patienten och dess medicinska behov varvid korrekta bedömningar baserade på adekvat information ger en högkvalitativ vård med hög patientsäkerhet. Syfte: Syftet med studien var att beskriva patientens upplevelse av vårdrelationen i mötet med ambulanspersonalen. Metod: Metoden som användes var en icke-systematisk litteraturöversikt med en integrerad analys. Sexton artiklar inkluderades och kvalitetsgranskades, varav 15 var kvalitativa och en var av kvantitativ metod. Resultat: Två kategorier och fem underkategorier identifierades. Kategorierna var; ambulanspersonalens förmåga att skapa möten utifrån patientens bästa, samt upplevelsen av att vara sedd av ambulanspersonalen. Resultatet visar på positiva och negativa konsekvenser i vårdrelationen baserat på hur patienten blivit bemött av ambulanspersonalen. Patienterna påtalade att det var viktigt att ambulanspersonalen visade ett respektfullt bemötande, förutsåg patienternas behov samt att personalen var pålästa för att kunna skapa en bra vårdrelation. Information var en viktig del under mötet vilket skapade ökad delaktighet som gynnade omvårdnaden. Slutsats: Vårdrelationen upplevs olika för alla individer. Patienterna upplever ett behov av att bli respekterade och utan detta skapades en misstro till ambulanspersonalen. Vårdrelationen med ambulanspersonalen färgar vårdrelationerna i den fortsatta vårdkedjan. Sammanfattningsvis kan detta arbete främja ambulanspersonalens arbete med vårdrelationer för att förbättra patientsäkerhetsarbetet och skapa trygga och respektfulla patientmöten. Background: All patients have a right to high-quality care with high patient safety. In nursing research, caring relationships are the core of caring and a necessary starting point to be able to carry out care. A good care relationship can lead to the patient becoming involved in their care and making decisions that promote their health. When there is an imbalance in the care relationship, the patient’s participation is hindered. In pre-hospital emergency care, the care relationship is a central part of the meeting between the ambulance staff and the patient. It contributes to the overall picture of the patient being seen, correct assessments are carried out based on correct information, which can contribute to high-quality care with high patient safety. Aim: The aim of the study was to describe the patient’s experience of the care relationship in the encounter with the ambulance staff. Method: The method used was a nonsystematic literature review with an integrated analysis. Sixteen articles were included after data collection and quality review and of these 15 were qualitative and one quantitative method. Results: Two categories with five subcategories were identified. The categories were; ambulance staff ability to create encounters based on the patients' best interest, and the experience of being seen by the ambulance staff. The result shows positive and negative consequences in the care relationship based on how the patient was treated by the ambulance staff. The patients stated it was important that the ambulance staff showed a respectful attitude, anticipated the patients’ needs and that the staff were well-educated in order to create a good care relationship. The patients also felt that it was important to receive information during the care and that the patients wanted to be involved in the decisions that affected the care. Conclusion: The care relationship is experienced differently for all individuals. The patients feel a need to be respected and without this a distrust of the staff was created. The care relationship with the ambulance staff colors the care relationships in the continuing care chain. In summary, this work can promote the ambulance staff’s work with care relationships to improve patient safety work and create safe and respectful patient encounters.
Midwifery care in The Gambia : A focus group study with clinical midwives, midwifery students, educators and leaders on how barriers and facilitators impact quality midwifery care
No full textOBJECTIVE: The aim of this study is to explore the impact of barriers and facilitators on the quality of midwifery care in The Gambia, from the perspectives of clinical midwives, midwifery students, educators, and leaders. METHODS: A qualitative study based on focus group discussions with 29 clinical midwives, midwifery students, educators and leaders analysed with content analysis. The study was conducted in The Gambia. RESULTS: The analyses led to three main categories outlining barriers and facilitators for the quality of midwifery care: 1) the gap between theory and practice, 2) working in a harsh environment and 3) facilitating factors that can pave ways forward. The results are described in generic categories: 1a) national plans and facility-based guidelines, 1b) midwifery education, 1c) becoming a skilled midwife, 2a) scarcity of resources, 2b) encountering community barriers, 2c) midwives - a passionate but demotivated profession, 3a) positive assets for quality midwifery care, 3b) women in leadership as a tool for a motivated midwifery workforce and 3c) teamwork. CONCLUSIONS: Addressing the gaps between theory and practice, and strengthening the incentives for midwives to remain in their profession are central for improved quality of midwifery care in The Gambia. Guaranteed employment after completing education, equal opportunities for men and women to become midwives and the significance of passion are assets which need to be carefully maintained within the health care system