Publikationer från Sophiahemmets Högskola
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Disruptive and supportive factors in elderly people living with chronic pain : A literature review
No full textBakgrund Långvarig smärta är en individuell och komplex upplevelse, vanlig bland äldre personer. Smärta och dess intensitet kan påverkas av biologiska, psykologiska och sociala faktorer. Långvarig smärta hos äldre kan orsaka nedsatt livskvalitet, öka psykisk ohälsa och behov av vård. Bristande förståelse av smärtans osynlighet och stigmatisering kan försämra vården. Syfte Syftet med denna litteraturöversikt var att belysa äldre personers upplevelse av hindrande och stödjande faktorer vid långvarig smärta. Metod Denna icke - systematisk litteraturöversikt innehåller 15 vetenskapliga, kvalitativa och kvantitativa artiklar. Artiklar söktes i databaserna PubMed och CINAHL, samt manuell sökning anpassades, enligt relevanta sökningsord och uppställda urvalskriterier. Artiklarnas kvalitet granskades enligt Sophiahemmet Högskolas bedömningsunderlag och analyserades med integrerad analysmetod. Resultat Den här studien undersökte vilka faktorer som äldre personer med långvarig smärta upplever som stödjande respektive hindrande. Resultaten visade att långvarig smärta påverkar deras fysiska förmåga, psykiska hälsa och sociala liv. Personcentrerad vård, regelbunden fysisk aktivitet, fungerande copingstrategier för att hantera smärta samt socialt stöd kan bidra till att minska besvären av långvarig smärta. Slutsats Forskning i denna studie upptäckte att långvarig smärta hos äldre personer kan negativt påverka fysisk och psykisk hälsa som försämrar livskvalitet. Stödjande faktorer som aktiv coping, individanpassad vård och socialt stöd är centrala och kan hjälpa till att bidra till välbefinnande och hantera långvarig smärta hos äldre personer. Ett personcentrerat förhållningssätt och helhetssyn som inkluderar fysisk, psykisk, social och andlig hälsa rekommenderas i vården.Background The intensity and perception of pain can be influenced by biological, psychological, and social factors. In older individuals, chronic pain can lead to reduced quality of life, increased mental health issues, and a greater need for care. A lack of understanding about the invisible nature of pain, along with stigma, can worsen the care provided to older adults suffering from chronic pain. Aim The aim of this literature review was to highlight the barriers and supportive factors that affect older adults' ability to live with chronic pain. Method This non-systematic literature review includes 15 scientific articles, both qualitative and quantitative. The articles were retrieved from the databases PubMed and CINAHL, and supplemented by a manual search, using relevant keywords and predefined inclusion criteria. The quality of the articles was assessed using the evaluation framework of Sophiahemmets University, and the data were analysed using an integrated analysis method. Results This study investigated which factors older people with chronic pain experience as supportive and hindering. The results showed that chronic pain affects their physical ability, mental health and social life. Person - centred care, regular physical activity, effective pain management strategies and social support can help reduce the burden of chronic pain. Conclusions The research in this study found that chronic pain in older adults can negatively impact both physical and mental health, leading to a reduced quality of life. Supportive factors such as active coping, individualized care, and social support are key elements that can help promote well-being and aid in managing chronic pain in older adults. A person-centred approach and a holistic perspective, including physical, psychological, social, and spiritual health - are recommended in healthcare
Confidential conversations in palliative care : An ethnographic exploration of trust and interpersonal relationship between nurse and patient
No full textAIM: To explore aspects of interpersonal relationships in palliative care nursing, focusing on confidential conversations between patients and registered nurses (RN). DESIGN: A qualitative study employing focused ethnography. METHODS: Data were collected through unstructured participant observations, field notes and interviews with patients and RN in specialist palliative care. Data were analysed using reflective thematic analysis. FINDINGS: Confidential conversations in palliative care are founded on trust that is fragile and develops dynamically through consistent interactions. Small talk, presence and silence are essential for initiating and maintaining trust and the interpersonal relationship. The environment, patient condition and RN emotional presence and competence shape these conversations. As the relationship evolves, conversations adapt to the patient's changing needs. Missed signals or interruptions can disrupt flow, but the potential for repair remains, allowing for restoration and strengthening of trust and connection. CONCLUSION: Confidential conversations in palliative care are grounded in fragile, dynamic trust, necessitating ongoing presence, sensitivity and adaptability from RN. To support these interactions, healthcare environments must prioritise privacy, relational continuity and communication training. Future research should investigate how organisational structures and clinical settings influence confidential conversations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Healthcare environments should facilitate confidential conversations by ensuring relational continuity and minimising distractions. Communication training that emphasises presence and management of silence can strengthen nurse-patient relationships, enhancing patient care and emotional support. IMPACT: This study explores key aspects of confidential conversations in palliative care, emphasising trust and emotional sensitivity. It addresses a research gap in palliative care using rare observational methods to deepen understanding of nursing relational aspects. The findings offer practical guidance for enhancing communication and relational skills, informing training and policy development and ultimately, improving emotional support and care. REPORTING METHOD: Findings are reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. PATIENT OR PUBLIC CONTRIBUTION: This study did not involve patient or public participation in its design, conduct or reporting
Facilitating research participation through a research navigator programme : Researchers' insights from a project with asylum seekers and refugees
No full textBACKGROUND: Underrepresentation of vulnerable populations, such as asylum seekers and refugees, remains a persistent challenge in health research, often due to barriers such as limited access, mistrust, and logistical constraints. The study explored researchers' experiences of using community-based research navigators to facilitate participation among asylum seekers and refugees in a research project conducted in Sweden. METHODS: A descriptive qualitative design was employed, involving eight in-depth interviews with four researchers before and after implementing the community-based research navigator programme. The community-based research navigator programme recruited volunteers from the target population, including Syrian, Eritrean, and Somalian refugees and asylum seekers to support participation in the research project, in Sweden. Data were analysed using reflexive thematic analysis guided by Braun and Clarke's six-phase framework. RESULTS: The researchers experienced the community-based research navigators as a 'critical enabler of participant recruitment and recognition', while expressed 'complexities of intergroup relationships and logistics' which are the two main themes of the results. Navigators' meaningful engagement and recognition and community-based language concordance as a trust builder are the two subthemes of critical enabler of participant recruitment. Complexities of intergroup relationships and logistics is manifested in three subthemes of power dynamics, communication and relational challenges and logistic challenges. CONCLUSION: The community-based research navigator programme showed to be a valuable yet complex strategy for facilitating research participation among asylum seekers and refugees, according to the participating researchers. It also may involve ethical and logistical challenges that require careful planning and sensitive implementation. Tailored training, culture-sensitive approaches, and recognition of intergroup dynamics are essential for enhancing the similar programme's effectiveness. This approach holds promise for improving inclusivity and equity in health research involving hard-to-reach populations, such as asylum-seekers and refugees
Eye-tracking metrics to compare visual attention in prosthodontic preclinical evaluations
No full textAIM: The study aimed to evaluate gaze behavior during tooth preparation assessments by analyzing and comparing eye-tracking metrics between novice and expert groups. METHODS: Thirty-five participants, divided into novices (n = 18, mean age = 22.9 ± 1.5 years) and experts (n = 17, mean age = 44.3 ± 13.1 years), were recruited for this observational study. The novice group consisted of third-year dental students, while the expert group comprised licensed dentists with an average of 18.9 ± 12.7 years of clinical experience. Eye-tracking metrics, including total duration of fixation (TDF), number of fixations (NF), time to first fixation (TFF), and pupil size, were measured across different areas of interest (AOIs). The data was analyzed with a two-way repeated measures analysis of variance (ANOVA) model. RESULTS: Both novices and experts focused mainly on the "buccal wall" and "margin" (finishing line) AOIs during tooth preparation evaluation. The novices showed significantly longer TDF (P = 0.034), more NF (P = 0.047), and longer TFF (P = 0.021) compared to experts. However, there were no significant differences in pupil diameter between groups or AOIs, indicating similar cognitive load despite differences in visual behavior. CONCLUSION: Overall, the novices tend to have longer fixation durations, more frequent fixations, and a delayed time to first fixation compared to experts during tooth preparation assessments. The study also concludes that both novices and experts primarily focus on the buccal wall and finishing line. These differences indicate that visual processing varies between the two groups, with novices demonstrating less efficient visual processing skills. In general, the findings highlight how experience influences gaze behavior in the assessment of tooth preparation. CLINICAL SIGNIFICANCE: These findings can refine pre-clinical prosthodontic education by fostering expert-like visual processing skills, enabling students to better understand and perform prosthodontic tasks. This targeted approach enhances their training and prepares them more effectively for clinical practice
Intended and experienced literacy practices in a Swedish undergraduate nursing education
No full textINTRODUCTION: Academic literacy in higher education has been widely studied, but less attention has been given to literacy practices within professional programmes such as nursing education. This study aimed to analyze one Swedish undergraduate nursing programme regarding the presence of academic and professional literacy, and secondarily to explore students' note-taking as a component of literacy practices. METHODS: The study employed a descriptive and exploratory design, analyzing curriculum documents and surveying nursing students. An analysis of the intended curriculum (course syllabi) of a three-year undergraduate nursing programme at Karolinska Institutet was conducted to identify explicit and implicit literacy components. A digital questionnaire focusing on note-taking practices was distributed to second-semester students (n = 67; response rate 40%). Closed questions were analyzed using descriptive statistics, while open-ended responses underwent qualitative content analysis. RESULTS: The curriculum analysis demonstrated that academic literacy was primarily addressed through scientific writing, group projects, and thesis work, particularly in the first two and final two semesters. Professional literacy was integrated across all semesters and included communication with patients, families, and interprofessional teams, documentation, and interpretation of professional texts. Surveyed students reported frequent note-taking, primarily during lectures and prior to examinations, using both pen and paper and digital devices, with a preference for pen and paper. Qualitative data indicated that students use note-taking mainly to support memorization, understanding, and exam preparation, with limited focus on professional literacy needs. CONCLUSION: The nursing curriculum integrates both academic and professional literacy practices, although with different emphases across the study period. Students' current note-taking practices are predominantly academically oriented. These findings highlight the need for more explicit integration and scaffolding of both academic and professional literacy throughout nursing education to better prepare students for their future professional roles, i.e., for clinical communication, documentation, and interprofessional collaboration essential to safe and effective patient care
Decision-making for older patients in acute prehospital situations : A scoping review
No full textBACKGROUND: Shared decision-making aims to ensure that healthcare professionals and patients jointly make decisions regarding the patient's care. However, professionals often find it challenging to implement shared decision-making with older patients who have cognitive impairments or diminished decision-making capacity. Research indicates a significant gap in the understanding of how decision-making processes unfold in prehospital settings. AIM: The objective of this scoping review was to explore how decision-making involving older patients in acute prehospital situations is characterized. DESIGN AND METHOD: This scoping review is based on the Joanna Briggs Institute's guidelines for scoping reviews and is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR). DATA SOURCES: CINAHL, PubMed, Scopus, PsychINFO and Web of Science were searched to identify relevant studies published between the years 2000 and 2024. RESULTS: The results are based on 26 studies and indicate that decision-making among older patients is a conditional process, characterised by collaborative support involving the patient, significant others and healthcare professionals. Barriers to this process include hierarchical dynamics, fear of reprisals and uncertainty regarding the risk-benefit ratio. Factors that support decision-making include situationally relevant competence, organisational resources and the presence of specific symptoms and signs. CONCLUSION: Shared decision-making with older patients in acute prehospital settings is conditional, often resulting in decisions being made primarily by healthcare professionals. There is considerable room for improvement in how this process is systematically approached. A structured approach is needed-one that assesses the older patient's decision-making capacity, considers the perspectives of family members, and incorporates input from individuals who know the patient well, all while minimizing hierarchical barriers
Healthcare professionals and integration : Supporting a sustainable Swedish society
No full textThis essay examines the essential role of healthcare professionals, particularly nurses, in supporting the integration of immigrants and refugees into Swedish society. In response to global displacement caused by conflict, persecution, and climate crises, Sweden has welcomed large numbers of asylum seekers, prompting the need for sustainable integration strategies. The essay argues that health is foundational to integration, enabling individuals to participate in education, employment, and community life. It highlights the mental health challenges faced by newcomers, including trauma, depression, and social isolation, and emphasizes the importance of culturally sensitive, trauma-informed care. Nurses are uniquely positioned to act as caregivers, educators, advocates, and cultural mediators, helping bridge gaps between individuals and healthcare systems. Their work aligns with the United Nations Sustainable Development Goals, particularly those related to health, education, and reduced inequalities. The essay also addresses systemic barriers such as resource constraints, institutional inertia, and gaps in professional training that hinder effective integration. It calls for a shared societal responsibility across healthcare, education, and policy sectors to foster inclusive environments. By embedding sustainability and cultural competence into nursing education and practice, Sweden can strengthen its capacity to support displaced populations and build a more equitable, resilient, and cohesive society for all
Health aspects and lifestyle of licensed manual therapists during the COVID-19 pandemic in Sweden : The CAMP cohort study
No full textBackground: This study assessed health and change in lifestyle factors in Swedish manual therapists during one year of the COVID-19 pandemic, and potential differences with regards to age, sex, and business constellation. Further, therapists' strategies for health promotion during the pandemic were explored. Methods: In this cohort study, 816 clinically active manual therapists were followed with web-based surveys during a year of the COVID-19 pandemic in Sweden, measuring physical activity, sedentary time, COVID-19-related worries, maladaptive coping, alcohol and tobacco consumption. Health promotion and impact of the pandemic on physical and mental health were explored in free text questions. Generalized estimating equations were conducted to assess changes in sample averages over time, and qualitative content analysis was used to code and categorize free-text answers. Results: There was a decrease in physical activity and sedentary time increased as well as subjective mental health impact by the pandemic over one year. Maladaptive coping decreased during follow-up, and alcohol and tobacco consumption decreased in younger participants, and women, respectively. Participants stated that the pandemic affected their physical and mental health and reported using health promoting activities primarily targeting physical activity, nutrition, and sleep. Conclusion: Swedish manual therapists maintained good lifestyle habits except for a small decrease in physical activity and slight increase in sedentary behavior and subjective mental health impact by the pandemic over time. There were small differences in terms of maladaptive coping, alcohol consumption, and tobacco consumption, however, these differences were not likely clinically relevant. The therapists seemed conscientious regarding health promotion measures during one year of the COVID-19 pandemic.As manuscript in dissertation.</p
Implementing the Family Talk Intervention among families with a severely ill parent or child with palliative care needs : A longitudinal study of the perspectives of hospital social workers
No full textBACKGROUND: The Family Talk Intervention (FTI) is a psychosocial intervention supporting families where a family member has palliative care needs. This study aimed to evaluate how the Family Talk Intervention (FTI) was implemented over time from the perspective of hospital social workers (HSWs) in their everyday clinical practice among families with a severely ill parent or child in need of palliative care. METHODS: HSWs (n = 21) working in adult and children's care completed a 10-day education where they were trained to use FTI. The education was part of a multifaced implementation strategy involving educational outreach visits, facilitation, clinical implementation meetings, and audit and feedback. The HSWs were then expected to use FTI in their clinical practice to support families with dependent children. To assess if and how FTI was integrated into their daily practice, they were also asked to complete the Swedish version of the Normalization Process Theory Measure (S-NoMAD) on three occasions: on completion of the FTI-education, six months later, and one year later. For the longitudinal analysis of data, Friedman's test was used. RESULTS: The HSWs rated the use of FTI high after completing the FTI-education, indicating a positive attitude towards FTI. In the longitudinal analysis, statistically significant changes were seen for two questions in S-NoMAD, where the HSWs' ratings showed that the FTI became more familiar and normalized over time. Generally, the HSWs' ratings of S-NoMAD's main constructs were high and stable over time, indicating a positive view of FTI and its implementation. However, for the single questions, the ratings were slightly more negative to some contextual aspects, such as managerial support and resources. CONCLUSION: As results showed, HSW mainly rated different aspects of the implementation process as positive, both from the beginning, but also over time. Therefore, the intervention could be judged to have been implemented as a tool to support families when a parent or a child is severely ill. Contextual factors, involving managerial support and resources were rated lower, indicating the importance of those aspects when introducing interventions into healthcare. The result also indicates that the multifaced implementation strategy supported the HSW's everyday clinical practice. CLINICAL TRIAL REGISTRATION: clinicaltrials, nr, identifier (NCT05365919; 2022-03-04 and; NCT05020158 2021-05-11)
Chronic pain: people´s experiences of physical activity as treatment : A non-systematic literature review
No full textBakgrund Långvarig smärta är ett omfattande och komplext hälsoproblem som påverkar flera aspekter av individens liv, fysiskt, psykiskt och socialt. Detta hälsoproblem behandlas som bäst genom en kombination av icke-farmakologiska och farmakologiska insatser, multimodal behandling. Fysisk aktivitet som del av multimodala behandlingsprogram kan visa positiva effekter fysiologiskt och psykologiskt. Sjuksköterskan har en viktig roll i detta genom att stödja personer med långvarig smärta, främja hälsosamma levnadsvanor, ge råd och stärka patientens egen förmåga till egenvård. För att möjliggöra fysisk aktivitet som behandling behöver sjuksköterskan har god förståelse för patienters upplevelser av fysisk aktivitet i relation till sin smärta. Syfte Syftet med studien var att beskriva personers erfarenheter av att använda fysisk aktivitet som behandling vid långvarig smärta. Metod Den här studien använde sig av design i form av en icke-systematisk litteraturöversikt med ett systematiskt arbetssätt. Arbetet baserades på evidens från tio utvalda artiklar som följt det valda urvalet samt genomgått kvalitetsgranskning av författarna till det här arbetet. Insamlade data har analyserats och kategoriserats i huvud- och subkategorier utifrån en integrerad analys. Resultat Användning av fysisk aktivitet som behandling har visats ha god påverkan på smärtan såväl som på följder av smärtan. Fysisk aktivitet kan bidra till god effekt fysiskt, psykiskt och socialt. Personer med långvarig smärta kan uppleva det svårt att utföra fysisk aktivitet utifrån ett flertal identifierade barriärer såsom smärtans begränsning, praktiska och sociala hinder samt bristande motivation och kunskap. Det identifierades även faktorer som underlättade utförandet av fysisk aktivitet såsom socialt stöd, vilja och motivation samt hjälp och stöd från vårdgivare. Slutsats Personer med långvarig smärta beskriver goda erfarenheter av fysisk aktivitet som del av behandlingen. Patienter kan dock behöva stöd från sjuksköterskan då det finns barriärer som hindrar dem att utföra fysisk aktivitet. Background Chronic pain is a comprehensive and complex health problem that affects several aspects of the individual´s life, physically, psychologically, and socially. This health issue is best treated through a combination of pharmacological and non-pharmacological interventions, called a multimodal approach. Physical activity, as a treatment, has previously shown positive effects both physiologically and psychologically. Nurses play a vital role in supporting individuals with chronic pain by promoting healthy lifestyle habits, offering guidance, and strengthening the individual's capacity for self-care. To enable physical activity as a treatment, nurses require a thorough understanding of how patients experience physical activity in relation to their pain. Aim This study aimed to describe people's experiences of using physical activity as a treatment for chronic pain. Method The method used in this study is a non-systematic literature review with a systematic approach. This work is based on collected evidence from ten articles that have undergone quality control by the authors. The collected data has been analyzed and categorized into main and subcategories based on a model of integrated analysis. Results The use of physical activity as treatment for chronic pain has been shown to have a good impact on pain as well as on the consequences caused by the pain. Physical activity can have a positive effect on physical, mental, and social well-being. People with chronic pain may find it difficult to perform physical activity based on identified barriers, the limitations of pain, practical and social obstacles, and a lack of motivation and knowledge. Factors that facilitated physical activity performance were also identified, including social support, willingness, motivation, and help and support from caregivers. Conclusions People with chronic pain describe positive experiences of physical activity as part of their treatment.. However, patients may need support from the nurse as there are barriers that prevent them from engaging in physical activity.