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Biomedical subjects

B Fridlund

Publications and source records attributed to B Fridlund.

At least 55 records · Page 3Linked to original sources

Effects of extended preoperative information on perioperative stress: an anaesthetic nurse intervention for patients with breast cancer and total hip replacement.

An anaesthetic nurse intervention was performed in order to evaluate the effects of extended preoperative information, given by anaesthetic nurses, on perioperative stress in patients operated on for breast cancer or total hip replacement (THR). Forty-six consecutive patients scheduled for surgery for breast cancer, and 55 for THR, were randomized into two groups which were given different modes of preoperative information. Patients in the control group were informed about pre- and postoperative routines by a ward nurse. Patients in the intervention group were given extended formalized information by an anaesthetic nurse. Wilcoxon rank sum test was used to show relations between variables. There were no significant differences between the intervention group and control group for patients with breast cancer or for patients with THR. Breast cancer patients in the intervention group were significantly more anxious than THR patients in the intervention group (P < 0.01). Breast cancer patients in the intervention group showed the highest anxiety scores on the Hospital Anxiety and Depression Scale (HADS) scale on the day of surgery. This information may reflect an increased level of anxiety due to the extended information given preoperatively. The information may thus have had a negative effect on breast cancer patients, resulting in an increased state of anxiety. The result indicates a need for individualized modes of information to provide a proper balance between enough and too much information.

Aged↗

Female patients with congestive heart failure: how they conceive their life situation.

Congestive heart failure (CHF) is a significant health problem for women, particularly elderly women. The risk factors for heart failure appear to be different in women than in men, with hypertension and diabetes playing a greater role in women and ischaemic heart disease a greater role in men. The aim of this study was to describe, from a nurse's perspective, how female patients with CHF conceive their life situation. Interview questions were designed with a focus on five dimensions: biophysical, socio-cultural, emotional, intellectual and spiritual-existential. A qualitative method was used with a phenomenographic approach, as this approach examines aspects of the surroundings as they are conceived. Five categories emerged in the results: feeling content, feeling a sense of support, feeling a sense of limitation, feeling anxiety and feeling powerless. A sense of limitation regarding working capacity and being able to support those in their surroundings causes patients with CHF to experience anxiety due to feeling insecure about themselves and in relation to their surroundings. This may result in feelings of worthlessness in women with CHF, both concerning their own capacity and the fact that they feel they are a burden to those around them. Through nursing intervention, these patients can receive help to break this vicious circle of feeling limited and powerless. This can be done by encouraging them to verbalize their feelings and set realistic goals and expectations, and by increasing their knowledge and that of their families concerning CHF and its symptoms, with a focus on self-care and existing possibilities. These measures will make it easier for women with CHF to maintain a hopeful perspective and a sense of control, competence, and self-esteem.

Adaptation, Psychological↗

Male patients with congestive heart failure and their conception of the life situation.

Patients with congestive heart failure (CHF) are an extensive group in Sweden both with regard to prevalence and number of medical care events. As the age of the population and survival after myocardial infarction are increasing, the incidence of CHF is also on the rise. The aim of this study is to describe, from a nurse's perspective, how male patients with CHF conceive their life situation. Interview questions were designed with a focus on five dimensions: the biophysical, the sociocultural, the emotional, the intellectual, and the spiritual-existential. A qualitative method was used with a phenomenographic approach as it examines aspects of the surroundings as conceived. In the results, six categories emerged: feeling a belief in the future, gaining awareness, feeling support from the environment, feeling limitation, feeling a lack of energy and feeling resignation. The mental and physical lack of energy which patients feel easily leads to limited working capacity and social activities. This limitation may cause patients with CHF to believe that neither they nor their environment can influence their life situation and there is a risk that these patients become resigned. In order to help them get out of this vicious circle of limitation and resignation, it is important that the nurse teaches them self-care and shows them the possibilities that exist in everyday life. With increased awareness of their life situation, patients may adapt to their CHF and see that it is possible to improve their future themselves.

Activities of Daily Living↗

Survey of post-operative patients' pain management.

Although effective pain treatment is available for both cancer-related pain and acute post-operative pain, many patients suffer unnecessarily. The aim of this study was to evaluate post-operative patients' pain management. A descriptive survey study was conducted in a 460-bed acute hospital in the southwestern part of Sweden. One hundred post-operative inpatients, on their second post-operative day, took part in the study. They were consecutively selected from six surgical wards. Data were collected using an interview questionnaire designed by the American Pain Society and analysed by descriptive and inferential statistics. At the time of the interview, 29 of the patients reported moderate to severe pain. Regarding the patients' worst pain experienced during the last 24 h, 79 of them reported moderate to very severe pain. Significant correlations were found between reported poor pain relief after pain medication and high intensity of pain both within the last 24 h and at the time of the interview. Eighty-three patients were satisfied with the way nurses treated their pain, while 64 patients were satisfied with the way physicians treated their pain. However, the higher the pain intensity experienced by the patients the less satisfied they were. The fact that patients do not know what kinds of relief are available may be one reason for the patients expressing satisfaction despite being in pain, another that the patients judge the kindness of the staff rather than their way of treating the pain. The field of pain management is rapidly changing requiring professional knowledge and experience in order to ensure pain management of good quality.

Adult↗

The case study as a research strategy.

A research strategy seldom used in the caring sciences is the case study. A case study is an empirical in-depth inquiry about an individual, family, group or organization. It is preferable when 'how' and 'why' questions are asked. The case study is mainly used to explain those causal links in real-life intervention that are too complex for either the survey or experimental strategies. Like other research strategies, its design includes questions or propositions, units of analysis, the logic linking the data to the questions or propositions, and the interpretations of the outcomes. A case study can be reported as a single case or as a compilation of a series of cases. In conclusion, a case study is a simple and excellent way for a care professional to present him or herself to the scientific world.

Humans↗

Elderly persons' social network and need for social support after their first myocardial infarction.

Social network and social support are phenomena suggested to be of importance to successful recovery from myocardial infarction. However, very few studies have been carried out, especially among the elderly, focusing on their social network and its ability to provide adequate support after myocardial infarction. The aim of this study was to examine elderly persons' social network and need for social support three months after their first myocardial infarction. The sample consisted of 128 persons between 65 and 94 years of age who answered a questionnaire. The results showed that the subjects, even the oldest ones, had an available social network and that they were satisfied with the support it provided. There was an increased need for social support after the myocardial infarction, especially for emotional support and appraisal, but also for instrumental aid and information. Despite these positive results indicating that elderly persons with myocardial infarction have a social network, whose members provide them with support, there may be a need for support also from persons outside this network. Assessment of social network characteristics and the need for social support as well as the provision of adequate information about additional support networks are important tasks for all health professionals.

Adaptation, Psychological↗

Urinary incontinence among a 65-year old Swedish population: medical history and psychosocial consequences.

Urinary incontinence (UI) is a disability caused by an impairment, which can lead to a handicap of importance for nursing care. This means that UI is not only a practical-medical concern but also a socio-economic problem. The purpose of the study was to determine the prevalence of UI among 65 year-olds in a Swedish Health Care District and to compare gender differences concerning medical history and psychosocial consequences. In a Primary Health Care District, a questionnaire pertaining to UI was mailed to all women and men 65 years of age (N = 458). A total of 91% (n = 419) was sufficient for data analysis, which was performed by descriptive and inferential statistics. It was found that 28% (n = 61) of the women and 9% (n = 21) of the men were afflicted with UI. Women reported significantly more urge incontinence (p < .05) as well as stress incontinence (p < .05). Information from the health service about UI had been given to 46% (n = 28) of the women and 33% (n = 7) of the men. The strongest reason reported, both in women (42%, n = 26) and men (40%, n = 8), for not seeking help from the health service was that UI was a normal condition for people of their age. Most of the women had to urinate at least twice per night (42%) compared to once per night (44%) for the men. It is important to establish a UI clinic at every main Primary Health Care Centre which builds on nursing care and whose aim is to inform the general public that UI is a common problem, that it leads to psychosocial consequences, and that the health service can offer active rehabilitation interventions.

Aged↗

Urinary incontinence among a 65-year old Swedish population: medical history and psychosocial consequences.

Urinary incontinence (UI) is a disability caused by an impairment, which can lead to a handicap of importance for nursing care. This means that UI is not only a practical-medical concern but also a socio-economic problem. The purpose of the study was to determine the prevalence of UI among 65 year-olds in a Swedish Health Care District and to compare gender differences concerning medical history and psychosocial consequences. In a Primary Health Care District, a questionnaire pertaining to UI was mailed to all women and men 65 years of age (N = 458). A total of 91% (n = 419) was sufficient for data analysis, which was performed by descriptive and inferential statistics. It was found that 28% (n = 61) of the women and 9% (n = 21) of the men were afflicted with UI. Women reported significantly more urge incontinence (p < .05) as well as stress incontinence (p < .05). Information from the health service about UI had been given to 46% (n = 28) of the women and 33% (n = 7) of the men. The strongest reason reported, both in women (42%, n = 26) and men (40%, n = 8), for not seeking help from the health service was that UI was a normal condition for people of their age. Most of the women had to urinate at least twice per night (42%) compared to once per night (44%) for the men. It is important to establish a UI clinic at every main Primary Health Care Centre which builds on nursing care and whose aim is to inform the general public that UI is a common problem, that it leads to psychosocial consequences, and that the health service can offer active rehabilitation interventions.

Aged↗

Patients' conceptions of their life situation within the first week after a stroke event: a qualitative analysis.

The aim of this study was to find out how stroke patients conceived their life situation within the first week of the acute care phase as seen from the nurses' viewpoint. Six patients were interviewed within 3 weeks from their first stroke, using questions based on a holistic philosophy and analysed with the phenomonographic approach. Two main categories emerged from the results: the feeling of unreality and the awareness of a changed role in life, together with six subcategories; feeling of a changed perception of the body; feeling of being confused; loss of capability; awareness of confined life space; the importance of support and encouragement; and the will to look for new opportunities. The study concludes that the body change resulting from a stroke leads to both physical and psychological trauma, in which the psychological crisis can be very deep and best described as a personal catastrophe. The patient's capability to receive and understand information becomes blocked, which influences both the nurse and the patient's next of kin with regard to their care of the patient. Conversations with the patient must be frequent so that the acute care can be evaluated and agreement reached between the patient's wishes and the nurses' objectives. The results indicate the significance of intervention programmes based on crisis theory within the first week of a stroke event.

Acute Disease↗

Long-term effects of a comprehensive rehabilitation programme after myocardial infarction.

The aim of this study was to determine the long-term effects on myocardial infarction (MI) patients of a six-month comprehensive rehabilitation programme (CRP) conducted by an interdisciplinary team regarding cardiac events, physical and psychological conditions, life habits, and cardiac health knowledge. The results of a multivariate analysis carried out five years after the MI showed that cardiac events and psychological condition were not significantly influenced by the CRP. However, it was found that the physical condition of the patients benefited from the CRP; self-reported physical fitness (p < 0.002) and physical exercise test (p < 0.007). CRP participation was linked to significant modifications of life habits (diet change; p < 0.04, sexual activity; p < 0.000). The cardiac health knowledge was significantly improved by participation in the CRP (basic cardiac knowledge; p < 0.005; knowledge about misconceptions; p < 0.04). In conclusion, CRPs have had positive long-term effects on physical condition, life habits and cardiac health knowledge. No such effects, however, were found regarding either cardiac events or psychological condition.

Female↗

Young adults' views on dental care--a qualitative analysis.

The aim of the present study was to determine young adults' views on dental care. The gathered data were gleaned from interviews and analysed in accordance with comparative method. It was possible to discern the views from two perspectives: the patients' opinions regarding costs in relation to given functions within dental care, and the attitudes to given functions in dental care per se. Costs for information and service were deemed questionable, whereas the costs for examination and treatment were accepted. The patients' stance was active with respect to information and treatment, whereas a greater degree of passivity prevailed within the areas of examination and service. According to this report, maintaining cheap dental care rates was deemed important. The patients questioned having to pay for information perceived as irrelevant to dental care. They expressed a hidden wish to assume an active role while being given more information, and to exercise greater influence with reference to own dental care, but were not in the habit of stating their views to dental staff. Thus, continuous patient satisfaction studies are vital in order to meet this group's needs. One suggestion for further research is to study how young adults regard dental care based on the theory presented.

Adult↗

Social support in self-help groups, as experienced by persons having coronary heart disease and their next of kin.

Self-help groups related to coronary heart disease constitute a network for support in which the members of the group have the opportunity both to receive and provide social support. The purpose of this study was to reach in-depth information from group members about lived experience of social support in a self-help group. A qualitative research method influenced by phenomenology was used and the findings showed a pattern of social support that can be described as a sharing of experience among confident equals, thanks to mutual feelings of caring and belonging, which in turn strengthens confidence. The group members' experience of social support show that the group constitutes a cornerstone in a network for support and contributes to well-being, coping ability and a build up of confidence at the prospect of a more promising future.

Adaptation, Psychological↗

Loving care in the ambulance service.

The ambulance service should offer good care signified by humane and individual treatment of the patients, based on love to our fellow man. The aim of this study was to find out how loving care was practised in one ambulance service. The method for the study was the critical incident technique. Twelve paramedics, the majority of whom are qualified nurses, took part in the study; they were asked to describe, in writing, critical incidents in which they had acted with loving care. The paramedics' writings disclosed their ability to do their job with loving care, bearing on their cognizance, solicitude and empathy. On the whole, subject cognizance, the ability to judge and treat based upon the monitored symptoms of the patients, was apparent. In the main, subject solicitude loving care was shown through humbleness, consideration, closeness and being in rapport, and generally subject empathy, the paramedic's empathic capacity and his knowledge about man's behaviour in a crisis, became evident. From a clinical standpoint the study shows the importance of the paramedics possessing professional skill. As a contribution to science the study adds to continued research based upon descriptions made by other groups of personnel about the phenomenon to be studied; namely, loving care.

Adult↗

Cardiac nurses' preparedness to use self-help groups as a support strategy.

Self-help groups are lay, mutual support groups in which people who share some long-term existential problems in their lives meet regularly to support each other empathetically. These groups can be viewed as supplementary sources of support outside patients' existing social networks. As such, it is of importance to be aware of them when planning nursing care. The aim of this study was to examine cardiac nurses' preparedness to use self-help groups as a support strategy. A qualitative research method was used and 12 registered nurses from two coronary care units were interviewed. The findings showed that nurses knowledge of social support, self-help groups and of patients' social circumstances as well as their attitudes to their own roles as nurses were of importance in their preparedness to use self-help groups as a support strategy. Lack of knowledge of social support and self-help groups affected the nurses' attitudes towards lay care and was probably the reason for not using self-help groups as a support strategy. Most of the nurses were well informed about their patients' social circumstances, they had an explicit family nursing approach and were not at all against further expansion of their nursing role. However, there is a need for education in innovative ways of working that respond to and interact with informal support networks if nurses are to be able to contribute to empowerment of their patients.

Adult↗

The nurse in clinical practice--a qualitative analysis of nursing competence.

Swedish colleges and universities are now adapting their syllabuses to the new open European labour market. In this respect the syllabus for training of nurses is to be reorganized. Thinking in terms of health will be very important in the training program and will require practical experience of nursing. The aim of this study was to examine the demands made on competent nurses working in clinical practice. An open question was asked and the results were analysed by the constant comparative method. The 23 nurses interviewed had to answer the question: "What do you require of a competent nurse?" From the empirical data, characteristics of six different ideal types were described. A competent nurse has the ability--to create a good atmosphere; concentrate on the patient and always to have an ethical and humanitarian approach; to teach and instruct; to organize, make priorities, cooperate and make documentations; to use her theoretical knowledge and be able to put it to use; to be keen on development and change. The study showed that a competent nurse has a wide field of knowledge, but also highlighted the complex of the nursing profession. If the nursing student can acquire these skills she will be well prepared for her central role in clinical practice.

Adult↗

Health benefits from a layman intervention in the primary health care.

In order to make a necessary life-style change, it is of the utmost importance that a sound motivation is created and the best help a person can get in the process of change is social support. The aim of this study was to locate people having physical symptoms of ill-being and to evaluate the work of a primary prevention programme, especially with regard to health benefits. The sample for the study was made up of 134 consecutive patients who went to see a health care professional because they had subjective complaints. The patients were offered a keep-fit exercise programme, i.e. a layman intervention of an educative-supportive nature, which consisted of ten assignments in a fitness club. The assignments comprised both physical exercise and psychosocial instructions. Two self-rated questionnaires were to be filled in; one at the beginning of the intervention and the other 1 year after its completion. Demographic data focused the attention on a female, manual, middle-aged worker, having symptoms bearing on the musculoskeletal system. The intervention definitely affected the life-style, thus favourably changing physical, psychosocial, and behavioural variables (e.g. increased physical well-being t-test: P < 0.001; decreased stress, t-test: P < 0.001; increased physical events, t-test: P < 0.01). In plain language, the use of the said intervention can result in the patients taking less time on sick-relief. Therefore, if many more people could be encouraged to take part in intervention programmes, the national medical cost would most likely be reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗