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Biomedical subjects

E Hamrin

Publications and source records attributed to E Hamrin.

At least 19 recordsLinked to original sources
PubMed1998

Sense of coherence, quality of life, and function among elderly hip fracture patients.

The aim was to study whether sense of coherence (SOC) had any predictive power in patients with hip fractures regarding length of stay in hospital, state of confusion and health, functional ability, quality of life, and municipal home-help service. A total of 73 patients admitted from their own homes participated (mean age 80.4 years). The patients were followed during a 4-month period. Acute confusional state was diagnosed using a Swedish version of the NEECHAM Confusion Scale. SOC and self-rated functional health status were assessed during the hospitalization period and one month after discharge; Quality of Life Index (QLI) and instrumental daily activities (SPE) were assessed four months after discharge. Focusing on the differences in outcome between persons with a stronger vs a weaker SOC, there were few significant differences in physical status between the subgroups. However, the persons with a weaker SOC stayed longer in the hospital and reported a significantly lower score on the NEECHAM Confusion Scale, as well as more discomfort and disability symptoms related to communication, mental, and emotional status. Furthermore, these persons had less favorable scores on the overall QLI and subscales respectively, and on all subscales measuring instrumental daily activities. The persons with a weaker SOC were significantly more dependent on assistance before admission to the hospital than those with a stronger SOC. The conclusions drawn from the study indicate that persons with a stronger SOC seem to cope in a better way with their situation after a hip fracture.

Activities of Daily Living↗
PubMed1997

Parental reports of changes and challenges that result from parenting a child with cancer.

Cancer in a child leads to a more stressful family life, including problems in adjusting to the situation. The aim of this study was to identify the parents' experience of problems related to their child's/adolescent's cancer and the effect of those problems on the parents' life situation. Swedish parents of 15 children and adolescents with varying diagnoses and treatments were interviewed using qualitative methods. The interview data were analyzed by two researchers using a constant comparative method. The results included eight categories of problems influencing the parents' life situation: watching our child suffer; being governed by our child's disease; behaving differently as a family member; experiencing strong feelings and reactions; trying to cope; dealing with the reactions of others; finding support from others; and evaluating the quality of care. Seven of these categories validate previously reported parental concerns, but one, evaluating the quality of care, has not been previously reported. Study findings can be used to help sensitize health care personnel to the problems experienced by parents of children and adolescents with cancer and the capacity parents have to deal with the problems.

Adolescent↗
PubMed1997

Development of a tool to measure the life situation of parents of children with cancer.

The aim of this study was to test the validity and reliability of the recently developed Life Situation Scale for Parents (LSS-P) among parents of children with cancer. One hundred and ten parents of seventy-four children and adolescents who visited three paediatric wards in Sweden filled out three instruments: The LSS-P, the Quality of Life Scale and the Family Support Scale. The reliability coefficient, Cronbach's alpha, was found to be 0.82 for the LSS-P. A factor analysis with orthogonal varimax rotation of 37 items of the LSS-P gave twelve factors. A higher order factor analysis reduced the factors to four (Care, Well-being, Social life and Preparedness), explaining the underlying dimensions to 57.9%. The total LSS-P correlated significantly with the Quality of Life Scale, and the higher order factor Care with the Family Support Scale. The LSS-P discriminated, in some aspects, between two-parent visiting the ward for treatment or check-up. The conclusion is that this first version of the LSS-P was valid and reliable (internal consistency) to a certain extent, but that the instrument should be tested on larger samples and during different phases of the disease.

Adolescent↗
PubMed1997

Quality indicators in clinical nursing: a review of the literature.

The purpose of the present study was, by means of a literature review, to describe and analyse the characteristics of clinical indicators used to assess and promote quality improvement in nursing care. It was found that a generally accepted definition of a clinical indicator is a 'quantitative measure that can be used as a guide to monitor and evaluate the quality of important patient care and support service activities'. By the seriousness of the event and the degree to which it can be avoided, clinical indicators are described as sentinel event or rate-based indicators. They can measure structure, process or outcome of care. Authors have had different approaches in focus when selecting and developing indicators viz. specific aspects of care/nursing diagnosis, medical diagnosis, generic aspects of care and clinical areas. These different points of departure were influenced by research knowledge, theories/frameworks, or by the opinions of patients or staff. The threshold of an indicator is essential when measuring the quality of care as it describes a critical level between what is considered good or not. Thresholds should be dynamic, realistic, and improve over time. However, the literature on how to establish specific thresholds is limited. The review has also revealed that there is an uncertainty regarding the use of terms such as indicators, standards, norm, criteria and aspects of care.

Clinical Nursing Research↗
PubMed1997

Symptom distress and life situation in adolescents with cancer.

Having a life-threatening disease like cancer during adolescence poses a number of problems. The purpose of this study was to identify the adolescent's own experience of areas of the life situation affected by the disease and problems related to it. Ten adolescents with varying diagnoses and treatment were interviewed. They also completed a quantitative measurement of problems. The result shows eight domains and 24 subdomains influencing the experience of life situation. Those were disease and treatment (side effects, isolation, medical procedures), identification (others are ill, appearance), feelings and reactions (mood, self-image, meaning, hope), coping (positive thinking, distraction, positive effects), togetherness (family, friends, school), support (family and friends, the youth association, professional support), reactions of the families (parents, siblings), and quality of care (professionalism, information, organization, equipment). The problems mentioned in the interviews are also compared with the quantitative measurement used. The adolescents mentioned 77 problems in the interviews, of which 17 were not on the list of problems. Of those 17, seven dealt with physical problems, and six were problems concerning the quality of care. They ranked wanting and depending on parents as the worst problems for themselves from the list of problems.

Adaptation, Psychological↗
PubMed1997

Caring and uncaring encounters within nursing and health care from the cancer patient's perspective.

The aim of this phenomenological study was to explore caring and uncaring encounters with nurses and other health professionals from the perspective of the person who has been diagnosed and treated for cancer. Through thematic analysis of in-depth dialogues with five women and four men in the remission or recovery phase of cancer, three major categories regarding caring and uncaring encounters were identified. The essential structure of a caring encounter was found to be threefold: 1. the nurse/health professional perceived as caring: an indispensable companion on the cancer trajectory; 2. the resulting mutual trust and caring connection; and 3. the perceived effect of the caring encounter: a sense of solidarity, empowerment, well-being, and healing. The essential structure of an uncaring encounter is also threefold: 1. the nurse/health professional perceived as uncaring: an unfortunate hindrance to the perception of well-being and healing; 2. the resulting sense of mistrust and disconnection; and 3. the perceived effect of the uncaring encounter: a sense of uneasiness, discouragement, and a sense of being broken down. The findings emphasize the primacy of competence in professional caring, as well as that of genuine concern, openness and a willingness to connect with others. The often devastating effects of uncaring encounters on the recipient of nursing and health care raises the question whether uncaring as an ethical and a professional problem should perhaps be dealt with as malpractice in nursing and health care.

Adult↗
PubMed1997

Life situation and problems as reported by children with cancer and their parents.

In recent years, the intensification of treatment for children with cancer has resulted in a considerable increase in the number of those who are cured. The intensive treatment has, however, led to a number of problems for the children and their families. The aim of this study was to identify children's experience of problems related to their cancer and the disease-effect on the child's life situation. Five children with varying diagnoses and treatment plans and five parents were interviewed separately. The qualitative interview data were compared with a quantitative measurement of problems. The interview data were analyzed by two of the authors according to qualitative analysis processes. Six categories regarding influencing factors on the children's life situation were found: (1) medical treatment and side effects, (2) isolation, (3) togetherness and support, (4) being in the center, (5) feelings and reactions, and (6) quality of care. About half of the variables on the list of problems were mentioned in 1 or more of the 10 interviews. Study findings suggest that health care personnel help children with cancer to reduce their fear of painful and frightening procedures by creating a relationship with the child.

Adaptation, Psychological↗
PubMed1996

Measurement of quality of life in women with breast cancer. Development of a Life Satisfaction Questionnaire (LSQ-32) and a comparison with the EORTC QLQ-C30.

The purpose was to develop and validate a new instrument suitable for measuring perceived quality of life in women with breast cancer. The instrument is to be used within conventional cancer therapy as well as in complementary care, and is called the LSQ-32 (Life Satisfaction Questionnaire). The subjects were 362 women with breast cancer in all cancer stages. Cronbach's alpha reliability coefficient of the LSQ was 0.89. The construct validity was estimated by a principal component analysis. Six orthogonal factors were identified: (1) 'Quality of family relation', (2) 'Physical symptoms', (3) 'Socioeconomic situation', (4) 'Quality of daily activities', (5) 'Sickness impact' and (6) 'Quality of close friend relation'. The criterion-related validity was estimated by comparing the LSQ-32 and the EORTC QLQ-C30. The scales/items of the EORTC QLQ-C30 were represented in the LSQ-32, but the factors 'Quality of family relation' and 'Quality of close friend relation' were not found in the EORTC QLQ-C30. It was concluded that the LSQ-32 as well as the EORTC QLQ-C30 are valuable tools in the measurement of quality of life in women with breast cancer. The LSQ-32, however, also contains an existential factor.

Adult↗
PubMed1996

Experiencing existential changes: the lived experience of having cancer.

This phenomenological study was designed to explore the lived experience of having cancer, as perceived by people who have been diagnosed and treated for cancer. The aim of the study was to add to the knowledge and understanding of this complex human phenomenon. Data were collected through in-depth interviews with nine people who were in the remission or recovery phase of cancer. The interviews were tape-recorded and transcribed verbatim for each participant. Through intersubjective interactions and thematic analysis, the essential description of the lived experience of having cancer was constructed. The overriding theme of the lived experience of having cancer is "experiencing existential changes." Five basic subthemes were identified in the participants accounts, all of which are part of the existential changes involved in the lived experience of having cancer. These are: uncertainty, vulnerability, isolation, discomfort, and redefinition. The study can increase the understanding of what it is like to have cancer.

Adaptation, Psychological↗
PubMed1996

Clinical incidence of lymphoedema in breast cancer patients in Jönköping County, Sweden.

The clinical incidence of lymphoedema of the arm in breast cancer patients was studied before and after general mammography screening in the county of Jönköping, Sweden. There was a significant decrease of incidence of lymphoedema from 15% in 1983 to 8% in 1988. Clinical and pathological therapy data have been analysed in relation to lymphoedema. Significant factors contributing to lymphoedema were the number of lymph nodes examined and the number of pathologically positive lymph nodes. A higher proportion of patients receiving post-operative radiotherapy to the axilla developed lymphoedema, compared with those with surgery alone. A comparison between the two groups is impossible due to the fact that post-operative radiotherapy was prescribed only to patients with pathologically positive lymph nodes.

Adult↗
PubMed1996

A Swedish version of the appraisal of Self-Care Agency (ASA) scale.

The "Appraisal of Self-care Agency" scale (the ASA scale) is designed to measure self-care agency in accordance with Orem's self-care deficit theory of nursing. The aim of this study was to obtain a reliable Swedish version of the ASA scale by measuring the internal consistency. ASA-A for self-appraisal and ASA-B for appraisal of another were tested with a convenience sample of 52 elderly in-patients and 53 caregivers in six geriatric care units. Cronbach's alpha reliability coefficient was 0.59 for the ASA-A scores, 0.77 for ASA-B scores obtained by caregivers comprising different professions, and 0.87 for scores obtained by registered nurses. Further testing of both validity and reliability is needed if this version of the scale is to be used in nursing research and practice.

Activities of Daily Living↗
PubMed1996

Swedish Health care personnel's perceptions of disease and treatment-related problems experienced by children with cancer and their families.

In recent decades, the intensification of treatment of children with cancer has resulted in a considerable increase in the number of those cured. The intensive treatment has also led to several problems for the children and their families. The aim of the present study was to identify the physical, psychological, social, and existential problems; symptoms and inconvenience caused by the disease and treatment or the hospital stay determined by Swedish health care personnel to be the most troublesome for children with cancer and their families. A modified three-round Delphi technique was used. In this way, 207 different problems were identified by 24 health care personnel. According to the personnel, the child is most troubled by physical symptoms, and family members are most troubled by feelings of anxiety about future events or possible events. The personnel interpreted the family members' problems as significantly worse than the child's. The results are related to the age and the diagnosis of the child.

Adult↗
PubMed1995

Development of a tool for measuring the concept of good care among patients and staff in relation to Swedish legislation.

An instrument for measuring the concept of good care, in relation to the Swedish Health and Medical Services Act, has been developed and tested in short-term care. The instrument comprises 14 statements on good care. The construct validity was estimated by factor analysis based on the results from 240 patients. Five factors explained 62% of the variance of the 14 variables and covered the following areas: information, security, accessibility, continuity, and influence and respect. Patients (n = 240) and registered nurses (n = 57) showed differences in estimations of the concept of good care on all factors. There were only minor differences, however, within the patient group and the nursing group, respectively, on comparing the two samples. The instrument needs further testing in different care conditions.

Adult↗
PubMed1995

Sense of coherence among elderly somatic patients: predictive power regarding future needs of care.

The main aim was to study the predictive power of sense of coherence regarding future needs of care among elderly patients evaluated as medically ready for discharge from somatic emergency care. A secondary aim was to study the consistency of sense of coherence over time among patients with this kind of experience. The sample consisted of 53 Swedish patients (mean age 82.8 years, SD = 6.6 years) who had completed their medical treatment at surgical or orthopaedic departments. The predominant diagnosis was lower limb fractures. Sense of coherence was assessed twice, on the day the patient was evaluated as medically ready for discharge and 1 month later. On the second assessment occasion, 28 patients had returned to their homes, 17 were staying at institutions, and eight had died. Patients who returned to their homes reported the strongest sense of coherence while still in hospital. Patients who were staying at institutions scored lowest on the overall sense of coherence scale and on the comprehensibility subscale. Patients who died before the second measurement occasion scored lowest on the meaningfulness subscale. A correlation of 0.51 was noted between the two assessments of sense of coherence, indicating a moderate temporal consistency.

Aged↗
PubMed1995

Relation between gait speed, knee muscle torque and motor scores in post-stroke patients.

A study was undertaken to investigate the relation between gait speed, motor function and isokinetic knee muscle torque in stroke victims. Two different gait speeds, freely chosen speed and fastest speed, were measured on a 10-m long walkway in 34 stroke victims (median age 71 years) three months after the stroke. At the same time different motor functions were assessed, and isokinetic knee muscle torque was measured. One year after the stroke 24 of the subjects were again investigated. The two gait speeds measured were both slower than those in normal healthy subjects of the same age. The motor assessment revealed that the group of stroke patients had light to moderately severe stroke symptoms. The isokinetic muscle torque was significantly lower in the paretic than in the non-paretic legs. The non-paretic legs were also weaker than the legs of healthy subjects. No significant changes in any of the measured variables were found between the three months' assessment and the one year post-stroke assessment. There were some significant correlations between gait speed and motor scores and between gait speed and muscle torque, but usually of moderate strength. Multiple regression analysis with gait speed as dependent variable and combined isokinetic muscle torque and three different motor scores as independent variables gave higher R values.

Aged↗
PubMed1994

Nurses' notes on sleep patterns in patients undergoing coronary artery bypass surgery: a retrospective evaluation of patient records.

In this study, patient records from 80 male patients, aged 43-76, undergoing first-time coronary artery bypass surgery were evaluated with regard to nurses' documentation on sleep during the first four postoperative days. This documentation was classified into descriptions of quality and quantity of sleep. Notations on sleep were found in 69-86% of patient records each night, and was most common the second night. Descriptions of both quality and quantity of sleep occurred in only 12 out of 320 patient-nights. Notes regarding duration of sleep were found for 146 patient-nights (45.6%), of which 103 (32.2%) contained sleep disturbances. Information on quality of sleep was given for 116 patient-nights (36.3%), with only 38 patient-nights (11.9%) of sleep disturbances. For 72 patient-nights, documentation of the patients' sleep was lacking. Frequent awakening was the most common sleep disturbances noted during all but the first night, when continuous awakening dominated. We conclude that the nurses' documentation regarding sleep and sleep disturbances varied over a wide range, with a mixture of quantitative and qualitative information, and that more structured descriptions are needed.

Adult↗
PubMed1994

Testing a modified Swedish version of the Rush Medicus Nursing Process Quality Monitoring Instrument in short-term care.

A modified Swedish version of the Rush Medicus Nursing Process Quality Monitoring Instrument (RMI-MSV) has been tested within surgical, medical and orthopedic units in a county hospital. Three units, one from each area, were randomized as experimental (E) units and three units as control (C) units. Two measurements, comprising 20 patients and five registered nurses in each unit, were carried out with an interval of 6 months. All the E units received feedback on the first measurement and one unit received special intervention concerning the main objective dealing with documentation. The E units tended to show greater improvements than the C units concerning most of the six main objectives included in the instrument. However, the objective dealing with documentation was the only one presenting a statistically significant greater improvement in E units compared with C units (p = 0.045). The effects obtained supported the evidence for validity of the RMI-MSV. The RMI-MSV was found to be sensitive to changes and appropriate for quality assessment. Further research is needed to develop non-situation-related factors which influence the quality of nursing care.

Adolescent↗