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Larsson M, Ahlstrand I, Larsson I, Lood Q, Hammar IA, Sundler AJ, Pennbrant S, Ekman A, Forsberg E, Hedén L, Nunstedt H, Sterner A, Hallgren J. Occupational balance and associated factors among students during higher education within healthcare and social work in Sweden: a multicentre repeated cross-sectional study. BMJ Open 2024; 14:e080995. [PMID: 38643013 PMCID: PMC11033650 DOI: 10.1136/bmjopen-2023-080995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/26/2024] [Indexed: 04/22/2024] Open
Abstract
OBJECTIVE The aim was to explore whether occupational balance is associated with health, health-promoting resources, healthy lifestyle and social study factors among students during higher education within healthcare and social work. DESIGN The study has a multicentre repeated cross-sectional design. Data were collected via a self-reported, web-based questionnaire based on the validated instruments: the 11-item Occupational Balance Questionnaire (OBQ11), the Sense of Coherence (SOC) Scale, the Salutogenic Health Indicator Scale (SHIS) and five questions from the General Nordic Questionnaire (QPS Nordic) together with questions about general health and lifestyle factors. SETTING Students at six universities in western Sweden at one of the following healthcare or social work programmes: biomedical scientists, dental hygienists, nurses, occupational therapists, physiotherapists, radiology nurses and social workers. PARTICIPANTS Of 2283 students, 851 (37.3%) participated. RESULTS The students experienced that occupational balance increased during education. The total OBQ11 score was higher among students in semesters 4 and 6/7, compared with semester 1 students. Students with higher OBQ11 also reported higher SOC throughout their education, while health seemed to decrease. Students who reported higher levels of OBQ11 reported lower levels of health and well-being in semesters 4 and 6/7, compared with semester 1. There was an opposite pattern for students reporting lower levels of OBQ11. CONCLUSIONS The association between higher levels of OBQ11 and lower levels of health and well-being is remarkable. There is a need for more research on this contradiction and what it means for students' health and well-being in the long run.
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Affiliation(s)
| | - Inger Ahlstrand
- School of Health and Welfare, Jönköping University, Jonkoping, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Research and Development Centre, Spenshult AB, Oskarstroem, Sweden
| | - Qarin Lood
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Isabelle Andersson Hammar
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Boras, Sweden
| | - Sandra Pennbrant
- Department of Health Sciences, Hogskolan Vast, Trollhattan, Sweden
| | - Aimée Ekman
- School of Health and Welfare, Jönköping University, Jonkoping, Sweden
| | - Elenita Forsberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Lena Hedén
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Boras, Sweden
| | - Håkan Nunstedt
- Department of Health Sciences, Hogskolan Vast, Trollhattan, Sweden
| | - Anders Sterner
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Boras, Sweden
| | - Jenny Hallgren
- Institution of Health Sciences, University of Skövde, Skovde, Sweden
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Sundler AJ, Hedén L, Holmström IK, van Dulmen S, Bergman K, Östensson S, Östman M. The patient's first point of contact (PINPOINT) - protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses. BMC Prim Care 2023; 24:249. [PMID: 38031004 PMCID: PMC10685613 DOI: 10.1186/s12875-023-02208-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/14/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND A major challenge for primary care is to set priorities and balance demands with available resources. The registered nurses in this study are practice nurses working in primary care offices, playing a large role in initial assessments. The overall objective of this research is to investigate practices of communication and decision-making during nurses' initial assessment of patients' health problems in primary care, examine working mechanisms in good practices and develop feasible solutions. METHODS Project PINPOINT aims for a prospective multicenter study using various methods for data collection and analysis. A purposive sample of 150 patient‒nurse consultations, including 30 nurses and 150 patients, will be recruited at primary care centers in three different geographic areas of southwest Sweden. The study will report on outcomes of communication practices in relation to patient-reported expectations and experiences, communication processes and patient involvement, assessment and decision-making, related priorities and value conflicts with data from patient questionnaires, audio-recorded real-time communication, and reflective interviews with nurses. DISCUSSION This research will contribute to the knowledge needed for the guidance of first-line decision-making processes to best meet patient and public health needs. This knowledge is necessary for the development of assessments and decisions to be better aligned to patients and to set priorities. Insights from this research can empower patients and service providers and help understand and enhance feasible person-centered communication strategies tailored to patients' level of health literacy. More specifically, this research will contribute to knowledge that can strengthen nurses' communication, assessments, and clinical decision-making in primary care. In the long term, this will contribute to how the competencies of practice nurses and other professionals are organized and carried out to make the best use of the resources within primary care. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT06067672.
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Affiliation(s)
- Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden.
| | - Lena Hedén
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden
| | - Inger K Holmström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Sandra van Dulmen
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden
- Nivel (Netherlands Institute for Health Services Research), Utrecht, the Netherlands
- Radboud Institute for Health Sciences, Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Karin Bergman
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden
| | - Sofia Östensson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, SE-501 90, Sweden
| | - Malin Östman
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Region Västra Götaland, Närhälsan Källstorp Healthcare Centre, Trollhättan, Sweden
- Education, Development & Innovation, Primary Health Care, Region Västra Götaland, Research, Sweden
- General Practice/Family Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Kleye I, Sundler AJ, Karlsson K, Darcy L, Hedén L. Positive effects of a child-centered intervention on children's fear and pain during needle procedures. Paediatr Neonatal Pain 2023; 5:23-30. [PMID: 36911787 PMCID: PMC9997124 DOI: 10.1002/pne2.12095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/07/2022] [Accepted: 01/19/2023] [Indexed: 02/09/2023]
Abstract
To examine whether children experience less fear or pain using a child-centered intervention and if there were differences between the intervention group and the control group regarding heart rate, time required for the procedure, success rate for the cannula insertion, and patient satisfaction. A controlled single-center case study of observational design, with one control and one intervention group. Child self-reported fear or pain levels did not reveal any differences for those receiving the intervention compared with controls. However, according to a behavioral observation measure with the Procedure Behavior Check List, effects of the intervention were lower distress in relation to fear and pain during the cannula insertion. The time it took to perform the cannula insertion also decreased significantly in the intervention group. More children in the intervention group reported that they were satisfied with the needle procedure compared with the children in the control group. The child-centered intervention provides reduced observed distress related to fear and pain in children undergoing a cannula insertion and reduced total time by more than 50%. This study found that child involvement in care strengthen their ability to manage a needle procedure.
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Affiliation(s)
- Ida Kleye
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Annelie J Sundler
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Katarina Karlsson
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Laura Darcy
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
| | - Lena Hedén
- Faculty of Caring Science Work Life and Social Welfare, University of Borås Boras Sweden
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Höglander J, Holmström IK, Gustafsson T, Lindberg E, Söderholm HM, Hedén L, von Heideken Wågert P, Sundler AJ. Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants - a study protocol. BMC Geriatr 2023; 23:112. [PMID: 36841761 PMCID: PMC9960173 DOI: 10.1186/s12877-023-03831-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants' responses to and the effect of the intervention. METHODS A multicentre case-control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. DISCUSSION This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. TRIAL REGISTRATION ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826.
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Affiliation(s)
- Jessica Höglander
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
| | - Inger K. Holmström
- grid.411579.f0000 0000 9689 909XSchool of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden ,grid.8993.b0000 0004 1936 9457Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Tanja Gustafsson
- grid.412442.50000 0000 9477 7523Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Elisabeth Lindberg
- grid.412442.50000 0000 9477 7523Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Hanna Maurin Söderholm
- grid.412442.50000 0000 9477 7523Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Lena Hedén
- grid.412442.50000 0000 9477 7523Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Petra von Heideken Wågert
- grid.411579.f0000 0000 9689 909XSchool of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Annelie J. Sundler
- grid.412442.50000 0000 9477 7523Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Gustafsson T, Sundler AJ, Hedén L, Lindberg E, Maurin Söderholm H. Communication in home care-A feasibility study of an educational intervention in self-efficacy and job satisfaction. Nurs Open 2022; 10:1375-1382. [PMID: 36168120 PMCID: PMC9912385 DOI: 10.1002/nop2.1387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/16/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022] Open
Abstract
AIM To explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care. DESIGN A feasibility study with pre- and post-assessments. METHODS Feasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically. RESULTS The questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.
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Affiliation(s)
- Tanja Gustafsson
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Annelie J. Sundler
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Lena Hedén
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Elisabeth Lindberg
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Hanna Maurin Söderholm
- Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden,PreHospen Centre for Prehospital Research, University of Borås; Faculty of Caring Science, Work Life and Social WelfareUniversity of BoråsBoråsSweden
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Ahlstrand I, Larsson I, Larsson M, Ekman A, Hedén L, Laakso K, Lindmark U, Nunstedt H, Oxelmark L, Pennbrant S, Sundler AJ, Hallgren J. Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study. BMC Public Health 2022; 22:1314. [PMID: 35804344 PMCID: PMC9270798 DOI: 10.1186/s12889-022-13690-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 06/20/2022] [Indexed: 11/21/2022] Open
Abstract
Background Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work. Methods This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ). Results Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC. Conclusions Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.
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Affiliation(s)
- Inger Ahlstrand
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Halmstad University, Box 823, S-30118, Halmstad, Sweden.
| | | | - Aimée Ekman
- Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Lena Hedén
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Katja Laakso
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulrika Lindmark
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Centre for Oral Health, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Håkan Nunstedt
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Lena Oxelmark
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sandra Pennbrant
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Annelie J Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Jenny Hallgren
- School of Health and Education, University of Skövde, Skövde, Sweden
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Kleye I, Sundler AJ, Darcy L, Karlsson K, Hedén L. Children's communication of emotional cues and concerns during a preoperative needle procedure. Patient Educ Couns 2022; 105:1518-1523. [PMID: 34625321 DOI: 10.1016/j.pec.2021.09.035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 09/13/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE This study explores children's expressions of emotional cues and concerns during needle procedures, nurses' responses and findings in relation to children's age and sex. METHODS Twenty-six children aged 6-12 years were video recorded during a preoperative needle procedure. Emotional communication was analyzed using Verona Coding Definitions of Emotional Sequences. RESULTS A total of 111 cues or concerns were identified in the observed needle procedures, with a distribution of 77 cues and 34 concerns. A majority of children (85%) expressed emotional cues through non-verbal communication. No differences between child age or sex related to expressed emotion were found. The child elicited the communicated emotion in 98% of sequences. Nurses' responses were coded as not providing space for communication in 75% of sequences. CONCLUSION Children are capable of expressing their emotional distress, primarily non-verbally, during needle procedures. A child showing less overt expressions during a needle procedure does not necessarily experience less fear or pain. The nurses' communication focused on practical information during the needle procedure, with less attention to the child's distress. PRACTICE IMPLICATIONS Nurses need to develop strategies to be aware of emotions the child communicates before, during and after a needle procedure.
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Affiliation(s)
- Ida Kleye
- Department of Health Sciences Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90 Borås, Sweden.
| | - Annelie J Sundler
- Department of Health Sciences Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90 Borås, Sweden
| | - Laura Darcy
- Department of Health Sciences Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90 Borås, Sweden
| | - Katarina Karlsson
- Department of Health Sciences Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90 Borås, Sweden
| | - Lena Hedén
- Department of Health Sciences Faculty of Caring Science, Work Life and Social Welfare, University of Borås, S-501 90 Borås, Sweden
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Kamsvåg T, Hedén L, Essen L, Ljungman G. Ibuprofen in needle procedures in children with cancer-A feasibility and pilot study. Acta Paediatr 2021; 110:704-710. [PMID: 32585039 DOI: 10.1111/apa.15449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/22/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Abstract
AIM To investigate the feasibility, and perform a pilot study, of a randomised clinical trial, investigating whether children experience less pain, fear and/or distress when they receive oral ibuprofen vs placebo before a needle is inserted in a subcutaneously implanted intravenous port. METHODS Twenty-three children were included consecutively and randomised to either oral ibuprofen (n = 12) 7.5 mg/kg body weight or placebo (n = 11). The child's pain, fear and distress were reported by parents, nurses and the children (if ≥7 years of age). Feasibility criteria were defined as (a) ≥4 children included/month, (b) ≥80% of eligible patients agreed to participate, (c) >90% treated according to protocol, (d) <5% missing data, (e) s-cortisol samples analysed in ≥90% of the children. RESULTS All feasibility criteria were met except recruitment and consent. Parents, nurses and children reported no trend of benefit of oral ibuprofen with regard to pain, fear and distress compared with placebo. CONCLUSION The study failed to meet important feasibility criteria and was closed due to low recruitment rate and absence of trend of effect. From this data, we cannot state that ibuprofen is not helpful in needle procedures but that it seems unlikely.
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Affiliation(s)
- Tove Kamsvåg
- Department of Women's and Children's Health Pediatric Oncology Uppsala University Uppsala Sweden
| | - Lena Hedén
- Department of Women's and Children's Health Pediatric Oncology Uppsala University Uppsala Sweden
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
| | - Louise Essen
- Department of Women's and Children’s Health Clinical Psychology in Healthcare Uppsala University Uppsala Sweden
| | - Gustaf Ljungman
- Department of Women's and Children's Health Pediatric Oncology Uppsala University Uppsala Sweden
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Hedén L, Berglund M, Gillsjö C. Effects of the Intervention "Reflective STRENGTH-Giving Dialogues" for Older Adults Living with Long-Term Pain: A Pilot Study. J Aging Res 2020; 2020:7597524. [PMID: 32953174 PMCID: PMC7481915 DOI: 10.1155/2020/7597524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/27/2020] [Accepted: 07/30/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Long-term musculoskeletal pain is a major, often undertreated, disabling health problem among an increasing number of older adults. Reflective STRENGTH-giving dialogues (STRENGTH) may be a tool to support older adults living with long-term pain. The main aim of this pilot study was to investigate the immediate and longitudinal effect of the intervention STRENGTH on levels of pain, wellbeing, occurrence of depression symptoms, and sense of coherence (SOC) among community-dwelling older adults suffering from musculoskeletal pain compared to a control group. METHODS The study was semiexperimental with an intervention group and a control group. The effect of a single STRENGTH intervention was reported on the Numeric Rating Scale (NRS) regarding pain and wellbeing. To evaluate the longitudinal effect of STRENGTH, using the Brief Pain Inventory-Short Form (BPI-SF), the Geriatric Depression Scale-20 (GDS-20), SOC-13 at baseline (T1), and six months after the intervention/no intervention (T2), a total of 30 older adults, aged 72 to 97 years (Mdn 86 years), were included consecutively and fulfilled the intervention series (n = 18) or untreated controls (n = 12). RESULTS The intervention with STRENGTH decreases pain (NRS 6 Mdn versus NRS 4 Mdn, p < 0.001) and increases wellbeing (NRS 7 Mdn versus NRS 8 Mdn, p < 0.001). After a six-month study period with STRENGTH, no longitudinal effect difference was found compared to baseline. Compared to the control group, there was an increasing trend between decreased pain level and increased SOC level for STRENGTH intervention. CONCLUSIONS This pilot study supports STRENGTH's effect as a pain-alleviating model that provides a decrease in pain levels and an increase of wellbeing in older adults with long-term pain. STRENGTH dialogues could be a useful intervention to provide individually holistic care in older adults living with long-term pain.
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Affiliation(s)
- Lena Hedén
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Mia Berglund
- School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Catharina Gillsjö
- School of Health Sciences, University of Skövde, Skövde, Sweden
- College of Nursing, University of Rhode Island, South Kingstown, RI, USA
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Israelsson‐Skogsberg Å, Persson C, Markström A, Hedén L. Children with home mechanical ventilation-Parents' health-related quality of life, family functioning and sleep. Acta Paediatr 2020; 109:1807-1814. [PMID: 31955457 DOI: 10.1111/apa.15177] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 01/10/2020] [Accepted: 01/14/2020] [Indexed: 11/28/2022]
Abstract
AIM Children requiring home mechanical ventilation (HMV) have grown in number and complexity. Parents of children with HMV are often responsible for the advanced homecare. This study explored the health-related quality of life (HRQoL), family functioning and sleep in parents of children with HMV. A secondary aim was to explore the impact on HRQoL, family functioning and sleep of selected potential determinants. METHODS Questionnaires were completed by 45 mothers and 40 fathers, to 55 children receiving HMV. Parents were identified via respiratory clinics in the Swedish national quality register for oxygen and home respiratory treatment and invited to participate between December 2016 and December 2018. RESULTS There were no differences between mothers and fathers overall HRQoL or family functioning reports, although differences within the physical (P < .043) and cognitive (P < .009) functioning dimensions were found. One of four parents reported moderate or severe insomnia. The variability in HRQoL and family functioning was predicted by HMV mode and sleep quality to an extent of 45% and 21%, respectively. CONCLUSION Sleep quality and the child's HMV mode predicted parental HRQoL and family functioning. The results underscore the importance of evaluating parents' sleep and of being aware that invasive ventilation influences parental HRQoL and family functioning.
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Affiliation(s)
| | - Carina Persson
- Faculty of Health and Life Sciences Linnaeus University Kalmar Sweden
| | - Agneta Markström
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala University Uppsala Sweden
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Lena Hedén
- Faculty of Caring Science, Work Life and Social Welfare University of Borås Borås Sweden
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11
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Kleye I, Hedén L, Karlsson K, Sundler AJ, Darcy L. Children's individual voices are required for adequate management of fear and pain during hospital care and treatment. Scand J Caring Sci 2020; 35:530-537. [PMID: 32363693 DOI: 10.1111/scs.12865] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/07/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Children often report both fear and pain in conjunction with clinical care and treatment. Interventions developed in the field have still not been sufficient to prevent and relieve children's fear and pain. More knowledge, from children's own perspectives, is needed about how they deal with their experiences. AIM To explore child-identified strategies that children use to manage fear and pain during needle-related medical procedures in hospital. METHODS Interviews with children, age 4-12 years, with experience of hospital care were analysed qualitatively using content analysis. RESULTS Children have self-identified strategies for dealing with fear and pain during hospital care and treatment. The strategies vary depending on examination or treatment and on how the child felt at that particular day. Children describe what they can do themselves, how adults can empower them and support from surroundings as strategies that give them a choice and a voice. Children wished to have influence, decide when and how information should be given, scream out loud or squeeze something hard, to deal with fear and pain. The results also show that children tried to be brave, gain control and think positively. Something nice to look at and opportunities to play with others also contributed. CONCLUSIONS Strategies vary between children and are used differently on different occasions. Healthcare professionals pose a threat to the child's needs and ability to use their strategies due to lack of knowledge of the child's chosen strategies.
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Affiliation(s)
- Ida Kleye
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Lena Hedén
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Katarina Karlsson
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Annelie J Sundler
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
| | - Laura Darcy
- Department of Health Sciences, Faculty of Caring Science, Work life and Social Welfare, University of Borås, Borås, Sweden
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12
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Lindmark U, Ahlstrand I, Ekman A, Berg L, Hedén L, Källstrand J, Larsson M, Nunstedt H, Oxelmark L, Pennbrant S, Sundler A, Larsson I. Health-promoting factors in higher education for a sustainable working life - protocol for a multicenter longitudinal study. BMC Public Health 2020; 20:233. [PMID: 32059653 PMCID: PMC7023742 DOI: 10.1186/s12889-020-8181-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 01/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The World Health Organization has highlighted the importance of health promotion for health service providers in order to ensure sustainable working life for individuals involved in providing health services. Such sustainability begins when students are preparing to manage their own future health and welfare in working life. It has been suggested that universities, employees and trainee health professionals should adopt or follow a salutogenic approach that not only complements the providing of information on known health risks but also favors health promotion strategies. This paper describes the study design and data collection methods in a planned study aiming to explore health-promoting factors for a sustainable working life among students in higher education within healthcare and social work. METHODS This protocol describes a multicenter longitudinal study involving Swedish students on higher education programs in the healthcare and social work sectors. In 2018, the study invited students on seven education programs at six universities to participate. These programs were for qualification as: biomedical laboratory scientists (n = 121); dental hygienists (n = 87); nurses (n = 1411); occupational therapists (n = 111); physiotherapists (n = 48); radiographers (n = 60); and, social workers (n = 443). In total, 2283 students were invited to participate. Participants completed a baseline, a self-reported questionnaire including six validated instruments measuring health-promoting factors and processes. There are to be five follow-up questionnaires. Three while the students are studying, one a year after graduating, and one three years after graduating. Each questionnaire captures different health-promoting dimensions, namely: health-promoting resources (i.e. sense of coherence); occupational balance; emotional intelligence; health and welfare; social interaction; and work and workplace experiences/perceptions. DISCUSSION This study focuses on the vastly important aspect of promoting a sustainable working life for healthcare and social work employees. In contrast to previous studies in this area, the present study uses different, validated instruments in health promotion, taking a salutogenic approach. It is hoped that, by stimulating the implementation of new strategies, the study's findings will lead to education programs that prepare students better for a sustainable working life in healthcare and social work.
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Affiliation(s)
- U Lindmark
- Centre for Oral Health, Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - I Ahlstrand
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - A Ekman
- Department of Social Work, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - L Berg
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - L Hedén
- Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden
| | - J Källstrand
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - M Larsson
- School of Health and Education, University of Skövde, Skövde, Sweden
| | - H Nunstedt
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - L Oxelmark
- Institute of Health and Care Sciences, the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - S Pennbrant
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - A Sundler
- Faculty of Caring Science, Work Life, and Social Welfare, University of Borås, Borås, Sweden
| | - I Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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13
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Hedén L, von Essen L, Ljungman G. Children's self-reports of fear and pain levels during needle procedures. Nurs Open 2020; 7:376-382. [PMID: 31871722 PMCID: PMC6917931 DOI: 10.1002/nop2.399] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 09/02/2019] [Accepted: 09/23/2019] [Indexed: 11/23/2022] Open
Abstract
Aim The objective was to determine the levels of and potential relationships between, procedure-related fear and pain in children. Design Clinical based cross-sectional. Methods Ninety children aged between 7-18 years were included consecutively and self-reported levels of pain and fear on a 0-100 mm visual analogue scales (VAS) when undergoing routine needle insertion into a subcutaneously implanted intravenous port following topical anaesthesia. Results The needle-related fear level was reported to be as high as the needle-related pain level (mean VAS: 14 mm and 12 mm, respectively, N = 90). With fear as the dependent variable, age and pain were significantly associated and explained 16% of the variance. With pain as the dependent variable, fear was significantly associated and explained 11% of the variance. A post hoc analysis indicated that younger children reported their fear levels to be higher than their pain levels.
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Affiliation(s)
- Lena Hedén
- Faculty of Caring Sciences, Work Life and Social WelfareUniversity of BoråsBoråsSweden
| | - Louise von Essen
- Department of Women's and Children's HealthClinical Psychology in HealthcareUppsala UniversityUppsalaSweden
| | - Gustaf Ljungman
- Department of Women's and Children's HealthPediatric OncologyUppsala UniversityUppsalaSweden
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14
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Israelsson-Skogsberg Å, Markström A, Laakso K, Hedén L, Lindahl B. Siblings' Lived Experiences of Having a Brother or Sister With Home Mechanical Ventilation: A Phenomenological Hermeneutical Study. J Fam Nurs 2019; 25:469-492. [PMID: 31354023 DOI: 10.1177/1074840719863916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Over the past few decades, there has been an increase in the number of children receiving home mechanical ventilation (HMV), and in many ways, families have taken responsibility for the required advanced homecare, which has placed considerable time demands on the family unit. Little is known about the life situation of the siblings of HMV-assisted children; their own voices and an insider perspective are missing. The aim of this study was to illuminate the everyday life experiences of siblings of HMV-assisted children. Data were obtained via interviews with 10 siblings with a median age of 9 years. Data were analyzed using a phenomenological hermeneutical method inspired by the French philosopher Ricoeur. Four themes emerged, all of which suggest that a complex and profound intertwined sibling bond develops that links the past, present, and future. The findings of this study provide valuable information from an insider's perspective about the meaning of having an HMV-assisted sibling. Family-focused care with particular attention and support for siblings of HMV-assisted children can encourage the development of internal strengths, self-confidence, and resilience.
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15
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Affiliation(s)
- Annelie J. Sundler
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | | | - Linda Johansson
- Anaesthesia and intensive care unit, Hallands Sjukhus, Varberg, Sweden
| | - Lena Hedén
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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16
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Israelsson-Skogsberg Å, Hedén L, Lindahl B, Laakso K. 'I'm almost never sick': Everyday life experiences of children and young people with home mechanical ventilation. J Child Health Care 2018; 22:6-18. [PMID: 29298495 DOI: 10.1177/1367493517749328] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Developments in medical technology and treatment have increased the survival rates of children with serious illnesses or injuries, including those receiving home mechanical ventilation, which is a small but growing group. The aim of this study was to explore everyday life experiences of children and young people living with home mechanical ventilation (HMV). Data were obtained through interviews with nine participants. The interviews were supported by photovoice methodology: photographs taken by the participants before or during the interviews were used to facilitate conversation. Interview data were analyzed using qualitative content analysis. The findings revealed that everyday life on a ventilator can be described as including power but simultaneously as characterized by vulnerability to the outside world, comparable to balancing on a tightrope. Various types of technology, both information and communication technology (ICT) and vital medical technology, enabled the participants to engage with the world around them. This study contributes knowledge about the experiences of children and young people with HMV, who depict their lives as good and valuable. The study also underscores, when designing plans and home support, it is necessary to take a sensible approach to personal experiences of what a good life is and what resources are needed to attain and maintain health.
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Affiliation(s)
| | - Lena Hedén
- 1 Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Berit Lindahl
- 1 Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Katja Laakso
- 2 Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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17
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Hedén L, Ahlstrom L. Individual response technology to promote active learning within the caring sciences: An experimental research study. Nurse Educ Today 2016; 36:202-206. [PMID: 26515492 DOI: 10.1016/j.nedt.2015.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 09/18/2015] [Accepted: 10/13/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND One major challenge in delivering lectures to large and diverse classes is the maintenance of a high standard of lecturing in order to engage students and increase their participation and involvement. The lecturer's assignment is to arrange and prepare the lecture before teaching, hence enabling students' enhanced learning. Individual response technology could encourage students' active learning and activate higher cognitive levels. OBJECTIVES The aim of this study was to evaluate individual response technology as a complement during lectures for students in higher education, in terms of the students' experiences of participation, engagement, and active learning. Also of interest was whether this technology can be considered a supportive technical system. DESIGN Data were collected through a questionnaire where levels of each condition were reported on a numeric rating scale (0-10) at baseline and after the introduction of individual response technology. To get a broader perspective, two types of lectures (pediatric and statistical) were included, giving a total of four assessment times. PARTICIPANTS The participants comprised 59 students in Bachelor of Nursing program at a Swedish metropolitan university. RESULTS Overall, when individual response technology was used, students reported increased experience of engagement (n=82, mean 6.1 vs. n=65, mean 7.3, p<0.001), participation (n=92, mean 6.1 vs. n=79, mean 7.7, p<0.001), and active learning (n=92, mean 7.3 vs. n=79, mean 8.2 p<0.001). Additionally, the students experienced this technology as a supportive technical system during lectures (mean 6.6 vs. mean 8.1, p<0.001). CONCLUSIONS The use of individual response technology during teaching is one way to enhance students' experiences of engagement, participation, and learning within the caring sciences.
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Affiliation(s)
- Lena Hedén
- Faculty of Caring Sciences, University of Borås, Borås, Sweden; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
| | - Linda Ahlstrom
- Faculty of Caring Sciences, University of Borås, Borås, Sweden; Department of Public Health & Community Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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18
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Hedén L, von Essen L, Ljungman G. The relationship between fear and pain levels during needle procedures in children from the parents' perspective. Eur J Pain 2015; 20:223-30. [DOI: 10.1002/ejp.711] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 11/11/2022]
Affiliation(s)
- L. Hedén
- Department of Women's and Children's Health; Pediatric Oncology; Uppsala University; Sweden
- School of Health Sciences; University of Borås; Sweden
| | - L. von Essen
- Department of Public Health and Caring Sciences; Clinical Psychology in Healthcare; Uppsala University; Sweden
| | - G. Ljungman
- Department of Women's and Children's Health; Pediatric Oncology; Uppsala University; Sweden
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19
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Hedén L, Essen L, Ljungman G. Effect of high-dose paracetamol on needle procedures in children with cancer--an RCT. Acta Paediatr 2014; 103:314-9. [PMID: 24219618 DOI: 10.1111/apa.12509] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/23/2013] [Accepted: 11/08/2013] [Indexed: 11/28/2022]
Abstract
AIM The aim was to investigate whether children experience less pain, fear and/or distress when they receive high-dose paracetamol compared with placebo, using a needle insertion in a subcutaneously implanted intravenous port as a model. METHODS Fifty-one children ranging from 1 to 18 years of age being treated in a paediatric oncology setting were included consecutively when undergoing routine needle insertion into a subcutaneously implanted intravenous port. All children were subjected to one needle insertion following topical anaesthetic (EMLA) application in this double-blind, placebo-controlled RCT, comparing orally administered paracetamol (n = 24) 40 mg/kg body weight (max 2000 mg) with placebo (n = 27). The patients' pain, fear and distress were reported by parents, nurses and children (≥7 years of age) using 0- to 100-mm visual analogue scales (VAS). In addition, pain observation, procedure time and cortisol reduction were assessed. RESULTS No differences between the paracetamol and the placebo group were found with respect to demographic characteristics. According to VAS reports, paracetamol did not reduce pain, fear and distress compared with placebo. Pain observation, cortisol reduction and procedure time did not differ between the study groups. CONCLUSION Paracetamol provides no additive effect in reducing pain, fear and distress when combined with topical anaesthesia in children undergoing port needle insertion.
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Affiliation(s)
- L Hedén
- Department of Women's and Children's Health Paediatrics Oncology Uppsala University Uppsala Sweden
| | - L Essen
- Department of Public Health and Caring Sciences Psychosocial Oncology and Supportive Care Uppsala University Uppsala Sweden
| | - G Ljungman
- Department of Women's and Children's Health Paediatrics Oncology Uppsala University Uppsala Sweden
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20
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Hedén L, Pöder U, Von Essen L, Ljungman G. Parents' perceptions of their child's symptom burden during and after cancer treatment. Eur J Oncol Nurs 2013. [DOI: 10.1016/j.ejon.2013.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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Hedén L, Pöder U, von Essen L, Ljungman G. Parents' perceptions of their child's symptom burden during and after cancer treatment. J Pain Symptom Manage 2013; 46:366-75. [PMID: 23498966 DOI: 10.1016/j.jpainsymman.2012.09.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 08/31/2012] [Accepted: 09/13/2012] [Indexed: 11/24/2022]
Abstract
CONTEXT Previously reported studies of children with cancer mostly provide cross-sectional knowledge of the prevalence of symptoms but do not show when during the disease trajectory and after the end of successful treatment certain symptoms are most prevalent and/or distressing. OBJECTIVES The aim was to describe parents' perceptions of their child's symptom burden longitudinally during and after cancer treatment and to investigate whether parents' perceptions vary with child characteristics and parent gender. METHODS One hundred sixty parents (49% fathers) of 89 children answered a modified version of the Memorial Symptom Assessment Scale (MSAS) 10-18 at six different time points from one week after the child's diagnosis (T1) to 12-18 months after the end of successful treatment (T6). RESULTS Feeling drowsy, pain, and lack of energy are initially the most prevalent symptoms. During treatment, the most prevalent symptom is less hair than usual. Pain, feeling sad, and nausea are initially the most distressing symptoms. Pain is both prevalent and distressing throughout the treatment. The child's symptom burden decreases over time. There is no difference regarding the reported symptom burden between the parents of a daughter or a son, or parents of a child older or younger than seven years of age. Mothers' and fathers' assessments of the symptom number, total MSAS and the subscales, are associated, but mothers' assessments are often higher than fathers' assessments. CONCLUSION The prevalence and distress of symptoms and symptom burden decrease over time. However, even though the cancer is cured, feeling sad is reported as being prevalent and psychological distress is an issue. A dialogue between staff and the family about distressing symptoms and when they can be expected may increase acceptance and adaptation in children and parents during the disease trajectory.
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Affiliation(s)
- Lena Hedén
- Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Sweden.
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22
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Hedén L, von Essen L, Frykholm P, Ljungman G. Low-dose oral midazolam reduces fear and distress during needle procedures in children with cancer. Pediatr Blood Cancer 2009; 53:1200-4. [PMID: 19688837 DOI: 10.1002/pbc.22233] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Children with cancer often mention needle procedures as the most frightening, distressing, and sometimes painful aspect of the disease and treatment. The aim was to investigate whether children experience less fear, distress, and/or pain according to parents, nurses, and children >or=7 years of age when they receive oral midazolam versus placebo before a needle is inserted in a subcutaneously implanted intravenous port. PROCEDURE Fifty children 1-18 years of age who were being treated in a pediatric oncology and hematology setting were included consecutively when undergoing routine needle insertion into an intravenous port. All children were subjected to one needle insertion in this randomized, triple-blind, placebo-controlled study in which orally administered midazolam (n = 24) 0.3 mg/kg body weight (maximum 10 mg) was compared with placebo (n = 26). Parents, nurses, and children >or=7 years reported the patients' fear, distress, and pain on 0-100 mm Visual Analogue Scales. RESULTS Fear was lower in the midazolam group according to parents (P = 0.001), nurses (P = 0.001), and children (P = 0.015). Parents and nurses also reported lower distress (P = 0.020 and 0.007, respectively). Post hoc analyses indicated that the effects were more pronounced in younger children (<7 years of age). CONCLUSION Low-dose oral midazolam was effective in reducing fear and distress in pediatric oncology patients, especially in younger children, undergoing subcutaneous port needle insertion.
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Affiliation(s)
- Lena Hedén
- Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Uppsala, Sweden.
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Ingemarsson I, Hedén L. Cervical score and onset of spontaneous labor in prolonged pregnancy dated by second-trimester ultrasonic scan. Obstet Gynecol 1989; 74:102-5. [PMID: 2660039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The interval from expected day of delivery to spontaneous onset of labor was correlated with parity and cervical score in 103 women with uncomplicated prolonged pregnancy (greater than 294 days). All women had a routine ultrasonic scan in weeks 16-18 for the purpose of dating. The mean (+/- SD) modified Bishop score on entry to the study was 4.15 +/- 2.0 for nulliparas and 4.90 +/- 2.1 for multiparas. The duration beyond 294 days to spontaneous onset of labor varied little (mean 3.5-4.5 days) for nulliparas with scores greater than 2 and for multiparas regardless of score. Nulliparous women with a poor score (less than 3) had spontaneous onset of labor and delivery within a mean of 9.8 days. Half of the multiparas (50.0%) and 43.9% of the nulliparas gave birth within 3 days. About 90% of all women gave birth within 7 days. All but three had a vaginal delivery; the instrumental vaginal delivery rate was 16.3%. The results suggest that in postterm women dated with a second-trimester ultrasonic scan, the cervical scores are in general more favorable than previously reported in series not dated with early scans. The postterm group is also much smaller, and the time interval from entry into the postterm period to spontaneous onset of labor is shorter.
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Affiliation(s)
- I Ingemarsson
- Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden
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Wretlind B, Hedén L, Wadström T. Formation of extracellular haemolysin by Aeromonas hydrophila in relation to protease and staphylolytic enzyme. J Gen Microbiol 1973; 78:57-65. [PMID: 4356947 DOI: 10.1099/00221287-78-1-57] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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25
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Wretlind B, Hedén L, Sjöberg L, Wadström T. Production of enzymes and toxins by hospital strains of Pseudomonas aeruginosa in relation to serotype and phage-typing pattern. J Med Microbiol 1973; 6:91-100. [PMID: 4632256 DOI: 10.1099/00222615-6-1-91] [Citation(s) in RCA: 43] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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