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  • 1.
    Backman Lönn, Beatrice
    et al.
    Region Västernorrland, Sundsvall Hospital, Sundsvall.
    Olofsson, Niclas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Translation and validation of the Clinical Trial Nursing Questionnaire in Swedish: A first step to clarify the clinical research nurse role in Sweden2019In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 28, no 13-14, p. 2696-2705Article in journal (Refereed)
    Abstract [en]

    Aim and objectives: To translate the Clinical Trial Nursing Questionnaire (CTNQ) into Swedish and test it for face and content validity as well as internal consistency and reproducibility using test–retest procedures. Introduction/Background: In many countries, as in Sweden, a registered nurse can be involved in research by becoming a clinical research nurse. The clinical research nurse plays a pivotal role in clinical studies as a part of the research team. Scales have been developed and used with the objective to clarify the role of clinical research nurses: one of them is the CTNQ. Methods: A quantitative cross-sectional design with a test–retest procedure was applied to validate the translated questionnaire. By using a snowball sampling method, relevant participants were identified and 49 registered nurses working in the field of research as clinical research nurses answered the questionnaire on two occasions. An expert panel of three clinical research nurses evaluated the questionnaire for face and content validity. The STROBE checklist for observational research has been followed for presenting the research (see File S1). Results: Face and content validity was agreed upon in the expert panel group. Tests for internal consistency of the CTNQ was calculated and showed a high Cronbach's alpha for both the frequency and importance subscales. The test–retest correlation analysis (reproducibility) also revealed a high correlation coefficient for both subscales. Conclusion: The CTNQ-SWE is a valid and robust instrument in a Swedish version. The instrument can be of importance in assessing the role of clinical research nurses in Sweden in future studies. Relevance to clinical practice: Use of the CTNQ-SWE in future research can be of value for clarification and professional development of the clinical research nurse role in Sweden. The further use of the CTNQ in Sweden can be of value in understanding the process where licensed nurses make a transition into becoming a clinical research nurse, and to identify needs for customised education.

  • 2.
    Blusi, Madeleine
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Research and Development, Association of Local Authorities in Västernorrland County, Box 3014, 871 03 Härnösand, Sweden.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Older family carers in rural areas - experiences from using caregiver support services based on Information and Communication Technology (ICT)2013In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 10, no 3, p. 1-9Article in journal (Refereed)
    Abstract [en]

    The aim of this intervention study was to illuminate the meaning of ICT-basedcaregiver support as experienced by older family carers living in vast ruralareas, caring for a spouse at home. In order to access the support serviceparticipants were provided with a computer and high speed Internet in theirhomes. Semi structured webcam-interviews were carried out with 31 familycarers. A strategy for webcam interviewing was developed in order to ensurequality and create a comfortable interview situation for the family carers.Interviews were analyzed using content analyses, resulting in the themes: Adoptingnew technology with help from others and Regaining social inclusion.The results indicate that ICT-based support can be valuable for older familycarers in rural areas as it contributes to improve quality in daily life in anumber of ways. In order to fully experience the benefits, family carers needto be frequent users of the provided support. Adequate training andencouragement from others were essential in motivating family carers to use thesupport service. Access to Internet and webcamera contributed to reducingloneliness and isolation, strengthening relationships with relatives living faraway and enabled access to services no longer available in the area. Use of theICT-service had a positive influence on the relationship between the oldercarer and adult grandchildren. It also contributed to carer competence andpromote feelings of regaining independence and a societal role.

  • 3.
    Blusi, Madeleine
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Research and Development, Association of Local Authorities in Västernorrland County, Härnösand, Sweden .
    Dalin, Rolf
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Information and Communication systems. Department of Research and Development, Association of Local Authorities in Västernorrland County, Härnösand, Sweden.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    The benefits of e-health support for older family caregivers in rural areas2014In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 20, no 2, p. 63-69Article in journal (Refereed)
    Abstract [en]

    We conducted a pragmatic, mixed methods study comparing rural family caregivers receiving e-health caregiver support (n = 35) with a control group (n = 21) receiving conventional, non-e-health, caregiver support. After 18 months, the benefits of support were evaluated using the Care Effectiveness Scale (40-items exploring the domains of preparedness, enrichment and predictability). In all domains the e-health group scored significantly higher than the control group. The adjusted difference for overall benefits was 3.0 (P = 0.02) on the scale 0-10. In addition, semi structured interviews were conducted with a sub-sample of the caregivers. For the e-health group flexibility, availability and being able to individualise the support were essential factors. All caregivers in the control group found conventional support to be beneficial, but also stressed unmet needs related to the conventional support being standardised and non-flexible. The study suggests that providers of caregiver support should offer e-health support as an alternative to conventional caregiver support, as it can be more beneficial to family caregivers.

  • 4.
    Blusi, Madeleine
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Dalin, Rolf
    Mid Sweden University, Faculty of Science, Technology and Media, Department of Information and Communication systems. the Association of Local Authorities FoU Västernorrland - the Association of Local Authorities in Västernorrland.
    Older People Using e-Health Services—Exploring Frequency of Use and Associations with Perceived Benefits for Spouse Caregivers2016In: Informatics, ISSN 2227-9709, Vol. 3, no 3, article id 15Article in journal (Refereed)
    Abstract [en]

    ICT, information- and communication technologies, and e-health services are essential for meeting future care demands. Greater knowledge regarding the implementation of e-health services in long-term care for older people is needed. The purpose of the study was to explore older people’s use of e-health services and associations between frequency of use and perceived benefits. In the longitudinal comparative intervention study (n = 65), intervention group participants (n = 42) used an e-health service for 1.5 years. A control group (n = 23) used similar services provided in a traditional manner. Data was collected through questionnaires and analyzed using linear and logistic regressions. Although general use of the Internet was similar in both groups, the e-health group perceived significantly higher benefits. The component information- and education programs, developed specifically for the e-health service, had the highest association with benefits. Conclusion: e-health services targeted at supporting older people who care for a spouse at home can provide benefits which most likely will not be obtained without participation in an organized e-service. Care professionals play an essential role in encouraging spouse caregivers to become e-service users. Keywords: e-health; spouse caregiver; caregiver support; independence; frequency of use; benefits

  • 5.
    Blusi, Madeleine
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Exploring the influence of Internet-based caregiver support on experiences of isolation for older spouse caregivers in rural areas: a qualitative interview study2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 211-220Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Many older spouse caregivers are tied to the home by their caring duties and feel isolated. The values of supporting older caregivers are well known. In rural areas with long distances and decline in essential services, attending caregiver support groups can be difficult. Using Internet-based services can provide an opportunity for rural caregivers to participate in caregiver support, regardless of geographical distances and without the need for physical presence.

    AIMS AND OBJECTIVES: This study aimed to explore how Internet-based caregiver support may influence the experience of isolation among older spouse caregivers in rural areas.

    DESIGN: An intervention study where 63 older rural caregivers received an Internet-based caregiver support service.

    METHOD: A qualitative interview study based on 31 interviews with open-ended questions, analysed using latent content analysis.

    FINDINGS: Two themes represent the findings from the study: Expanding the concept of place and Developing networks. Even though participants still spent their days in the house, they experienced that daily life was being spent in a variety of places, both physically, virtually and emotionally. The Internet-based support service provided them with a tool to reconnect with family and develop new friends.

    CONCLUSIONS: Internet-based caregiver support may reduce the experience of isolation for spouse caregivers in rural areas. Nurses played a crucial part in the development, by encouraging, educating and inspiring caregivers and supporting their independence.

    IMPLICATIONS FOR PRACTICE: Internet-based services ought to be an option for caregiver support in rural areas as it may reduce feelings of isolation for older spouse caregivers.

  • 6.
    Hildingsson, Ingegerd
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Fathers experiences of support during pregnancy and the first year following childbirth - Findings from a Swedish regional survey2011In: Journal of Men's Health, ISSN 1875-6867, E-ISSN 1875-6859, Vol. 8, no 4, p. 258-266Article in journal (Refereed)
    Abstract [en]

    Background: Support during pregnancy is mainly directed towards pregnant women, although parenthood is viewed as a joint project by society and by parents themselves. Research has shown that fathers often feel excluded by health care professionals. The aim of the present study was to describe personal and professional sources of support used by prospective and new fathers and to study factors associated with fathers having no support from anyone in mid-pregnancy. Methods: This was a prospective longitudinal study of 655 new fathers living in a northern part of Sweden who completed four questionnaires. Results: The majority of fathers reported having good personal support at most time points, but 18% reported that they did not have support from anyone, when asked in mid-pregnancy. A logistic regression analysis showed that the following factors were associated with not receiving support from anyone: having previous children (odds ratio (OR) = 3.4; 95% confidence interval (CI) = 1.7-7.0, P <0.001), expectations from the midwife to attend antenatal visits (OR = 1.9; 95% CI = 1.1-3.4, P <0.05), not attending parent education classes (OR = 2.3; 95% CI = 1.1-4.8, P <0.05), not feeling involved by the prenatal midwife (OR = 1.9; 95% CI = 1.1-3.3, P <0.05), and not being offered the opportunity to attend fathers' groups (OR = 3.5; 95% CI = 1.1-12.3, P <0.05). Conclusion: Although personal support seemed satisfying for the majority of fathers, those with no support from close family/friends also lacked support from midwives as well in terms of the organization of care.

  • 7.
    Häggström, Marie
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Rising Holmström, Malin
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Establishing Patient Safety in Intensive Care -A Grounded Theory.: Building Trust-Important for Patient Safety2017In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 07, no 10Article in journal (Refereed)
    Abstract [en]

    Background: The modern intensive care unit (ICU) is a complex and high-risk environment, and even small adverse events and changes may deteriorate the patient’s conditions and eventually cause harm. Many factors can potentially be associated within an increased amount of errors, leading to adverse events. Nurses, nurse managers, and other leaders all play important roles in establishing patient safety. Aim: This study aimed to obtain a deeper understanding of leaders’ and nurses’ main concerns in establishing patient safety in Swedish intensive care units. Method: A grounded theory methodology was used. Data from 15 interviews with leaders and nurses involved in critical care in Sweden were collected, analysed and constant compared. Findings: The main concern in establishing patient safety was promoting quality of care, work engagement, and staffs well-being in strained ICUs. The core category building trust explained how the leaders’ and nurses’ strove for quality of care and wished a healthy, safe work environment. This is further explained in the categories “Being an accessible and able leader”, “Creating knowledge and understanding”, and “Establishing collaborative practice”. Conclusion: Establishing patient safety in the ICU requires that staffs enjoy going to work, have good work relations, are committed and want to stay at the unit. A healthy, salutogenetic unit with a work environment marked by trust provides a better opportunity to establish patient safety, and various leaders have potential to achieve this.

  • 8.
    Jansen, Jean Pierre
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. European Comm Homeopathy, Subcomm Provings, Groningen, Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Inst, Dept Hlth & Nutr, Driebergen, Netherlands.
    A minimum protocol for randomised homeopathic drug proving as basis for further research.2014In: Forschende Komplementärmedizin, ISSN 1661-4119, E-ISSN 1661-4127, Vol. 21, no 4, p. 232-8Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In order to further improve the methodology and quality of data collection in homeopathic drug provings (HDP), there is a need for a minimum standardised HDP protocol. The objective of the present study was to test the feasibility of this type of protocol.

    MATERIALS AND METHODS: The study protocol embraced a multi-centre, randomised, double-blind, placebo-controlled trial with 2 parallel groups. It was approved by an ethics review committee. During the pre-approval phase, discordances between the regulatory and homeopathic requirements for the protocol were checked and solutions found. The study medication was Potentilla anserina. 6 participants received verum and 4 placebo. The resulting symptom list will be published elsewhere. The procedure was accepted by all participants.

    RESULTS: Three important issues were addressed: the requirement to keep all participants blinded; the adverse events reporting to regulatory authorities; and the necessity of a placebo control group. Other issues that need further investigations were identified, e.g. sample size, observation period and dosage regimen.

    CONCLUSIONS: A minimum protocol of a HDP is feasible. All important design elements of HDP could be solved in discussions with the respective regulatory authorities, and participating homeopaths accepted the procedure.

  • 9.
    Jong, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Falkenberg, Torkel
    Karolinska Universitetet.
    Integrative Nursing in Sweden2014In: Integrative Nursing / [ed] Kreitzer, Mary Jo., Koithan, Mary., Oxford University Press, 2014, p. 515-525Chapter in book (Refereed)
  • 10.
    Jong, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ljadas, Karin
    Englund, Erling
    Appelberg, Jonas
    The Effects of Tactile Massage (TM) On Blood Pressure, Heart Rate and Blood Glucose in a Sample of Women Suffering from Primary Insomnia2012In: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012: , 2012, p. P241-Conference paper (Refereed)
    Abstract [en]

    The overall objective of this pilot study was to study the direct effects of tactile massage (TM) on blood pressure, heart rate and blood glucose in a sample of women suffering from primary insomniaThe study had an experimental prospective design, with a total of 10 women (mean age; 53 years, ±5.4). The participants underwent TM twice a week for six weeks resulting in a total of 120 treatments. For short term effects, systolic and diastolic blood pressure, heartrate and blood glucoses were assessed by the therapist before and after each treatment. Long term assessments were made at baseline, at week 7, and at week 13.As a short term result after the treatment with TM, the participants reached a statistically significant reduction of; systolic blood pressure (-5.5 mmHg, ± 5.0), diastolic blood pressure (-2.0 mmHg, ± 4.4), Heartrate (-5.1 beats per minute, ± 3.4) and blood glucose (-0.2 mmol, ± 0.5). No long term effects with respect to the studied variables can be observed.In summary, we have shown in a normotensive but highly stressed sample of women, that TM has beneficiary effects on parameters of stress and cardiovascular function. In total, 120 TM treatments was analyzed with respect to the objective of the study, but in order to more understand the practical effects, and to more deeply evaluate TM’s place in the modalities of stress reduction, we recommend further studies with larger samples.

  • 11.
    Jong, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Lundqvist, Veronica
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A cross-sectional study on Swedish licensed nurses’ use, practice, attitudes and knowledge about Complementary and Alternative Medicine (CAM)2013Conference paper (Refereed)
    Abstract [en]

    Background: Only a few and relatively outdated population studies with respect to CAM use among the general population in Sweden exists. Those who has been made indicates that CAM usage is relatively high where 30-39% reports lifetime use and 20% use the last year, with massage, Naprapathy and Chiropracy being most common. Nurses are often involved in direct patient care and hold a unique role where issues of CAM can be communicated, but little is known about them as a group on the topic of CAM. Objective: The objective of this cross-sectional study was to describe licensed nurses’ use, practice, attitudes and knowledge about CAM. Method: In a web based survey Licensed Nurses were invited for participation through two different approaches: firstly from the member register of Vårdförbundet (the Swedish Association of Health Professionals), and secondly via a general invitation to formal and informal nursing associations, web communities and workplaces. A total number of 960 nurses responded to the survey, 83% were female and the mean age of the respondents were 46 years (±10.8). Results: Among the respondents, 83.4% reported to have used at least one CAM method within the last two years. The most prevalently used methods are within the categories of massage and Dietary supplements/probiotics/herbal remedies and Mind-Body therapies. Fifteen percent of respondents are practicing some form of CAM method; 69% of those among family and friends, 25% in a private business, and 37% (n=52) within the public health care (mostly different form of massage and mind-body practices). Of the respondents, 11.7% express that they ask patients about CAM use, the most common reason 38% (n=366) not to is lack of knowledge about CAM (and their legal position with respect to CAM). A high proportion (66%) agrees that healthcare personnel should inform clients about CAM treatments when asked about it. Conclusion: Swedish nurses do to a very high extent use different CAM methods for themselves, and also practice it to some degree. In spite of this, due to lack of knowledge, they do not regularly ask or inform patients about CAM methods. From the results of the study we can see that nurses are in need of better training and education about CAM, both in order to be able to meet the needs of the patients, but also for reasons of safety since interactions exist between dietary supplements/probiotics/herbal remedies and conventional drugs.

  • 12.
    Jong, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Kristiansen, Lisbeth
    Gävle Högskola.
    Jong, Miek C.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Falkenberg, Torkel
    Karolinska Universitetet.
    Integrative Nursing in Sweden2019In: Integrative Nursing / [ed] Mary Koithan; Mary Jo Kreitzer, New York: Oxford University Press, 2019, 2, p. 652-662Chapter in book (Refereed)
    Abstract [en]

    This chapter describes the existing “core” of caring/nursing in the Nordic tradition and how that can be merged with the concepts of integrative nursing to form a vision and strategy for the future. Terms such as integrative nursing are unfamiliar among nurses in Sweden, but the concepts of holistic care and healing have been taught for a long time and are well integrated in education and legislation. This chapter discusses possible barriers, such as the level of decision-making in Swedish healthcare as well as the role and attitude towards legislation in the light of the dominant biomedical paradigm. Further discussion explores how integrative nursing may serve as a bridge between the caring, nursing, and biomedical perspectives in its effort to identify and construct evidence from the basis and understanding of complex interventions and complex systems science. Practical steps for progression are identified and suggested.

  • 13.
    Jong, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Ljadas, Karin
    Avd Klinisk Fysiologi, Sundsvalls Sjukhus, Landstinget Västernorrland.
    Englund, Erling
    Avd Forskning & Utveckling, Landstinget Västernorrland.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands.
    Appelberg, Jonas
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Avd Forskning & Utveckling, Landstinget Västernorrland.
    Feasibility and Effects of Touch Massage and Nurse Led Sleep Counselling in the Treatment of Primary Insomnia2016In: Journal of Sleep Disorders: Treatment and care, ISSN 2325-9639, E-ISSN 2325-9639, Vol. 5, no 1Article in journal (Refereed)
    Abstract [en]

    Cognitive Behavioral Therapy (CBT) is basically the only evidence based treatment both in short- as well as long term treatment of insomnia. Previous studies suggest that massage may have a role in initiating sleep and relaxation. This pilot study investigated the feasibility and effects of tactile massage (TM) and nurse led sleep counselling (SC) in the treatment of primary insomnia. Method: Thirty women with primary insomnia were randomized into three different groups: TM, SC or ‘care as usual’ (CAU) followed by a six weeks intervention period. Sleep quality was assessed with sleep diary and polysomnography. The results show that it is feasible to treat primary insomnia with TM. ‘Within’ group analysis showed that the TM group experienced significant improvements in measures of subjective sleep, SC and CAU had no improvements. No significant differences were found in the ‘between’ group analysis. Conclusion: On the basis of the findings, we can conclude that it is feasible to use the methods of TM and SC in the treatment of primary insomnia. Especially TM shows preliminary improvements in subjective measures of sleep, results which needs confirmation in full scale research. Based on the observed effects the research protocol/design is recommended to be simplified and also to combine TM and SC as intervention in future studies.

  • 14.
    Jong, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Lundqvist, Veronica
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Institute Driebergen The Netherlands .
    A cross-sectional study on Swedish licensed nurses’ use, practice, perception and knowledge about Complementary and Alternative Medicine2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 642-650Article in journal (Refereed)
    Abstract [en]

    Background: Only a few and relatively outdated population studies with respect to CAM use among the general population in Sweden exists. Those who has been made indicates that CAM usage is relatively high where 30-39% reports lifetime use and 20% use the last year, with massage, Naprapathy and Chiropracy being most common. Nurses are often involved in direct patient care and hold a unique role where issues of CAM can be communicated, but little is known about them as a group on the topic of CAM.Objective: The objective of this cross-sectional study was to describe licensed nurses’ use, practice, attitudes and knowledge about CAM. Method: In a web based survey Licensed Nurses were invited for participation through two different approaches: firstly from the member register of Vårdförbundet (the Swedish Association of Health Professionals), and secondly via a general invitation to formal and informal nursing associations, web communities and workplaces. A total number of 960 nurses responded to the survey, 83% were female and the mean age of the respondents were 46 years (±10.8).Results: Among the respondents, 83.4% reported to have used at least one CAM method within the last two years. The most prevalently used methods are within the categories of massage and Dietary supplements/probiotics/herbal remedies and Mind-Body therapies. Fifteen percent of respondents are practicing some form of CAM method; 69% of those among family and friends, 25% in a private business, and 37% (n=52) within the public health care (mostly different form of massage and mind-body practices). Of the respondents, 11.7% express that they ask patients about CAM use, the most common reason 38% (n=366) not to is lack of knowledge about CAM (and their legal position with respect to CAM). A high proportion (66%) agrees that healthcare personnel should inform clients about CAM treatments when asked about it.Conclusion: Swedish nurses do to a very high extent use different CAM methods for themselves, and also practice it to some degree. In spite of this, due to lack of knowledge, they do not regularly ask or inform patients about CAM methods. From the results of the study we can see that nurses are in need of better training and education about CAM, both in order to be able to meet the needs of the patients, but also for reasons of safety since interactions exist between dietary supplements/probiotics/herbal remedies and conventional drugs.

  • 15.
    Jong, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Mid Sweden Research & Development Centre, Västernorrland County Council, 851 70 Sundsvall, Sweden.
    Westman, Anton
    Department of Physiology and Pharmacology. Karolinska Institutet.
    Saveman, Britt-Inger
    Department of Nursing, Umeå University.
    Experiences of injuries and injury reporting among Swedish skydivers2014In: Journal of sports medicine (Hindawi Publishing Corporation), ISSN 2356-7651, E-ISSN 2314-6176, Vol. 2014, article id 102645Article in journal (Refereed)
    Abstract [en]

    The objective of the present study was to illuminate the experience of injuries and the process of injury reporting within the Swedish skydiving culture.

    The study had a qualitative approach where data was collected in narrative interviews that were subsequently analyzed with content analysis. Seventeen respondents between the ages of 22 and 44 were recruited at three skydiving drop zones in Sweden.

    Injury events related to the full phase of a skydive were described. Risk of injury is individually viewed as an integrated element of the recreational activity counterbalanced by its recreational value. The human factor of inadequate judgment such as miscalculation and distraction dominate the descriptions as causes of injuries. Organization and leadership act as facilitators or constrainers for reporting incidents and injuries.

    On the basis of this study it is interpreted that safety work and incident reporting in Swedish skydiving may be influenced more by local drop zone culture than by the national association policy. Formal and informal hierarchical structures among skydivers seem to decide how skydiving is practiced, rule enforcement, and injury reporting. We suggest that initial training and continuing education need to be change from the current top-down, to a bottom-up perspective, where the individual skydiver learns to see the positive implications of safety work and injury reporting.

  • 16.
    Jong, Miek C
    et al.
    Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands; National Information and Knowledge Centre for Integrative Medicine (NIKIM), Netherlands.
    Busch, Martine
    The van Praag Instituut, Utrecht, The Netherlands; National Information and Knowledge Centre for Integrative Medicine (NIKIM), Netherlands.
    van de Vijfer, Lucy
    Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Fritsma, Jolanda
    Zorgbelang Groningen, Groningen, Netherlands.
    Seldenrijk, Ruth
    Patiënten Platform Complementaire Gezondheidszorg, Netherlands.
    Pragmatic Model for Integrating Complementary and Alternative Medicine in Primary Care Management of Chronic Musculoskeletal Pain2016In: Primary Healthcare, ISSN 2167-1079, Vol. 6, no 2, article id 1000224Article in journal (Refereed)
    Abstract [en]

    Background: Integration of complementary and alternative medicine (CAM) into conventional care is driven by patients’ needs for holistic care. This study aimed to develop a model for integration of CAM into primary healthcare in close collaboration with patients suffering from chronic musculoskeletal pain (CMP). Methods: The study had a qualitative inductive approach following the principles of Grounded Theory, where data were collected and generated via several data sources and steps; individual and focus group interviews and meetings with patients, general practitioners (GPs), CAM practitioners, health insurers and other key informants. Results: Consensus was reached on a model in which shared decision making was introduced to facilitate discussions on CAM between patients and GPs. Guided by evidence and best-practices, GPs refer patients to one of five selected and reimbursed CAM therapies (acupuncture, homeopathy, naturopathy, osteopathy or Tai Chi) and respective practitioner within their integrative network. CAM practitioners report treatment outcome back to the GP who follows-up on the patient for further evaluation. Conclusions: In conclusion, it was feasible to develop a model for integration of CAM into primary healthcare management of CMP that was driven by patients’ needs and obtained consensus of all stakeholders. The model is the first in the Netherlands to provide for integrative health services in primary care. It needs to be tested in a study setting before further implementation is recommended.

  • 17.
    Jong, Miek C
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Baars, Erik
    Louis Bolk Institute, Dep Health & Nutrition.
    Adverse drug reactions to anthroposophic and homeopathic solutions for injection: a systematic evaluation of German pharmacovigilance databases2012In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 21, no 12, p. 1295-1301Article in journal (Refereed)
    Abstract [en]

    PURPOSE: Medicinal solutions for injection are frequently applied in anthroposophic medicine and homeopathy. Despite their extensive use, there is little data published on the safety of these products. Therefore, we investigated the safety of anthroposophic and homeopathic solutions for injection through a systematic evaluation of adverse drug reactions (ADRs). METHODS: ADRs were extracted from the pharmacovigilance databases of eight German manufacturers. Analysed ADRs included case reports in humans only, (spontaneous) case reports from post-marketing surveillance, literature and clinical/safety trials. RESULTS: Between 2000 and 2009, in total, 303 million ampoules for injection were sold, and 486 case reports were identified, corresponding to a total number of 1180 ADRs. Of all case reports, 71.8% (349/486) included ADRs that were listed (e.g. stated in package leaflet), and 9.5% (46/486) of the reports were classified as serious. The most frequently reported ADRs were pruritus, followed by angioedema, diarrhoea and erythema. A total of 27.3% (322/1180) were localized reactions for example; application or injection site erythema, pain, swelling and inflammation. The overall reporting rate of ADRs associated with injections was less than 4 per 1 million sold ampoules and classified as very rare. CONCLUSIONS: Our systematic evaluation demonstrated that the reporting rate of ADRs associated with anthroposophic and homeopathic solutions for injection is very low. Most reported ADRs were listed, and one quarter consisted of local reactions. These findings suggest a low risk profile for solutions for injection as therapeutically applied in anthroposophic medicine and homeopathy

  • 18.
    Jong, Miek C.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    van Wietmarschen, H.
    Louis Bolk Inst, Bunnik, Netherlands.
    Staps, S.
    Louis Bolk Inst, Bunnik, Netherlands.
    Needs and strengths of citizens in Amsterdam regarding improving their health and living environment2018In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 28, p. 39-39Article in journal (Other academic)
  • 19.
    Jong, Miek C.
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. The Arctic University of Norway, UiT, Tromsø, Norway.
    Lown, Anne
    University of California San Francisco, San Francisco, California, USA.
    Schats, Winnie
    Netherlands Cancer Institute, Amsterdam, The Netherlands.
    Otto, Heather Rose
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Mapping the concept, content and outcome of wilderness therapy for childhood cancer survivors: protocol for a scoping review2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 8Article in journal (Refereed)
    Abstract [en]

    Introduction: Long-term childhood cancer survivors are at risk for frailty and have significant health-related issues in adulthood. Various health promotion interventions have been proposed to enhance quality of life including wilderness therapy, which applies the impact of nature on health in a therapeutic context. Previous studies have described positive outcomes linked with various wilderness-related therapies for cancer survivors. However, there is no clarity on the role these therapies play in childhood cancer. The current scoping review aims to systematically map the concept, content and outcome of wilderness therapy for childhood cancer survivors.

    Methods and analysis: This review will be guided by the Joanna Briggs Institute Reviewers’ manual for scoping reviews. A systematic literature search using medical subject headings (MeSH) and text words related to wilderness therapy and childhood cancer survivors will be performed in EMBASE, ERIC, Medline, Psycinfo, CINAHL, Scopus, Web of Science, SPORTDiscus and Svemed+, Sociological Abstracts, supplemented by grey literature searches. Eligible quantitative and qualitative studies will be screened, included, assessed for quality and extracted for data by two reviewers independently. Results will be described in a narrative style, reported in extraction tables and diagrams, and where appropriate in themes and text.

    Ethics and dissemination: This study describes a protocol for a scoping review that will undertake secondary analysis of data already published in literature and is therefore exempt from medical ethical review. The scoping review will inform understanding of the benefits and risks of wilderness therapy for childhood cancer survivors, their families, practitioners, clinicians and researchers, and will help elucidate the steps necessary for building its evidence base going forward. Results will be published in a peer-reviewed scientific journal.

  • 20.
    Jong, Miek C
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Pijl, A
    de Gast, H
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    P02.128. The effects of guided imagery on preoperative anxiety and pain management in patients undergoing Laparoscopic Cholecystectomy in a multi-centre RCT study2012In: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012. BMC Complementary and Alternative Medicine 2012, 12(Suppl 1): P184 (12 June 2012), BioMed Central, 2012, p. 184-Conference paper (Refereed)
    Abstract [en]

    PurposeLaparoscopic Cholecystectomy (LC) is common practicein treatment of symptomatic gall stones. LC is often associatedwith preoperative anxiety and stress which maynegatively impact postoperative pain perception andrecovery from surgery. The aim of the present study wasto investigate whether a “non-pharmacological” interventionwith guided imagery can reduce preoperative anxiety,postoperative pain perception and medication comparedto standard care in patients undergoing LC.MethodsIn a pragmatic multi-centre randomized controlled study140 patients were randomized to a Guided Imagery (GI)group or control group. The GI group was provided witha CD to practice guided imagery once a day, 7 days priorto surgery. Patients in the control group received standardcare instructions only. Primary outcome measurement wasthe use of postoperative analgesics. Secondary outcomeparameters were preoperative anxiety levels using theAmsterdam Preoperative Anxiety and Information Scale(APAIS), postoperative pain perception (VAS-scale), generalpatient satisfaction (PSQ) and safety (adverse events)with treatment.Results95 out of 140 randomized patients completed the study,43 in the GI and 52 in the control group. The major reasonsfor dropping out were acute LCs or cancellation ofLC. Both groups were highly comparable with respect todemographic data. The majority was female (GI: 77%,Control: 75%). Postoperative morphine use was not significantlydifferent between the GI (15.8±18.5 mg) andcontrol group (12.5±13.6 mg, p=0.34). No significant differenceswere observed in anxiety and postoperative VASscores. Twenty-three percent of patients did exercises1-3 times, 65% 4-7 times and 12% >7 times. Within GIgroup analysis showed significantly less postoperativemorphine use upon better compliance to GI exercises(p=0.02).ConclusionIt is not as simple as replacing a pill with a CD. GuidedImagery seems to reduce postoperative pain medicationonce compliance to imagery exercises is achieved.

  • 21.
    Jong, Miek C
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Baars, Eric W
    University of Leiden, The Netherlands.
    Systematic Evaluation of the Safety of Injectables as used in Homeopathic and Anthroposophic Medicine2010Conference paper (Refereed)
  • 22.
    Karlström, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Engström-Olofsson, Regina
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Postoperative pain after cesarean birth affects breastfeeding and infant care2007In: Journal of Obstetric, Gynecologic and Neonatal Nursing, ISSN 0884-2175, E-ISSN 1552-6909, Vol. 36, no 5, p. 430-440Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To study women's experience of postoperative pain and pain relief after cesarean birth and factors associated with pain assessment and the birth experience. DESIGN: Descriptive patient survey. Data were collected through a questionnaire. The outcome variables were assessments of pain using a Visual Analog Scale and women's birth experience measured on a seven-point Likert scale. SETTING: Central Swedish county hospital, maternity unit. PATIENTS/PARTICIPANTS: The sample consisted of 60 women undergoing cesarean birth. RESULTS: Women reported high levels of experienced pain during the first 24 hours. Seventy-eight percent of the women scored greater than or equal to 4 on the Visual Analog Scale, which can be seen as inadequately treated pain. There was no difference between elective and emergency cesarean births in the levels of pain. In spite of high levels of pain, women were pleased with the pain relief. The risk of a negative birth experience was 80% higher for women undergoing an emergency cesarean birth compared with elective cesarean birth. Postoperative pain negatively affected breastfeeding and infant care. CONCLUSIONS: There is a need for individual and adequate pain treatment for women undergoing cesarean birth, as high levels of pain interfere with early infant care and breastfeeding.

  • 23.
    Karlström, Annika
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Engström-Olofsson, Regina
    Nystedt, Astrid
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Hildingsson, Ingegerd
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Women's postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesareansection2010In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 19, no 9-10, p. 1326-1334Article in journal (Refereed)
    Abstract [en]

    Aim.

    The aim was to evaluate a new anaesthetic routine and to study the effect of spinal opioids for caesarean section on postoperative pain, expectations of pain, satisfaction with pain treatment, breastfeeding, infant care and length of hospital stay.

    Background.

    Inadequate postoperative pain relief is a problem among hospitalised patients. Women undergoing caesarean section have been shown to experience high levels of pain during the first days after operation. Women are expected to breastfeed and care for their newborn while recovering from major abdominal surgery and sufficient pain relief are of importance.

    Design.

    Comparative patient survey.

    Methods.

    Data were collected through a questionnaire distributed to two independent samples of women undergoing elective and emergency caesarean section before and after the introduction of an additive of opioids in obstetric spinal anaesthesia. Chi-square tests were performed, and risk ratios were used for bivariate analysis. Logistic regression modelling was used for multivariate analysis.

    Results.

    The group of women undergoing caesarean section with opioids added to the spinal anaesthesia reported significantly lower levels of experienced pain. High pain levels irrespective of mode of caesarean section affected breastfeeding and infant care. Length of hospital stay for caesarean women was shortened and the consumption of analgesics was reduced.

    Conclusions.

    Women receiving an additive of opioids in spinal anaesthesia experienced lower levels of pain. Low pain levels facilitate breastfeeding and infant care and are of relevance for financial considerations.

    Relevance to clinical practice.

    The results of this study indicate that spinal opioids for women undergoing caesarean section have a positive effect on the postoperative pain experience. Women undergoing caesarean section and have high pain levels are in special need of attention and care because of a higher risk of a decreased ability to breastfeed and to take care of their newborn.

  • 24.
    Klein-Laansma, Christien T
    et al.
    Louis Bolk Institute, Bunnik, The Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    von Hagens, Cornelia
    University Women's Hospital, Universitätsfrauenklinik Heidelberg, Heidelberg, Germany.
    Jansen, Jean Pierre C H
    Louis Bolk Institute, Bunnik, The Netherlands.
    van Wietmarschen, Herman
    Louis Bolk Institute, Bunnik, The Netherlands.
    Jong, Miek C.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Institute, Bunnik, The Netherlands.
    Semi-Individualized Homeopathy Add-On Versus Usual Care Only for Premenstrual Disorders: A Randomized, Controlled Feasibility Study2018In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 24, no 7, p. 684-693Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Premenstrual syndrome and premenstrual dysphoric disorder (PMS/PMDD) bother a substantial number of women. Homeopathy seems a promising treatment, but it needs investigation using reliable study designs. The feasibility of organizing an international randomized pragmatic trial on a homeopathic add-on treatment (usual care [UC] + HT) compared with UC alone was evaluated.

    DESIGN: A multicenter, randomized, controlled pragmatic trial with parallel groups.

    SETTINGS/LOCATION: The study was organized in general and private homeopathic practices in the Netherlands and Sweden and in an outpatient university clinic in Germany.

    SUBJECTS: Women diagnosed as having PMS/PMDD, based on prospective daily rating by the daily record of severity of problems (DRSP) during a period of 2 months, were included and randomized.

    INTERVENTIONS: Women were to receive UC + HT or UC for 4 months. Homeopathic medicine selection was according to a previously tested prognostic questionnaire and electronic algorithm. Usual care was as provided by the women's general practitioner according to their preferences.

    OUTCOME MEASURES: Before and after treatment, the women completed diaries (DRSP), the measure yourself concerns and well-being, and other questionnaires. Intention-to-treat (ITT) and per protocol (PP) analyses were performed.

    RESULTS: In Germany, the study could not proceed because of legal limitations. In Sweden, recruitment proved extremely difficult. In the Netherlands and Sweden, 60 women were randomized (UC + HT: 28; UC: 32), data of 47/46 women were analyzed (ITT/PP). After 4 months, relative mean change of DRSP scores in the UC + HT group was significantly better than in the UC group (p = 0.03).

    CONCLUSIONS: With respect to recruitment and different legal status, it does not seem feasible to perform a larger, international, pragmatic randomized trial on (semi-)individualized homeopathy for PMS/PMDD. Since the added value of HT compared with UC was demonstrated by significant differences in symptom score changes, further studies are warranted.

  • 25.
    Lundberg, Kristina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Husum Health Center, Västernorrland County Council, Husum.
    Jong, Miek C.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Institute, Driebergen, The Netherlands; National Information and Knowledge Center for Integrative Medicine, Amsterdam, The Netherlands.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Health Promotion in Practice—District Nurses׳ Experiences of Working with Health Promotion and Lifestyle Interventions Among Patients at Risk of Developing Cardiovascular Disease2017In: Explore: The Journal of Science and Healing, ISSN 1550-8307, E-ISSN 1878-7541, Vol. 13, no 2, p. 108-115Article in journal (Refereed)
    Abstract [en]

    Objective Health Promotion Practice (HPP) has the objective to promote a healthier lifestyle and reduce the risk of disease. The aim of this study was to examine district nurses׳ experiences of working with health preventive actions among patients with risk factors for cardiovascular disease (CVD), and to identify facilitators and obstacles in HPP. Design/Setting The study was carried out with a qualitative approach where individual semistructured interviews were performed with a total of 12 district nurses in primary care. Data transcripts were analyzed with a manifest content analysis. Findings Five categories were identified. Firstly, informants regarded HPP as the core essence of their work. Secondly, counseling and coaching were reported as crucial elements in working with HPP. Thirdly, informants identified tools such as motivational interviewing (MI) to facilitate HPP. In the fourth category facilitators and barriers of HPP appeared, consisting of both positive and negative attitudes and presence as well as lack of organizational culture and structure. Finally, some informants were dissatisfied with HPP and viewed it as compulsory or as a burden, while others were satisfied and experienced it as a stimulating challenge. Conclusion This study identified that HPP is the core of the district nurses׳ work to promote a healthier lifestyle in individuals with CVD. Organizational structures and culture need to be improved in order to support district nurses to successfully work with HPP. To optimize health promotion and strengthen patients׳ self-care, it is recommended that HPP include holistic elements of care.

  • 26.
    Lundberg, Kristina
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    District Nurses Experiences of Working with Health Promotion and Lifestyle Interventions Among Patients at Risk of Developing Cardiovascular Disease2014In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, no 5, p. A118-A118Article in journal (Refereed)
    Abstract [en]

    Purpose: In preventive health work it is possible to map risk factors at healthy individuals which include information and advice aiming to decrease the risk of developing cardiovascular disease. This preventive health care is in Sweden carried out primarily by the district nurses and they have a key role in promoting health and prevent cardiovascular disease. The aim of the study was to examine district nurses' experiences of working with health promotion among patients with risk factors of cardiovascular disease, and to identify possibilities and obstacles for prevention work in the practical reality.

    Methods: The study has been carried out with a qualitative approach where narrative interviews were performed with a total of 12 district nurses working at health centers in north Sweden. Data transcripts were analyzed with qualitative content analysis.

    Results: The participants express that their work in health promotion is an essence of the job as district nurse. It gives an opportunity to promote healthier lifestyle on an individual level with direct effects on patients' health. Participants are clear about what should be included in the preventive work and mention the topics of diet, exercise, tobacco, alcohol habits and obesity. The district nurses state that education in Motivational Interviewing, (MI), in Physical Activity on Prescription, (PAP) and the colleagues attitudes are important facilitators for making the health promotive work to function in the practical reality. Lack of knowledge (own and among colleagues) and inadequate organizational structures constitute obstacles.

    Conclusion: District nurses are unanimous about what should be included preventive health care. It is experienced as an important part of their duties but has sometimes difficulties to prioritize it. Furthermore, the district nurses consider that knowledge within MI, PAP and the employees' attitudes constitute possibilities while one sees lack of time, negative attitudes and inadequate structures that obstacles for the preventive work.

  • 27.
    Olsson, Helen
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Strand, Susanne
    Mid Sweden University, Faculty of Human Sciences, Department of Social Sciences. Sundsvall Forensic Psychiatric Hospital, Sundsvall, Sweden.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Decreased risk for violence in patients admitted to forensic care, measured with the HCR-202013In: Archives of Psychiatric Nursing, ISSN 0883-9417, E-ISSN 1532-8228, Vol. 27, no 4, p. 191-197Article in journal (Refereed)
    Abstract [en]

    Aim: To explore if patients admitted to forensic psychiatric care decreased their assessed risk for violence over time, to identify patients who decreased their assessed risk for violence exceptionally well (30% or more) on the Clinical (C) and Risk management (R) scales in the (HCR-20), and to compare them in terms of demographic data.

    Methods: The HCR-20 risk assessment instrument was used to assess the risk for violence in 267 patients admitted to a Swedish forensic psychiatric clinic between 1997 and 2010. Their assessments at admission were compared with a second, and most recent, risk assessment.

    Results: The risk for violence decreased over time. Demographic criteria had no impact on differences on decreased risk. Only two factors, namely gender and psychopathy showed a difference. Risk factors associated with stress and lack of personal support were the items that turned out to be the most difficult to reduce.

    Conclusion: The results show that risk prevention in forensic care does work and it is important to continue to work with risk management. The study highlights the importance of a careful analysis of the patient's risk for violence in order to work with the patient's specific risk factors to reduce the risk.

  • 28.
    Pijl, AJ
    et al.
    Department of Anesthesiology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
    de Gast, HM
    Department of Anesthesiology, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Hoen, MB
    Department of Anesthesiology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
    Kluyver, EB
    Department of Anesthesiology, Slotervaartziekenhuis, Amsterdam, The Netherlands.
    van der Vegt, MH
    Department of Anesthesiology, Zaans Medisch Centrum, Zaandam, The Netherlands.
    Kanhai, SRR
    Department of Anesthesiology, Sint Lucas Andreas Ziekenhuis, The Netherlands.
    Jong, Miek
    Avd Nutrition and Health, The Louis Bolk Institute, The Netherlands.
    Guided Imagery Intervention does not Affect Surgical Outcome of Patients Undergoing laparoscopic Cholecystectomy: A Multi-Centre, Randomised Controlled Study2016In: Journal of Patient Care, Vol. 2, no 3, article id 10000119Article in journal (Refereed)
    Abstract [en]

    Objective:To investigate if a “non-pharmacological” intervention with guided imagery could reduce postoperative analgesic consumption, pain perception and preoperative anxiety, compared to standard care, in patients undergoing laparoscopic cholecystectomy (LC). Methods: A randomized controlled study with two parallel groups was performed at two hospital departments of anesthesiology. A total of 140 patients (≥ 18 years) that were scheduled for LC were randomized to either receive guided imagery (N=70) or standard care instructions (N=70) as a control group. Patients in the guided imagery group were provided a CD to practice guided imagery once a day, 7 days prior to surgery. Primary outcome measurement was post-operative analgesic consumption. Secondary outcomes were preoperative anxiety, post-operative self-rated pain, patient satisfaction and adverse events.Results: Of 140 patients that were randomized, 95 patients completed the study, 43 in the guided imagery group and 52 in the control group. Both groups were comparable at baseline with respect to demographic data. Compliance with intervention was fairly good as 77% of the patients had listened to the CD according to instructions. No significant differences (p=0.34) were observed for postoperative morphine use between the intervention (15.8 ± 18.5 mg) and control group (12.5 ± 13.6 mg). Secondary outcomes such as preoperative anxiety (APAIS: 15.2 ± 5.9 vs. 16.4 ± 5.9; p=0.36)), postoperative pain (VAS: 3.4 ± 1.8 vs. 3.0 ± 1.8; p=0.31) and patient satisfaction (PSQ: 4.1 ± 0.9 vs. 3.9 ± 0.8; p=0.47) also demonstrated no significant differences. No adverse events were reported in both groups.Conclusion: A short preoperative guided imagery intervention demonstrated no additional beneficial effects compared to standard care for patients undergoing LC. It therefore seems not to be as simple as to provide patients with a CD before surgery in order to effectively self-manage postoperative pain.

  • 29.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Experiences of abandonment and anonymity among arthroplastic surgery patients in the perioperative period: Some issues concerning communication, pain and suffering2005Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall objective of the thesis is to describe and illustrate the experience of being an arthroplastic surgery patient during the perioperative period with regard to the issues of communication, pain,suffering and satisfaction with care. While waiting for surgery, the participants in this thesis experience suffering in different ways and mainly experience health care as being unavailable and negative in a faceless system (I). Obtaining information related to their illness is difficult, as it is hard to establish contact with health care providers. The responsibility for establishing contact and obtaining information rests solely with the patients (II). In Paper I, due to poor communication, the respondents express feelings of abandonment, anonymity and being disparaged by the health care system. During the participants' journey through the health care system, the negative experience acquires a more positive nature, as personal contacts are established with health care representatives (I-IV). The findings in the different papers (I-IV) are interpreted in the light of Katie Eriksson and Lennart Fredriksson’s descriptions of suffering and the caring conversation. There are participants in this thesis who have been able to reach a personal understanding of themselves and have found reconciliation in suffering. In this way, they have been able to maintain or obtain meaning in their lifeworld. Through their own power, or with the help of family and friends, individuals may be able to attain confirmation of their suffering, have the time and space to suffer and find reconciliation. However, as long as health care is experienced as a faceless system, there are individuals in this study who are unable to face their suffering. During the patients’ journey through the system, it becomes obvious that the system obtains a face when the individuals are able to establish trustful contact with an actual person within the system. The system does not obtain a face as long as the individuals perceive themselves as being poorly treated by health care representatives. In these cases, the system is actually the cause of additional suffering. In the terms defined by Fredriksson, the system obtains a face when a turning point occurs in the form of a caring conversation. During the waiting time, there are few opportunities for a caring conversation. An opportunity is more likely to occur when the individual is admitted to hospital. This is reflected in the extensive degree of satisfaction with care as expressed in Papers II-IV. High levels of satisfaction are reported, although the participants report having experienced high levels of postoperative pain. In Paper III, 68% (n=40) and, in Paper IV, 83.5% (n=50) of the patients experienced pain of = 4 on the Visual Analogue Scale (VAS). When they have been admitted to hospital, the individuals sense that they are confirmed by and visible in the system. This visibility is mutual, as the individual becomes an actual person to health care representatives. In a caring conversation, a sense of trust is established and, as this occurs, the individual and the care provider dare to communicate in an open way, where both are present in the situation.

  • 30.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Sömn utifrån ett folkhälso- omvårdnads- och ett fysiologiskt perspektiv2010Conference paper (Other (popular science, discussion, etc.))
  • 31.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ljadas, Karin
    Englund, Erling
    Appelberg, Jonas
    Is tactile massage (touch massage) a treatment option for primary insomnia?2010Conference paper (Refereed)
    Abstract [en]

    The primary objective of the present trial was to study if tactile massage (TM) was equivalent to nurse led sleep counseling (SC) in the treatment of primary insomnia. In the randomized controlled design in total 30 women (aged 18-65 years) was allocated to one of three groups; TM, SC or a control group. Treatment with TM was administered twice a week for six weeks, SC once a week for six weeks. Subjective sleep quality (Karolinska sleep diary) during was assessed during baseline (week 0) until week 6.and at subsequent follow up at week 7, and 13. Objective sleep quality (Polysomnography) and parameters of subjective health (SF-36, Shirom-Melamed Burnout Questionnaire) and several physiological markers of stress (Cortisol, HbA1c, Blood Pressure) was assessed at baseline and subsequent follow up. Data analysis shall be analyzed with R-ANOVA methodology. Data collection will be completed by April 2010 and preliminary findings will be presented at ICCMR 2010. Primary insomnia a d other sleep disorders are a major public health problem worldwide. Sleep has an important role in the balance act between health and disease. Insufficient sleep and restitution is acknowledged as a factor contributing cardiovascular disease and lethal injury. Tactile stimulation stimulates the release of hormones, for example oxytocin which is important for the circadian homeostasis, and also related to the parasympathetic nervous system. Treatment of sleep disorders with Cognitive Behavioural Therapy (CBT), is so far the only long-term evidence based treatment for primary insomnia. Within regular health care there is no sustainable treatment for people with primary insomnia, hypnotic drugs only has short term effects and several side effects. CBT shows promising results but the availability of therapists are scarce. Nurse led SC or/and TM may have a role in the treatment of people with sleep disorders through its low-tech/low-cost design and an absence of side effects

  • 32.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ljadas, Karin
    Englund, Erling
    Appelberg, Jonas
    Tactile massage and nurse led sleep counseling in the treatment of primary insomnia2010Conference paper (Refereed)
    Abstract [en]

    The primary objective of the present trial was to study if tactile massage (TM) was equivalent to nurse led sleep counseling (SC) in the treatment of primary insomnia. In the randomized controlled design in total 30 women (aged 18-65 years) was allocated to one of three groups; TM, SC or a control group. Treatment with TM was administered twice a week for six weeks, SC once a week for six weeks. Subjective sleep quality (Karolinska sleep diary) during was assessed during baseline (week 0) until week 6.and at subsequent follow up at week 7, and 13. Objective sleep quality (Polysomnography) and parameters of subjective health (SF-36, Shirom-Melamed Burnout Questionnaire) and several physiological markers of stress (Cortisol, HbA1c, Blood Pressure) was assessed at baseline and subsequent follow up. Data analysis shall be analyzed with R-ANOVA methodology. Data collection will be completed by April 2010 and preliminary findings will be presented at ICCMR 2010. Primary insomnia a d other sleep disorders are a major public health problem worldwide. Sleep has an important role in the balance act between health and disease. Insufficient sleep and restitution is acknowledged as a factor contributing cardiovascular disease and lethal injury. Tactile stimulation stimulates the release of hormones, for example oxytocin which is important for the circadian homeostasis, and also related to the parasympathetic nervous system. Treatment of sleep disorders with Cognitive Behavioural Therapy (CBT), is so far the only long-term evidence based treatment for primary insomnia. Within regular health care there is no sustainable treatment for people with primary insomnia, hypnotic drugs only has short term effects and several side effects. CBT shows promising results but the availability of therapists are scarce. Nurse led SC or/and TM may have a role in the treatment of people with sleep disorders through its low-tech/low-cost design and an absence of side effects.

  • 33.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Lundberg, Kristina
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Englund, Erling
    Research and Development Centre, County Council of Västernorrland, Sundsvall, Sweden.
    Westman, Anton
    Department of Surgical and Perioperative Sciences, Section of Anesthesiology and Intensive Care, Umeå University, Umeå, Sweden.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Effectiveness of motivational interviewing and physical activity on prescription on leisure exercise time in subjects suffering from mild to moderate hypertension2011In: BMC Research Notes, ISSN 1756-0500, E-ISSN 1756-0500, Vol. 4, p. Art. no. 352-Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:Physical inactivity is considered to be the strongest individual risk factor for poor health in Sweden. It has been shown that increased physical activity can reduce hypertension and the risk of developing cardiovascular diseases. The objective of the present pilot study was to investigate whether a combination of Motivational Interviewing (MI) and Physical Activity on Prescription (PAP) would increase leisure exercise time and subsequently improve health-related variables.METHODS:This pilot study was of a repeated measures design, with a 15 months intervention in 31 patients with mild to moderate hypertension. Primary outcome parameter was leisure exercise time and secondary outcome parameters were changes in blood pressure, Body Mass Index (BMI), waist circumference, lipid status, glycosylated haemoglobin (HbA1c) and maximal oxygen uptake (VO2max). Assessments of the outcome parameters were made at baseline and after 3, 9 and 15 months. RESULTS:Leisure exercise time improved significantly from <60 min/week at baseline to a mean activity level of 300 (+/- 165) minutes/week at 15 months follow up. Furthermore, statistically significant improvements (p<0.05) were observed in systolic (-14,5 +/- 8.3 mmHg) and diastolic blood pressure (-5,1 +/- 5.8 mmHg), heart rate (-4.9 +/- 8.7 beats/min, weight (-1.2 +/- 3.4 kg) BMI -0.6 +/- 1.2 kg/m2), waist circumference (-3.5 +/- 4.1 cm) as well as in VO2max (2.94 +/- 3.8 ml/kg and 0.23, +/- 0.34 lit/min) upon intervention as compared to baseline. CONCLUSIONS:A 15 month intervention period with MI, in combination with PAP, significantly increased leisure exercise time and improved health-related variables in hypertensive patients. This outcome warrants further research to investigate the efficacy of MI and PAP in the treatment of mild to moderate hypertension.

  • 34.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Norbergh, Karl-Gustaf
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Malker, Hans
    Landstinget Västernorrland.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    What information do patients waiting for and undergoing arthroplastic surgery want? Their side of the story2006In: Journal of Orthopaedic Nursing, ISSN 1361-3111, E-ISSN 1873-4839, Vol. 10, no 1, p. 5-14Article in journal (Refereed)
    Abstract [en]

    This nurse-led focus-group study investigated information needs of patients waiting for arthroplastic surgery – how did they obtain the information and advice they needed? The content analysis of the interview transcripts revealed two main categories – ways of obtaining information and advice and what is needed – what patients want. In the picture emerging from the findings, it is evident that the content of the information that is given does not solely determine whether the respondents’ information needs are met. The way the information is given and whether the respondent is confirmed as a human being and taken seriously by the staff, is believed to be more important in the mutual process of communicating information. On a concrete level, respondents ask for information and advice on what they can do to manage their present life situation while waiting for surgery; this includes pain management, advice on self-training and contact with physiotherapists. They want to know “when” surgery will be performed and to be given opportunities to ask questions. This study serves as another piece in the puzzle investigating patients’ information needs. Implications for nursing are discussed, together with suggestions for future areas of research.

  • 35.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nordahl, Gunnar
    Patient satisfaction with postoperative pain management despite experiencing high levels of pain1998In: European Nurse, ISSN 1358-8621, Vol. 3, no 4, p. 264-273Article in journal (Refereed)
    Abstract [en]

    .European Nurse 3(4): 264-273. The survey was conducted at a Swedish county hospital. Fifty-nine patients undergoing orthopaedic surgery (hip and knee arthroplasty) participated. In structured interviews, the patients answered questions about preoperative information, general satisfaction with nursing care and on assessment of their postoperative pain. On the fourth day after surgery, they were asked to estimate their experienced level of postoperative pain on the Visual Analogue Scale (VAS). The results reveal that approximately 70% of the patients undergoing surgery for knee arthroplasty (KA) had experienced pain corresponding to at least >/=4 on the VAS. This was very different from the study hypothesis, which was that fewer than half the patients would experience pain of >/=4 on VAS. Patients undergoing KA experienced significantly more pain postoperatively than patients undergoing hip arthroplasty (HA) (p = 0.001). Of HA patients, 46% experienced pain of 2:4 on the VAS; this was also slightly more than the study hypothesis. Forty-nine percent of patients had received information about pain and pain treatment on admission to hospital. Patients who had received information had a slight tendency to experience higher levels of pain, on movement (p = 0.077). In spite of high levels of experienced pain among a large number of the patients, they were generally satisfied with their pain management and the nursing care and the personal approach of the hospital staff. The ethics committee at the University of Umea approved the study.

  • 36.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nordahl, Gunnar
    Olofsson, Niclas
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    The impact of preoperative information on state anxiety, postoperative pain and satisfaction with pain management.2003In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 51, no 2, p. 169-176Article in journal (Refereed)
    Abstract [en]

    The primary objective of this study was to test whether specific information given prior to surgery can help patients obtain better pain relief after total knee arthroplasty (TKA). Secondary objectives were to study the impact of preoperative information on state and trait anxiety, satisfaction with pain management and satisfaction with nursing care. The study was an intervention study with two groups of equal size (n ¼ 30). The intervention group was given specific information while the control group received routine information. Pain assessments were made preoperatively and every 3 h for the first three postoperative days, using the visual analogue scale (VAS). The results of this study suggest that information does influence the experience of pain after surgery and related psychological factors. The postoperative pain declined more rapidly for patients in the treatment group, the degree of preoperative state anxiety was lower and they were more satisfied with the postoperative pain management.

  • 37.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Nyberg, Maria
    Mid Sweden University.
    Nordahl, Gunnar
    Patientens upplevelse av postoperativ smärtlindring.: information preoperativt, bemötande av personal1997Report (Other academic)
    Abstract [sv]

    Denna studie är genomförd på ortopedkliniken vid Sundsvalls Sjukhus. Femtionio patienter som ge-nomgått planerad ledplastik deltog (höft, knä). I strukturerade intervjuer har patienterna fått svara på frågor om de informerats om smärtlindring före operation, allmän tillfredsställelse med vården och omhändertagandet av deras smärtor efter operation. Det visade sig att ca 70% av de patienter som opererat in knäprotes, har upplevt postoperativa smärtor motsvarande  4 (minst 4) på VAS. Detta var betydligt mer än utgångshypotesen, vilken var att mindre än hälften skulle uppleva smärtor motsva-rande  4 på VAS. Knäpatienterna hade signifikant mer smärtor postoperativt än de som fått en höft-protes inope- rerad (p= 0.001). Av dessa upplevde ca 50% smärtor  4 på VAS, även det en högre in-cidens än hypotesen. Visst samband ses mellan upplevelse av höga smärtnivåer preoperativt och post-operativt. Av patienterna som deltog i studien hade endast hälften fått information om smär-ta/smärtlindring före operation. De som fått information hade en viss tendens till att uppleva rörelse-smärtor i högre grad postoperativt (p=0.077).

  • 38.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Rolleri, Marianne
    Landstinget Västernorrland.
    Englund, Erling
    Landstinget Västernorrland.
    Auricular acupuncture versus sham acupuncture in the treatment of women suffering from insomnia2008In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 14, no 1, p. 39-46Article in journal (Refereed)
    Abstract [en]

    Background: Improvement in sleep parameters in relation to acupuncture treatment is often found and referredto as being a positive side-effect in the treatment of other illnesses. There is a lack of randomized studies,which primarily study the direct effect of acupuncture on sleep.Objectives: To investigate whether or not auricular acupuncture has an effect on sleep parameters amongpeople with insomnia.Design: A single-blind, randomized pilot study where the treatment group received auricular acupuncturetreatment (AAT) on active points and the control group received AAT on sham points during a 6-week treatmentperiod.Setting: Participants were recruited from the psychiatric outpatient clinics in the geographical area connectedto a local hospital in central Sweden.Subjects: In all, 28 women were included in the study, with 14 in each group. Their mean and median agewas 53 years.Outcome Measures: Sleep parameters were obtained by using the Karolinska Sleep Diary.Results: No statistically significant differences were observed between the groups relating to parameters associatedwith the definition of insomnia. The treatment group experienced that it was easier to wake up in themorning compared with the control group (repeated-measures analysis of variance, p 0.04). Both groupsshowed a statistically significant recovery in subjective sleep parameters during the study period (weeks 1–6)compared with baseline values (week 0).Conclusions: Only modest evidence was found supporting the hypothesis that AAT may have an effect oninsomnia. Least improvements were found in total sleep time and number of awakenings, 2 parameters directlyassociated with the definition of insomnia. AAT may have a role in the treatment of insomnia, especially incombination with other treatments such as cognitive behavioral therapy. This study provides an example of how to perform studies using alternative therapies for sleep disorders.

  • 39.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Westman, Anton
    Umeå University.
    Saveman, Britt-Inger
    Umeå University.
    Skydiving culture and its relation to injury risks and injury reporting2010Conference paper (Refereed)
    Abstract [en]

    This article explores some aspects of the Swedish skydiving culture and its relation to injury risks and injury reporting. The reference frame emerging from the analyses encompasses experiences of joy, passion and playfulness; and of injury, suffering and death. For the individual the risk of injury is viewed as an integrated element of the recreational activity, counterbalanced by its recreational value. From the findings we suggest that Swedish skydiving culture on an organisational level is carried by the local club; not the national association. Though the association has far-reaching powers over the clubs, skydiving culture at the local drop zone and formal and informal hierarchical structures among skydivers are what really decide how rules are enforced, and if incidents and injuries are reported.

  • 40.
    Sjöling, Mats
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Ågren, Ylva
    Olofsson, Niclas
    Hellzén, Ove
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Asplund, Kenneth
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Waiting for surgery; living a life on hold: A continuous struggle against a faceless system2005In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 42, no 5, p. 539-547Article in journal (Refereed)
    Abstract [en]

    This interpretive-phenomenological study examined the lived experience of being on the waiting list for arthroplastic surgery of the knee or hip and its impact on daily life. The interviews reveal that respondents experience suffering from different points of view; illness-, caring- and life- suffering. Suffering leads to a struggle in order to have their caring needs met and the struggle is often fruitless - against a faceless enemy - "the system". No one is there to answer their plea or to address the frustration that then arises and, in combination with their present life situation, this may lead to a disrupted self-image. Finding or creating meaning in suffering appears to be a crucial issue in the struggling process. Respondents who are able to preserve or create meaning in life may find it easier to accept the waiting times and wait for their turn in the queue. They are able to reformulate their life-world and live a full life, in spite of severe pain and disability.

  • 41.
    Valan, Lotha
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Region Västernorrland.
    Kristiansen, Lisbeth
    Högskolan i Gävle.
    Sundin, Karin
    Umeå Universitet.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Health-Related Internet Information Both Strengthens and Weakens Parents’ Potential for Self-Care: A Mixed-Methods Study on Parents’ Search Patterns2018In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 8, no 10, p. 731-745, article id 88148Article in journal (Refereed)
    Abstract [en]

    Today’s parents belong to the digital generation and regularly use the Internet as a source of information. Parents’ quests for health-related online information comprise an effort to manage symptoms of illness or address questions about child development which may be an expression of self-management or self-care. Purpose: This study aims to describe health and child development related Internet search patterns used by parents of children ages zero to six, and further, how the obtained information was used in contacts with Child Health Care. Design and Methods: A two-step mixed- method approach is used in this study, comprising both a quantitative and a qualitative approach. First, a questionnaire was distributed to parents (n = 800) at 13 health centers in a medium sized county in Sweden. Second, one narrative interview with two parents total was conducted. Descriptive and non-parametric statistics were calculated, and qualitative manifest content analyses were performed. Results: A total of 687 completed the questionnaire, which corresponds to a response rate of 86%. The results show that 97% used the Internet for health-related and developmental child issues. The results show that parents often look at basic tips and the Internet is seen as a fast and accessible forum to obtain information. Parents often initiated their Internet searches using Google search for the specific subject, but the most common and most used website (used by 95% of parents), was the Swedish health site 1177.se. 98.4% of parents evaluated the general information searches they made on the Internet as reliable despite only 31% of the parents checking to see if the websites they used were scientifically based. Parents (81.7%) stated that they wanted their Child Health Nurses (CHN) to give them recommendations for valid websites. Conclusions: The results in this study show that, on the one hand, the Internet could strengthen parental knowledge (support self-care capacity), but, on the other hand, the found information could worry them and increase their anxiety—negatively affected self-care capacity. The parents suggested that the information should be double-checked to establish trust and develop self-care knowledge. Having a good resource to rely on, such as personal contact with a CHN, or using reliable websites seems to strengthen and reassure parents.

  • 42.
    Valan, Lotha
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Research and Development, Hälsocentralen Bjästa, Västernorrland County Council, Bjästa, Sweden.
    Sundin, Karin
    Avdelning Omvårdnad, Umeå Universitet.
    Kristiansen, Lisbeth
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Child health nurses’ experiences and opinions of parent Internet use2018In: Early Child Development and Care, ISSN 0300-4430, E-ISSN 1476-8275, Vol. 188, no 12, p. 1736-1747Article in journal (Refereed)
    Abstract [en]

    ABSTRACT Background: On the basis of parents? growing use of the Internet as a resource for health-related information, and the total lack of scientific literature about how nurses in child healthcare experience how their work is affected, further information is needed.Purpose: This study describes child health nurses? (CHN) experiences and opinions of parent Internet use.Design and methods: Using a qualitative descriptive approach, CHNs (n?=?20) working at Health Centres in northern Sweden were interviewed.Results: An overarching theme named ?Parents? use of Internet has influenced Nurses? work? was identified. The theme comprises three categories; ?Internet facilitating care, access, and provision?; ?The Internet complicating the professional role and performance?; and ?Sensing an imperative for a new role as a CHN.Conclusions: These findings add a fresh perspective to understanding the new and transformed professional role of CHNs.

  • 43.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Louis Bolk Institute, the Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Busch, Martine
    van Praag Institute, Utrecht, The Netherlands.
    Meijer, Judith E M
    The Netherlands Foundation Health Centers, National Information and Knowledge Center for Integrative Medicine, Netherlands.
    von Rosenstiel, Inès A
    Slotervaart Hospital, National Information and Knowledge Center for Integrative Medicine, Netherlands .
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Institute, the Netherlands.
    Attitudes, Beliefs, and Practices of Integrative Medicine Among Nurses in the Netherlands2015In: Journal of Holistic Nursing, ISSN 0898-0101, E-ISSN 1552-5724, Vol. 33, no 2, p. 110-121Article in journal (Refereed)
    Abstract [en]

    PURPOSE: This study assessed the attitude, beliefs, and practices of integrative medicine (IM) among nurses in the Netherlands.

    DESIGN: Subscribers of a Dutch nursing journal were asked to fill in an anonymous, structured, online survey related to the topic under study.

    RESULTS: A total of 355 people responded, of which 37% were familiar with the concept of IM in advance. On completion of the survey, the majority (83%) considered IM as a (very) important innovation in health care. Familiarity (odds ratio = 3.20; 95% confidence interval [1.48, 6.94]) and organization (nursing home compared to hospital (odds ratio = 5.98; 95% confidence interval [1.36, 26.23]) were characteristics associated with a positive attitude toward IM. Between 23% and 46% of respondents encountered obstacles regarding implementation of IM. The main obstacles were lack of support (69% to 78%), means (57% to 85%), and time (63% to 70%).

    CONCLUSIONS: Dutch nurses seem to have relatively positive attitudes and beliefs regarding IM. The outcome of this survey may contribute an increased awareness of the key role that nurses can play in the development and implementation of IM.

  • 44.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A Barrier Opener for Personal Insights: Nursing and Medical Students Experiences of Participating in an Experiential Mind-Body Skills Program2014In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, no 5, p. A98-A99Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to obtain an in-depth understanding on how nursing-, and medical students participating in a Mind-Body Medicine Skills program experienced participation and what the program has meant to them on a personal and a professional level.

    Methods: Based on a qualitative approach, first and second year students were interviewed 3 months after completion of the program. Interviews were analyzed with a qualitative content analysis. As a part of a larger study evaluating the effects on stress, empathy and self-reflection, this qualitative sub-study included 10 nursing students from Mid Sweden University, Sweden, and 10 medical students from University of Utrecht, The Netherlands. The Mind-Body Medicine Skills program was adapted from the program developed at Georgetown University School of Medicine, Washington DC, and included 11 experiential sessions were the students were introduced to different mind-body techniques (mindfulness meditation, guided imagery, bio-feedback etc).

    Results: Data analysis is ongoing and more complete analysis will be presented at the conference. In preliminary analysis an overarching theme has been identified: The Mind-Body Medicine Skills program as a barrier opener of personal insights, and a starting point for a new journey in life. The participants describe how the course have made it possible for them obtain insights about themselves, both by self reflection in relation to experiences and through listening to the stories of the others. It is also described that they currently do not at all times explicitly use the direct techniques, but more separate personalized elements, which they have been able to incorporate in everyday situations: i.e. moments of mindfulness while walking, biking or eating, or taking a moment of breathing and relaxation before dealing with problematic situations with others.

    Conclusion: Participation in the Mind-Body Medicine Skills program can on an individual basis have a deep and profound meaning, stimulating to personal growth.

  • 45.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Effects of a Mind-Body Medicine Skills Program on Perceived Stress, Empathy and Self-Reflection Among Medicine and Nursing Students: A Quantitative Study2014In: Journal of Alternative and Complementary Medicine, ISSN 1075-5535, E-ISSN 1557-7708, Vol. 20, no 5, p. A99-A99Article in journal (Refereed)
    Abstract [en]

    Purpose: This study aimed to implement and quantitatively evaluate the Mind-Body Medicine (MBM) Skills program among Dutch medical and Swedish nursing students.

    Methods: The MBM Skills program was piloted among second year medical students at Utrecht University and first year nursing students at Mid Sweden University in the period 2011–2013. During the course, the participating students learned and practiced Mind-Body techniques such as relaxation, meditation, guided imagery, biofeedback, physical exercise, art, music and movement. The effects of the MBM skills program on perceived stress, empathy, and self-reflection were evaluated by the following validated scales: Perceived Stress Scale, Interpersonal Reactivity Index, and Groningen Reflection Ability Scale. Participating students and controls answer(-ed) the different questionnaires at baseline, at the end of the course, and 6 and 12 months later.

    Results: In total, 55 medical students and 49 nursing students have participated in the MBM skills program. Baseline analysis (age, gender, mind-body experience, perceived stress, four subscales of the IRI, and self-reflection) demonstrated that participating nursing students were significantly older (p<0.001), and had higher scores for empathetic concern (p<0.001) and self-reflection (p=0.001) than participating medical students. Further, baseline analysis showed no significant differences in baseline characteristics between intervention and control group for medical students, except from significantly higher levels of perceived stress among controls (p=0.008). Regarding nursing students, no differences were found between intervention and control group, except from significantly higher scores for empathetic concern among participants (p=0.023).

    Conclusion: We have successfully implemented the MBM Skills program for medical and nursing students. Baseline analysis showed that participants of the course were not a selected group, except from perceived stress among medical students and empathetic concern among nursing students. Data on the effects of the MBM skills program on perceived stress, empathic concern and self-reflection are currently being evaluated and will be presented at the conference.

  • 46.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Department of Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the Netherlan.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    Jong, Miek C.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Department of Healthcare and Nutrition, Louis Bolk Institute, Driebergen, the Netherlands; National Information and Knowledge Center Integrative Medicine (NIKIM), Amsterdam, the Netherlands.
    Long-term benefits by a mind–body medicine skills course on perceived stress and empathy among medical and nursing students2017In: Medical teacher, ISSN 0142-159X, E-ISSN 1466-187X, Vol. 39, no 7, p. 710-719Article in journal (Refereed)
    Abstract [en]

    Background: A significant number of medical students suffer from burnout symptoms and reduced empathy. This controlled, quasi-experimental study aimed to investigate whether a mind–body medicine (MBM) skills course could reduce perceived stress and increase empathy and self-reflection in medical and nursing students.

    Methods: The MBM course (consisting of experiential sessions of mind–body techniques and group reflections) was piloted among Dutch medical students and Swedish nursing students. Main outcome variables were perceived stress (PSS), empathy (IRI subscales perspective taking, fantasy, empathic concern, and personal distress), and self-reflection (GRAS). Participating and control students completed questionnaires at baseline, post-intervention, at 6 and 12 months follow-up.

    Results: Seventy-four medical and 47 nursing students participated in the course. Participating medical students showed significantly increased empathic concern [1.42 (95% CI 0.05, 2.78), p = 0.042], increased fantasy [3.24 (95% CI 1.58, 4.90), p < 0.001], and decreased personal distress [−1.73 (95% CI −3.04, −0.35), p = 0.010] compared to controls until 12 months follow-up. Participating nursing students showed significantly decreased levels of perceived stress [−5.09 (95% CI −8.37, −1.82), p = 0.002] and decreased personal distress [−5.01 (95% CI −6.97, −3.06), p < 0.001] compared to controls until 12 months follow-up.

    Conclusions: This study demonstrated long-term beneficial effects of the MBM course on perceived stress and empathy in medical and nursing students.

  • 47.
    van Vliet, Marja
    et al.
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences. Louis Bolk Inst, Bunnik, Netherlands.
    Jong, Miek C.
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences. Louis Bolk Inst, Bunnik, Netherlands.
    Jong, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Nursing Sciences.
    A Mind Body Skills Course Among Nursing and Medical Students: A Pathway for an Improved Perception of Self and the Surrounding World2018In: Global Qualitative Nursing Research, ISSN 2333-3936, Vol. 5Article in journal (Refereed)
    Abstract [en]

    Despite increased recognition of self-care and self-awareness as core competences for health care professionals, little attention is paid to these skills during their education. Evidence suggests that a Mind-Body (MB) skills course has the potential to enhance self-care and self-awareness among medical students. However, less is known about the meaning of this course for students and how it affects their personal and professional life. Therefore, we examined the lived experiences with an MB skills course among Dutch medical and Swedish nursing students. This course included various MB techniques, such as mindfulness meditation and guided imagery. Guided by a phenomenological hermeneutical method, three main themes were identified: "ability to be more present," "increased perception and awareness of self," and "connection on a deeper level with others." Overall, participation in the MB skills course served as a pathway to inner awareness and supported connecting with others as well as with the surrounding world.

  • 48.
    Westman, Anton
    et al.
    Umeå University.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Lindberg, Ann
    Swedish University of Agricultural Sciences.
    Björnstig, Ulf
    Umeå University.
    The SKYNET data: demography and injury reporting in Swedish skydiving2010Conference paper (Refereed)
    Abstract [en]

    The Swedish Parachute Association (SFF) national registry of skydiving injuries is one of the few trauma databases available for research on sport parachuting. The usefulness of this compulsory reporting system may benefit from a description of its base population and an evaluation of its sensitivity and specificity. METHODS: Cross-sectional analysis based on data collected through a web-based questionnaire (SKYNET), from all persons renewing a Swedish skydiving license 2008 (n=1049). Sensitivity was measured as the proportion of injury events fulfilling the reporting criterion (injury event requiring care of a physician) that were actually reported, by comparing the injury events reported to the SFF during the skydiving seasons 2006 and 2007 with the injury events retrospectively reported to the web-based questionnaire for the same time period. Specificity was measured as the proportion of false positives in relation to the defined reporting criterion for the same time period. Self-stated bone fractures, shoulder dislocations and cruciate ligament injuries were labeled as non-minor injuries. Factors affecting the likelihood of reporting were evaluated using logistic regression. RESULTS: The response rate was 100%. The overall sensitivity of the reporting system 2006/2007 was 0.37 (95% confidence interval (CI) 0.24-0.51). With self-stated non-minor injuries as the target for reporting, the sensitivity was 0.67 (95% CI 0.43-0.85). No significant effect on reporting was found for gender, age, license level, years in the sport, total number of jumps or club affiliation. The specificity was 0.91 (95% CI 0.83-0.95). Descriptive statistics of the Swedish skydiving population show several gender differences. CONCLUSIONS: The low sensitivity will yield false low incidence calculations, but as there is no evidence for differential underreporting, risk comparisons related to the candidate predictor variables appear reasonably valid. The false positive reporting warrants assortment of incoming data and a clarification of the reporting criteria. Attitudes to reporting may be of value to study, to understand the drivers and constraints for achieving a more complete notification of skydiving injuries.

  • 49.
    Westman, Anton
    et al.
    Umeå Universitet, Institutionen för Kirurgisk och perioperativ vetenskap, Umeå Universitet.
    Sjöling, Mats
    Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
    Lindberg, Ann
    Svenska Lantbruks Universitetet, Uppsala.
    Björnstig, Ulf
    Umeå Universitet, Institutionen för Kirurgisk och perioperativ vetenskap, Umeå Universitet.
    The SKYNET data: Demography and injury reporting in Swedish skydiving2010In: Accident Analysis and Prevention, ISSN 0001-4575, E-ISSN 1879-2057, Vol. 42, no 2, p. 778-783Article in journal (Refereed)
    Abstract [en]

    Background: The Swedish Parachute Association (SFF) national registry of skydiving injuries is one of the few trauma databases available for research on sport parachuting. The usefulness of this compulsory reporting system may benefit from a description of its base population and an evaluation of its sensitivity and specificity. Methods: Cross-sectional analysis based on data collected through a web-based questionnaire (SKYNET), from all persons renewing a Swedish skydiving license 2008(n=1049). Sensitivity was measured as the proportion of injury events fulfilling the reporting criterion(injury event requiring care of a physician) that were actually reported, by comparing the injury events reported to the SFF during the skydiving seasons 2006 and 2007 with the injury events retrospectively reported to the webbased questionnaire for the same time period. Specificity was measured as the proportion of false positives in relation to the defined reporting criterion for the same time period. Self-stated bone fractures, shoulder dislocations and cruciate ligament injuries were labeled as non-minor injuries. Factors affecting the likelihood of reporting were evaluated using logistic regression. Results: The response rate was 100%. The overall sensitivity of the reporting system 2006/2007 was 0.37(95% confidence interval(CI) 0.24-0.51). With self-stated non-minor injuries as the target for reporting, the sensitivity was 0.67(95% CI 0.43-46 0.85). No significant effect on reporting was found for gender, age, license level, years in the sport, total number of jumps or club affiliation. The specificity was 0.91(95% CI 0.83-0.95). Descriptive statistics of the Swedish skydiving population show several gender differences. Conclusions: The low sensitivity will  yield false low incidence calculations, but as there is no evidence for differential underreporting, risk comparisons related to the candidate predictor variables appear reasonably valid. The false positive reporting warrants assortment of incoming data and a clarification of the reporting criteria. Attitudes to reporting may be of value to study, to understand the drivers and constraints for achieving a more complete notification of skydiving injuries.

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