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Developing and Establishing the Psychometric Properties of an Ethos towards Wellness Questionnaire (EtWeQ)

Open Journal of Nursing 2014年第7期4卷 538-547页

作者： bengt fridlund Amir Baigi School of Health Sciences Jonkoping UniversityJonkopingSweden The Sahlgrenska Academy Goteborg UniversityGoteborgSweden

Aim: Validated instruments exist measuring parts of personal health, ill-health and lifestyle, but there are few, if any, instruments “grasping the big picture” of wellness and ethos. Accordingly the aim was to develop and establish the psychometric properties of a 74-item Ethos towards Wellness Questionnaire (EtWeQ) with regards to content and construct validity, as well as homogeneity and stability reliability. Methods: A questionnaire based on a methodological and developmental design was sent out twice with a four week gap between, on 221 healthy middle-aged participants in four steps: item generating, content validating, statistical analyzing and establishing the final questionnaire. Results: The substantial base, consisting of content validity resulted in, besides basic characteristics, six well-defined and sufficient indexes comprising of;two health indexes (healthiness and ill-healthiness), three life context indexes (work, family, spare time), and one brief comprehensive index (ethos). The three life context as well as the ethos indexes at an ordinal scale level, identified overall satisfactory communalities of >0.30, factor loadings > 0.30, and factor total variance > 50% with regard to construct validity. The homogeneity reliability, in terms of Cronbach’s alpha coefficient > 0.70, at both occasions with a four week gap between, as well as the stability reliability in terms of intraclass correlation coefficient > 0.70, were also considered satisfactory in the same indexes. Conclusions: This newly developed, and likely the only questionnaire focusing on “grasping the big human picture”, was based on both a philosophical reasoning and empirical recommendations of wellness, is shown to be a valid and reliable measurement in screening or in follow-up of healthy people’s wellness and ethos.

关键词： Ethos Healthy Factors Holistic Psychometrics Wellness

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Views on patient safety by operations managers in somatic hospital care: a qualitative analysis

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Open Journal of Nursing 2011年第3期1卷 33-42页

作者： Gunilla Karlsson Karl Hedman bengt fridlund 不详

Healthcare outcome is to achieve optimal health for each patient. It is a well-known phenomenon that patients suffer from care injuries. Operations managers have difficulties in seeing that the relationship between safety culture, values and attitudes affects the medical care to the detriment of the patient. The aim was to describe the views on patient safety by operations managers and the establishment of patient safety and safety culture in somatic hospital care. Four open questions were answered by 29 operations managers in somatic hospital care. Data analysis was carried out by deductive qualitative content analysis. Operations managers found production to be the most important goal, and patient safety was linked to this basic mission. Safety work meant to achieve optimal health outcomes for each patient in a continuous development of operations. This was accomplished by pursuing a high level of competence among employees, having a functioning report system and preventing medical errors. Safety culture was mentioned to a smaller extent. The primary target of patient safety work by the operations managers was improving care quality which resulted in fewer complications and shorter care time. A change in emphasis to primary safety work is necessary. To accomplish this increased knowledge of communication, teamwork and clinical decision making are required.

关键词： Evaluation Healthcare Improvement ProFessional Healthcare Patient Safety Qualitative Content Analysis Safety Culture

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Nurses’ Experiences of Using the Liverpool Care Pathway Plan in Hospitalized Patients with Heart Failure in the End-of-Life Stage: A Qualitative Content Analysis

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Open Journal of Nursing 2016年第8期6卷 591-599页

作者： Randi Hove Nina Fålun bengt fridlund Institute of Nursing Department of Health and Social Sciences Bergen University College Bergen Norway Department of Heart Disease F&oslashrde Hospital F&oslashrde Norway Department of Heart Disease Haukeland University Hospital Bergen Norway School of Health and Welfare J&oumlnk&oumlping University J&oumlnk&oumlping Sweden

Background: The introduction of care pathway plans for end-of-life cares such as the Liverpool Care Pathway (LCP) reveals a unique possibility for inter professional collaboration. Knowledge of symptom relief and how to meet the patients’ needs at the last stage of the palliative phase are essential for the nurses’ approach and care actions, but the documentation of such implementations is still rare and sometimes criticized. Aim: To explore and describe nurses’ experiences of using the LCP plan with patients hospitalized with heart failure at the end-of-life stage. An explorative design was applied, using qualitative content analysis of 20 interviews with nurses practicing the LCP plan in two district hospitals in Norway. Results: The nurses found the LCP plan as quality assurance for treatment and care in patients with heart failure in the last hours and days of life. The use of the LCP plan implied: 1) individualized adjustment, 2) symptom relief and 3) a holistic approach. Conclusion: Nurses experienced that using the LCP plan as a comprehensive action plan contributed in the decision making process and improved inter professional communication. Using the LCP plan should be seen as a tool to practice individualized and holistic nursing to patients at the end-of-life and their families, as well as a purposeful relief of symptoms associated with heart failure.

关键词： End-of-Life Care Heart Failure Nursing Palliative Care Qualitative Method

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Development and psychometric evaluation of the radiographers’ competence scale

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Open Journal of Nursing 2012年第2期2卷 85-96页

作者： Bodil TAndersson Lennart Christensson bengt fridlund Anders Brostrom School of Health Sciences Jonkoping UniversityJonkopingSweden Department of Clinical Neurophysiology University Hospital LinkopingLinkopingSweden

Assessing the competence of registered radiographers’ clinical work is of great importance because of the recent change in nursing focus and rapid technological development. Self-assessment assists radiographers to validate and improve clinical practice by identifying their strengths as well as areas that may need to be developed. The aim of the study was to develop and psychometrically test a specially designed instrument, the Radiographers Competence Scale (RCS). A cross sectional survey was conducted comprising 406 randomly selected radiographers all over Sweden. The study consisted of two phases;the development of the instrument and evaluation of its psychometric properties. The first phase included three steps: 1) construction of the RCS;2) pilot testing of face and content validity;and 3) creation of a web-based 54-item questionnaire for testing the instrument. The second phase comprised psychometric evaluation of construct validity, internal consistency reliability and item reduction. The analysis reduced the initial 54 items of the RCS to 28 items. A logical two-factor solution was identified explaining 53.8% of the total variance. The first factor labelled “Nurse initiated care” explained 31.7% of the total variance. Factor 2 labelled “Technical and radiographic processes” explained 22.1% of the total variance. The scale had good internal consistency reliability, with a Cronbach’s alpha of 0.87. The RCS is a short, easy to administer scale for capturing radiographers’ competence levels and the frequency of using their competence. The scale was found to be valid and reliable. The self-assessment RCS can be used in management, patient safety and quality improvement to enhance the radiographic process.

关键词： Competence Scale Instrument Development Management Nursing Psychometric Evaluation Radiographer RCS

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Factors influencing female patients’ recovery after their first myocardial infarction as experienced by cardiac rehabilitation nurses

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Open Journal of Nursing 2013年第2期3卷 230-240页

作者： Inger Wieslander Jan Martensson bengt fridlund Petra Svedberg School of Social and Health Sciences Halmstad UniversityHalmstadSweden School of Health Sciences Jonkoping UniversityJonkopingSweden

Background: In the developed part of the world, coronary heart disease is the major cause of death and is one of the leading causes of disease burden. In Sweden, more than 30,000 people per year are affected by myocardial infarction and out of these approximately 40% are women. Nearly 70% of the women survive and after a myocardial infarction a recovery process follows. Today’s health care focuses more on treatment, symptoms and risk factors than on the individuals’ perceptions of the recovery process. Aim: To explore cardiac rehabilitation nurses’ experiences of factors influencing female patients’ recovery after their first myocardial infarction. Methods: Twenty cardiac rehabilitation nurses were interviewed. The study was conducted using qualitative content analysis. Results: The cardiac rehabilitation nurses experienced that women’s recovery after a first myocardial infarction was influenced whether they had a supportive context, their ability to cope with the stresses of life, if they wanted to be involved in their own personal care and how they related to themselves. Conclusions: Women’s recovery after a myocardial infarction was influenced by factors related to surroundings as well as own individual factors. The underlying meaning of women’s recovery can be described as the transition process of a recovery to health. Our findings suggest that a focus on person-centered nursing would be beneficial in order to promote the every woman’s personal and unique recovery after a myocardial infarction. Finally, the cardiac rehabilitation nurses’ experiences of factors influencing male patients’ recovery after their first myocardial infarction should be important to investigate.

关键词： Cardiac Rehabilitation Nurses Myocardial Infarction Recovery Transition Process Women

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Lifestyle changes in coronary heart disease—Effects of cardiac rehabilitation programs with focus on intensity, duration and content—A systematic review

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Open Journal of Nursing 2012年第4期2卷 420-430页

作者： Camilla Strid Hans Lingfors bengt fridlund Jan Martensson Department of Medicine HoglandssjukhusetEksjoSweden Health Centre of Habo and Development Unit for Primary Health Care JonkopingSweden Department of Nursing School of Health SciencesJonkopingSweden

Background: Although coronary heart disease (CHD) is the most common cause of death worldwide the literature shows a wide variation in the arrangement of cardiac rehabilitation and achieved lifestyle changes. Aim: The purpose of this study was to evaluate the effects of intensity (number of patient follow-ups), duration (length of intervention) and content in cardiac rehabilitation programs (CRP) regarding lifestyle changes in patients with CHD. Method: A systematic literature review of articles published in the databases PubMed and CINAHL between 1990 and 2007 was conducted. This resulted in 1120 hits of which 25 articles finally met the set criteria for inclusion. Results: The majority of significant positive results on lifestyle factors were shown among the studies describing high intensity and long duration. Included studies showed a wide variation in content, but four different interventions (informative content, educational content, practical content, behavioral and self care-oriented content) emerged. The group of studies which contained all four interventions focused on most lifestyle factors and achieved the most significant positive results. Conclusion: This systematic literature review shows that CRP should include high intensity, long duration and an intervention content covering information, knowledge, practical training, self care-activity and behavior changes in order to achieve effect on all four lifestyle factors of diet, physical activity and exercise, smoking and stress. Lifestyle changes can be reached in less lifestyle factors, with a longer duration and a variation of intensity of contacts but in combining with an informative and educational content with an additional content of a practical nature or self activity.

关键词： Coronary Heart Disease Secondary Prevention Cardiac Rehabilitation Lifestyle Intensity Duration Content Systematic Review

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Undiagnosed obstructive sleep apnea in hypertensive outpatients in primary care—Associations with sleep complaints, depressive symptoms and global perceived health

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Open Journal of Nursing 2013年第6期3卷 445-452页

作者： Anders Brostrom Ola Sunnergren Kristofer Arestedt Peter Johansson Per Nilsen bengt fridlund Eva Svanborg Department of Nursing Science School of Health SciencesJonkoping UniversityJonkopingSweden Department of Clinical Neurophysiology Linkoping University HospitalLinkopingSweden Department of Clinical and Experimental Medicine Division of Clinical NeurophysiologyFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of ENT Ryhov HospitalJonkopingSweden School of Health and Caring Sciences Faculty of HealthSocial Work and Behavioural SciencesLinnaeus UniversityKalmarSweden Department of Medicine and Health Sciences Division of Nursing SciencesFaculty of Health SciencesLinkoping UniversityLinkopingSweden Department of Cardiology Linkoping University HospitalLinkopingSweden. Department of Medicine and Health Sciences Division of Cardiovascular MedicineFaculty of Health SciencesLinköping UniversityLinkopingSweden Division of Health Care Analysis Faculty of Health SciencesDepartment of Health and SocietyLinkoping UniversityLinkopingSweden

Objective: 1) To describe the prevalence of undiagnosed obstructive sleep apnea (OSA) and depressive symptoms in hypertensive men and women below 65 years of age, and 2) to describe the association of OSA to subjective sleep complaints, depressive symptoms and global perceived health. Design: Cross-sectional design focusing on nursing care outcomes of obstructive sleep apnea. Setting: Four primary care health centres in Sweden. PATIENTS: 411 consecutive patients (52% women), mean age 57.9 years (SD 5.9 years), with diagnosed hypertension (BP > 140/90). Main Outcome Measures: Prevalence of OSA and depressive symptoms, and association of OSA to sleep complaints, depressive symptoms and global perceived health. RESULTS: Mild, moderate and severe OSA was seen among 29%, 16% and 14% of patients, respectively. Depressive symptoms were seen in 16% of the total group, with a higher prevalence among men, compared to women, 21% vs. 12%. No differences were found regarding blood pressure, estimated sleep need, sleep sufficiency index, insomnia symptoms, daytime sleepiness or depressive symptoms with respect to different degrees of OSA. Apnea-hypopnea index was significantly associated to perceived health after adjustment for gender and comorbidities, but when depressive symptoms and non-restorative sleep were added to the model, 33% of the variance in global perceived health was explained. Conclusion: OSA is highly prevalent among patients with hypertension in primary care and does together with sleep complaints and depressive symptoms have a negative impact on global perceived health. Hypertensive patients without subjective sleep complaints or depressive symptoms may still have OSA.

关键词： Depression Global Perceived Health Hypertension Nursing Care Obstructive Sleep Apnea Sleep Disordered Breathing Sleep

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Psychometric evaluation of a Swedish version of Krantz Health Opinion Survey

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Open Journal of Nursing 2012年第3期2卷 181-187页

作者： Petra Svedberg Bodil Ivarsson Ulrica G Nilsson Asa Roxberg Amir Baigi David Brunt Margareta Brannstrom bengt fridlund Sylvi Persson Mikael Rask Carin Alm-Roijer School of Social and Health Sciences Halmstad UniversityHalmstadSweden Department of Cardiothoracic Surgery University Hospital of LundLundSweden Centre of Health Care Sciences Orebro University Hospital OrebroSweden University College of Haraldsplass BergenNorway School of Health and Caring Sciences Linnaeus UniversityVaxjoSweden General Practice and Public Health Halland County CouncilFalkenbergSweden Department of Nursing Umea UniversityUmeaSweden School of Health Sciences Jonkoping UniversityJonkopingSweden The Faculty of Health and Society Malmo UniversityMalmoSweden

The purpose of this study was to evaluate the psychometric properties of a Swedish version of The Krantz Health Opinion Survey (KHOS). A convenience sample of 79 persons (47 men and 32 women) was recruited from The Heart and Lung Patients’ National Association at ten local meeting places in different areas in Sweden. The questionnaire was examined for face and content validity, internal consistency and test-retest reliability. The findings showed that the Swedish version of KHOS is acceptable in terms of face and content validity, internal consistency and test-retest reliability over time among 79 individuals >65 years of age and with a cardiac disease. In conclusion, wider evaluations of the psychometric use of KHOS for other populations and settings are recommended.

关键词： Heart Diseases Consumer Health Information Questionnaire Reliability Content Validity

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Essentials of Teamcare in Randomized Controlled Trials of Multidisciplinary or Interdisciplinary Interventions in Somatic Care:A Systematic Review

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Open Journal of Nursing 2015年第12期5卷 1089-1101页

作者： bengt fridlund Ewa K.Andersson Sidona-Valentina Bala Gull-Britt Dahlman Anna K.Ekwall Stinne Glasdam Ami Hommel Catharina Lindberg Eva I.Persson Andreas Rantala Annica Sjostrom-Strand Jonas Wihlborg Karin Samuelson Department of Health Sciences Lund UniversityLundSweden School of Health&Welfare Jonkoping UniversityJonkopingSweden Department of Health Blekinge Institute of TechnologyKarlskronaSweden

Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs. Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care. Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL. Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown. Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.

关键词： Teamcare Randomized Controlled Trial Somatic Care Systematic Review

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Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review

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Open Journal of Nursing 2014年第3期4卷 181-197页

作者： bengt fridlund A.C.Jonsson E.K.Andersson S-V.Bala G-B.Dahlman A.Forsberg S.Glasdam A.Hommel A.Kristensson C.Lindberg B.Sivberg A.Sjostrom-Strand *** K.Samuelson Department of Health Sciences Lund UniversityLundSweden School of Health Sciences Jonkoping UniversityJonkopingSweden School of Health Science Blekinge Institute of TechnologyKarlskronaSweden

Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effec

关键词： Nurse-Led Nursing Care Randomized Controlled Trial Somatic Care Systematic Review

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