Tillfredsställelse i aktivitet hos friska äldre personer: En kartläggning

De äldre i samhället blir allt fler och de önskar att vara fortsatt aktiva och självständiga. Detta kräver kunskap och insatser för ett gott åldrande. Inga tidigare studier på tillfredsställelse i aktivitet har gjorts på gruppen friska personer över 70 år. Syftet med studien var att kartlägga hur aktiva friska personer, 70 år och äldre är, samt hur de skattar sin tillfredsställelse med vardagliga aktiviteter och upplever sin hälsa. Syftet var också att undersöka om det fanns några skillnader i aktivitetsnivå och tillfredsställelse med sin grad av aktivitet mellan kvinnor och män samt ensamboende och sammanboende. En kvantitativ studie gjordes med hjälp av bedömningsinstrumentet Satisfaction with Daily Occupations. Resultatet visade att deltagarna var aktiva och tillfredsställda med sin grad av aktivitet/delaktighet. Det fanns få skillnader mellan kön och civilstånd. Ett signifikant samband mellan hälsa och tillfredsställelse i aktivitet påvisades. Deltagarnas aktiva livssituation och höga tillfredsställelse verkade ha betydelse för deras subjektiva hälsa

Stress of conscience of COVID-19 among perianaesthesia nurses having worked in a COVID-ICU during the coronavirus pandemic:an international perspective

BACKGROUND: Several studies have reported that working in a COVID-ICU impacted nurses’ mental well-being. Yet little is known about how perianaesthesia nurses who have been working in a COVID-ICU perceived their stress of conscience. The aim of this study was to: (1) describe and compare stress related to troubled conscience among perianaesthesia nurses in three countries who have been working in a COVID-ICU during the pandemic, (2) compare their levels of troubled conscience between working in a COVID-ICU and their usual workplace, and (3) compare nurses that usually work in an ICU department with nurses who usually work outside of the ICU. METHODS: A descriptive, international cross‐sectional online survey including the Stress of Conscience Questionnaire (SCQ) was distributed between organizational member countries of the International Collaboration of PeriAnaesthesia Nurses. RESULTS: A total of 246 nurses from three countries participated. Significant differences were found in stress of conscience when working in the Covid-ICU between Sweden 31.8 (8.6), Denmark 23.1 (8.6), and Netherlands 16.4 (6.5) p < 0.001. Significant differences were also found between nurses working in a COVID-ICU in contrast with their usual workplace: 23.1(5.6) versus 17.7(5.3), p < 0.001. The most stressful aspect of conscience reported was that work in the COVID-ICU was so demanding, nurses did not have sufficient energy to be involved with their family as much as they desired. No statistical differences were found between nurses that usually work in an ICU department with nurses who usually work outside of the ICU. CONCLUSION: The COVID-19 pandemic has negatively impacted stress of conscience among nurses working in the COVID-ICU. Swedish nurses were found to be more significantly impacted. This could be related to low numbers of existing ICU beds and ICU nurses prior to the pandemic necessitating a longer time required for working in a COVID-ICU. Stress of conscience also increased when working in the Covid-ICU compared to working in the usual workplace, and the most stressing aspect reported was that COVID-ICU work was so demanding that nurses did not have the energy to devote themselves to their family as they would have liked

Mapping registered nurse anaesthetists' intraoperative work: tasks, multitasking, interruptions and their causes, and interactions: a prospective observational study

Introduction Safe anaesthesia care is a fundamental part of healthcare. In a previous study, registered nurse anaesthetists (RNAs) had the highest task frequency, with the largest amount of multitasking and interruptions among all professionals working in a surgical team. There is a lack of knowledge on how these factors are distributed during the intraoperative anaesthesia care process, and what implications they might have on safety and quality of care. Objective To map the RNAs' work as done in practice, including tasks, multitasking, interruptions and their causes, and interactions, during all phases of the intraoperative anaesthesia work process. Methods Structured observations of RNAs (n=8) conducted during 30 procedures lasting a total of 73 hours in an operating department at a county hospital in Sweden, using the Work Observation Method By Activity Timing tool. Results High task intensity and multitasking were revealed during preparation for anaesthesia induction (79 tasks/hour, 61.9% of task time spent multitasking), anaesthesia induction (98 tasks/hour, 50.7%) and preparation for anaesthesia maintenance (86 tasks/hour, 80.2%). Frequent interruptions took place during preoperative preparation (4.7 /hour), anaesthesia induction (6.2 /hour) and preparation for anaesthesia maintenance (4.3 /hour). The interruptions were most often related to medication care (n=54, 19.8%), equipment issues (n=40, 14.7%) or the procedure itself (n=39, 14.3%). RNAs' work was conducted mostly independently (58.4%), but RNAs interacted with multiple professionals in and outside the operating room during anaesthesia. Conclusion The tasks, multitasking, interruptions and their causes, and interactions during different phases illustrated the RNAs' work as done, as part of a complex adaptive system. Management of safety in the most intense phases-preparing for anaesthesia induction, induction and preparing for anaesthesia maintenance-should be investigated further. The complexity and adaptivity of the nature of RNAs' work should be taken into consideration in future management, development, research and education.</p

Does the Reserve Options Mechanism really decrease exchange rate volatility? The Synthetic Control Method Approach

After the invention of the Reserve Option Mechanism (ROM) by the Central Bank of Turkey, it has been debated whether it can help decrease the volatility of foreign exchange rate. In this study, I apply a new micro-econometric technique, the synthetic control method, in order to construct a counterfactual foreign exchange rate volatility in the absence of the ROM. I find that, USD/TRY rate is less volatile under the ROM. However, the ROM has not worked efficiently after the announcement of FED's tapering in May 2013. Furthermore, the ROM could have decreased the volatility of foreign exchange rate if FED had not started tapering

Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study

Objectives: The work context of the operating room (OR) is considered complex and dynamic with high cognitive demands. A multidimensional view of the complete preoperative and intraoperative work process of the surgical team in the OR has been sparsely described. The aim of this study was to describe the type and frequency of tasks, multitasking, interruptions and their causes during surgical procedures from a multidimensional perspective on the surgical team in the OR.Design: Prospective observational study using the Work Observation Method By Activity Timing tool.Setting: An OR department at a county hospital in Sweden.Participants: OR nurses (ORNs) (n=10), registered nurse anaesthetists (RNAs) (n=8) and surgeons (n=9).Results: The type, frequency and time spent on specific tasks, multitasking and interruptions were measured. From a multidimensional view, the surgical team performed 64 tasks per hour. Communication represented almost half (45.7%) of all observed tasks. Concerning task time, direct care dominated the surgeons’ and ORNs’ intraoperative time, while in RNAs’ work, it was intra-indirect care. In total, 48.2% of time was spent in multitasking and was most often observed in ORNs’ and surgeons’ work during communication. Interruptions occurred 3.0 per hour, and the largest proportion, 26.7%, was related to equipment. Interruptions were most commonly followed by professional communication.Conclusions: The surgical team constantly dealt with multitasking and interruptions, both with potential impact on workflow and patient safety. Interruptions were commonly followed by professional communication, which may reflect the interactions and constant adaptations in a complex adaptive system. Future research should focus on understanding the complexity within the system, on the design of different work processes and on how teams meet the challenges of a complex adaptive system.</p

Predicted basal metabolic rate and cancer risk in the European Prospective Investigation into Cancer and Nutrition

Emerging evidence suggests that a metabolic profile associated with obesity may be a more relevant risk factor for some cancers than adiposity per se. Basal metabolic rate (BMR) is an indicator of overall body metabolism and may be a proxy for the impact of a specific metabolic profile on cancer risk. Therefore, we investigated the association of predicted BMR with incidence of 13 obesity-related cancers in the European Prospective Investigation into Cancer and Nutrition (EPIC). BMR at baseline was calculated using the WHO/FAO/UNU equations and the relationships between BMR and cancer risk were investigated using multivariable Cox proportional hazards regression models. A total of 141,295 men and 317,613 women, with a mean follow-up of 14 years were included in the analysis. Overall, higher BMR was associated with a greater risk for most cancers that have been linked with obesity. However, among normal weight participants, higher BMR was associated with elevated risks of esophageal adenocarcinoma (hazard ratio per 1-standard deviation change in BMR [HR1-SD]: 2.46; 95% CI 1.20; 5.03) and distal colon cancer (HR1-SD: 1.33; 95% CI 1.001; 1.77) among men and with proximal colon (HR1-SD: 1.16; 95% CI 1.01; 1.35), pancreatic (HR1-SD: 1.37; 95% CI 1.13; 1.66), thyroid (HR1-SD: 1.65; 95% CI 1.33; 2.05), postmenopausal breast (HR1-SD: 1.17; 95% CI 1.11; 1.22) and endometrial (HR1-SD: 1.20; 95% CI 1.03; 1.40) cancers in women. These results indicate that higher BMR may be an indicator of a metabolic phenotype associated with risk of certain cancer types, and may be a useful predictor of cancer risk independent of body fatness

Musik, en omvårdnadshandling

I den dagliga vården av patienten står sjuksköterskan inför många utmaningar där en helhetssyn på patienten ska ligga till grund för sjuksköterskans vård. Att låta patienten lyssna till musik kan uppfattas som något ”extra”, dvs. inte som något som ingår som en naturlig del i det dagliga vårdarbetet. Lugn musik kan skapa en förändring i patientens inre, i upplevelsen av en situation samt stänga ute oönskade och obehagliga ljud. Musik kan distrahera, ge avkoppling, öka välbefinnande, främja hälsa och lindra lidande. Musik är därför en omvårdnadshandling som hör hemma i dagens sjukvård, den är billig samt kräver inte mycket tid eller resurser. Aktuell artikel avser att ge en sammanställning över nuvarande kunskapsläge av musik som omvårdnadshandling.Clinical nursing practice faces many challenges in caring for the needs of hospitalized patients. Meeting the holistic needs of patient’s poses another challenge because these therapeutic interventions, e.g. music intervention, are usually viewed as “extras”, not as basic skills. Providing music to the patients is an inexpensive technique, which does not require the use of extra manpower and resources. Music intervention can maximize the effort of promoting comfort and relaxation, as well as reduce or control distress for the patient. This paper intends to provide an overview over the present knowledge of describing the clinical effects of music intervention in hospitalized patients

Ungdomars stress i skolan

Syftet med studien är att undersöka vilken kunskap lärare med elever i årskurs 6-9 har om elevers stress och vad de gör och kan tänka sig göra för att underlätta för stressade elever, och vad jag i min kommande profession som svensklärare kan ta med mig ut av deras erfarenheter. Metoden jag använt för att ta reda på svaren till frågeställningarna är kvalitativa intervjuer. Resultatet visar på att lärare är relativt kunniga om vad stress är, dock skulle de behöva mer kunskap för att se symptomen på stress hos sina elever. Lärarna har en hel del konkreta metoder för att förebygga och underlätta för stressade elever, och många av dem finner stöd i litteraturen. Jag har fått en del nya idéer om hur man just i svenskämnet kan förebygga stress. Slutligen är det viktigt att identifiera stress på ett tidigt stadium så att man på så sätt kan sätta in stressförebyggande åtgärder och eliminera stressfaktorerna så vi inte utsätter eleverna för mer stress än nödvändigt.The purpose of this study is to examine what knowledge teachers with students in the age 12 to 15 have regarding student stress and what they do and are prepared to do to relive stressed pupils, and what I in my future profession as Swedish Instructor can take with me of their experiences. The metod I have used to determine the answers to the questions was qualitative interviews. The result shows that Teatchers are relatively knowledgable about stress, but they could use more knowledge about recognizing the symptoms in thier students. The teatchers have a lot of concrete ways to prevent stress make it easier for stressed students, many of them find solice in literature on the subject. I have obtained some new ideas about how you can prevent stress in the swedish subject. Finaly its important to identify stress at an early stage so that stress realiving metods can be aplied and the stress factors eliminated so that we don't put the pupils through unnecesary stress

Vietnamese, activity and pain : A cultural perspective in occupational therapy focus

Hur påverkar kulturen det kliniska arbetsterapeutiska arbetet med människor från en annan kulturell bakgrund? Den/de referens-ram/ar arbetsterapeuter använder sig av kommer, åtminstone oftast, från västvärlden med de värderingar och normer som finns här. I östasiatiska kulturer finns en delvis annan ”tids- och jag-uppfattning” än i västvärlden. Om värderingar och normer inte stämmer med patienternas finns en risk att behandlingen inte blir av tillräckligt god kvalitet. Smärtpatienter är en stor patientgrupp i primärvården. Förändringar av aktivitetsförmågan som påverkar delaktighet i både personligt liv, socialt liv och arbetsliv förekommer ofta. För att knyta samman de båda aspekterna, kultur och aktivitet, gjordes en kvalitativ studie med syfte att belysa uppfattningar om smärta vid aktivitet samt kulturens betydelse för en grupp vietnameser boende i Sverige. Fem informanter med smärta valdes genom lämplighetsurval och intervjuades med semistrukturerade frågor. Genom snöbollssampling valdes två informanter för ett samtal om kulturens betydelse med hjälp av frågeområden från en teoretisk modell. Genom att använda begreppen i två olika teoretiska modeller och fenomengrafisk metod redovisas uppfattningar om smärta vid aktivitet och hur kulturen påverkar dessa uppfattningar. Resultatet visar att smärtan påverkar aktivitetsförmågan negativt och att kulturella faktorer kan göra att arbetsterapeut och patient missuppfattar varandra.How does culture influence occupational therapy practice with people from another cultural background. The clinical frame/es used by occupational therapists is, most likely, based on values and norms from the western world. In East Asian culture there is partly a different way to relate to self and temporal orientation than in west. If values and norms don’t fit the patient the risk is that the treatment will not be good enough. Patients in pain are a large group in primary care. Change in activities will often have affect on the participation in personal, social and work related areas. In order to connect these two aspects, culture and activity, a qualitative study was made in  purpose of enlightening opinions on pain in activity and the influence of culture in a group of Vietnamese living in Sweden. Five informants with pain were chosen by suitable selection and were interviewed by semi structured questions. With snowball selection two informants were chosen to a conversation about the influence of culture. The questions emerged from a theoretical model. In using the concepts of two different theoretical models and phenomenografical method the experience of pain due to activity and how culture influence these opinions is shown. The result show that pain has a negative impact on the ability to be active and that cultural factors might lead to misunderstanding between occupational therapist and patient