Fræðsla á skurð- og lyflækningadeildum : nám er forsenda þess að manneskja geti aðlagast nýjum aðstæðum

Neðst á síðunni er að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenHvergi í menntakerfinu er neitt námskeið sem undirbýr einstaklinginn fyrir veikindi og sjúkrahúsinnlagnir. Það nám byrjar hjá flestum þegar síst varir, þegar veikindin, slysin eða áföllin skella á. Fjölgun meðferðaúrræða hefur leitt til aukinnar eftirspurnareftir meðferð. Á sama tíma hafa auknar kröfur um hámarkshagkvæmi haft þau áhrif að legutími á sjúkradeildum hefur styst. Styttri legutími hefur það í för með sér að sjúklingar eru oftast útskrifaðir af sjúkrahúsum áður en meðferð er lokið. Langoftast útskrifast þeir heim til sín þar sem aðstandendur taka við umönnun þeirra

Fyrst manneskja þar á eftir sjúklingur : ákvarðanir um meðferðarúrræði

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenTilgangurinn að baki skrifa um „fyrst manneskja þar á eftir sjúklingur“ er að opna umræðu um meðferðarmöguleika í ljósi laga um réttindi sjúklinga. Það er ekki unnt að skoða meðferðarmöguleika án þess að hugleiða jafnhliða mannleg samskipti innan heilbrigðiskerfisins

Multidisciplinary Pain Rehabilitation Programs in Iceland: An Exploration and Description of the Short-term and Long-term Effects

Aim: The overall aim of the thesis was to explore and describe the short- and long-term effects of three multidisciplinary pain rehabilitation programs on pain severity and pain interference and the long-term effects on pain self management, sleep quality, well-being, health, and health-related quality of life (HRQOL). Content of the thesis: This thesis consists of three original papers. Paper I comprises a phenomenological study, while Papers II and III present results from longitudinal prospective cohort studies. People in chronic pain who were on a waiting list for multidisciplinary pain rehabilitation at one of three centres in Iceland – Reykjalundur, Kristnes and Rehabilitation and Health Clinic at Hveragerði– were invited to participate. The program lasted between four and seven weeks, with data collected pre-treatment, at program completion, three months after program completion and in a one-year follow-up. Methods: Paper I was a phenomenological study that employed the Vancouver School of Doing Phenomenology. Eleven participants were interviewed, with 11 interviews conducted pre-treatment and 10 occurring three months after the participants had completed the intervention. Paper II was a longitudinal prospective cohort study with questionnaires filled out pre treatment, at completion and at one-year follow-up. Paper III was a longitudinal prospective cohort study with questionnaires completed pre treatment and at one-year follow-up. Results: Most participants were women aged 20–69 (M = 47.3) who were married or living with a partner. Paper I: The overarching theme was the journey of breaking the vicious circle of chronic pain. Prior to attending rehabilitation, the participants were in survival mode, stuck in a vicious circle of chronic pain. They used a variety of strategies to relieve and conceal their pain. Reaching out for professional help was a positive turning point. Whilst attending the pain rehabilitation program, participants learned to deconstruct their habitual but inefficient ways of dealing with chronic pain. Three months after completing the program, they were still rebuilding their daily lives. Pain was still present but interfered much less with daily activities than previously. Paper II: Eighty-one participants responded to all three questionnaires. Average self-reported pain severity decreased at program completion and at one-year follow-up (p < 0.001), and the interference of pain with general activities, mood, walking ability, sleep and enjoyment of life also declined. At one-year follow-up, more than a fifth (21%) of participants rated their health as good or very good, which was markedly better than before treatment (7%; p < 0.001). The three most commonly used pain self-management strategies pre-treatment were positive thinking (68%), medication (58%) and distraction (58%). No change was found in use of pain self-management strategies between pre-treatment and one-year follow-up. Paper III: Seventy-nine participants responded to both questionnaires. Participants scored their pain lower at one-year follow-up than pre-treatment (p < 0.001). At one year follow-up, three times as many participants (18%) slept through the night (p = 0.004) as had done so pre-treatment (6%). Most had disrupted sleep, mainly because of pain and psychological problems, at both the pre-treatment and one-year follow-up time points. HRQOL increased at one-year follow-up, with higher scores in all areas except the Mental Component Summary (MCS). The pre-treatment Physical Component Summary (PCS) was the only potential predictor for PCS at one-year follow up. Higher pre-treatment MCS scores and having pursued higher education predicted higher MCS scores at one-year follow-up. Sleep problems, being a woman and having children under 18 years predicted lower MCS scores at one-year follow-up. Conclusion: Pain rehabilitation programs can be the first step toward breaking the vicious circle of chronic pain. The intervention was effective for participants at one-year follow-up. Their self-reported pain severity and pain interference had decreased, Moreover, their health and HRQOL increased. However, they had failed to continue using the methods highlighted in the pain rehabilitation program, and their sleep problems persisted. The findings reveal the need for more emphasis on sleep problems and mental health in connection with chronic pain in multidisciplinary pain rehabilitation interventions. Therefore, some sort of follow-up is recommended for support, education and maintaining the long-term effect of the intervention.The University of Akureyri Research Fund, the Research Fund of Ingibjörg R. Magnúsdóttir, the KEA Research Fund, and the Memorial Fund of Kristín Thoroddsen

Work-related stress and workenvironment of Icelandic female head nurses

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnBakgrunnur og tilgangur rannsóknar: Samkvæmt erlendum rannsóknum finna hjúkrunardeildarstjórar fyrir miklu vinnuálagi sem skapað getur vinnutengda streitu. Tilgangur þessarar rannsóknar var í fyrsta lagi að kanna hvort hjúkrunardeildarstjórar á Íslandi hafi einkenni um vinnutengda streitu, í öðru lagi hverju hún tengist og í þriðja lagi hvaða þættir stuðla að því að þeir séu sáttir eða ósáttir við starfsumhverfi sitt. Aðferðin var lýsandi þversniðsrannsókn. Þýðið voru allir kvenhjúkrunardeildarstjórar á öllum sjúkrahúsum landsins. Þeir fjórir karlmenn, sem gegna því hlutverki, voru ekki með í þýðinu. Spurningalisti var sendur rafrænt á 136 kvenhjúkrunardeildarstjóra í gegnum Outcome­kannanakerfið og svöruðu 110 (81%). Niðurstöður leiddu í ljós að 45% hjúkrunardeildarstjóranna voru yfir streituviðmiðum PSS­streitukvarðans (The Perceived Stress Scale). Ungir hjúkrunardeildarstjórar, þeir sem höfðu litla stjórnunarreynslu og þeir sem unnu langan vinnudag voru líklegri en aðrir til að vera yfir streituviðmiðunarmörkum. Tæplega þriðjungur hjúkrunardeildarstjóranna (28%), sem ekki fundu fyrir streitu, reyndust yfir streituviðmiðunum. Fram komu sterk jákvæð tengsl milli vinnutengdrar streitu og þess að vera andlega úrvinda eftir vinnudaginn. Það sem hjúkrunardeildarstjórarnir töldu geta minnkað vinnutengda streitu mest var fullnægjandi mönnun og að hafa aðstoðardeildarstjóra. Þeir nefndu einnig mikilvægi stuðnings, betra upplýsingaflæðis, að fækka þyrfti verkefnum og að tilgreina þyrfti betur starfssvið hjúkrunardeildarstjóra. Hjúkrunardeildarstjórarnir voru sáttir við margt, svo sem gott samstarfsfólk, góðan starfsanda, ánægjuleg samskipti og að starfið væri fjölbreytt, skemmtilegt og gefandi. Ósáttastir voru þeir við starfsmannaeklu, tímaálag, stuðnings­ og skilningsleysi yfirstjórnar, fjárskort, eilífar sparnaðarkröfur og lág laun miðað við ábyrgð. Helstu ályktanir: Að vera hjúkrunardeildarstjóri er streitusamt starf sem sést á því að tæplega helmingur hjúkrunardeildarstjóranna var yfir viðurkenndum streituviðmiðum og nær þriðjungur hjúkrunardeildarstjóranna var yfir streituviðmiðunum án þess að gera sér grein fyrir því. Áhættuþættir vinnutengdrar streitu voru, samkvæmt niðurstöðum þessarar rannsóknar, meðal annars að vera ungur í starfi, hafa ekki langa stjórnunarreynslu og vinna langan vinnudag. Þrátt fyrir allt voru hjúkrunardeildarstjórar sáttir við margt í sínu starfsumhverfi, svo sem gott samstarfsfólk.Background and purpose. Head nurses work under great pressure and can therefore experience work­related stress. The purpose of this investigation was, firstly, to study whether head­nurses in Iceland have symptoms of work­related stress, secondly, what the underlying factors are and thirdly, what factors contribute to their contentment or discontentment with their work­environment. The method was descriptive cross­sectional. The population was all head nurses in all hospitals in Iceland. The four male head nurses were not included. A questionnaire was sent through Outcome web­ survey to 136 female head nurses of which 110 participated (81%). Results showed that 45% of the head nurses were over the stress benchmark on the The Perceived Stress Scale (PSS). Being a young head­nurse, having short administrative experience as well as long working hours were risk factors to exceed the stress limits. Nearly one­third of the head nurses (28%) were over the stress benchmark without realizing or acknowledging it. There was a strong positive relationship between work­related stress and being mentally exhausted at the end of the workday. What the head nurses felt were the most important factors in decreasing work­related stress was adequate number of personnel and having an assistant head nurse. They also mentioned support, decreased number and scope of tasks, and more accurate job description. The head nurses were content with many aspects of their jobs, such as good co­workers, work atmosphere, satisfying communication and found their work versatile, enjoyable and rewarding. They were discontent with lack of staff, time pressure, lack of support from superiors, lack of funds and constant requests to cut down costs as well as being paid low salaries compared to great responsibility. Conclusions: Being a head­nurse is stressful as can be seen by the fact that almost half of the head­nurses were over the stress benchmark and almost one third of the head nurses were over the stress benchmark without realizing it. The main risk­factors of work­ related stress are: being young, short administrative experience, and long working­hours. Despite all, the head­nurses were content with many factors in their work­environment such as good co­workers.Félagi íslenskra hjúkrunarfræðing

Musculoskeletal pain and its correlation to stress in Icelandic female head nurses

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnBakgrunnur og tilgangur rannsóknar: Heilsa hjúkrunardeildarstjóra er ekki nægjanlega rannsökuð en vitað er að starfið er streitusamt. Engin rannsókn fannst þar sem rannsakaðir voru stoðkerfisverkir hjá hjúkrunardeildarstjórum. Tilgangur þessarar rannsóknar var að kanna stoðkerfisverki hjá hjúkrunardeildarstjórum sl. sex mánuði á þremur líkamssvæðum: hálsi/hnakka, herðum/öxlum og neðri hluta baks, og fylgni verkjanna við streitu. Aðferðin var lýsandi þversniðsrannsókn. Þátttakendur í rannsókninni voru kvenhjúkrunardeildarstjórar á öllum sjúkrahúsum landsins. Spurningalisti var sendur rafrænt á 136 hjúkrunardeildarstjóra í gegnum Outcome-kannanakerfið, 110 svöruðu (81%). Spurningar, sem snúa að stoðkerfisverkjum, voru fengnar frá rannsóknar- og heilbrigðisdeild Vinnueftirlitsins og voru verkir metnir á kvarðanum 1-10. Streita var metin með tíu spurninga PSSstreitukvarðanum. Lýsandi tölfræði og ályktunartölfræði var notuð við úrvinnslu gagna. Niðurstöður leiddu í ljós talsverða verki hjá hjúkrunardeildarstjórum en 83% þeirra höfðu haft verki í herðum/öxlum síðustu sex mánuði og um 81% höfðu haft verki í hálsi/hnakka á sama tímabili. Um 72% hjúkrunardeildarstjóranna höfðu haft verki í neðri hluta baks síðustu sex mánuði. Því lengur sem hjúkrunardeildarstjórarnir höfðu haft verki þeim mun meiri voru verkirnir í hálsi/hnakka (F(4, 92) = 29,45, p<0,001), herðum/öxlum (F(4, 97) = 30,0, p<0,001) og neðri hluta baks (F(4, 89) = 33,3, p<0,001). Einnig komu fram jákvæð tengsl milli styrkleika verkja og dagafjölda verkja síðastliðna sex mánuði á einu líkamssvæði við annað. Þeir hjúkrunardeildarstjórar, sem voru yfir streituviðmiði, höfðu verki í fleiri daga og höfðu að meðaltali meiri verki frá hálsi/hnakka og herðum/öxlum en þeir sem voru yfir streituviðmiði. Ekki kom fram fylgni milli verkja í neðri hluta baks og streitu. Helstu ályktanir: Skoða þarf leiðir til að minnka stoð- kerfisverki hjúkrunardeildarstjóra og einnig þarf að finna leiðir til að minnka streitu þeirra og vinna markvisst að heilsusamlegra vinnuumhverfi fyrir þá. Heilsa þeirra má ekki bera skaða af krefjandi vinnuumhverfi.Background and aim: The health of head nurses is not adequately studied. However, it is known that it is a stressful job. No research was found that studied their musculoskeletal pain and its correlation to stress. The aim of this study was to investigate musculoskeletal pain among Icelandic female head nurses in the last six months in three areas of the body: the neck area, shoulder area and the lower-back and the correlation of this pain to stress. The method was a descriptive cross-sectional survey. Participants in the study were female head nurses of the country's hospitals. A questionnaire was sent to 136 head nurses through Outcome web-survey, 110 responded (81%). The questions about musculoskeletal pain are from Vinnueftirlitið (Head Office of the Administration of Occupational Safety and Health) and the pain was evaluated on a scale of 1-10. Stress was measured with the ten questions PSS-scale. Participants were instructed that the study was about their work-environment. Exploratory statistics and descriptive statistics were used for statistical analysis. The results show that during the last six months 83% of the head nurses had experienced musculoskeletal pain in the shoulder area, 81% in the neck area and about 72% of them had had musculoskeletal pain in the lower back. The longer the time the head nurses had felt pain the greater the pain was (neck area: F(4, 92) = 29.45, p<0.001, shoulder area: F(4, 97) = 30.0, p<0.001, lower back: F(4, 89) = 33.3, p<0.001). A positive correlation was also found between the severity of pain and the number of days in pain in various sites of musculoskeletal pain in the last six months. The head nurses who suffered stress had pain longer and had more pain from the neck and shoulder area than those who did not suffer stress. No correlation was found between low-back pain and stress. Conclusions: Further studies regarding musculoskeletal pain of head nurses and how to reduce it are called for. A conscious effort must be made to make their work environment more health-enhancing. Their health must not bear the damage from a demanding work environmen

Pain, sleep, and health-related quality of life after multidisciplinary intervention for chronic pain

Funding: The University of Akureyri Research Fund (R1508, R1609, R1705, R1906), Research Fund of Ingibjörg R. Magnúsdóttir, Memorial Fund of Kristín Thoroddsen, and KEA Research Fund are thanked for funding. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants’ one-year follow-up HRQOL. Seventy-nine patients aged 20–68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p < 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention.Peer reviewe

Pain rehabilitation’s effect on people in chronic pain : A prospective cohort study

Funding Information: Funding: The University of Akureyri Research Fund (R1508, R1609, R1705, R1906), Research Fund of Ingibjörg R. Magnúsdóttir, Memorial Fund of Kristín Thoroddsen, and KEA Research Fund are thanked for funding. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Multidisciplinary long-term pain rehabilitation programs with a team of healthcare professionals are an integrated approach to treat patients with chronic non-malignant pain. In this longitudinal prospective cohort study, we investigated the long-term effects of multidisciplinary pain rehabilitation on the self-reported causes of pain, pain self-management strategies, sleep, pain severity, and pain’s interference with life, pre-and post-treatment. Eighty-one patients, aged 20–69 years, with chronic pain responded. The two most frequently reported perceived causes of pain were fibromyalgia and accidents. The difference in average self-reported pain severity decreased significantly at one-year follow-up (p < 0.001), as did pain’s interference with general activities, mood, walking ability, sleep, and enjoyment of life. At one-year follow-up, participants (21%) rated their health as good/very good and were more likely to state that it was better than a year before (20%). No change was found in the use of pain self-management strategies such as physical training at one-year follow-up. The intervention was effective for the participants, as reflected in the decreased pain severity and pain interference with life.Peer reviewe

Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain

Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants’ one-year follow-up HRQOL. Seventy-nine patients aged 20–68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p &lt; 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention

Fræðsla á skurð- og lyflækningadeildum : nám er forsenda þess að manneskja geti aðlagast nýjum aðstæðum

Neðst á síðunni er að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenHvergi í menntakerfinu er neitt námskeið sem undirbýr einstaklinginn fyrir veikindi og sjúkrahúsinnlagnir. Það nám byrjar hjá flestum þegar síst varir, þegar veikindin, slysin eða áföllin skella á. Fjölgun meðferðaúrræða hefur leitt til aukinnar eftirspurnareftir meðferð. Á sama tíma hafa auknar kröfur um hámarkshagkvæmi haft þau áhrif að legutími á sjúkradeildum hefur styst. Styttri legutími hefur það í för með sér að sjúklingar eru oftast útskrifaðir af sjúkrahúsum áður en meðferð er lokið. Langoftast útskrifast þeir heim til sín þar sem aðstandendur taka við umönnun þeirra

Börn og hreyfing

Verkefnið er lokaðRitgerð þessi er unnin sem lokaverkefni til B.Ed.- prófs við kennaradeild Háskólans á Akureyri vorið 2008. Lokaverkefnið skiptist í tvo hluta og er fyrri hluti þess fræðileg umfjöllun um hreyfiþroska barna, ásamt þáttum sem byggja á honum. Seinni hlutinn fjallar um nokkrar litlar kannanir sem gerðar voru um viðhorf nokkurra aðila til þess hvort orðið hefðu breytingar á hreyfingu barna í áranna rás. Í þessum könnunum tóku þátt ýmsir fagaðilar; leikskóla- og íþróttakennarar, sjúkra- og þroskaþjálfi, ásamt foreldum 5 ára barna. Að síðustu voru einstaklingar fæddir á árunum 1975 og 1985 beðnir um að segja frá sinni hreyfingu í æsku. Einnig sögðu foreldrar barna fæddra 1995 og 2002 frá hreyfingu þeirra. Rannsóknin var eigindleg og var notaður spurningalisti sem leikskólakennarar, íþróttakennari, sjúkra- og þroskaþjálfarar svöruðu og meginniðurstaða þessara fagaðila reyndist sambærileg, þ.e. að það hafi orðið neikvæð breyting á hreyfingu barna. Spurningar voru sendar foreldrum 5 ára barna bréfleiðis og reyndust niðurstöðurnar mjög svipaðar hjá flestum foreldranna um að neikvæðar breytingar hafi orðið á hreyfingu barna. Einstaklingarnir sem fæddir eru 1975 og 1985 voru spurðir um hreyfingu þeirra frá því á yngri árum og foreldrar þeirra einstaklinga sem fæddir eru 1995 og 2002 voru spurðir um hvernig barna þeirra væri háttað. Það kemur fram hjá þessum einstaklingum að viss breyting hefur átt sér stað á hreyfingu 5 ára barna hérna á Sauðárkróki. Rannsakandi telur þurfa að efla til muna alla hreyfingu barna í þeirra nánasta umhverfi og þurfa foreldrar, leikskólakennarar og aðrir þeir sem annast börn að leggja sitt af mörkum og stuðla að aukinni hreyfingu barna. Börn sem hafa verið dugleg að hreyfa sig frá unga aldri til unglingsára og lengur hafa flest gott sjálfstraust sem fleytir þeim í gegnum lífið, einnig getur hreyfing haft fyrirbyggjandi áhrif gegn ýmsum sjúkdómum á fullorðinsárum