Caisa Oster - Academia.edu (original) (raw)

Papers by Caisa Oster

Health Expectations, Oct 11, 2019

Patients' willingness to participate in clinical research is crucial for producing meaningful and... more Patients' willingness to participate in clinical research is crucial for producing meaningful and generalizable results. 1,2 Today, many studies fail to reach representativeness, 3,4 regardless of study design, country or field of research. 5,6 For example, a review found that only a third of the original target population were recruited in randomized, controlled multicenter studies performed in the UK between 1994 and 2002. 7 In addition to the risk of misleading outcomes, 8 scientists are also often forced to cancel research in advance due to an insufficient number of participants. 6 Participant recruitment in psychiatric research is particularly unsatisfying. 9,10 For example, only

Aim: The aim was to study how young adults with experience of a psychotic disorder perceive parti... more Aim: The aim was to study how young adults with experience of a psychotic disorder perceive participation in care. Another aim was to study how the same group experiences rehabilitation and influence regarding medical treatment. Method: The study is qualitative descriptive and semi structured interviews with five young adults between 18-25 years of age, were conducted. Results: Most of the respondents experienced that they were involved in the care provided. When put on the sick list, rehabilitation in the form of group activities were experienced as valuable. Some respondents experienced that the group activities were expensive. The participants experienced influence regarding medical treatment, for example that medical changes were easily implemented. The respondents requested increased continuity concerning medical follow-up. Conclusion: The respondents perceived a need for increased impact within the hospital based care as well as increased continuity concerning follow-up of medical treatment. It is recommended that information concerning possible rehabilitation initiatives is provided to young adults with a psychotic disorder.

Journal of Psychoactive Drugs, Apr 20, 2020

Although opioid maintenance treatment lowers mortality and has proven efficacy in reducing opioid... more Although opioid maintenance treatment lowers mortality and has proven efficacy in reducing opioid use, it is not an option for every person with an opioid addiction. Studies of the experiences of those who have overcome their addiction without pharmaceuticals are rare, but vital to understanding the quitting process and how it can be facilitated. This study investigated what persons with a previous heroin addiction perceived as helpful when overcoming their addiction without the use of pharmaceuticals, and what they consider important for health services to consider. Eleven adults with former heroin addiction participated. Most described the leaving process as prolonged and including many attempts. Experiences such as being worn out and numb, life-threatening overdoses, personal losses or a growing feeling of missing important stages in life fueled the decision process. Envisioning a future without drugs was described as an important component. To maintain the decision to refrain from heroin use the possibility to gain a new social context was crucial. Results imply that health care professionals should be proactive by seizing the moment of opportunity for change (e.g., after an overdose), and should be empathetic and never give up on a person. Those concerned with care, welfare and other support or control systems in society must cooperate to offer more personalized support.

Academic Psychiatry, Dec 5, 2019

Objective Few studies report about the feedback students receive in undergraduate psychiatry trai... more Objective Few studies report about the feedback students receive in undergraduate psychiatry training. The aim of this study was to evaluate an effort to optimize feedback to medical students during rotations in psychiatry. Methods A structured feedback tool was constructed and introduced during psychiatric rotations. At the end of each week during 3 weeks of clinical psychiatry training, 86 medical students anonymously reported whether they had received any feedback, if the new feedback tool had been used and if the received feedback felt valuable. At the end of rotations, students were also asked to leave text comments about their experience of the feedback tool. Course evaluations concerning perceived feedback, before and after introducing a feedback tool, were compared. Results The 86 students reported about feedback at three occasions, leaving a total of 212 reports (82% response rate). In all reports, the students affirmed having received some feedback, either with or without the feedback tool. In the 123 (58%) reports where feedback was received with the feedback tool, 110 (89%) answered that the feedback was experienced as valuable. Among those 89 (42%) reports where feedback had been delivered without the feedback tool, 41 (46%) described the feedback as valuable. Course evaluation of perceived feedback improved. Conclusions Feedback to medical students during psychiatry rotations seems to be optimized by using a structured feedback tool.

Journal of Nursing Management, Oct 22, 2019

Nursing in psychiatric care has been accused of a lack of autonomy and becoming instrumental by a... more Nursing in psychiatric care has been accused of a lack of autonomy and becoming instrumental by acquiescing to the medical model, mostly focusing on delivering treatments prescribed by physicians (Bladon, 2017; Lakeman & Molloy, 2017). Specifically, nursing has been described as having a marginalized status (Holmberg, Caro, & Sobis, 2018), unclear role definition (Delaney & Johnson, 2014) and being invisible (Harrison, Hauck, & Ashby, 2017), all of which has led to difficulties in implementation of theories and models (Barker, 2001; Bladon, 2017). Furthermore, psychiatric inpatient care is often confusing from the patients' perspective, creating difficulties to

Journal of Burn Care & Research, Oct 7, 2020

Personality trait stability may be influenced by several factors, there among different life even... more Personality trait stability may be influenced by several factors, there among different life events such as psychological trauma. However, little is known regarding trait stability after physical trauma. Therefore, our primary aim was to assess the extent of stability in personality in burn patients during the first year after injury. Eighty-four burn patients, admitted to a national burn center, were assessed with the Swedish universities Scales of Personality during acute care and 12 months postburn. Personality domain scores remained stable between acute care and 12 months postburn. On the trait level, the only change was seen in personality trait Stress Susceptibility, where burn patients’ scores were lower compared with norm scores during acute care but then increased, and normalized, at 12 months postburn. To conclude, personality scores remained relatively stable during the first year after burn trauma.

Bakgrund: Specialistsjuksköterskans kompetens är en fördjupning av de kunskaper och förmågor som ... more Bakgrund: Specialistsjuksköterskans kompetens är en fördjupning av de kunskaper och förmågor som erhållits i grundutbildningen. Behovet av specialiserade sjuksköterskor ökar men då arbetsuppgifterna mellan grund-och specialistutbildade sjuksköterskor inte skiljer sig nämnvärt åt kan detta få till följd att specialistsjuksköterskorna lämnar det kliniska arbetet. Den specialistkompetens som efterfrågats riskerar därmed att försvinna. På denna grund, och som ett led i att förtydliga specialistsjuksköterskans roll i psykiatrisk slutenvård, är det av intresse att uppmärksamma hur specialistsjuksköterskan uppfattas och vilka förväntningar som finns på dennes kompetens. Syfte: att beskriva läkares uppfattningar av specialistsjuksköterskans kompetens i psykiatrisk vård. Metod: Åtta kvalitativa semistrukturerade intervjuer analyserades med en fenomenografisk ansats. Resultat: Huvudresultaten sammanfattades i fem kategorier: Specialistsjuksköterskans roll är otydlig och osynlig; Specialistsjuksköterskan utför särskilda arbetsuppgifter; Specialistsjuksköterskan besitter fördjupad kompetens; Specialistkompetens leder till personlig utveckling samt Specialistsjuksköterskan är en ambassadör. Slutsats: Det behövs en ökad förståelse för specialistsjuksköterskans kompetens. För att detta ska kunna ske efterfrågas en tydligare beskrivning av vad det innebär att arbeta som specialistsjuksköterska på en psykiatrisk slutenvårdsavdelning.

Burns, Dec 1, 2019

Introduction: This qualitative study aims to explore former burn patients' perception of burn-spe... more Introduction: This qualitative study aims to explore former burn patients' perception of burn-specific health and investigate how these experiences correspond to the subscales in the Burn Specific Health Scale-Brief (BSHS-B). Method: Respondents were former burn patients, admitted to the Uppsala Burn Centre between 2000 and 2007. A total of 20 respondents with a Total Body Surface Area (TBSA) of 20% or larger, were approached at 10À17years after burn and interviewed using a semi-structured guide. Data was analyzed using thematic analysis. Results: Despite extensive burn injuries, respondents said they led a close-to-normal life. Their descriptions validated the significance of the existing themes of BSHS-B. Additional themes of importance for health after burn were skin related problems, morphine de-escalation, the importance of work, stress and avoidance, mentality and the healthcare system. Conclusion: The BSHS-B alone may not be sufficient in providing a comprehensive picture of former burn patients' self-perceived health in the long-term perspective. Investigating supplementary areas reflecting former patients' sociocultural and attitudinal environment, as well as personal factors, may be of great importance.

Journal of Vascular Nursing, Jun 1, 2023

Journal of Addictive Diseases, Feb 6, 2017

Introduction: The Drinking Motives Questionnaire (DMQ) measures motives for alcohol consumption o... more Introduction: The Drinking Motives Questionnaire (DMQ) measures motives for alcohol consumption on four subscales. Coping with negative affect and enhancement of positive affect have been shown to be associated with high levels of alcohol consumption and alcohol-related problems. Few studies exist concerning drinking motives among treatment-seeking patients. The aims of the study were to investigate the factor structure of the shortened form of the revised DMQ (DMQ-R SF), map main drinking, explore group differences in motives due to sex, age, level of drinking problems and symptoms of depression/anxiety and to investigate whether different drinking motives predict alcohol-related problems in this group.

Journal of Addiction Medicine, Mar 1, 2018

The field of eHealth systems is rapidly developing and is now expanding into alcohol treatment se... more The field of eHealth systems is rapidly developing and is now expanding into alcohol treatment settings. Despite a growing public and professional interest, cellular photo digital breathalyzers (CPDBs) have not been investigated in a clinical context so far. In this study, we aimed to investigate the experiences of patients in alcohol treatment who had been using a CPDB-TripleA-for a minimum of three months. What are their personal experiences of using the CPDB? Do the patients think it supports them to change their drinking habits, and if so, in what way? Methods: A qualitative interview study with individuals who had been using the CPDB TripleA, for at least 3 months as complement to treatment (12-step program or hospital-based outpatient care). A thematic analysis with an inductive approach was used to identify, analyze, and interpret patterns within data. Results: In all, 12 interviews were conducted with 8 men and 4 women. Participants were generally enthusiastic about the CPDB and found it convenient and useful, even though it created a need for privacy when using the device. Although technical problems were substantial, participants were tolerant to those. The system was perceived to support self-control and to restore relations, but did not replace the need for close contact with caregivers. Self-motivation to change drinking habits was essential, and could not be reached by solely using the CPDB. Conclusions: Participants perceived the CPDB as a convenient and useful tool that was supportive under the circumstances that it was used in a context that included personal contact with a caregiver; and the user felt more than just a minimum of motivation to reduce drinking. Technical stability needs to be achieved to secure long-term use.

Background: The goal of psychiatric nursing interventions is to enhance people’s ability tocope w... more Background: The goal of psychiatric nursing interventions is to enhance people’s ability tocope with feelings of futility, to get control of their lives and to learn coping strategies inorder to manage their mental illness and its consequences. Specialist nurses in psychiatric carecoordinate and direct nursing care based on evidence-based knowledge.Aim: The aim of this study was to investigate what kind of nursing acts specialist nurses usein the psychiatric inpatient unit and investigate how they perceive their professional role.Method: The design used was a descriptive qualitative interview study. Nine specialist nursesworking in psychiatric inpatient units were interviewed. Six of the participants were womenand three were men aged 28-53 years. Qualitative content analysis was used as the analyticalmethod.Results: The main results of the study were summarized in two broad areas: Nursingtreatments specialist nurses use in the psychiatric inpatient unit and Specialist nurse’sperception of their professional role. The following six categories were placed in the twoareas; planning nursing care, prevention and health promotion nursing, care of theenvironment significance, nursing in compulsory psychiatric care, broader knowledge andexperiences of colleagues ' view of specialist nurses' role. Five of the categories contain twoto three subcategories. The result shows that the difference between the basic nurses andspecialist nurses perceived as diffuse in practical nursing.Conclusion: The findings show that specialist nurses in this study work in accordance to thenational psychiatric association’s competence description. Specialist nurses are nursingexperts and with their broad knowledge about psychiatric nursing give them a holisticapproach to the psychiatric care.Keywords: Psychiatric nursing, Specialist nurse, Inpatient unit

International Journal of Mental Health Nursing, Feb 15, 2018

A promising intervention in mental health in-patient care is behavioural activation (BA). Interve... more A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staffled behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care.

Journal of Psychoactive Drugs, Jun 23, 2023

Substance abuse, 2022

Aims: Opioid agonist treatment (OAT) programs are life-saving, as they reduce opioid use, overdos... more Aims: Opioid agonist treatment (OAT) programs are life-saving, as they reduce opioid use, overdoses, and criminal activities. Disadvantages reported with long-term OAT include side effects of the medication, especially on cognitive ability and sexual function, which may discourage potential participants. Many of those who participate in OAT have a desire to come off treatment. The aims of this study were to explore patients’ thoughts about coming off OAT and to investigate their perceptions of what support they would need in order to realize a planned withdrawal from OAT. Methods: A qualitative interview study with semi-structured interviews, using applied thematic analysis. Persons with experiences of participating in OAT were invited from Swedish programs and a private Facebook community. Results: Fifteen persons, with a mean of 9.6 (±6.4) years of treatment experience, were included. The participants underlined the need for a patient-centered focus within the treatment. They wanted to be regarded as capable of deciding if, when, and how a planned ending was to take place. They also called for staff to be supportive in making such decisions. Participants recommended staff to be sensitive to the needs of the specific patient and to have strategies for coming off OAT that could be adjusted for the single person. Conclusions: OAT programs need to be continually updated and adapted to the persons who can benefit from them. Applying a person-centered, holistic perspective would enhance the quality of the treatment by emanating from individual goals. Regulatory guidelines need to take into account research on patient experiences and perspectives on coming off.

Youth & Society, Sep 18, 2020

Self-report questionnaires on alcohol use are commonly used in both research and in clinical work... more Self-report questionnaires on alcohol use are commonly used in both research and in clinical work with adolescents, but little is known about how adolescent responders perceive and interpret them. This study explores how adolescents think while responding to two alcohol-related questionnaires. It also investigates whether the instruments can initiate selfreflective processes on alcohol use. Data were collected among adolescents visiting a center for young people with substance use problems in Sweden. The participants found the questionnaires easy to complete and widely relevant, and the questionnaires commonly initiated a process of selfreflection. Results support the use in clinical settings.

Journal of Burn Care & Research, 2014

A severe burn not only affects the patients, but may also have a great impact on the lives of fam... more A severe burn not only affects the patients, but may also have a great impact on the lives of family members. It is known that family members of patients with burns experience psychological distress, but health-related quality of life (HRQoL) has not been studied in this group. The aim was to study predictors of HRQoL in family members of patients with burns. Forty-four family members of adult patients treated in a burn center, between 2000 and 2007, completed questionnaires during care, and at 3, 6, and 12 months after injury. HRQoL was assessed with the EuroQol 5D (EQ-5D), which consists of the dimensions: mobility, self-care, usual activities, pain, and anxiety/depression. The questionnaire generates an EQ-5D index and a visual analog scale (VAS) score. Overall, the EQ-5D index was similar to that of the general population. A slight improvement in HRQoL was found in the VAS scores and in the anxiety/depression dimension over time. In regression models, HRQoL was primarily predicted by earlier life events, symptoms of post-traumatic stress disorder, and HRQoL, assessed during the patients' hospitalization. In summary, HRQoL assessed with VAS scores increased slightly during the first year postburn, and early screening for life events and psychological symptoms, and HRQoL might be useful in identifying family members in need of support.

Bakgrund: Tidigare forskning visar att flertalet patienter har en positiv inställning till studen... more Bakgrund: Tidigare forskning visar att flertalet patienter har en positiv inställning till studentmedverkan. Trots detta finns olika faktorer som kan påverka patientens inställning negativt. Syfte: Att undersöka studentmedverkan i vården ur ett patientperspektiv hos kvinnor i obstetrisk-och gynekologisk vård. Metod: Kvantitativ studie, enkätstudie. Patienter som vårdats på kvinnodivisionens mottagningar och avdelningar på ett universitetssjukhus i Mellansverige tillfrågades under en tvåveckorsperiod att svara på enkätfrågor. Resultat: Den övervägande delen av patienterna, 71 %, var bekväma med att en studerande var med under sitt vårdbesök. Patienterna med tidigare erfarenheter av studentmedverkan under sitt vårdbesök var mer positivt inställda till studentmedverkan överlag. Var patienterna bekväma med en mycket ung student under sitt vårdbesök, skattade sig patienterna mer bekväma överlag med studentmedverkan. En större andel av patienterna skattade sig mer bekväma med en kvinnlig student, 71 %, än med en manlig student, 41 %, under sitt vårdbesök. Patienterna på avdelningarna skattade sig i större utsträckning mer bekväma än patienterna på mottagningarna. Slutsats: Majoriteten av patienterna kände sig bekväma med studentmedverkan inom obstetrisk-och gynekologisk vård, däremot sjunker graden av bekvämlighet då vården den studerande utför självständigt, ökar. Patienterna som tidigare mött studenter vid sina vårdbesök och även de som är bekväma med en mycket ung student var mer positivt inställda till studentmedverkan. Fler patienter kände sig mer bekväma med kvinnliga studenter än med manliga studenter.

Syftet med denna studie är att beskriva patienters inställning till sin antipsykotiska medicineri... more Syftet med denna studie är att beskriva patienters inställning till sin antipsykotiska medicinering och orsaker till varför läkemedelsordinationer inte följs. Metod: Enkätstudie med kvalitativ innehållsanalys. Resultat: Två teman och 13 kategorier framkom för att beskriva patienters inställning till läkemedlet. Dessa teman är Läkemedel som hjälp och Läkemedel som belastning. Antalet kategorier under temat läkemedel som hjälp är nio stycken och antalet kategorier under temat läkemedel som belastning är fyra. För att beskriva varför ordinationer inte följts framkom fyra kategorier. Slutsats: Huvudresultaten i denna studie är de två teman som framkom, Läkemedel som hjälp och Läkemedel som belastning. Deltagarna i denna studie uppgav både positiva och negativa attityder till sin antipsykotiska medicin. Medicinen förbättrade sjukdomsbilden och ökade deras välbefinnande, men den var också förknippad med biverkningar och att man var bunden till att äta ett läkemedel. Inställningen till antipsykotiska läkemedel var dock övervägande positiv i denna studie. Deltagare som någon gång valt att sluta med medicinen uppgav att de gjort det på grund av glömska, biverkningar och en önskan om att få vara frisk.