Mariette Bengtsson - Academia.edu (original) (raw)

Papers by Mariette Bengtsson

Research paper thumbnail of How to plan and perform a qualitative study using content analysis

Research paper thumbnail of Diagnosis of irritable bowel syndrome would be better made by gastroenterologists than primary care physicians

Gastroenterology Insights, 2010

Irritable bowel syndrome (IBS) is a common disease, and constitutes a large portion of patients a... more Irritable bowel syndrome (IBS) is a common disease, and constitutes a large portion of patients admitted to gastroenterology units. We wanted to examine whether there is a need for patients with suspected IBS to have a thorough examination by a gastroenterologist to establish the diagnosis, or whether other specialist or subspecialist physicians could better or equally identify the problems. From April 2003 to April 2005, females admitted with presumed IBS and consequently scrutinized by a gastroenterologist in our department were included. They were examined by a physician to establish a diagnosis. Four years later, the medical records were again scrutinized including abdominal symptoms, laboratory analyses and X-ray findings, to check if the findings were identical to the original diagnoses. Fifty admissions were identified. Nine of the patients did not want to participate, and 2 patients did not keep the appointment. The diagnosis of IBS was confirmed in only 20 (51%) and the other 19 (49%) had another diagnosis other than IBS. At follow up, 3 patients included with the IBS diagnosis had organic diseases, and 4 with another diagnosis also had IBS. Thus, 46% of the examined women with expected IBS had another diagnosis. A thorough examination of the patient and confirmation of the symptoms by a gastroenterologist is necessary before diagnosis of IBS is confirmed. For this purpose, patients need to meet a specialist when diagnosis is uncertain. This work is licensed under a Creative Commons Attribution 3.0 License (by-nc 3.0) ©Copyright M.

Research paper thumbnail of Gastrointestinal symptoms among endometriosis patients-A case-cohort study

BMC women's health, 2015

Women with endometriosis often experience gastrointestinal symptoms. Gonadotropin-releasing hormo... more Women with endometriosis often experience gastrointestinal symptoms. Gonadotropin-releasing hormone (GnRH) analogs are used to treat endometriosis; however, some patients develop gastrointestinal dysmotility following this treatment. The aims of the present study were to investigate gastrointestinal symptoms among patients with endometriosis and to examine whether symptoms were associated with menstruation, localization of endometriosis lesions, or treatment with either opioids or GnRH analogs, and if hormonal treatment affected the symptoms. All patients with diagnosed endometriosis at the Department of Gynecology were invited to participate in the study. Gastrointestinal symptoms were registered using the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS); socioeconomic and medical histories were compiled using a clinical data survey. Data were compared to a control group from the general population. A total of 109 patients and 65 controls were investigated. Compared to ...

Research paper thumbnail of Being a haematopoietic stem cell donor for a sick sibling: Adult donors' experiences prior to donation

European journal of oncology nursing : the official journal of European Oncology Nursing Society, Jan 23, 2015

There is a lack of knowledge about sibling stem cell donors' experiences pre-donation and the... more There is a lack of knowledge about sibling stem cell donors' experiences pre-donation and the waiting period before the donation might have been long. The donors and their corresponding sibling recipients were simultaneously included in two different interview studies. The results from the recipient study have been presented in a separate paper. The aim was to explore the experiences of being a stem cell donor for a sibling, prior to donation. Ten adult sibling donors were interviewed prior to stem cell donation. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. The main theme Being a cog in a big wheel describes the complex process of being a sibling donor prior to donation, covering a mixture of emotions and thoughts. The four subthemes Being available, Being anxious, Being concerned and Being obliged cover the various experiences. The sibling donors' experiences are influenced by the quality of the relationship wit...

Research paper thumbnail of Having a sibling as donor: patients' experiences immediately before allogeneic hematopoietic stem cell transplantation

European journal of oncology nursing : the official journal of European Oncology Nursing Society, 2014

Allogeneic hematopoietic stem cell transplantation (HSCT) offers a potential cure for a variety o... more Allogeneic hematopoietic stem cell transplantation (HSCT) offers a potential cure for a variety of diseases but is also associated with significant risks. With HSCT the donor is either a relative, most often a sibling, or an unrelated registry donor. The aim was to explore patients' experiences, immediately before transplantation, regarding having a sibling as donor. Ten adult patients with sibling donors were interviewed before admission for HSCT. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. The main theme Being in no man's land is a metaphor for the patients' complex situation with its mixture of emotions and thoughts prior to transplantation. The three subthemes Trust in the sibling donor, Concern about others and Loss of control cover the various experiences. The patient's experiences are influenced by their personal situation and the quality of the relationship with the sibling donor. While patients ...

Research paper thumbnail of Registered nurses' perceptions of their professional work in nursing homes and home-based care: a focus group study

Research paper thumbnail of WOMEN WITH IRRITABLE BOWEL SYNDROME Aspects of quality of life and health

Research paper thumbnail of A course of instruction for women with irritable bowel syndrome

Patient Education and Counseling, 2006

A course of instruction for women with irritable bowel syndrome." Patient Educ Couns. 2005 Aug 9;... more A course of instruction for women with irritable bowel syndrome." Patient Educ Couns. 2005 Aug 9; [Epub ahead of print] http://dx.Abstract Objective. The aim of this study was to determine the effects a course of instruction about Irritable Bowel Syndrome (IBS) might have on symptoms, psychological wellbeing, and medical care requirements in these patients. Methods. Twenty-nine women with IBS participated in a programme of instruction on medical care, physical activity, stress-management, diet and health-insurance. The women completed the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being Index and provided information about their requirements of medical care before and after the course. Results. Twenty-three of the women included, completed the questionnaires at 12 months after the course. When comparing these values to those at baseline, there were improvements in abdominal pain (p<0.037) and vitality (p<0.045) as well as a reduction in the number of visits to physicians (p<0.037) and dieticians (p<0.042). Conclusion. Information related to the disease, might help women with IBS to perceive less pain and more vitality and thereby experience a higher quality of life. Practice Implications. A course of instruction for patients with IBS may be of benefit for the patients, and could be a part of a multicomponent approach in the treatment of this patient group.

Research paper thumbnail of The nursing and medical students motivation to attain knowledge

Nurse Education Today, 2010

Objectives: The aim was to gather information regarding what students consider important for thei... more Objectives: The aim was to gather information regarding what students consider important for their motivation to attain knowledge, in order to shape courses that foster this motivation. Method: A qualitative design comprising focus groups including 31 nursing and medical students for interviews, semi-structured questions, and content analysis was utilized. Result: The students thought it was important to coordinate more superficial knowledge with learning in depth, and to apply the theoretical knowledge in practise. Self-motivation, committed teachers and discussions with other students were considered to be important for learning. The difference between the groups was that the nurses were focused on their assessments because of lack of time, while the medical students were more learning for life. Their greatest problem was to know what of all knowledge they needed to learn and should focus on. Conclusion: The motivation must come from the students themselves, but dedicated teachers giving performance feed-back, discussions in different forms and choices of learning and assessment methods enhance enthusiasm and learning. By providing an educational environment that resonates with the students' needs, teachers may be successful in their teaching.

Research paper thumbnail of The uniqueness of elderly care: Registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care

Nurse Education Today, 2014

The expected shortage of registered nurses with an advanced degree as specialists in geriatric ca... more The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses&amp;amp;amp;amp;amp;amp;amp;amp;#39; experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments.

Research paper thumbnail of A Holistic Approach for Planning Care of Patients With Irritable Bowel Syndrome

Gastroenterology Nursing, 2010

The aims of this study were to determine whether a registered nurse can collect information and p... more The aims of this study were to determine whether a registered nurse can collect information and plan a holistic and individual strategy for the treatment of patients with irritable bowel syndrome (IBS) and whether this approach can reduce these patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; health aspects. The referrals of 50 Swedish-speaking female patients aged between 18 and 65 years with the preliminary diagnosis of IBS were collected and scrutinized by a gastroenterologist at a university hospital. Of these, 41 patients agreed to participate but 2 did not show up. The 39 patients were randomized into one of two groups: (1) the intervention group (n = 19) where the subjects were interviewed on the basis of the theory of culture care by a nurse before visiting a gastroenterologist and (2) the control group (n = 20) where the subjects first met a gastroenterologist. After the medical examination, 19 subjects were found to have diseases other than IBS. The interview gave a holistic view of the subjects&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; problems, which could be of use when planning further care. Because subjects sometimes did not receive an accurate diagnosis by their primary care physician, however, the clinic nurse could not give these subjects IBS-specific information because the subjects&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; diagnosis had not been established. The initial medical assessments based on the primary care doctors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; care of many subjects with IBS symptoms were a noted weak point.

Research paper thumbnail of Women With Irritable Bowel Syndrome and Their Perception of a Good Quality of Life

Gastroenterology Nursing, 2007

Irritable bowel syndrome has a negative impact on a person&amp;amp;amp;amp;amp;amp;amp;amp;am... more Irritable bowel syndrome has a negative impact on a person&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s quality of life, but only a few existing studies have been based on patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; own perceptions. This study therefore aimed to collect information on the view of female patients with irritable bowel syndrome regarding what constitutes a good quality of life for them and to create a healthcare model for these patients. For the study, 30 women with irritable bowel syndrome (median age, 38.5 years; range, 20-65 years) responded in writing to a single, all-inclusive question: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;What is your perception of a good quality of life?&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; When the questionnaires were returned, there was time for a short dialogue, and notes of the conversations were made. Data were analyzed qualitatively according to Burnard&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s method of thematic content analysis. The answers also were counted and thereby quantified. The women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s perception of a good quality of life could be divided into five categories: (a) physical and mental health, (b) social well-being, (c) welfare, (d) strength and energy, and (e) self-fulfillment. According to the results, a healthcare model for patients with irritable bowel syndrome should include four main areas: (a) treatment of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s symptoms, (b) confirmation of the patient, (c) confirmation of the diagnosis, and (d) instruction for the patient. The healthcare model should be focused on the primary care level and should include a longitudinal plan of healthcare that also describes the secondary care level.

Research paper thumbnail of Further Validation of the Visual Analogue Scale for Irritable Bowel Syndrome After Use in Clinical Practice

Gastroenterology Nursing, 2013

The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), a self-rating questionnaire, wa... more The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), a self-rating questionnaire, was designed to measure symptoms and the effect of treatment in patients suffering from irritable bowel syndrome. The aim of this descriptive correlational study was to conduct further psychometric validation after the VAS-IBS had been used in clinical practice, translate it into English, and compare the results with controls. Forty-nine patients with irritable bowel syndrome (median age = 38 years old [range, 18-69 years]) were compared with 90 healthy persons (median age = 44 years old [range, 21-77 years]) who served as controls. The patients with irritable bowel syndrome completed 3 questionnaires: the VAS-IBS, the Gastrointestinal Symptom Rating Scale, and the Perception of Change of Symptoms. Controls completed only the VAS-IBS. Results showed that the VAS-IBS is a valid questionnaire that measures the degree of change of symptoms and discriminates between patients who have irritable bowel syndrome from those who do not. It is important to compare the VAS-IBS among different cultural populations so we suggest that the English version of the VAS-IBS should now be used in English-speaking countries and be further tested for validity and reliability with English-speaking patients.

Research paper thumbnail of Psychological Well-Being and Symptoms in Women With Chronic Constipation Treated With Sodium Picosulphate

Gastroenterology Nursing, 2005

The use of sodium picosulphate has been restricted to a few weeks due to its potentially harmful ... more The use of sodium picosulphate has been restricted to a few weeks due to its potentially harmful effect on the colon. In spite of this restriction, however, many patients prefer this pharmaceutical drug. The authors have earlier studied the use of sodium picosulphate and found regular use leads to a moderate dose escalation. The aim of this study was to examine whether subjects who use laxatives containing sodium picosulphate differ in their psychological well-being and symptoms from subjects who use other laxatives, and to decide, on the basis of the results, how to use drugs containing sodium picosulphate. Eighty-six women, age 27-65 years, with chronic constipation were interviewed by two self-administered questionnaires: the Psychological General Well-Being Index (PGWB) and the Gastrointestinal Symptom Rating Scale (GSRS). Twenty-two of the subjects were interviewed a second time some months later after inclusion in a drug trial. Thirty-five women used sodium picosulphate regularly every week and 51 used other laxatives. Psychological well-being according to the PGWB was better for the subjects who used sodium picosulphate regularly than for those who used other laxatives (97 compared to 86, p, .017) This difference was due to less anxiety (p, .0001). There was no difference between the groups according to the GSRS. After inclusion in a drug trial, but before the introduction of the drugs, the group who did not use sodium picosulphate was remarkably improved with less anxiety, better self-control, and reduced abdominal pain and constipation. As the psychological well-being was better for the subjects who used sodium picosulphate, these drugs can be used when patients fail to respond to traditional therapies.

Research paper thumbnail of The brief Visual Analogue Scale for Irritable Bowel Syndrome questionnaire can be used to evaluate psychological well-being in patients with irritable bowel syndrome

European Journal of Internal Medicine, 2013

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.

Research paper thumbnail of A prospective evaluation of the diagnostic value of video capsule endoscopy in patients initially classified as irritable bowel syndrome

European Journal of Internal Medicine, 2009

Irritable bowel syndrome (IBS) is characterized by chronic gastrointestinal dysfunction in the ab... more Irritable bowel syndrome (IBS) is characterized by chronic gastrointestinal dysfunction in the absence of detectable organic disease. The recently developed technique, video capsule endoscopy (CE), has been shown to be much more sensitive than traditional enterography in detecting mucosal changes in the small intestine. This study was performed to see if any earlier, not detectable by other standard methods, mucosal changes could be found in the small intestine in patients diagnosed as having IBS. All consecutive women who, over the past five years, had received a well-founded diagnosis of IBS at the Department of Medicine were identified. Twenty-eight women, mean age 36+/-12 years were willing to participate in the study. They underwent a CE after a pre-test with a dummy capsule. The actual IBS activity was estimated by the validated Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being (PGWB) Index questionnaires. The duration of the IBS symptoms was a mean of 10 years (range 3-25). Symptoms were present, according to the scores of the GSRS and the PGWB index, at the time the patients underwent the CE. In the majority, 24 of 27 IBS patients examined, no specific small intestinal lesions were seen on CE. In two patients, CE revealed multiple small intestinal lesions such as ulcerations and/or erosions, and in one patient a duodenal ulceration. In the vast majority of patients who fulfil the symptom criteria of IBS, no pathological mucosal lesions can be found by CE explaining the symptomatology. However, a subgroup of these patients may benefit from investigation by CE to reconsider the diagnosis.

Research paper thumbnail of Anxiety in close relationships is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease

European Journal of Internal Medicine, 2013

Attachment in adult Attitude to health IBD IBS Physician-patient relationship Psychological illne... more Attachment in adult Attitude to health IBD IBS Physician-patient relationship Psychological illness behavior Self-esteem Background: Previous research has suggested an interaction between personality factors and inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS). We therefore aimed to elucidate differences in psychological and coping functioning between patients with IBD and IBS, and to assess the relationship of disease activity with these functions. Methods: Seventy-four patients with IBD (mean age 43 ± 17 years, range 18-82 years) and 81 patients with IBS (mean age 37 ± 12 years, range 21-66 years) completed the questionnaires; Rosenberg Self-Esteem Scale, Toronto Alexithymia, Experiences in Close Relationships, and Sense of Coherence. Disease activity was evaluated either by the Harvey-Bradshaw index, the Simple Clinical Colitis Activity Index, or the Visual Analogue Scale for Irritable Bowel Syndrome. Results: The study revealed that patients with IBS had higher degree of anxiety in close relationships than patients with IBD (p = 0.003), and lower self-esteem (p = 0.001). No other statistical differences between the whole groups IBS and IBD or between subgroups were seen. Conclusions: The fact that patients with IBS seem to have higher levels of anxiety in relationships and lower self-esteem could influence the way the patient deal with the disease and how the communication with health care professionals works out. A higher awareness of the importance of past negative life events should be taken into consideration. Whether the disease or the personal traits are the primary event should be addressed in future research.

Research paper thumbnail of Diarrhoea is not the only symptom that needs to be treated in patients with microscopic colitis

European Journal of Internal Medicine, 2013

Research paper thumbnail of Retrospective study of long-term treatment with sodium picosulfate

European Journal of Gastroenterology & Hepatology, 2004

... The patients used sodium picosulfate because of insufficient effects of other laxatives. ... ... more ... The patients used sodium picosulfate because of insufficient effects of other laxatives. ... We know by experience that patients who use other types of laxative drug also have to increase ... effects, and the cost of sodium picosulfate, it can be recommended for long-term treatment of ...

Research paper thumbnail of Autoantibodies and gastrointestinal symptoms in infertile women in relation to in vitro fertilization

BMC Pregnancy and Childbirth, 2013

Background: Prior reports suggest a link between gonadotropin-releasing hormone (GnRH) and gastro... more Background: Prior reports suggest a link between gonadotropin-releasing hormone (GnRH) and gastrointestinal function. The aim of the study was to prospectively investigate women subjected to in vitro fertilization (IVF) using the GnRH analog buserelin, taking into account gastrointestinal symptoms and antibody development against buserelin, GnRH, luteinizing hormone (LH), and their receptors. Methods: Gastrointestinal symptoms were registered by the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) before and after IVF treatment, and five years later. Health-related quality of life was evaluated by the 36-item Short-Form questionnaire (SF-36). ELISA was used for antibody analyses before and after treatment. Data were compared with women from the general population. Results: In total, 124 patients were investigated before and after IVF, and 62 were re-evaluated after five years. Buserelin treatment led to significant impairment of constipation (p = 0.004), nausea and vomiting (p = 0.035), psychological well-being (p = 0.000), and the intestinal symptoms' influence on daily life (p = 0.027). At 5-year follow-up, abdominal pain was worsened (p = 0.041), but psychological well-being was improved (p = 0.036), compared to prior treatment, and 15% had an observable deterioration in gastrointestinal symptoms. None developed severe dysmotility. Patients had higher prevalence of IgG antibodies against LH (p = 0.001) and its receptor (p = 0.016), and IgM antibodies against the GnRH receptor (p = 0.001) prior treatment compared with controls, but no antibody development was observed after IVF. Conclusion: Patients experience gastrointestinal symptoms during buserelin treatment, and abdominal pain is still increased after five years, but buserelin does not increase antibody formation against GnRH, LH or their receptors.

Research paper thumbnail of How to plan and perform a qualitative study using content analysis

Research paper thumbnail of Diagnosis of irritable bowel syndrome would be better made by gastroenterologists than primary care physicians

Gastroenterology Insights, 2010

Irritable bowel syndrome (IBS) is a common disease, and constitutes a large portion of patients a... more Irritable bowel syndrome (IBS) is a common disease, and constitutes a large portion of patients admitted to gastroenterology units. We wanted to examine whether there is a need for patients with suspected IBS to have a thorough examination by a gastroenterologist to establish the diagnosis, or whether other specialist or subspecialist physicians could better or equally identify the problems. From April 2003 to April 2005, females admitted with presumed IBS and consequently scrutinized by a gastroenterologist in our department were included. They were examined by a physician to establish a diagnosis. Four years later, the medical records were again scrutinized including abdominal symptoms, laboratory analyses and X-ray findings, to check if the findings were identical to the original diagnoses. Fifty admissions were identified. Nine of the patients did not want to participate, and 2 patients did not keep the appointment. The diagnosis of IBS was confirmed in only 20 (51%) and the other 19 (49%) had another diagnosis other than IBS. At follow up, 3 patients included with the IBS diagnosis had organic diseases, and 4 with another diagnosis also had IBS. Thus, 46% of the examined women with expected IBS had another diagnosis. A thorough examination of the patient and confirmation of the symptoms by a gastroenterologist is necessary before diagnosis of IBS is confirmed. For this purpose, patients need to meet a specialist when diagnosis is uncertain. This work is licensed under a Creative Commons Attribution 3.0 License (by-nc 3.0) ©Copyright M.

Research paper thumbnail of Gastrointestinal symptoms among endometriosis patients-A case-cohort study

BMC women's health, 2015

Women with endometriosis often experience gastrointestinal symptoms. Gonadotropin-releasing hormo... more Women with endometriosis often experience gastrointestinal symptoms. Gonadotropin-releasing hormone (GnRH) analogs are used to treat endometriosis; however, some patients develop gastrointestinal dysmotility following this treatment. The aims of the present study were to investigate gastrointestinal symptoms among patients with endometriosis and to examine whether symptoms were associated with menstruation, localization of endometriosis lesions, or treatment with either opioids or GnRH analogs, and if hormonal treatment affected the symptoms. All patients with diagnosed endometriosis at the Department of Gynecology were invited to participate in the study. Gastrointestinal symptoms were registered using the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS); socioeconomic and medical histories were compiled using a clinical data survey. Data were compared to a control group from the general population. A total of 109 patients and 65 controls were investigated. Compared to ...

Research paper thumbnail of Being a haematopoietic stem cell donor for a sick sibling: Adult donors' experiences prior to donation

European journal of oncology nursing : the official journal of European Oncology Nursing Society, Jan 23, 2015

There is a lack of knowledge about sibling stem cell donors' experiences pre-donation and the... more There is a lack of knowledge about sibling stem cell donors' experiences pre-donation and the waiting period before the donation might have been long. The donors and their corresponding sibling recipients were simultaneously included in two different interview studies. The results from the recipient study have been presented in a separate paper. The aim was to explore the experiences of being a stem cell donor for a sibling, prior to donation. Ten adult sibling donors were interviewed prior to stem cell donation. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. The main theme Being a cog in a big wheel describes the complex process of being a sibling donor prior to donation, covering a mixture of emotions and thoughts. The four subthemes Being available, Being anxious, Being concerned and Being obliged cover the various experiences. The sibling donors' experiences are influenced by the quality of the relationship wit...

Research paper thumbnail of Having a sibling as donor: patients' experiences immediately before allogeneic hematopoietic stem cell transplantation

European journal of oncology nursing : the official journal of European Oncology Nursing Society, 2014

Allogeneic hematopoietic stem cell transplantation (HSCT) offers a potential cure for a variety o... more Allogeneic hematopoietic stem cell transplantation (HSCT) offers a potential cure for a variety of diseases but is also associated with significant risks. With HSCT the donor is either a relative, most often a sibling, or an unrelated registry donor. The aim was to explore patients' experiences, immediately before transplantation, regarding having a sibling as donor. Ten adult patients with sibling donors were interviewed before admission for HSCT. The interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. The main theme Being in no man's land is a metaphor for the patients' complex situation with its mixture of emotions and thoughts prior to transplantation. The three subthemes Trust in the sibling donor, Concern about others and Loss of control cover the various experiences. The patient's experiences are influenced by their personal situation and the quality of the relationship with the sibling donor. While patients ...

Research paper thumbnail of Registered nurses' perceptions of their professional work in nursing homes and home-based care: a focus group study

Research paper thumbnail of WOMEN WITH IRRITABLE BOWEL SYNDROME Aspects of quality of life and health

Research paper thumbnail of A course of instruction for women with irritable bowel syndrome

Patient Education and Counseling, 2006

A course of instruction for women with irritable bowel syndrome." Patient Educ Couns. 2005 Aug 9;... more A course of instruction for women with irritable bowel syndrome." Patient Educ Couns. 2005 Aug 9; [Epub ahead of print] http://dx.Abstract Objective. The aim of this study was to determine the effects a course of instruction about Irritable Bowel Syndrome (IBS) might have on symptoms, psychological wellbeing, and medical care requirements in these patients. Methods. Twenty-nine women with IBS participated in a programme of instruction on medical care, physical activity, stress-management, diet and health-insurance. The women completed the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being Index and provided information about their requirements of medical care before and after the course. Results. Twenty-three of the women included, completed the questionnaires at 12 months after the course. When comparing these values to those at baseline, there were improvements in abdominal pain (p<0.037) and vitality (p<0.045) as well as a reduction in the number of visits to physicians (p<0.037) and dieticians (p<0.042). Conclusion. Information related to the disease, might help women with IBS to perceive less pain and more vitality and thereby experience a higher quality of life. Practice Implications. A course of instruction for patients with IBS may be of benefit for the patients, and could be a part of a multicomponent approach in the treatment of this patient group.

Research paper thumbnail of The nursing and medical students motivation to attain knowledge

Nurse Education Today, 2010

Objectives: The aim was to gather information regarding what students consider important for thei... more Objectives: The aim was to gather information regarding what students consider important for their motivation to attain knowledge, in order to shape courses that foster this motivation. Method: A qualitative design comprising focus groups including 31 nursing and medical students for interviews, semi-structured questions, and content analysis was utilized. Result: The students thought it was important to coordinate more superficial knowledge with learning in depth, and to apply the theoretical knowledge in practise. Self-motivation, committed teachers and discussions with other students were considered to be important for learning. The difference between the groups was that the nurses were focused on their assessments because of lack of time, while the medical students were more learning for life. Their greatest problem was to know what of all knowledge they needed to learn and should focus on. Conclusion: The motivation must come from the students themselves, but dedicated teachers giving performance feed-back, discussions in different forms and choices of learning and assessment methods enhance enthusiasm and learning. By providing an educational environment that resonates with the students' needs, teachers may be successful in their teaching.

Research paper thumbnail of The uniqueness of elderly care: Registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care

Nurse Education Today, 2014

The expected shortage of registered nurses with an advanced degree as specialists in geriatric ca... more The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses&amp;amp;amp;amp;amp;amp;amp;amp;#39; experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments.

Research paper thumbnail of A Holistic Approach for Planning Care of Patients With Irritable Bowel Syndrome

Gastroenterology Nursing, 2010

The aims of this study were to determine whether a registered nurse can collect information and p... more The aims of this study were to determine whether a registered nurse can collect information and plan a holistic and individual strategy for the treatment of patients with irritable bowel syndrome (IBS) and whether this approach can reduce these patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; health aspects. The referrals of 50 Swedish-speaking female patients aged between 18 and 65 years with the preliminary diagnosis of IBS were collected and scrutinized by a gastroenterologist at a university hospital. Of these, 41 patients agreed to participate but 2 did not show up. The 39 patients were randomized into one of two groups: (1) the intervention group (n = 19) where the subjects were interviewed on the basis of the theory of culture care by a nurse before visiting a gastroenterologist and (2) the control group (n = 20) where the subjects first met a gastroenterologist. After the medical examination, 19 subjects were found to have diseases other than IBS. The interview gave a holistic view of the subjects&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; problems, which could be of use when planning further care. Because subjects sometimes did not receive an accurate diagnosis by their primary care physician, however, the clinic nurse could not give these subjects IBS-specific information because the subjects&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; diagnosis had not been established. The initial medical assessments based on the primary care doctors&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; care of many subjects with IBS symptoms were a noted weak point.

Research paper thumbnail of Women With Irritable Bowel Syndrome and Their Perception of a Good Quality of Life

Gastroenterology Nursing, 2007

Irritable bowel syndrome has a negative impact on a person&amp;amp;amp;amp;amp;amp;amp;amp;am... more Irritable bowel syndrome has a negative impact on a person&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s quality of life, but only a few existing studies have been based on patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; own perceptions. This study therefore aimed to collect information on the view of female patients with irritable bowel syndrome regarding what constitutes a good quality of life for them and to create a healthcare model for these patients. For the study, 30 women with irritable bowel syndrome (median age, 38.5 years; range, 20-65 years) responded in writing to a single, all-inclusive question: &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;What is your perception of a good quality of life?&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; When the questionnaires were returned, there was time for a short dialogue, and notes of the conversations were made. Data were analyzed qualitatively according to Burnard&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s method of thematic content analysis. The answers also were counted and thereby quantified. The women&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s perception of a good quality of life could be divided into five categories: (a) physical and mental health, (b) social well-being, (c) welfare, (d) strength and energy, and (e) self-fulfillment. According to the results, a healthcare model for patients with irritable bowel syndrome should include four main areas: (a) treatment of the patient&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s symptoms, (b) confirmation of the patient, (c) confirmation of the diagnosis, and (d) instruction for the patient. The healthcare model should be focused on the primary care level and should include a longitudinal plan of healthcare that also describes the secondary care level.

Research paper thumbnail of Further Validation of the Visual Analogue Scale for Irritable Bowel Syndrome After Use in Clinical Practice

Gastroenterology Nursing, 2013

The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), a self-rating questionnaire, wa... more The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS), a self-rating questionnaire, was designed to measure symptoms and the effect of treatment in patients suffering from irritable bowel syndrome. The aim of this descriptive correlational study was to conduct further psychometric validation after the VAS-IBS had been used in clinical practice, translate it into English, and compare the results with controls. Forty-nine patients with irritable bowel syndrome (median age = 38 years old [range, 18-69 years]) were compared with 90 healthy persons (median age = 44 years old [range, 21-77 years]) who served as controls. The patients with irritable bowel syndrome completed 3 questionnaires: the VAS-IBS, the Gastrointestinal Symptom Rating Scale, and the Perception of Change of Symptoms. Controls completed only the VAS-IBS. Results showed that the VAS-IBS is a valid questionnaire that measures the degree of change of symptoms and discriminates between patients who have irritable bowel syndrome from those who do not. It is important to compare the VAS-IBS among different cultural populations so we suggest that the English version of the VAS-IBS should now be used in English-speaking countries and be further tested for validity and reliability with English-speaking patients.

Research paper thumbnail of Psychological Well-Being and Symptoms in Women With Chronic Constipation Treated With Sodium Picosulphate

Gastroenterology Nursing, 2005

The use of sodium picosulphate has been restricted to a few weeks due to its potentially harmful ... more The use of sodium picosulphate has been restricted to a few weeks due to its potentially harmful effect on the colon. In spite of this restriction, however, many patients prefer this pharmaceutical drug. The authors have earlier studied the use of sodium picosulphate and found regular use leads to a moderate dose escalation. The aim of this study was to examine whether subjects who use laxatives containing sodium picosulphate differ in their psychological well-being and symptoms from subjects who use other laxatives, and to decide, on the basis of the results, how to use drugs containing sodium picosulphate. Eighty-six women, age 27-65 years, with chronic constipation were interviewed by two self-administered questionnaires: the Psychological General Well-Being Index (PGWB) and the Gastrointestinal Symptom Rating Scale (GSRS). Twenty-two of the subjects were interviewed a second time some months later after inclusion in a drug trial. Thirty-five women used sodium picosulphate regularly every week and 51 used other laxatives. Psychological well-being according to the PGWB was better for the subjects who used sodium picosulphate regularly than for those who used other laxatives (97 compared to 86, p, .017) This difference was due to less anxiety (p, .0001). There was no difference between the groups according to the GSRS. After inclusion in a drug trial, but before the introduction of the drugs, the group who did not use sodium picosulphate was remarkably improved with less anxiety, better self-control, and reduced abdominal pain and constipation. As the psychological well-being was better for the subjects who used sodium picosulphate, these drugs can be used when patients fail to respond to traditional therapies.

Research paper thumbnail of The brief Visual Analogue Scale for Irritable Bowel Syndrome questionnaire can be used to evaluate psychological well-being in patients with irritable bowel syndrome

European Journal of Internal Medicine, 2013

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.

Research paper thumbnail of A prospective evaluation of the diagnostic value of video capsule endoscopy in patients initially classified as irritable bowel syndrome

European Journal of Internal Medicine, 2009

Irritable bowel syndrome (IBS) is characterized by chronic gastrointestinal dysfunction in the ab... more Irritable bowel syndrome (IBS) is characterized by chronic gastrointestinal dysfunction in the absence of detectable organic disease. The recently developed technique, video capsule endoscopy (CE), has been shown to be much more sensitive than traditional enterography in detecting mucosal changes in the small intestine. This study was performed to see if any earlier, not detectable by other standard methods, mucosal changes could be found in the small intestine in patients diagnosed as having IBS. All consecutive women who, over the past five years, had received a well-founded diagnosis of IBS at the Department of Medicine were identified. Twenty-eight women, mean age 36+/-12 years were willing to participate in the study. They underwent a CE after a pre-test with a dummy capsule. The actual IBS activity was estimated by the validated Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-Being (PGWB) Index questionnaires. The duration of the IBS symptoms was a mean of 10 years (range 3-25). Symptoms were present, according to the scores of the GSRS and the PGWB index, at the time the patients underwent the CE. In the majority, 24 of 27 IBS patients examined, no specific small intestinal lesions were seen on CE. In two patients, CE revealed multiple small intestinal lesions such as ulcerations and/or erosions, and in one patient a duodenal ulceration. In the vast majority of patients who fulfil the symptom criteria of IBS, no pathological mucosal lesions can be found by CE explaining the symptomatology. However, a subgroup of these patients may benefit from investigation by CE to reconsider the diagnosis.

Research paper thumbnail of Anxiety in close relationships is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease

European Journal of Internal Medicine, 2013

Attachment in adult Attitude to health IBD IBS Physician-patient relationship Psychological illne... more Attachment in adult Attitude to health IBD IBS Physician-patient relationship Psychological illness behavior Self-esteem Background: Previous research has suggested an interaction between personality factors and inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS). We therefore aimed to elucidate differences in psychological and coping functioning between patients with IBD and IBS, and to assess the relationship of disease activity with these functions. Methods: Seventy-four patients with IBD (mean age 43 ± 17 years, range 18-82 years) and 81 patients with IBS (mean age 37 ± 12 years, range 21-66 years) completed the questionnaires; Rosenberg Self-Esteem Scale, Toronto Alexithymia, Experiences in Close Relationships, and Sense of Coherence. Disease activity was evaluated either by the Harvey-Bradshaw index, the Simple Clinical Colitis Activity Index, or the Visual Analogue Scale for Irritable Bowel Syndrome. Results: The study revealed that patients with IBS had higher degree of anxiety in close relationships than patients with IBD (p = 0.003), and lower self-esteem (p = 0.001). No other statistical differences between the whole groups IBS and IBD or between subgroups were seen. Conclusions: The fact that patients with IBS seem to have higher levels of anxiety in relationships and lower self-esteem could influence the way the patient deal with the disease and how the communication with health care professionals works out. A higher awareness of the importance of past negative life events should be taken into consideration. Whether the disease or the personal traits are the primary event should be addressed in future research.

Research paper thumbnail of Diarrhoea is not the only symptom that needs to be treated in patients with microscopic colitis

European Journal of Internal Medicine, 2013

Research paper thumbnail of Retrospective study of long-term treatment with sodium picosulfate

European Journal of Gastroenterology & Hepatology, 2004

... The patients used sodium picosulfate because of insufficient effects of other laxatives. ... ... more ... The patients used sodium picosulfate because of insufficient effects of other laxatives. ... We know by experience that patients who use other types of laxative drug also have to increase ... effects, and the cost of sodium picosulfate, it can be recommended for long-term treatment of ...

Research paper thumbnail of Autoantibodies and gastrointestinal symptoms in infertile women in relation to in vitro fertilization

BMC Pregnancy and Childbirth, 2013

Background: Prior reports suggest a link between gonadotropin-releasing hormone (GnRH) and gastro... more Background: Prior reports suggest a link between gonadotropin-releasing hormone (GnRH) and gastrointestinal function. The aim of the study was to prospectively investigate women subjected to in vitro fertilization (IVF) using the GnRH analog buserelin, taking into account gastrointestinal symptoms and antibody development against buserelin, GnRH, luteinizing hormone (LH), and their receptors. Methods: Gastrointestinal symptoms were registered by the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) before and after IVF treatment, and five years later. Health-related quality of life was evaluated by the 36-item Short-Form questionnaire (SF-36). ELISA was used for antibody analyses before and after treatment. Data were compared with women from the general population. Results: In total, 124 patients were investigated before and after IVF, and 62 were re-evaluated after five years. Buserelin treatment led to significant impairment of constipation (p = 0.004), nausea and vomiting (p = 0.035), psychological well-being (p = 0.000), and the intestinal symptoms' influence on daily life (p = 0.027). At 5-year follow-up, abdominal pain was worsened (p = 0.041), but psychological well-being was improved (p = 0.036), compared to prior treatment, and 15% had an observable deterioration in gastrointestinal symptoms. None developed severe dysmotility. Patients had higher prevalence of IgG antibodies against LH (p = 0.001) and its receptor (p = 0.016), and IgM antibodies against the GnRH receptor (p = 0.001) prior treatment compared with controls, but no antibody development was observed after IVF. Conclusion: Patients experience gastrointestinal symptoms during buserelin treatment, and abdominal pain is still increased after five years, but buserelin does not increase antibody formation against GnRH, LH or their receptors.