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Prospective study of a Swedish infertile cohort 2005-08: population characteristics, treatments and pregnancy rates.

https://arctichealth.org/en/permalink/ahliterature259500
Source
Fam Pract. 2014 Jun;31(3):290-7
Publication Type
Article
Date
Jun-2014
Author
Arthur Aanesen
Margareta Westerbotn
Source
Fam Pract. 2014 Jun;31(3):290-7
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Female
Fertilization in Vitro
Humans
Infertility, Female - diagnosis - therapy
Infertility, Male - diagnosis - therapy
Insemination, Artificial
Male
Ovulation Induction
Pregnancy
Pregnancy Rate
Prospective Studies
Sweden
Abstract
We here report on results from a prospective study comprising 380 infertile couples undergoing infertility work-up and various treatments for infertility in our clinic. The aim was to investigate the overall birth rate as a result of different treatments, as well as spontaneous pregnancies.
Three hundred and eighty couples were consecutively included between December 2005 and May 2008. All couples underwent a fertility work-up, including hysterosalpingogram, hormonal characterization, clinical examination, screening for infectious diseases and semen analysis. The mean age of the women at the time of inclusion was 33.2 years. The mean duration of infertility prior to inclusion was 1.8 years. And 46.6% (n = 177) of the women had been pregnant prior to their first visit to the clinic and 30.0% (n = 114) had been pregnant earlier in their present relationship.
As of November 2010, 57.3% (n = 218) of the women had given birth to a child when they were lost to follow up by the study. Spontaneous conception was observed in 11.3% (n = 43) of the women, 14.5% (n = 64) conceived after intrauterine insemination (IUI), 4.2% (n = 16) conceived after ovarian hyperstimulation and ovulation induction (OH/OI) and 28.4% (n = 113) after in vitro fertilization. There were 280 pregnancies and 58 spontaneous abortions (22.3%) in the group. Mean anti-mullerian hormone significantly correlated with antral follicle count and age and was significantly higher in the subgroup that became pregnant after IUI.
Spontaneous pregnancies and IUI + OH/OI contributed significantly to the pregnancies observed in the total population. Predictive factors for pregnancy were anti-mullerian hormone in the group undergoing IUI treatment and in the age group =38-duration of infertility. Previous pregnancies, body mass index, estradiol, follicle stimulating hormone or having given birth prior to the infertility period were not predictive of pregnancy for the infertile couples in this study.
PubMed ID
24591683 View in PubMed
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The ethics of coercive treatment of people with dementia.

https://arctichealth.org/en/permalink/ahliterature258065
Source
Nurs Ethics. 2013 May;20(3):248-62
Publication Type
Article
Date
May-2013
Author
Eva Lejman
Margareta Westerbotn
Ulrika Pöder
Barbro Wadensten
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
Source
Nurs Ethics. 2013 May;20(3):248-62
Date
May-2013
Language
English
Publication Type
Article
Keywords
Adult
Coercion
Dementia - nursing
Geriatric Nursing - education - ethics - standards
Humans
Interviews as Topic
Middle Aged
Nursing Homes - legislation & jurisprudence - standards
Nursing Staff - psychology
Patient Rights
Professional Misconduct
Qualitative Research
Restraint, Physical - ethics - psychology
Risk Management - standards
Rural nursing
Sweden
Abstract
The aim of the present study was to describe how registered nurses in nursing homes ensure legal security, good and safe nursing care and uphold the dignity of nursing home residents with severe dementia without violating residents' integrity. Semi-structured interviews were conducted with 10 charge nurses in a county in central Sweden. The transcribed interviews were examined using manifest and latent content analyses. The manifest analysis identified actual local routines involving coercive treatment and registered nurses' descriptions of complications and alternative measures. The latent analysis resulted in three themes describing nursing strategies: one with coercive treatment, one with coercive treatment under specific circumstances and one to prevent coercive treatment. Interpretations of legal terms regarding coercive treatment and inadequate gerontological nursing training and understaffing seem to preserve the use of coercive treatment.
PubMed ID
23329782 View in PubMed
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A population-based study on well-being in the very old: the role of cardiovascular diseases and drugs.

https://arctichealth.org/en/permalink/ahliterature70738
Source
Arch Gerontol Geriatr. 2005 May-Jun;40(3):287-97
Publication Type
Article
Author
Margareta Westerbotn
Hedda Agüero-Torres
Johan Fastbom
Pernilla Hillerås
Author Affiliation
Sophiahemmet University College, Box 5605, SE-114 86 Stockholm, Sweden. margareta.westerbotn@sophiahemmethogskola.se
Source
Arch Gerontol Geriatr. 2005 May-Jun;40(3):287-97
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular Agents - adverse effects - therapeutic use
Cardiovascular Diseases - drug therapy - epidemiology
Cross-Sectional Studies
Emotions - drug effects
Female
Geriatrics
Humans
Male
Population Surveillance - methods
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
Cardiovascular diseases constitute the most common health problems in very old people. Consequently, cardiovascular drugs are the medicines that are most frequently used by elderly subjects. Although many studies have examined the physiological effect and adverse reactions of these drugs, knowledge on their effect on emotional well-being is missing. The present study aims to examine the association between cardiovascular diseases and their medical treatment on the emotional well-being of very old people. We investigated a representative group of elderly subjects gathered from a population-based study (n=235). Participants were 84 years or older and cognitively intact (mini-mental state examination (MMSE) > or =24 points). Well-being was assessed with the positive and negative affect schedule (PANAS), measuring different mood categories. Cardiovascular diseases were diagnosed following the International Classification of Diseases. In this population the prevalence of cardiovascular diseases was high (62%). Multivariate regression analysis showed that while being affected by a cardiovascular disease did not affect the emotional well-being of the subjects (PANAS-PA, p=0.171; PANAS-NA, p=0.209), the use of some cardiovascular drugs showed an association. Cardiac glycosides (p=0.006) and nitrates (p=0.008) were associated with increased negative feelings. Due to high prevalence of cardiovascular diseases and use of cardiovascular medicines, this finding has relevance on the quality of life of elderly people. However, due to the nature of this study we cannot assess cause-effect relationship of this positive association. Therefore, the present findings suggest that there is a need for clinical studies in this increasing and limited studied age group.
PubMed ID
15814162 View in PubMed
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How do older people experience their management of medicines?

https://arctichealth.org/en/permalink/ahliterature272419
Source
J Clin Nurs. 2008 Mar;17(5A):106-15
Publication Type
Article
Date
Mar-2008
Author
Margareta Westerbotn
Elin Fahlström
Johan Fastbom
Hedda Agüero-Torres
Pernilla Hillerås
Source
J Clin Nurs. 2008 Mar;17(5A):106-15
Date
Mar-2008
Language
English
Publication Type
Article
Keywords
Humans
Qualitative Research
Sweden
Abstract
The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective.
Very old people tend to use more medicines, and without proper medication, many of them would not function well and would not be able to remain in their own homes.
This qualitative study involved audiotaped interviews with 25 very old persons.
aged >or=85 years, mini-mental state examination >or=24, living at home, taking medicines regularly. Data collected May-June 2005, analysed using content analysis.
Descriptive study.
Findings revealed that most participants managed their medicines by themselves and were very content with this. Older people who received some help with their medicines were also very pleased with that help. The most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back up.
Our results indicate that most of the participants were very pleased with their medicine management, either on their own or they were able to get some help. There was, however, a need for assistance in delivering the medicines to their homes.
Understanding how older people experience their management of medicines and to reveal the components which may affect them in this situation is important to improve nursing care. To observe the life of an older person as a whole is important in nursing care, so that the person's behaviour can be understood, as how older people manage to handle their medicines may have an impact on their autonomy and on health-care resource use.
PubMed ID
18298761 View in PubMed
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Time trends in 20 years of medication use in older adults: Findings from three elderly cohorts in Stockholm, Sweden.

https://arctichealth.org/en/permalink/ahliterature274393
Source
Arch Gerontol Geriatr. 2016 Mar-Apr;63:28-35
Publication Type
Article
Author
Åsa Gransjön Craftman
Kristina Johnell
Johan Fastbom
Margareta Westerbotn
Eva von Strauss
Source
Arch Gerontol Geriatr. 2016 Mar-Apr;63:28-35
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analgesics - therapeutic use
Antipsychotic Agents - therapeutic use
Cross-Sectional Studies
Drug Prescriptions - statistics & numerical data
Drug Utilization - statistics & numerical data - trends
Female
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Polypharmacy
Population Surveillance
Prevalence
Psychotropic Drugs - therapeutic use
Sweden
Abstract
New drugs and expanded drug indications are constantly being introduced. Welfare states strive to provide equity in drug treatment for all of its citizens and todaýs healthcare systems spend financial resources on drugs for the elderly in a higher rate than for any other age group. Drug utilization in elderly persons has an impact in health and wellbeing in older people.
It was to describe the changes in medication use including people aged 78 years and over regardless of residence and other characteristics over 20 years.
The study population consisted of 4304 participants in three population-based cross-sectional surveys conducted in the Kungsholmen area of central Stockholm, Sweden. The participant's current drug utilization was reviewed by physicians following standardized protocols. Data were statistical analyzed. Logistic regression models was used to estimate odds ratios and 95% confidence intervals for use of analgesics and psychotropic drugs in the cohorts of 2001 and 2007, controlling for age, gender, education and cognition.
Results shows that the prevalence of medication use and polypharmacy in older adults has increased dramatically the late 1980s to the 2000s in central Stockholm, Sweden. In particular, the use of analgesics increased significantly, while some drug groups decreased, i.e., antipsychotics. Women used more medication than men in all three cohorts. Older adults living in service buildings used the largest amount of drugs in 1987, whereas those living in institutions were the most frequent users in 2001 and 2007.
PubMed ID
26791168 View in PubMed
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Older people's experience of utilisation and administration of medicines in a health- and social care context.

https://arctichealth.org/en/permalink/ahliterature280485
Source
Scand J Caring Sci. 2015 Dec;29(4):760-8
Publication Type
Article
Date
Dec-2015
Author
Åsa Gransjön Craftman
Margareta Westerbotn
Eva von Strauss
Pernilla Hillerås
Lena Marmstål Hammar
Source
Scand J Caring Sci. 2015 Dec;29(4):760-8
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chronic Disease - drug therapy
Drug Therapy - nursing
Female
Home Care Services - organization & administration
Home Health Aides - organization & administration
Humans
Male
Medication Adherence - psychology
Qualitative Research
Sweden
Abstract
People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.
The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.
A qualitative descriptive study.
Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.
The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.
Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.
A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.
PubMed ID
25648845 View in PubMed
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Unlicensed personnel administering medications to older persons living at home: a challenge for social and care services.

https://arctichealth.org/en/permalink/ahliterature273264
Source
Int J Older People Nurs. 2015 Sep;10(3):201-10
Publication Type
Article
Date
Sep-2015
Author
Asa Gransjön Craftman
Lena M Hammar
Eva von Strauss
Pernilla Hillerås
Margareta Westerbotn
Source
Int J Older People Nurs. 2015 Sep;10(3):201-10
Date
Sep-2015
Language
English
Publication Type
Article
Keywords
Aged
Drug Therapy - nursing
Female
Focus Groups
Home Health Aides
Humans
Licensure
Male
Personnel Delegation
Professional Competence
Sweden
Abstract
Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.
The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.
Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.
According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.
Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients.
This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.
PubMed ID
25515934 View in PubMed
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Taking part in Nordic collaboration; nursing students' experiences and perceptions from a learning perspective: A qualitative study.

https://arctichealth.org/en/permalink/ahliterature261015
Source
Nurse Educ Today. 2015 Feb 25;
Publication Type
Article
Date
Feb-25-2015
Author
Margareta Westerbotn
Åsa Kneck
Olav Johannes Hovland
Malene Elrond
Ingrid Pedersen
Gun-Britt Lejonqvist
Johild Dulavik
Tove Ecklon
Inga-Lill Nilsson
Árún K Sigurdardottir
Source
Nurse Educ Today. 2015 Feb 25;
Date
Feb-25-2015
Language
English
Publication Type
Article
Abstract
Nordic networking of different kinds has a long tradition aiming to increase collaboration and understanding between citizens in different countries. Cultural competence in relation to health care and nursing is important for clinical nurses and is a central issue in nurse education.
To gain an understanding of what nurse students experienced and learned during an intensive course in diabetes together with students and nurse educators from Denmark, Finland, Iceland, Norway, Sweden and the Faroe Islands.
In 2012, an intensive course within the Nordic network, Nordkvist, was conducted in Faroe Islands with the theme "Nursing - to live a good life with diabetes". To answer the objective of the study, 26 students conducted written reflections based on two questions. The data was analyzed using qualitative content analysis.
Through meetings with nurse students and educators from the Nordic countries the intensive course strengthened the students' identification with the nursing profession. The students gained new perspectives on diabetes, such as how complex it can be to live with a chronic illness. Because of the difficulties in understanding one another and because of different mother tongues, the students gained a better understanding of patients' vulnerability in relation to hospital jargon and how it felt to be in an unfamiliar place.
The intensive course increased the students' personal and professional growth, cross-cultural competence, and their identification with nursing. Students' understanding of health care in the Nordic countries improved as similarities and differences were recognized.
PubMed ID
25758015 View in PubMed
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8 records – page 1 of 1.