Evy Lidell

Young women's sexual health and their views on dialogue with health professionals

Background. Many women who experience sexual problems or who have been subjected to sexual abuse, do not seek help, and often health professionals avoid raising such issues. The aim of this study was to describe young womens sexual health and their views on a dialogue about aspects of sexuality in connection with a gynecologic examination. Method. Cross‐sectional study. Women, 23, 26 and 29 years of age, called for gynecologic screening between March and July 2006 (n = 488; response rate 75%). Descriptive statistics, multiple logistic regression and bivariate analysis were used. Results. The majority (95%) had a positive attitude towards sexuality, although many women reported sexual problems, and one‐fifth (22%) were dissatisfied with their sex life. Women considered it appropriate to be asked about sexuality in general (92%), while a majority (72%) found questions about sexual abuse appropriate. However, depending on the area, the majority (76–99%) had never been asked such questions. Demographic variables, aspects of life, sexuality and sexual abuse were irrelevant for whether women considered it appropriate to be asked questions about aspects of sexuality, by a midwife/doctor in connection with a gynecologic examination. Conclusion. The result can activate health professionals to initiate a dialogue about sexual issues among young women. In this way, many women who experience sexual problems or have been subjected to sexual abuse, may be provided the opportunity to improve their sexual health.

Trust and confirmation in a gynecologic examination situation : A critical incident technique analysis

Background.  Gynecologic examination is a common measure in reproductive health care. Many women experience the examination as a more or less negative event, with shortcomings in the examiners behavior. The aim of the study was to describe, in terms of critical incidences, womens experiences concerning the personnels behavior in the situation of gynecologic examination.

Time for dialysis as time to live : experiences of time in everyday life of the Swedish next of kin of hemodialysis patients

The aim of this study was to explore the content of time in everyday life as experienced by the next of kin of patients on hemodialysis in Sweden. Chronic renal disease often requires hemodialysis, which is a time-consuming treatment that makes it necessary to carefully plan everyday life and involves the next of kin to a large degree. This study used a descriptive design with a content analysis approach. The analysis of the data from the twenty interviews revealed the experiences of time in the everyday lives of the next of kin of a patient on hemodialysis. The content of time in everyday life can be described as follows: fragmented time, vacuous time, and uninterrupted time. The findings show how everyday life time for the next of kin is minimized and that the common life space is contracted. The next of kin must be provided with supervision in order to provide them with more of their own time in everyday life, which can benefit their health.The aim of this study was to explore the content of time in everyday life as experienced by the next of kin of patients on hemodialysis in Sweden. Chronic renal disease often requires hemodialysis, which is a time-consuming treatment that makes it necessary to carefully plan everyday life and involves the next of kin to a large degree. This study used a descriptive design with a content analysis approach. The analysis of the data from the twenty interviews revealed the experiences of time in the everyday lives of the next of kin of a patient on hemodialysis. The content of time in everyday life can be described as follows: fragmented time, vacuous time, and uninterrupted time. The findings show how everyday life time for the next of kin is minimized and that the common life space is contracted. The next of kin must be provided with supervision in order to provide them with more of their own time in everyday life, which can benefit their health.

Young women's perceptions of being asked questions about sexuality and sexual abuse: a content analysis

OBJECTIVE to describe young womens perceptions of being asked questions by midwives or doctors pertaining to sexuality and sexual abuse in connection with visits for gynaecological examination. DESIGN a qualitative study. Data comprised responses to open-ended questions in a questionnaire and were analysed by qualitative content analysis. SETTING a county in the south-west of Sweden. PARTICIPANTS all of the 23-, 26- and 29-year-old women who attended eight midwife and youth centres for cervical screening during the period between March and July 2006 were invited to participate. The open-ended question about sexuality was answered by 413 women, and 409 women answered the question about sexual abuse, representing approximately 84% of the women who answered the questionnaire as a whole. FINDINGS the data resulted in a total of eight categories and 31 codes, which showed the womens perceptions of being asked questions about sexuality and sexual abuse. Six of the categories dealt with why it was considered natural to be questioned. Health professionals can be trusted and questions can open up a dialogue as well as clarify the womans situation. The context of a visit for a gynaecological examination is relevant and questions will make it possible for the professionals to strengthen the woman. Another reason was that sexuality is an essential part of life. Those women who felt that it would not feel natural to be asked questions about sexuality and sexual abuse considered that the context is wrong and that such questions will encroach on the womans personal sphere. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE womens responses indicate that there are good reasons for midwives and doctors to raise questions about sexuality and sexual abuse when they meet young women. Taking opportunity to find those who have sexual problems and/or experience of sexual abuse could reduce the suffering of these women and lead to an economic gain to society. The provision of training and supervision for midwives and doctors is important to enhance the quality of conversations about sexual matters. In order to deal with such issues, it is necessary to have knowledge of sexual health, relationships and violence, as well as a professional stance and a good conversational technique.

Depressed Mood Over Time after Open Heart Surgery Impacts Patient Well-Being: A Combined Study

Background: Depression is a common cause of decreased well-being after open heart surgery (OHS) and a risk factor for new cardiac events. Little is known about the long-term prevalence of depressive symptoms after OHS or their effect on well-being. The aim of this study was to explore the presence of depressed mood in patients during the recovery phase after open heart surgery as well as depressed mood and well-being 3 years later. Method: Eighty consecutively included patients completed a questionnaire about depressed mood at 5 weeks, 5 months and 3 years after OHS. A telephone interview took place after receipt of the third questionnaire to explore their well-being. Quantitative and qualitative data were analysed separately and thereafter together. Result: Depressed mood occurred in 52% of the patients during recovery or 3 years after OHS. The qualitative content analysis produced the theme of transition, which was based on three categories. Conclusion: Depressed mood was reported by the majority of patients during recovery after OHS and had a long-term effect on their well-being. OHS constituted a transition for all patients, but those with depressed mood had difficulty finishing the transition process and reorientating life.

A caring perspective on rehabilitation after myocardial infarction. A theoretical framework and a suggestion for a rehabilitation programme.

ABSTRACT Several rehabilitation models after myocardial infarction (MI) have been developed during recent years, usually with a biomedical perspective. The MI client is a biopsychosocial human being and therefore a multifactorial approach built on holistic care may offer an efficient rehabilitation process. This includes increased social support and decreased life stress for the MI client in order to obtain an adaptive coping capacity for a life style change. Health care professionals are required with specialised knowledge about how and why to care for an MI client. The present theoretical framework provides a basis for building a multifactorial rehabilitation with a caring perspective.

Vulnerability factors from a pre-and post-myocardial infarction perspective: a qualitative analysis

Summary In- and out-of-hospital rehabilitation programmes have been developed to support patients in the recovery process after MI to engender a sense of security. In spite of these interventions, about one-fifth of the patients report emotional problems. The aim of this study was to uncover factors constituting vulnerability in persons with a history of myocardial infarction. A qualitative research method was used and 12 informants were strategically selected and interviewed. The findings showed that the vulnerability was composed of factors of anxiety, inferiority, insecurity, lack of intimacy, and disconfirmation. Each of the factors encompassed themes of life experiences pre-myocardial infarction as well as themes of expressions post-myocardial infarction. Data showed that the post-myocardial infarction expressions were reflecting the pre-myocardial infarction experiences. The findings were discussed in the light of emotional support and personal worth in order to increase the understanding of the vulnerability factors and their impact on recovery conditions. It was concluded that the person-world relationship was a basis for factors constituting vulnerability along the lifespan which affected the prerequisites for emotional well-being post myocardial infarction. Further research is needed, such as prospective and intervention studies, in order to generate generalizable information.

Endurance * integration of strength and vulnerability in relatives' response to open heart surgery as a lived experience

Open heart surgery is a threatening life event for patients and their relatives. The relatives’ situation is especially complex since at the same time they both support the patient and suffer themselves. The purpose of the present study was to describe relatives’ lived experiences of a family members open-heart surgery in a lifeworld perspective. Nine relatives of patients who underwent coronary artery bypass and/or heart valve surgery were interviewed in depth using a phenomenological approach. Endurance was found to be the essential characteristic for this group and was derived from four constituents: unconditionality, uncertainty, mutuality and sadness. Unable to escape their changed lifeworld, they demonstrated endurance throughout the entire illness process, which implied a great sense of responsibility and the setting aside of their own needs and wishes. The endurance rendered them both strong and vulnerable, although the vulnerability was not immediately apparent. There is a risk that relatives in need for help to handle this threatening situation may be ignored by health care professionals because they seem so capable. A lifeworld perspective in health care including the entire family can prevent such a situation.

Medication usage among young adult women: A comparison between Sweden, the USA, and Greece

This study evaluated whether or not medication usage among young adult women differed across three countries. An additional aim was to evaluate the association between medication use and sociodemographic factors and exercise habits. A sample of 1098 young adult women were selected in Sweden, the USA, and Greece. Consistent medication usage by young adult women in the three countries related to oral contraceptives and vitamins; nevertheless, there were differences. The main differences were found in the use of laxatives, iron supplements, analgesics, antidepressants, and antacid medication. The most outstanding differences were the frequent use of laxatives in Sweden and vitamins in the USA. Different association patterns were found between medication use and culture, sociodemographic factors, and exercise. The assessment of medication use among young adult women can be performed very easily and provides an immediate indication of their well-being and needs for preventative care.

Status and trends in Swedish dissertations in the area of cardiovascular nursing

In Europe, cardiovascular nursing (CVN) is a young branch of nursing science. The explicit knowledge contained in CVN dissertations has, so far, not been studied in Europe, and this is especially true in the case of Sweden. Accordingly, the aim of this literature study was to describe the status of and compare trends in Swedish dissertations in the area of CVN in terms of organisational structure, approach, research strategy, social orientation and socio-demographic aspects. The literature search resulted in 29 dissertations and a 26-item questionnaire that illuminated the problem areas. Most dissertations were produced in the universities of Göteborg, Halmstad and Linköping; a minority had a nurse as main supervisor; rehabilitation was the most common CVN approach; very few of the dissertations had an experimental design; and the majority was hospital-based. The main trends were (A) an increase in dissertations that were written during the last 6 years, (B) an increased number of nurses as main supervisors as well as publication in nursing journals, (C) an increase in hospital care settings while a decrease in community settings, and finally, (D) an increased number of dissertations addressing the issues of tertiary prevention as well as focusing on patients and next-of-kin as target groups. An important implication is to stimulate nurse-led interventions at all preventative levels in order to maintain or improve the cardiac health of both healthy and sick individuals, but also in order to visualize CVN and distinguish it from cardiology.