Anna Sandgren
Docent
Institutionen för hälso- och vårdvetenskap
Fakulteten för hälso- och livsvetenskap
Verksamhetsledare och vetenskaplig ledare för Palliativt centrum som är en samverkan mellan Linnéuniversitetet, Region Kronoberg och Kronobergs läns åtta kommuner. Våra verksamhetsområden är Utbildning, Klinisk utveckling, Forskning och Folkbildning. Läs mer om centrumet på www.palliativtcentrum.se
Mina pågående forskningsprojekt
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Projekt: Erfarenheter av Covid-19-pandemin och dess återverkningar Projektets mål är att finna kunskap om hur närstående och personal har erfarit Covid-19 pandemin. Vilken betydelse har pandemin och…
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Projekt: Samtal vid allvarlig sjukdom – Kronobergsmodellen "Kronobergsmodellen – samtal vid allvarlig sjukdom” innebär ett strukturerat arbetssätt som syftar till att personer med allvarlig sjukdom…
Publikationer
Artikel i tidskrift (Refereegranskat)
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Granat, L., Andersson, S., Åberg, D., Hadziabdic, E., Sandgren, A. (2024). Evaluation of the Swedish Self-Efficacy in Palliative Care Scale and exploration of nurses' and physicians' self-efficacy in Swedish hospitals : A cross-sectional study. Scandinavian Journal of Caring Sciences. 38 (3). 568-578.
Status: Publicerad -
Sandgren, A., García-Fernandez, F.P., Gutiérrez Sánchez, D., Strang, P., Lopez Medina, I. (2024). Hospitalised patients with palliative care needs : Spain and Sweden compared. BMJ Supportive & Palliative Care. 14 (e1). E851-E859.
Status: Publicerad -
Baxter, R., Pusa, S., Andersson, S., Sandgren, A. (2024). Perils and payoffs for patients in serious illness conversations as described by physicians : a qualitative study. BMJ Open Quality. 13 (2).
Status: Publicerad -
Nielsen, M., Persson, C., Werkander Harstäde, C., Sandgren, A. (2024). The five aspects mealtime environment observation instrument for assessing mealtime environments in nursing homes : Development and validation. Scandinavian Journal of Caring Sciences. 38 (2). 512-522.
Status: Publicerad -
Pusa, S., Baxter, R., Andersson, S., Fromme, E.K., Paladino, J., et al. (2024). Core Competencies for Serious Illness Conversations : An Integrative Systematic Review. Journal of Palliative Care.
Status: Epub för tryck -
Kirvalidze, M., Bostrom, A., Liljas, A., Doheny, M., Hendry, A., et al. (2024). Effectiveness of integrated person-centered interventions for older people's care : Review of Swedish experiences and experts' perspective. Journal of Internal Medicine. 295 (6). 804-824.
Status: Publicerad -
Andersson, S., Granat, L., Baxter, R., Reimertz, H., Modeus, C., et al. (2024). Translation, Adaptation, and Validation of the Swedish Serious Illness Conversation Guide. Journal of Palliative Care. 39 (1). 21-28.
Status: Publicerad -
Reigada, C., Sandgren, A., Rivas, S., Carvajal, A., Hermida-Romero, S., et al. (2023). Palliative care stay room - designing, testing and evaluating a gamified social intervention to enhance palliative care awareness. BMC Palliative Care. 22 (1).
Status: Publicerad -
Persson, H.A., Ahlstrom, G., Årestedt, K., Behm, L., Drevenhorn, E., et al. (2023). Palliative care delivery at nursing homes before and after an educational intervention from professionals' perspective : A pre-post design. Scandinavian Journal of Caring Sciences. 37 (1). 229-242.
Status: Publicerad -
Blomqvist, M., Ivarsson, A., Carlsson, I., Sandgren, A., Jormfeldt, H. (2023). Relationship between Physical Activity and Health Outcomes in Persons with Psychotic Disorders after Participation in a 2-Year Individualized Lifestyle Intervention. Issues in Mental Health Nursing. 44 (7). 629-638.
Status: Publicerad -
Vogel, G., Joelsson-Alm, E., Forinder, U., Svensen, C., Sandgren, A. (2023). Shifting focus : A grounded theory of how family members to critically ill patients manage their situation. Intensive & Critical Care Nursing. 78.
Status: Publicerad -
Pusa, S., Baxter, R., Sandgren, A. (2023). Physicians' perceptions of the implementation of the serious illness care program : a qualitative study. BMC Health Services Research. 23 (1).
Status: Publicerad -
Vogel, G., Forinder, U., Sandgren, A., Svensen, C., Joelsson-Alm, E. (2023). The distorted memories of patients treated in the intensive care unit during the COVID-19 pandemic : A qualitative study. Intensive & Critical Care Nursing. 79.
Status: Publicerad -
Baxter, R., Pusa, S., Andersson, S., Fromme, E.K., Paladino, J., et al. (2023). Core elements of serious illness conversations : an integrative systematic review. BMJ Supportive & Palliative Care.
Status: Epub för tryck -
Lundberg, K., Kjellström, S., Sandgren, A. (2022). Unifying loyalty : a grounded theory about tactical officers’ challenges when leading licensed medical personnel in combat zones. Journal of Military Studies. 11 (1). 1-7.
Status: Publicerad -
Andersson, S., Granat, L., Brännström, M., Sandgren, A. (2022). Translation, Cultural Adaptation, and Content Validation of the Palliative Care Self-Efficacy Scale for Use in the Swedish Context. International Journal of Environmental Research and Public Health. 19 (3).
Status: Publicerad -
Morberg Jämterud, S., Sandgren, A. (2022). Health care professionals' perceptions of factors influencing the process of identifying patients for serious illness conversations : A qualitative study. Palliative Medicine : A Multiprofessional Journal. 36 (7). 1072-1079.
Status: Publicerad -
Andersson, S., Sandgren, A. (2022). Organizational readiness to implement the Serious Illness Care Program in hospital settings in Sweden. BMC Health Services Research. 22 (1).
Status: Publicerad -
Granat, L., Andersson, S., Hadziabdic, E., Brännström, M., Sandgren, A. (2022). Translation, adaptation, and validation of the Self-efficacy in Palliative Care scale (SEPC) for use in Swedish healthcare settings. BMC Palliative Care. 21 (1).
Status: Publicerad -
Reigada, C., Hermida-Romero, S., Tabera, A., Acilu, A., Sandgren, A., et al. (2022). Combining interdisciplinarity and creative design- A powerful strategy to increase palliative care awareness within a university community. Thinking Skills and Creativity. 46.
Status: Publicerad -
Heikkilä, K., Andersson, S., Lagerbielke, E., Persson, C., Sandgren, A., et al. (2022). Mealtime interventions and their outcomes in care homes for older people considering the five aspects meal model : An integrative review. Geriatric Nursing. 47. 171-182.
Status: Publicerad -
Hjelmfors, L., Martensson, J., Strömberg, A., Sandgren, A., Friedrichsen, M., et al. (2022). Communication about Prognosis and End-of-Life in Heart Failure Care and Experiences Using a Heart Failure Question Prompt List. International Journal of Environmental Research and Public Health. 19 (8).
Status: Publicerad -
Reigada, C., Hermida-Romero, S., Sandgren, A., Gómez, B., Olza, I., et al. (2021). Interdisciplinary discussions on palliative care among university students in Spain : giving voice to the social debate. International Journal of Qualitative Studies on Health and Well-being. 16 (1).
Status: Publicerad -
Sandgren, A., Axelsson, L., Bylund Grenklo, T., Benzein, E. (2021). Family members' expressions of dignity in palliative care : a qualitative study. Scandinavian Journal of Caring Sciences. 35 (3). 937-944.
Status: Publicerad -
Sandgren, A., Arnoldsson, L., Lagerholm, A., Bökberg, C. (2021). Quality of life among frail older persons (65+ years) in nursing homes : A cross-sectional study. Nursing Open. 8 (3). 1232-1242.
Status: Publicerad -
Vogel, G., Joelsson-Alm, E., Forinder, U., Svensen, C., Sandgren, A. (2021). Stabilizing life : A grounded theory of surviving critical illness. Intensive & Critical Care Nursing. 67.
Status: Publicerad -
Möllerberg, M., Årestedt, K., Sandgren, A., Benzein, E., Swahnberg, K. (2020). Adaptation and psychometric evaluation of the short version of Family Sense of Coherence Scale in a sample of persons with cancer in the palliative stage and their family members. Palliative & Supportive Care. 18 (1). 24-32.
Status: Publicerad -
Hommerberg, C., Gustafsson, A.W., Sandgren, A. (2020). Battle, Journey, Imprisonment and Burden : patterns of metaphor use in blogs about living with advanced cancer. BMC Palliative Care. 19. 1-10.
Status: Publicerad -
Hjelmfors, L., Van Der Wal, M.H.L., Friedrichsen, M., Milberg, A., Mårtensson, J., et al. (2020). Optimizing of a question prompt list to improve communication about the heart failure trajectory in patients, families, and health care professionals. BMC Palliative Care. 19 (1). 1-14.
Status: Publicerad -
Werkander Harstäde, C., Sandgren, A. (2020). Constructing stability - a classic grounded theory of next-of-kin in palliative cancer care. BMC Palliative Care. 19 (1). 1-9.
Status: Publicerad -
Gustafsson, A.W., Hommerberg, C., Sandgren, A. (2020). Coping by metaphors : The versatile function of metaphors in blogs about living with advanced cancer. Medical Humanities. 46 (3). 267-277.
Status: Publicerad -
Bylund-Grenklo, T., Werkander Harstäde, C., Sandgren, A., Benzein, E., Östlund, U. (2019). Dignity in life and care : the perspectives of Swedish patients in a palliative care context.. International Journal of Palliative Nursing. 25 (4). 193-201.
Status: Publicerad -
Möllerberg, M., Årestedt, K., Swahnberg, K., Benzein, E., Sandgren, A. (2019). Family sense of coherence and its associations with hope, anxiety and symptoms of depression in persons with cancer in palliative phase and their family members : A cross-sectional study. Palliative Medicine : A Multiprofessional Journal. 33 (10). 1310-1318.
Status: Publicerad -
Wallerstedt, B., Benzein, E., Schildmeijer, K., Sandgren, A. (2019). What is palliative care? : Perceptions of healthcare professionals. Scandinavian Journal of Caring Sciences. 33 (1). 77-84.
Status: Publicerad -
Blomqvist, M., Ivarsson, A., Carlsson, I., Sandgren, A., Jormfeldt, H. (2019). Health effects of an individualized lifestyle intervention for people with psychotic disorders in psychiatric outpatient services : a two year follow-up. Issues in Mental Health Nursing. 40 (10). 839-850.
Status: Publicerad -
Reigada, C., Martin-Utrilla, S., Perez-Ros, P., Centeno, C., Sandgren, A., et al. (2019). Understanding illnesses through a film festival : An observational study. Heliyon. 5 (8). 1-8.
Status: Publicerad -
Lindmark, U., Bülow, P.H., Mårtensson, J., Rönning, H., Ahlstrand, I., et al. (2019). The use of the concept of transition in different disciplines within health and social welfare: An integrative literature review. Nursing Open. 6 (3). 664-675.
Status: Publicerad -
Blomqvist, M., Sandgren, A., Carlsson, I., Jormfeldt, H. (2018). Enabling healthy living : Experiences of people with severe mental illness in psychiatric outpatient services. International Journal of Mental Health Nursing. 27 (1). 236-246.
Status: Publicerad -
Blomqvist, M., Ivarsson, A., Carlsson, I., Sandgren, A., Jormfeldt, H. (2018). Health risks among people with severe mental illness in psychiatric outpatient settings. Issues in Mental Health Nursing. 39 (7). 585-591.
Status: Publicerad -
Sandgren, A., Strang, P. (2018). Palliative care needs in hospitalized cancer patients : a 5-year follow-up study. Supportive Care in Cancer. 26 (1). 181-186.
Status: Publicerad -
Parola, V., Coelho, A., Sandgren, A., Fernandes, O., Apostolo, J. (2018). Caring in Palliative Care : A Phenomenological Study of Nurses' Lived Experiences. Journal of Hospice and Palliative Nursing. 20 (2). 180-186.
Status: Publicerad -
Coelho, A., Parola, V., Sandgren, A., Fernandes, O., Kolcaba, K., et al. (2018). The Effects of Guided Imagery on Comfort in Palliative Care. Journal of Hospice and Palliative Nursing. 20 (4). 392-399.
Status: Publicerad -
Vogel, G., Forinder, U., Sandgren, A., Svensen, C., Joelsson-Alm, E. (2018). Health-related quality of life after general surgical intensive care. Acta Anaesthesiologica Scandinavica. 62 (8). 1112-1119.
Status: Publicerad -
Alftberg, Å., Ahlström, G., Nilsen, P., Behm, L., Sandgren, A., et al. (2018). Conversations about Death and Dying with Older People : An Ethnographic Study in Nursing Homes. Healthcare. 6 (2).
Status: Publicerad -
Hjelmfors, L., Strömberg, A., Friedrichsen, M., Sandgren, A., Mårtensson, J., et al. (2018). Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care. BMC Palliative Care. 17.
Status: Publicerad -
Persson, H.A., Sandgren, A., Furst, C., Ahlström, G., Behm, L. (2018). Early and late signs that precede dying among older persons in nursing homes : the multidisciplinary team's perspective. BMC Geriatrics. 18.
Status: Publicerad -
Ahlström, G., Nilsen, P., Benzein, E., Behm, L., Wallerstedt, B., et al. (2018). Implementation of knowledge-based palliative care in nursing homes and pre-post post evaluation by cross-over design : a study protocol. BMC Palliative Care. 17.
Status: Publicerad -
Wallerstedt, B., Behm, L., Alftberg, Å., Sandgren, A., Benzein, E., et al. (2018). Striking a Balance : A Qualitative Study of Next of Kin Participation in the Care of Older Persons in Nursing Homes in Sweden. Healthcare. 6 (2).
Status: Publicerad -
Brolin, R., Syrén, S., Rask, M., Sandgren, A., Brunt, D. (2018). Residents' perceptions of the most positive and negative aspects of the housing situation for people with psychiatric disabilities. Scandinavian Journal of Caring Sciences. 32 (2). 603-611.
Status: Publicerad -
Hjelmfors, L., Sandgren, A., Strömberg, A., Mårtensson, J., Jaarsma, T., et al. (2018). “I was told that I would not die from heart failure” : patient perceptions of prognosis communication. Applied Nursing Research. 41. 41-45.
Status: Publicerad -
Munck, B., Sandgren, A. (2017). The impact of medical technology on sense of security in the palliative home care setting. British Journal of Community Nursing. 22 (3). 130-135.
Status: Publicerad -
Bylund, A., Benzein, E., Sandgren, A. (2017). Stabilizing family life after gastric bypass surgery. International Journal of Qualitative Studies on Health and Well-being. 12 (1).
Status: Publicerad -
Dalteg, T., Sandberg, J., Malm, D., Sandgren, A., Benzein, E. (2017). The heart is a representation of life : an exploration of illness beliefs in couples living with atrial fibrillation. Journal of Clinical Nursing. 26 (21-22). 3699-3709.
Status: Publicerad -
Sandgren, A. (2017). Complexities in Palliative Cancer Care : Can Grounded Theories be Useful to Increase Awareness?. The Grounded Theory Review. 16 (1). 75-78.
Status: Publicerad -
Grimheden, S., Lindqvist, G., Bylund Grenklo, T., Sandgren, A. (2017). An obligation to care for seriously ill children in their homes : a qualitative study of community nurses' perceptions. Nordic journal of nursing research. 37 (4). 201-208.
Status: Publicerad -
Möllerberg, M., Sandgren, A., Swahnberg, K., Benzein, E. (2017). Familial Interaction Patterns During the Palliative Phase of a Family Member Living With Cancer. Journal of Hospice and Palliative Nursing. 19 (1). 67-74.
Status: Publicerad -
Parola, V., Coelho, A., Cardoso, D., Sandgren, A., Apostolo, J. (2017). Burnout in Palliative Care Settings Compared With Other Settings : A Systematic Review. Journal of Hospice and Palliative Nursing. 19 (5). 442-451.
Status: Publicerad -
Möllerberg, M., Sandgren, A., Lithman, T., Noreen, D., Olsson, H., et al. (2016). The effects of a cancer diagnosis on the health of a patient's partner : a population-based registry study of cancer in Sweden. European Journal of Cancer Care. 25 (5). 744-752.
Status: Publicerad -
Dalteg, T., Benzein, E., Sandgren, A., Malm, D., Årestedt, K. (2016). Associations of Emotional Distress and Perceived Health in Persons With Atrial Fibrillation and Their Partners Using the Actor–Partner Interdependence Model. Journal of Family Nursing. 22 (3). 368-391.
Status: Publicerad -
Werkander Harstäde, C., Sandgren, A. (2016). Confronting the Forthcoming Death : A Classic Grounded Theory. Journal of Palliative Care & Medicine. 6.
Status: Publicerad -
Tranberg, M., Rasmussen, B.H., Fürst, C.J., Friedrichsen, M., Benzein, E., et al. (2016). Möten mellan människor : kulturkrockar i den palliativa vården. Omsorg : Nordisk tidsskrift for Palliativ Medisin. 33 (3). 27-31.
Status: Publicerad -
Brolin, R., Brunt, D., Rask, M., Syrén, S., Sandgren, A. (2016). Mastering everyday life in ordinary housing for people with psychiatric disabilities. The Grounded Theory Review. 15 (1). 10-25.
Status: Publicerad -
Brolin, R., Brunt, D., Rask, M., Syrén, S., Sandgren, A. (2016). Striving for meaning : Life in supported housing for people with psychiatric disabilities. International Journal of Qualitative Studies on Health and Well-being. 11.
Status: Publicerad -
Dalteg, T., Benzein, E., Sandgren, A., Fridlund, B., Malm, D. (2014). Managing uncertainty in couples living with atrial fibrillation. Journal of Cardiovascular Nursing. 29 (3). E1-E10.
Status: Publicerad -
Oliva, D., Sandgren, A., Nilsson, M., Lewin, F. (2014). Variations in self-reported nausea, vomiting and well-being during the first 10 days postchemotherapy in women with breast cancer. Clinical Journal of Oncology Nursing. 18 (2). E32-E36.
Status: Publicerad -
Malm, D., Sandgren, A. (2014). Regaining normalcy in relatives of patients with pacemaker. Open Journal of Nursing. 4 (3). 139-149.
Status: Publicerad -
Munck, B., Sandgren, A., Fridlund, B., Mårtensson, J. (2012). Next-of-kin’s conceptions of medical technology in palliative homecare. Journal of Clinical Nursing. 21 (13/14). 1868-1877.
Status: Publicerad -
Sandgren, A. (2012). Deciphering unwritten rules. The Grounded Theory Review. 11 (2).
Status: Publicerad -
Munck, B., Sandgren, A., Fridlund, B., Mårtensson, J. (2012). Patients’ understanding of medical technology in palliative home care; a qualitative analysis. Journal of Hospice and Palliative Nursing. 14 (3). 191-198.
Status: Publicerad -
Sandgren, A., Fridlund, B., Nyberg, P., Strang, P., Petersson, K., et al. (2010). Symptoms, care needs and diagnosis in palliative cancer patients in acute care hospitals: A 5-year follow-up survey. Acta Oncologica. 49 (4). 460-466(7).
Status: Publicerad -
Sandgren, A., Thulesius, H., Petersson, K., Fridlund, B. (2010). Living on hold in palliative cancer care. The Grounded Theory Review. 9 (1). 79-100.
Status: Publicerad -
Sandgren, A., Thulesius, H., Petersson, K., Fridlund, B. (2008). Anticipatory Caring. The Grounded Theory Review. 7 (3).
Status: Publicerad -
Sandgren, A., Thulesius, H., Petersson, K., Fridlund, B. (2007). "Doing good care" - a study of palliative home nursing care. International Journal of Qualitative Studies on Health and Well-being. 2. 227-235.
Status: Publicerad -
Sandgren, A., Thulesius, H., Fridlund, B., Petersson, K. (2006). Striving for emotional survival in palliative cancer nursing. Qualitative Health Research. 16 (1). 79-96.
Status: Publicerad
Artikel i tidskrift (Övrigt vetenskapligt)
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Hjelmfors, A., Strömberg, A.S., Friedrichsen, M.F., Sandgren, A., Mårtensson, J.M., et al. (2018). Using co-design to develop an intervention to improve communication about the heart failure trajectory and end-of-life care. European Journal of Cardiovascular Nursing. 17. 23-23.
Status: Publicerad -
Möllerberg, M., Sandgren, A., Swahnberg, K., Benzein, E. (2017). Familial interaction patterns during the palliative phase of a family member living with cancer. European Journal of Cancer. 72. S162-S162.
Status: Publicerad -
Dalteg, T., Sandberg, J.S.J., Malm, D.M.D., Sandgren, A., Benzein, E. (2017). The heart is a representation of life : an exploration of illness beliefs in couples living with atrial fibrillation. European Journal of Cardiovascular Nursing. 16. S41-S41.
Status: Publicerad -
Hjelmfors, A., Sandgren, A., Stromberg, A.S., Martensson, J.M., Jaarsma, T.J., et al. (2017). Patient perspectives of prognosis communication. European Journal of Cardiovascular Nursing. 16. S65-S66.
Status: Publicerad -
Hommerberg, C., Gustafsson, A.W., Benzein, E., Sandgren, A., Semino, E., et al. (2016). Rendering the ungraspable graspable : the use of metaphors in Swedish palliative cancer care. Palliative Medicine : A Multiprofessional Journal. 30 (6). NP364-NP364.
Status: Publicerad -
Möllerberg, M., Sandgren, A., Lithman, T., Noreen, D., Olsson, H., et al. (2015). The effects of cancer diagnosis on the health of the patient's partner : A population-based register study of cancer in Sweden. European Journal of Cancer. 51. S250-S51.
Status: Publicerad
Artikel i tidskrift (Övrigt (populärvetenskap, debatt))
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Hommerberg, C., Gustafsson, A.W., Benzein, E., Sandgren, A. (2016). Metaforer i palliativ cancervård. Palliativ vård: tidskriften för palliativ vård i Sverige. (4). 36-37.
Status: Publicerad
Artikel, forskningsöversikt (Refereegranskat)
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Baxter, R., Fromme, E.K., Sandgren, A. (2022). Patient Identification for Serious Illness Conversations : A Scoping Review. International Journal of Environmental Research and Public Health. MDPI. 19 (7).
Status: Publicerad -
Parola, V., Coelho, A., Cardoso, D., Sandgren, A., Apóstolo, J. (2017). Prevalence of burnout in health professionals working in palliative care : a systematic review. The JBI Database of Systematic Reviews and Implementation Reports. University of Adelaide. 15 (7). 1905-1933.
Status: Publicerad -
Henoch, I., Carlander, I., Holm, M., James, I., Sarenmalm, E.K., et al. (2016). Palliative Care Research - A Systematic Review of foci, designs and methods of research conducted in Sweden between 2007 and 2012. Scandinavian Journal of Caring Sciences. 30 (1). 5-25.
Status: Publicerad
Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
- Sandgren, A. (2010). Deciphering Unwritten Rules : Patients, relatives and nurses in palliative cancer care. Doctoral Thesis. Växjö, Kalmar, Linnaeus University Press.
Kapitel i bok, del av antologi (Övrigt vetenskapligt)
- Sandgren, A. (2014). Grounded Theory. Videnskabelig teori og metode : fra idé till eksamination. Köbenhavn, Munksgaard Forlag.
- Sandgren, A. (2012). Grounded Theory. Vetenskaplig teori och metod : Från idé till examination inom omvårdnad. Lund, Studentlitteratur AB. 407-425.
Konferensbidrag (Övrigt vetenskapligt)
- Wallerstedt, B., Schildmeijer, K., Benzein, E., Sandgren, A. (2017). Supporting QoL versus "having nothing more to do" : staff´s perceptions of palliative care. Presented at the 15th World Congress of the European Association for Palliative Care (EAPC), Madrid, Spain, May 18-20, 2017.
Övrigt (Övrigt (populärvetenskap, debatt))
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Hommerberg, C., Hommerberg, C., Wallberg Gustafsson, A., Sandgren, A. (2017). Hur vi talar om cancer. Linnéuniversitetet.
Informationsfilm om forskningsprojektet Metaforer i palliativ cancervård, publicerad i LnuPlay.
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Konstnärlig output (Övrigt (populärvetenskap, debatt))
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Hadziabdic, E., Brodén, K., Lilja, Å., Bratt, A.S., Sandgren, A., et al. (2024). ohållbart många ohälsosamma haikus om hållbar hälsa. Linnaeus University Press.
Seriealbum med haikus och illustrationer på temat Hållbar hälsa
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