| 451. |
- Nordblom, Ann-Katrin, et al.
(författare)
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Impact on a Person's Daily Life During Episodes of Supraventricular Tachycardia
- 2016
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Ingår i: Journal of Holistic Nursing. - : SAGE Publications. - 0898-0101 .- 1552-5724. ; 35:1, s. 33-43
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To describe impact of episodes of supraventricular tachycardia (SVT) on a person's daily life from a holistic perspective. Method: A deductive descriptive design was used. Twenty semistructured interviews (12 women and 8 men) were conducted before planned ablation of SVT and were analyzed using qualitative content analysis.Results: Living with SVT had a complex impact on daily life. initially, the patients described an inhibited existence due to demands to give up things that they had previously been doing, in case of the unpredictable episodes would occur. The episodes caused fatigue and worry, which togehter created barrier for living life to the full by making the person give up undertakings. The patients constantly needed to find short-term and long-term strategies to prevent new episodes from happening.Conclusion: Episodes of SVT entail a complex life situation as the person's entire existence is affected in daily life. To understand the impact of SVT on daily life, nurses and other health care professionals need increased knowlege and understanding to be able to provide support through relevant information and take optimal care measures.
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| 452. |
- Nordgren, Stina, et al.
(författare)
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Patients' perceptions of self-determination as expressed in the context of care
- 2001
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Ingår i: Journal of Advanced Nursing. - Oxford : Blackwell Scientific. - 0309-2402 .- 1365-2648. ; 35:1, s. 117-125
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of this study was to describe patients' perceptions of how self-determination finds expression in the context of care. Background Self-determination is an important concept within health care as well as an important patient right. New legislation on patient rights in Sweden and Europe is aimed at increased patient self-determination. Design and method Data were collected through semi-structured, tape-recorded interviews with 17 strategically chosen patients within somatic care and analysed using a method inspired by phenomenography. Results The analysis found three descriptive categories of the informants' perceptions: trusting, accepting and a feeling of powerlessness. The patients expressed a great sense of trust and confidence in the care provided and they accepted the health care procedures. At the same time, they expressed a feeling of powerlessness because of not being part of decision-making, as well as lacking knowledge and information about treatment strategies. The patients wished to have the right of more self-determination but lacked the strength and knowledge to be able to influence their own care. Conclusions Patients' perceptions of self-determination suggest that, in their encounters with the professional care, knowledge is expressed as power. The feeling of a lack of self-determination can be reduced by help and support from a nurse who allocates time for communication in order to learn the patient's needs and reach a mutual understanding.
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| 453. |
- Nordstrand, Aina, et al.
(författare)
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Implementation of national guidelines for the prevention and treatment of overweight and obesity in children and adolescents : A phenomenographic analysis of public health nurses’ perceptions
- 2016
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : CoAction Publishing. - 1748-2623 .- 1748-2631. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore and describe how public health nurses (PHNs) perceive the implementation of national guidelines for the prevention and treatment of overweight and obesity among children and adolescents in well-baby clinics and school health services.Design, sample, and measurements: An explorative descriptive design was carried out through individual interviews with 18 PHNs and analysed according to the phenomenographic tradition.Results: Four implementation strategies were described and assigned a metaphor: the structured PHN, pragmatic PHN, critical PHN, and the resigned PHN. Competence, patient receptiveness, internal consensus, interdisciplinary collaboration, resources, and organizational embedding were the determinants identified that most frequently affect implementation, and these determinants were distributed at different levels of the organization. The extent of facilitation seemed to determine which implementation strategy would be used.Conclusions: How PHNs implemented the guidelines for overweight and obesity were affected by determinants at different organizational levels. Contextual facilitation of implementation seemed better in larger organizations, but factors such as leadership, drive, and experience compensated in smaller municipalities. The implementation of guidelines was hindered when the barriers exceeded the benefits.
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| 454. |
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| 455. |
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| 456. |
- Norekvål, Tone M, et al.
(författare)
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Sense of coherence—a determinant of quality of life over time in older female acute myocardial infarction survivors
- 2010
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 19:5-6, s. 820-831
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To determine the relationships between different sense of coherence levels and quality of life, and in older female myocardial infarction survivors; to investigate how socio-demographic, clinical characteristics, sense of coherence self-reported symptoms and function affect quality of life; and to determine whether sense of coherence and quality of life are stable during a six-month follow-up.Background: Myocardinal infraction confers new physical and mental challenges. However, research on sense of coherence and other factors involved in maintaining physical, psychosocial and environmental aspects of quality of life in older female myocardinal infraction survivors is scant.Design: Survey.Methods: A postal survey was conducted of 145 women, aged 62-80 years, three months to five years after myocardial infarction (T1), with a follow-up after six months (T2). Self-reported socio-demographic and clinical data and hospital medical records data were collected. The sense of coherence scale (SOC-29) and the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL-BREF) were used.Results: We found a significant difference in quality of life between weak, moderate, and strong sense of coherence groups (p < 0 center dot 001). Sense of coherence contributed to the level of all quality of life domains (p < 0 center dot 001). Several clinical characteristics contributed to quality of life: (1) physical domain: comorbidities (p < 0 center dot 001), previous myocardial infarction (p = 0 center dot 013), ejection fraction (p < 0 center dot 011), length of hospital stay (p = 0 center dot 005) symptoms and function (p < 0 center dot 001); (2) psychological domain: previous myocardial infarction (p = 0 center dot 031) and symptoms and function (p < 0 center dot 001); and (3) environmental domain: education (p = 0 center dot 033) and symptoms and function (p = 0 center dot 003). On group level, both sense of coherence and quality of life were stable. Experiencing specific health changes (p < 0 center dot 001), not major life events, influenced quality of life during the six-month follow-up.Conclusion: Sense of coherence was an important stable determinant of quality of life domains in female myocardial infarction survivors. Although other factors were identified, further research is needed to elucidate additional determinants of quality of life.Relevance to clinical practice: These specific factors could guide clinicians in making treatment decisions that optimize the quality of life of their patients. Applying a salutogenic perspective through patient education may be important.
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| 457. |
- Norekvål, Tone M., et al.
(författare)
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Temporal trend analysis of nurses' knowledge about implantable cardioverter defibrillators
- 2015
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Ingår i: Nursing in Critical Care. - : Wiley. - 1362-1017 .- 1478-5153. ; 20:3, s. 146-154
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Tidskriftsartikel (refereegranskat)abstract
- Background: Although crucial, research on nurses' knowledge on the use of implantable cardioverter defibrillators (ICDs) is scant. The aims of the study were to investigate (i) the level of nurses' knowledge on care of patients with ICDs, (ii) whether knowledge level is related to education and type of hospital where nurses practice and (iii) whether knowledge level changes among nurses over time.Methods: We developed a questionnaire comprising 27 items in four parts: (1) Sociodemographics, (2) Technical facts about ICDs, (3) Daily life challenges and (4) Self-evaluation of knowledge. After validation, surveys were conducted during 1-week cardiac educational courses in 2003–2010. In total, 463 nurses working in cardiology-related areas participated, yielding a response rate of 91%.Results: Practical and technical knowledge about ICDs was lacking. Nurses were unaware or did not know that mobile phones can affect the device (80%), that patients are restricted from driving heavy vehicles (69%), and that ICDs can deliver unintended shock therapy (73%). However, they were aware that ICD patients can resume sexual (87%) and physical activity (85%). There were few significant differences with regard to education and type of hospital where nurses practiced, but significant time trends in correct answers regarding kitchen appliances, resumption of physical activity and shock delivery.Conclusion: Over an 8-year period, despite the increased usage of ICDs, overall nurses had a lack of knowledge in relation to specific key clinical issues on the care of ICD patients. As a consequence, these patients may fail to receive qualified care. Future research should assess knowledge of other health care professionals and focus on interventions that increase and maintain an appropriate knowledge level in care of ICD patients.Relevance to clinical practice: The level of nurses' knowledge on care of patients with ICDs needs to be systematically raised in order to ensure appropriate counselling and nursing care.
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| 458. |
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| 459. |
- Norekvål, TM, et al.
(författare)
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Patient-reported outcomes as predictors of 10-year survival in women after acute myocardial infarction
- 2010
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Ingår i: Health and Quality of Life Outcomes. - : BioMed Central. - 1477-7525 .- 1477-7525. ; 8
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient-reported outcomes are increasingly seen as complementary to biomedical measures. However, their prognostic importance has yet to be established, particularly in female long-term myocardial infarction (MI) survivors. We aimed to determine whether 10-year survival in older women after MI relates to patient-reported outcomes, and to compare their survival with that of the general female population.Methods: We included all women aged 60-80 years suffering MI during 1992-1997, and treated at one university hospital in Norway. In 1998, 145 (60% of those alive) completed a questionnaire package including socio-demographics, the Sense of Coherence Scale (SOC-29), the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL-BREF) and an item on positive effects of illness. Clinical information was based on self-reports and hospital medical records data. We obtained complete data on vital status.Results: The all-cause mortality rate during the 1998-2008 follow-up of all patients was 41%. In adjusted analysis, the conventional predictors s-creatinine (HR 1.26 per 10% increase) and left ventricular ejection fraction below 30% (HR 27.38), as well as patient-reported outcomes like living alone (HR 6.24), dissatisfaction with self-rated health (HR 6.26), impaired psychological quality of life (HR 0.60 per 10 points difference), and experience of positive effects of illness (HR 6.30), predicted all-cause death. Major adverse cardiac and cerebral events were also significantly associated with both conventional predictors and patient-reported outcomes. Sense of coherence did not predict adverse events. Finally, 10-year survival was not significantly different from that of the general female population.Conclusion: Patient-reported outcomes have long-term prognostic importance, and should be taken into account when planning aftercare of low-risk older female MI patients.
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| 460. |
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