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- Arvidsson, Susann, 1965-, et al.
(författare)
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Factors promoting health-related quality of life in patients with rheumatic diseases 12 months after rehabilitation
- 2010
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Ingår i: Svenska Läkaresällskapets Riksstämma 2010. ; , s. 3-3
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Konferensbidrag (refereegranskat)abstract
- Rheumatic diseases have significant adverse impact on the individual from physical, mental and social aspects, resulting in a low estimation of health-related quality of life (HRQL). Patients with rheumatoid arthritis who receive a multi-disciplinary team-based care in a rheumatology clinic could get improved HRQL. Several factors can be supposed to promote health in patients with rheumatic diseases and in health-promoting work within the clinical practice it would be valuable to identify health factors that affect HRQL in a positive direction.This is a longitudinal cohort study in 185 patients with rheumatic diseases with test one week and 12 months after rehabilitation on a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors (chronic musculoskeletal pain, sleep quality, food habits, exercise habits, leisure habits, sexual lust, sense of coherence (SOC), social support and socio-demographic variables). The association between SF-36 subscales and suggested health factors were estimated by OR and 95 % CI calculated by multivariable logistic regressions.Factors predicting better outcome in HRQL in one or several SF-36 subscales were being of younger ages or middle-ages, feeling painless, having good sleep structure, feeling rested after sleep, doing low effort of exercise more than twice a week, having strong SOC, having emotional support and practical assistance, having higher educational level, and having working capacity. The most important factors were having strong SOC, feeling rested after sleep, having working capacity, being of younger ages or middle-ages, and having no/small problem with sleep structure.The most important factors promoting HRQL in patients with rheumatic diseases 12 months after rehabilitation were having strong SOC, feeling rested after sleep, having working capacity, being of younger ages or middle-ages, and having no/small problem with sleep structure. These health factors are important to address in clinical work with rheumatic diseases to optimise treatment strategies.
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| 4. |
- Arvidsson, Susann, 1965-, et al.
(författare)
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Psychometric Properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-23
- 2010
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Ingår i: Svenska Läkaresällskapets Riksstämma 2010. ; , s. 3-3
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Konferensbidrag (refereegranskat)abstract
- Empowerment is a central concept in a patient-focused rheumatology care. WHO describes empowerment as a process in which the person receives more control over decisions and actions that affect the own life and health. Today there is no Swedish empowerment instrument for rheumatic diseases created or transl[...]The already existing questionnaire, Swedish Diabetes Empowerment Scale (SWE-DES-23), was adapted for use in patients with rheumatic diseases by exchanging the word diabetes with rheumatic disease in all the questions. No items were added or removed. The adapted questionnaire was called SWE-RES-23. In 2009, 260 patients with rheumatic diseases from a rheumatology unit in the southwest of Sweden completed the questionnaire.In order to establish discriminant validity, a question about self-perceived health from SF-36 was used in addition to SWE-RES-23.Construct validity was tested by using exploratory factor analysis. In order to determine unidimensionality of the empowerment subscales, inter-item correlations were calculated. Internal consistency reliability was tested by the use of the Cronbach-α coefficient.The exploratory factor analysis resulted in five factors (empowerment subscales) with Eigenvalues >1 explaining 64.1% of the variance. The five empowerment subscales were: Goal achievement and overcoming barriers to goal achievement, Self-awareness, Managing stress, Assessing dissatisfaction and readiness to change, and Support for caring. The Cronbach-α values ranged from 0.59 to 0.91 and for the total score 0.92. All inter-item correlations were significant. Patients with very good and good self-reported health scored significantly higher on three empowerment subscales (Goal achievement, Self-awareness and Managing stress). The same patterns were seen in the other two empowerment subscales (Readiness to change and Support for change), but did not reach significance.The SWE-RES-23 was a first step in developing a questionnaire for assessment of empowerment of patients with rheumatic diseases. The questionnaire possesses acceptable validity and reliability. To fully validate the SWE-RES-23 further studies are needed, but the instrument is even now possible to use in empowerment education programmes for patients with rheumatic diseases.
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| 5. |
- Arvidsson, Susann, 1965-, et al.
(författare)
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Upplevelse av hälsobefrämjande egenvård vid reumatisk sjukdom
- 2009
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Konferensbidrag (refereegranskat)abstract
- BakgrundPersoner med reumatiska sjukdomar skattar sitt hälsostatus lågt. Hälsostatus och tron på den egna förmågan att kunna påverka hälsan påverkar i sin tur valet av egenvårdsbeteenden. Egenvårdsbeteenden är vanliga och kan förhindra försämrad hälsa och förlust av värdefull fysisk och psykisk aktivitet. Kunskaperna är små om hur personer med reumatiska sjukdomar upplever att utföra egenvård. Syftet är därmed att beskriva hur personer med reumatiska sjukdomar erfar att utföra egenvård för att nå hälsa.MetodStudien har en kvalitativ design med en fenomenlogisk ansats och en livsvärldsteoretisk grund. Data har samlats in genom ostrukturerade och öppna intervjuer med 12 personer med olika diagnostiserade reumatiska sjukdomar.ResultatPersoner med reumatiska sjukdomar upplever att egenvård är ett sätt att leva och att det innebär att ständigt vara redo för att förstå och reagera på signaler från den levda kroppen. Egenvård upplevs som en inre dialog inom den levda kroppen, men också en yttre dialog med närmiljön. Egenvård beskrivs också som en maktkamp där personen strävar efter och tvingar sig att kämpa mot sjukdomen och dess konkreta konsekvenser. Egenvården kräver också att val görs. Avgörande för valet är att personen har tillit till sig själv och tror på sin egen förmåga att välja hälsobefrämjande egenvård. Personer med reumatiska sjukdomar prioriterar egenvård som upplevs som positiv och/eller ger en belöning till den levda kroppen.SammanfattningPersoner med reumatiska sjukdomar upplever egenvård som ett sätt att leva och det innebär att vara i beredskap för att förstå och reagera på signaler som den levda kroppen sänder ut. Egenvård kräver dialog, maktkamp och val. Denna kunskap bidrar till en mer fullständig förståelse av faktorer som från ett patientperspektiv är viktiga för hälsan vid kronisk reumatisk sjukdom.
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- Axelsson, Åsa B., 1955, et al.
(författare)
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European cardiovascular nurses and allied professions’ practical skills in cardiopulmonary resuscitation
- 2009
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Ingår i: Cardiology. - 0008-6312. - 9783805591430 ; 113:S1
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this study was to test practical skills of cardiopulmonary resuscitation (CPR) in European cardiovascular nurses and allied professions. Methods: Eighty-six delegates at the Spring Meeting on Cardiovascular Nursing in Malmö, Sweden, in 2008, were recruited for this study. Laerdal Resusci Anne SkillReporter manikins connected to a computer with the Laerdal PC SkillReporting System were used. The participants were told to perform CPR according to the “new”guidelines from 2005; 30:2 for three minutes. Results: 88% of the tested participants were nurses and 79% were female. Mean age were 42 years (range 19–63 years). They came from 14 different European countries, though one third was from Sweden. About two thirds had trained CPR within the last year. Seven per cent had no previous CPR training. According to practical skills the average inflations per minute were five (SD+1.5), average inflation volume 992 ml (SD+423) and average flow rate 857 ml/second (SD+401). According assessment of chest compressions the average compression rate was 121 (SD+22.5), average compression per minute 79.5 (SD+14.4), average compression depth 43.8 mm (SD+9.4) and average compression duty cycle 43.8% (SD+5.7). Hand position “too low”was the most common committed error. Conclusion: The practical skill in CPR among the tested delegates was rather satisfying regarding chest compressions. However, there were wide ranges as shown by large standard deviations. Regarding ventilations, too large volumes together with flow rates as high as those performed by many of these delegates may easily lead to gastric inflation during clinical CPR.
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| 8. |
- Bala, Sidona-Valentina, et al.
(författare)
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Measuring person-centered care in nurse-led outpatient rheumatology clinics
- 2018
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Ingår i: International Conference on Probabilistic Models for Measurement.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Person-centered care (PCC) is a key component to effective illness management and high-quality care but conceptually underdeveloped in outpatient care settings for long-term disorders such as rheumatoid arthritis (RA), and there is a lack of instruments measuring patient perceived PCC.AIM: To conceptualize and operationalize outpatient PCC as a basis for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics.DESIGN: A conceptual outpatient PCC framework was developed based on theory and patient experiences.The resulting framework was operationalizedinto items that were tested regarding their accordancewith the theoretical framework and their measurement properties according to Rasch measurement theory (RMT) using the RUMM2030 software. RESULTS: The conceptual framework comprised five intermingled domains (personalization, shared decision-making, empowerment, communication, and social environment) that were operationalized into a 24-item PCC instrument for outpatient care in rheumatology (PCCoc/rheum). RMT analyses found items to successfully map out a quantitative continuum from lower to higher PCC levels, with generally acceptable model fit and a reliability of 0.88. Three items exhibiting multidimensionality, dysfunctional response categories, and/or unexpected hierarchical ordering were omitted. The revised PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories, and no DIF; reliability was 0.86.SUMMARY AND IMPLICATIONS: We found support for the PCCoc/rheum as a conceptually based outcome measure of patient perceived PCC. Results implied minor theoretical reconsiderations, and related scale revisions improved theoretical and clinical clarity. While in need of further testing, the PCCoc/rheum has great potential as a measure of outpatient PCC from a patient perspective.
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| 9. |
- Bala, Sidona-Valentina, et al.
(författare)
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Measuring person-centered care in nurse-led outpatient rheumatology clinics
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: Person-centered care (PCC) is a key component to effective illness management and high-quality care but conceptually underdeveloped in outpatient care settings for long-term disorders such as rheumatoid arthritis (RA), and there is a lack of instruments measuring patient perceived PCC. AIM: To conceptualize and operationalize outpatient PCC as a basis for measuring patient-perceived PCC in nurse-led outpatient rheumatology clinics. DESIGN: A conceptual outpatient PCC framework was developed based on theory and patient experiences.The resulting framework was operationalizedinto items that were tested regarding their accordancewith the theoretical framework and their measurement properties according to Rasch measurement theory (RMT) using the RUMM2030 software. RESULTS: The conceptual framework comprised five intermingled domains (personalization, shared decision-making, empowerment, communication, and social environment) that were operationalized into a 24-item PCC instrument for outpatient care in rheumatology (PCCoc/rheum). RMT analyses found items to successfully map out a quantitative continuum from lower to higher PCC levels, with generally acceptable model fit and a reliability of 0.88. Three items exhibiting multidimensionality, dysfunctional response categories, and/or unexpected hierarchical ordering were omitted. The revised PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories, and no DIF; reliability was 0.86. SUMMARY AND IMPLICATIONS: We found support for the PCCoc/rheum as a conceptually based outcome measure of patient perceived PCC. Results implied minor theoretical reconsiderations, and related scale revisions improved theoretical and clinical clarity. While in need of further testing, the PCCoc/rheum has great potential as a measure of outpatient PCC from a patient perspective.
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