| 1. |
- Silén, Marit, et al.
(författare)
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Nurses' conceptions of decision making concerning life-sustaining treatment
- 2008
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Ingår i: Nursing Ethics. - London : Edward Arnold. - 0969-7330 .- 1477-0989. ; 15:2, s. 160-173
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe nurses' conceptions of decision making with regard to life-sustaining treatment for dialysis patients. Semistructured interviews were conducted with 13 nurses caring for such patients at three hospitals. The interview material was subjected to qualitative content analysis. The nurses saw decision making as being characterized by uncertainty and by lack of communication and collaboration among all concerned. They described different ways of handling decision making, as well as insufficiency of physician-nurse collaboration, lack of confidence in physicians, hindrances to patient participation, and ambivalence about the role of patients' next of kin. Future research should test models for facilitating communication and decision making so that decisions will emerge from collaboration of all concerned. Nurses' role in decision making also needs to be discussed.
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| 2. |
- Bergh, Ingrid, 1956, et al.
(författare)
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Descriptions of pain in elderly patients following orthopaedic surgery.
- 2005
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 19:2, s. 110-8
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to investigate what words elderly patients, who had undergone hip surgery, used to describe their experience of pain in spoken language and to compare these words with those used in the Short-Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The study was carried out at two orthopaedic and two geriatric clinical departments at a large university hospital in Sweden. Altogether, 60 patients (mean age =77) who had undergone orthopaedic surgery took part in the study. A face-to-face interview was conducted with each patient on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and one structured interview. The results show that a majority of the elderly patients who participated in this study verbally stated pain and spontaneously used a majority of the words found in the SF-MPQ and in the POM. The patients also used a number of additional words not found in the SF-MPQ or the POM. Among those patients who did not use any of the words in the SF-MPQ and the POM, the use of the three additional words 'stel' (stiff), 'hemsk' (awful) and 'rad(d)(sla)' (afraid/fear) were especially marked. The patients also combined the words with a negation to describe what pain was not. To achieve a more balanced and nuanced description of the patient's pain and to make it easier for the patients to talk about their pain, there is a need for access to a set of predefined words that describe pain from a more multidimensional perspective than just intensity. If the elderly patient is allowed, and finds it necessary, to use his/her own words to describe what pain is but also to describe what pain is not, by combining the words with a negation, then the risk of the patient being forced to choose words that do not fully correspond to their pain can be reduced. If so, pain scales such as the SF-MPQ and the POM can create a communicative bridge between the elderly patient and health care professionals in the pain evaluation process.
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| 3. |
- Rask, Mikael, 1958-, et al.
(författare)
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Validity and reliability of a Swedish version of the Relationship Assessment Scale (RAS) : a pilot study
- 2010
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Ingår i: Canadian journal of cardiovascular nursing. - Ottawa : Canadian Council of Cardiovascular Nurses. - 0843-6096. ; 20:1, s. 16-21
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a need for a short and easily administered scale, in the Swedish language, for assessing partner relationships in the health care of persons with cardiac disease. PURPOSE: To establish the reliability and validity of the Swedish version of the Relationship Assessment Scale (RAS). DESIGN: The present pilot study has a methodological design. FINDINGS: Content validity has been tested for relevance, clarity and readability. The scale was tested for construct validity with explorative factor analysis. The reliability was tested by internal consistency and test-retest analysis. The result showed a two-factor solution, which does not correspond to the original proposed one-factor solution. The factor analyses revealed two quite distinct factors of RAS, labelled "Relationship built on expectations and satisfaction of needs" and "Relationship built on love and devotion". CONCLUSIONS: The scale has satisfactory psychometric properties in terms of content validity, construct validity, homogeneity and stability in a population of persons with cardiac disease. Wider evaluations of the RAS for other populations and settings are recommended.
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| 4. |
- Koinberg, Inga-Lill, 1955-, et al.
(författare)
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Nurse-led follow-up on demand or by a physician after breast cancer surgery : A randomised study
- 2004
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Ingår i: European Journal of Oncology Nursing. - London : Churchill Livingstone. - 1462-3889 .- 1532-2122. ; 8:2, s. 109-117
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Tidskriftsartikel (refereegranskat)abstract
- The value of routine follow-up with frequent visits to a breast cancer specialist - both in terms of detection of recurrence and patient satisfaction - has been questioned. The aim of this study was to compare nurse-ted follow-up on demand versus physician follow-up after breast cancer treatment with regards to patients’ well-being, satisfaction, access to medical care and medical safety. Two hundred and sixty-four consecutively selected women with newly diagnosed breast cancer, classified as UICC stage I or stage II, were randomised to follow-up at two hospitals in Sweden, either by routine medical follow-up, the physician group (PG, n = 131), or on demand by a specialist nurse, the nurse group (NG, n = 133). Measures were done at baseline and twice a year over a period of 5 years by means of a questionnaire containing the Hospital Anxiety and Depression Scale (HAD), and the Satisfaction and Accessibility (SaaC) scale. Number of contacts with the health care services, number of diagnostic procedures, and time to recurrence or death were monitored. The ratings of HAD and SaaC did not show any statistically significant differences between the groups. The levels of anxiety and depression were generally low and levels of patient satisfaction high. There were no differences between the groups concerning time to recurrence or death. This study indicates that women with breast cancer in stages I to II can be followed up by a specialist nurse with high patient satisfaction and good medical safety. © 2004 Published by Elsevier Ltd.
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| 5. |
- Löf, Lennart, et al.
(författare)
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Severely ill ICU patients recall of factual events and unreal experiences of hospital admission and ICU stay : 3 and 12 months after discharge.
- 2006
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier BV. - 0964-3397 .- 1532-4036. ; 22:3, s. 154-166
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Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge regarding how critically ill patients recall of the ICU and their life-threatening condition changes over time. The purpose of this study is to describe critically ill and ventilator-treated patients' recollections of both factual events and unreal experiences at 3 and 12 months following discharge from the ICU. The study is qualitative and encompasses nine critically ill ICU patients, ventilator-treated for more than 72 h. The participants were interviewed twice, at 3 and 12 months after their discharge from the ICU. The interviews were analysed using qualitative content analysis. The patients in this study reported unreal experiences, memory confusion and/or disturbances before admittance to the ICU and before their respirator treatment. Their "unreal experiences" were far clearer than their memories of factual occurrences. Patients' fragmentary memories of factual events and their recall of unreal experiences were practically unchanged after 12 month. Their unreal experiences could still be recalled and related after 12 months, but not with the same expression and feeling as earlier (3 months). The unreal experiences were not - after 12 months - their initial recollections, as they had been after 3 months. Conclusions: Patients' recollections of both factual events and unreal experiences show very little variation between 3 and 12 months. The stability of long-term memory after 12 months shows that the recollection of their experiences had been both traumatic and emotionally charged. This study shows that critically ill patients were affected by cognitive disturbances and/or disturbed memory before their arrival at the ICU. This result indicates the need of ICU follow-up clinics.
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| 6. |
- Löf, Lennart, et al.
(författare)
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ICU patients' recall of emotional reactions in the trajectory from falling critically ill to hospital discharge : follow-ups after 3 and 12 months
- 2008
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Ingår i: Intensive & Critical Care Nursing. - Edinburgh : Churchill Livingstone. - 0964-3397 .- 1532-4036. ; 24:2, s. 108-121
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Tidskriftsartikel (refereegranskat)abstract
- Patients' memories of frightening ICU experiences may be a threat to later psychological recovery. The purpose of the study is to describe ICU patients' recall of their emotional reactions, from falling critically ill to hospital discharge; this at 3 and 12 months following discharge from the ICU. The study is qualitative and concerns eight ICU patients ventilated for more than 72h. The participants were interviewed twice and the data were subjected to qualitative content analysis. It emerged that the memories of emotions during the trajectory of critical illness were extensive, detailed and strong, and that unpleasant emotions were clearly stable over time. At 12 months as compared with 3 months, the unpleasant emotions were less intense and had less prominent; furthermore the ICU care was more greatly associated with a sense of security, and there was greater recall of caring doctors and nurses (though not of their names) as well as next of kin. CONCLUSIONS: The study generated knowledge not previously described about how ICU patients' recollection of their emotions during the trajectory of critical illness changes over time. This has implications regarding future study of patients' ICU memories and regarding patients' need for support in coping with such memories.
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| 7. |
- Browall, Maria, et al.
(författare)
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The course of health related quality of life in postmenopausal women with breast cancer from breast surgery and up to five years post-treatment
- 2013
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Ingår i: Breast. - : Elsevier. - 0960-9776 .- 1532-3080. ; 49, s. S344-S345
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous studies include too few patients over 70 years to be able to assess treatment effects on Health Related Quality Of Life (HRQOL) in the older age group. We aimed to follow HRQOL in postmenopausal women (55-80 years) with breast cancer receiving adjuvant treatment, until five years post-treatment, and compare with a general population.Patients and methods: The patient sample included 150 women (adjuvant CT n=75 and RT n=75) and two reference samples from the Swedish SF-36 norm database.Results: Data from baseline showed significantly higher levels of physical functioning and general health among the patients compared to the reference sample, and significantly lower levels of bodily pain, emotional role functioning and mental health. Longitudinal analyses showed significant changes in all scales, and three different patterns (a decrease-stable, a decrease-increase, and a stable- increase pattern) were identified.Conclusion: Postmenopausal women seem to successfully manage the effects of adjuvant treatment on HRQOL.
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| 8. |
- Arvidsson, Linnea, et al.
(författare)
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Virtual Follow up After Distal Radius Fracture Surgery — Patient Experiences During the COVID-19 Pandemic
- 2023
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Ingår i: Journal of Patient Experience. - Thousand Oaks, CA : Sage Publications. - 2374-3735 .- 2374-3743. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- The majority of patients with a distal radius fracture (DRF) are elderly, a group known to experience difficulties with new technology, partly due to a low level of digital literacy. At the beginning of the coronavirus disease 2019 pandemic, during the spring 2020, patients that underwent DRF surgery had regular follow-ups replaced by video calls from their surgeon and physiotherapist. Afterward, patients answered questionnaires regarding health and digital literacy and took part in semistructured interviews regarding the experience of the virtual follow-up. By systemic text condensation, 2 major categories were identified: (1) The video call—new, but surprisingly simple: All but 1 found it easier than expected, and (2) Video calls—the patient's choice: All but 1 patient preferred video calls to physical visits for follow-up. This is the first mixed methods study to assess patients’ experiences of digital follow-up after DRF surgery. This study indicates that digital follow-up was highly appreciated, even among patients with low levels of digital literacy. Digital technologies must be made suitable even for patients with inadequate levels of digital literacy. © The Author(s) 2023.
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| 9. |
- Malmström, Johan, 1975, et al.
(författare)
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Bone response to free form-fabricated hydroxyapatite and zirconia scaffolds : A histological study in the human maxilla
- 2009
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Ingår i: Clinical Oral Implants Research. - : John Wiley & Sons. - 0905-7161 .- 1600-0501. ; 20:4, s. 379-385
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Synthetic and biological materials are increasingly used to provide temporary or permanent scaffolds for bone regeneration. This study evaluated the effect of material chemistry and microporosity on bone ingrowth and osseointegration of zirconia (ZrO2) and hydroxyapatite (HA) scaffolds in the human maxilla.Material and methods: Twelve patients subjected to dental implant placement were enrolled in the study. Scaffolds of ZrO 2 and HA were placed in the maxilla of each subject, using a randomization protocol. After 3 months of healing, biopsies were harvested comprising the scaffolds and surrounding bone tissue. The biopsies were processed for histological evaluation and morphometric analysis (bone ingrowth and bone-to-scaffold contact).Results: Healing was uneventful in all cases. All scaffolds demonstrated a measurable bone response using light microscopy and scanning electron microscopy. Microporous HA scaffolds revealed four times larger bone ingrowth and seven times larger bone contact as compared with ZrO2 scaffolds.Conclusion: The results show that chemistry and microporosity of HA promote bone ingrowth and bone contact of ceramic scaffolds in human maxilla.
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| 10. |
- Fritzell, Peter, et al.
(författare)
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Bacteria : back pain, leg pain and Modic sign—a surgical multicentre comparative study
- 2019
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 28:12, s. 2981-2989
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare bacterial findings in pain-generating degenerated discs in adults operated on for lumbar disc herniation (LDH), and mostly also suffering from low back pain (LBP), with findings in adolescent patients with non-degenerated non-pain-generating discs operated on for scoliosis, and to evaluate associations with Modic signs on magnetic resonance imaging (MRI). Cutibacterium acnes (Propionibacterium acnes) has been found in painful degenerated discs, why it has been suggested treating patients with LDH/LBP with antibiotics. As multidrug-resistant bacteria are a worldwide concern, new indications for using antibiotics should be based on solid scientific evidence.Methods: Between 2015 and 2017, 40 adults with LDH/LBP (median age 43, IQR 33–49) and 20 control patients with scoliosis (median age 17, IQR 15–20) underwent surgery at seven Swedish hospitals. Samples were cultured from skin, surgical wound, discs and vertebrae. Genetic relatedness of C. acnes isolates was investigated using single-nucleotide polymorphism analysis. DNA samples collected from discs/vertebrae were analysed using 16S rRNA-based PCR sequencing. MRI findings were assessed for Modic changes.Results: No bacterial growth was found in 6/40 (15%) LDH patients, compared with 3/20 (15%) scoliosis patients. Most positive samples in both groups were isolated from the skin and then from subcutis or deep within the wound. Of the four disc and vertebral samples from each of the 60 patients, 235/240 (98%) were DNA negative by bacterial PCR. A single species, C. acnes, was found exclusively in the disc/vertebra from one patient in each group. In the LDH group, 29/40 (72%) patients had at least one sample with growth of C. acnes, compared to 14/20 (70%) in the scoliosis group. Bacterial findings and Modic changes were not associated.Conclusions: Cutibacterium acnes found in discs and vertebrae during surgery for disc herniation in adults with degenerated discs may be caused by contamination, as findings in this group were similar to findings in a control group of young patients with scoliosis and non-degenerated discs. Furthermore, such findings were almost always combined with bacterial findings on the skin and/or in the wound. There was no association between preoperative Modic changes and bacterial findings. Antibiotic treatment of lumbar disc herniation with sciatica and/or low back pain, without signs of clinical discitis/spondylitis, should be seriously questioned.
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