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1.
  • Aengerud, Karin Hellstroem, et al. (författare)
  • Symptoms of Acute Myocardial Infarction as Described in Calls to Tele-Nurses and in Questionnaires A Mixed-Methods Study
  • 2023
  • Ingår i: Journal of Cardiovascular Nursing. - : LIPPINCOTT WILLIAMS & WILKINS. - 0889-4655 .- 1550-5049. ; 38:2, s. 150-157
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPatient-reported symptoms of acute myocardial infarction (MI) may be affected by recall bias depending on when and where symptoms are assessed.AimThe aim of this study was to gain an understanding of patients symptom description in more detail before and within 24 hours after a confirmed MI diagnosis.MethodsA convergent parallel mixed-methods design was used to examine symptoms described in calls between the tele-nurse and the patient compared with symptoms selected by the patient from a questionnaire less than 24 hours after hospital admission. Quantitative and qualitative data were analyzed separately and then merged into a final interpretation.ResultsThirty patients (median age, 67.5 years; 20 men) were included. Chest pain was the most commonly reported symptom in questionnaires (24/30). Likewise, in 19 of 30 calls, chest pain was the first complaint mentioned, usually described together with the symptom onset. Expressions used to describe symptom quality were pain, pressure, discomfort, ache, cramp, tension, and soreness. Associated symptoms commonly described were pain or numbness in the arms, cold sweat, dyspnea, weakness, and nausea. Bodily sensations, such as feeling unwell or weak, were also described. Fear and tiredness were described in calls significantly less often than reported in questionnaires (P = .01 and P = .02), whereas "other" symptoms were more often mentioned in calls compared with answers given in the questionnaire (P = .02). Some symptoms expressed in the calls were not listed in the questionnaire, which expands the understanding of acute MI symptoms. The results showed no major inconsistencies between datasets.ConclusionPatients MI symptom descriptions in tele-calls and those reported in questionnaires after diagnosis are comparable and convergent.
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2.
  • Allemann, Hanna, 1979-, et al. (författare)
  • Perceived Social Support in Persons With Heart Failure Living With an Implantable Cardioverter Defibrillator : A Cross-sectional Explorative Study
  • 2018
  • Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 33:6, s. E1-E8
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: The links between chronic illness, psychological well-being, and social support have previously been established. Social isolation and loneliness have shown an increased mortality risk for those with heart failure (HF). Increasingly more people with HF are living with an implantable cardioverter defibrillator (ICD), but only a few small-scale studies have focused on social support in this population.OBJECTIVE: The aim of this study was to explore factors related to perceived social support in a large cohort of individuals with HF living with an ICD.METHODS: All eligible adult ICD recipients in the Swedish ICD registry were invited to participate in this cross-sectional study. For this analysis, those with HF and complete data on perceived social support were included (N = 1550; age, 67.3 (SD, 9.8) years; 19.5% female).RESULTS: Most reported a high level of social support, but 18% did not. In logistic regression, living alone was the greatest predictor of low/medium support. Lower social support for those living alone was associated with poorer perceived health status, having symptoms of depression, and experiencing low perceived control. For those living with someone, lower support was associated with female gender, symptoms of depression and anxiety, and less control. Heart failure status and perceived symptom severity were not related to the outcome.CONCLUSION: One in five participants reported low/medium social support. Our study underlines the complex relationships between perceived social support, psychological well-being and perceived control over the heart condition. Multiple aspects need to be taken into account when developing interventions to provide psychosocial support and optimize outcomes in this patient group.
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4.
  • Alsén, Pia, 1956-, et al. (författare)
  • Illness perceptions after myocardial infarction : relations to fatigue, emotional distress, and health-related quality of life
  • 2010
  • Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 25:2, s. E1-E10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and RESEARCH Objective: Health-related quality of life (HRQoL) is impaired in patients after a myocardial infarction (MI), and fatigue and depression are common health complaints among these patients. Patients' own beliefs about their illness (illness perceptions) influence health behavior and health outcomes. The aim of the present study was to examine illness perception and its association with self-reported HRQoL, fatigue, and emotional distress among patients with MI. Subjects and Methods: The sample consisted of 204 patients who had had MI and who completed the questionnaires during the first week in the hospital and 4 months after the MI. The questionnaires used were the Illness Perception Questionnaire, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and the Short Form Health Survey (SF-36). Results: Patient's illness perception changed over time from a more acute to a more chronic perception of illness, and beliefs in personal and treatment control of MI had decreased. Furthermore, these negative beliefs were associated with worse experiences of fatigue and lowered HRQoL. Conclusions: Patients' illness perceptions influence health outcomes after an MI. Supporting MI patients in increasing their perception of personal control could be a primary nursing strategy in rehabilitation programs aimed at facilitating health behavior, decreasing experiences of fatigue, and increasing HRQoL. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
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5.
  • Andreae, Christina, 1969-, et al. (författare)
  • Changes in Appetite During the Heart Failure Trajectory and Association With Fatigue, Depressive Symptoms, and Quality of Life
  • 2021
  • Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 36:6, s. 539-545
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Decreased appetite can contribute to malnutrition in patients with heart failure (HF). Little is known about the trajectory of appetite over time in patients with HF and the factors associated with decreased appetite after discharge from the hospital.OBJECTIVE: The aims of this study were to investigate changes in appetite over time and explore how fatigue, depressive symptoms, and quality of life are associated with decreased appetite.METHODS: Data from the multicenter randomized Coordinating study evaluating Outcomes of Advising and Counseling in Heart Failure were used. Logistic regression and mixed-effects logistic regression were used to investigate changes in appetite over time and to explore the relationship between appetite and fatigue, depressive symptoms, and quality of life.RESULTS: A total of 734 patients with HF (mean age, 69 years) were included. Decreased appetite was present at all follow-up measurements; however, decreased appetite was significantly lower at the 1-month (odds ratio [OR], 0.43; confidence interval [CI], 0.29-0.63), 6-month (OR, 0.31; CI, 0.20-0.47), 12-month (OR, 0.22; CI, 0.14-0.34), and 18-month (OR, 0.24; CI, 0.15-0.37) follow-ups compared with baseline. Decreased appetite was associated with fatigue (OR, 3.09; CI, 1.98-4.84), depressive symptoms (OR, 1.76; CI, 1.35-2.29), and low quality of life (OR, 1.01; CI, 1.01-1.02) across all measurement points adjusted for covariates.CONCLUSIONS: Appetite improved after discharge; however, at all time points, at least 22% of patients reported decreased appetite. Fatigue, depressive symptoms, and low quality of life are factors associated with decreased appetite. Decreased appetite is a long-standing problem in that it does not disappear spontaneously after an acute HF deterioration.
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6.
  • Andreae, Christina, 1969-, et al. (författare)
  • Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure
  • 2018
  • Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 33:2, s. E15-E20
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Decreased appetite and depressive symptoms are clinical problems in patients with heart failure. Both may result in impaired health status. Objective: The aims of this study were to investigate the association between appetite and health status in patients with heart failure and to explore whether depressive symptoms moderate this association. Methods: In this cross-sectional study, patients with heart failure (n = 186; mean age, 71 years), New York Heart Association class II to IV, participated. Data on appetite (Council of Nutrition Appetite Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and health status (EQ-5D 3-level scale [EQ-5D-3L] descriptive system, EQ-5D-3L index, and EQ Visual Analog Scale) were collected by self-rating questionnaires. Pearson correlation was used to investigate the association between appetite and health status. Multiple regression was performed to examine whether depressive symptoms moderate the association between appetite and health status. Results: There was a significant association between appetite and health status for EQ-5D-3L descriptive system, mobility (P < .001), pain/discomfort (P < .001), and anxiety/depression (P < .001). This association was also shown in EQ-5D-3L index (P < .001) and EQ Visual Analog Scale (P < .001). Simple slope analysis showed that the association between appetite and health status was only significant for patients without depressive symptoms (B = 0.32, t = 4.66, P < .001). Conclusions: Higher level of appetite was associated with better health status. In moderation analysis, the association was presented for patients without depressive symptoms. Decreased appetite is an important sign of poor health status. To improve health status, health professionals should have greater attention on appetite, as well on signs of depressive symptoms.
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7.
  • Annema, Coby, et al. (författare)
  • Do patients with heart failure need a case manager?
  • 2009
  • Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 24:2, s. 127-31
  • Tidskriftsartikel (refereegranskat)abstract
    • The management of patients with heart failure (HF) is complex and often benefits from a patient-tailored approach. Since the early 1990s, HF disease management programs have been developed and implemented to improve outcomes of patients with HF. The body of evidence of the effectiveness of these programs is still growing, but meta-analyses of disease management program studies show various results on outcomes. This raises questions regarding the optimal organizational structure and components of a most cost-effective HF management program. Case management has been described as a solution to improve outcomes in complex patients and as a possible link to effective disease management. This raises the question of what case management can add to the disease management of patients with HF and which patients might benefit. The aim of this article is to discuss the potential contribution of case management in the disease management of patients with HF.
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8.
  • Axelsson, Åsa (författare)
  • Bystander cardiopulmonary resuscitation : would they do it again?
  • 2001
  • Ingår i: Journal of Cardiovascular Nursing. - Frederick, MD : Aspen Publishers. - 0889-4655 .- 1550-5049. ; 16:1, s. 15-20
  • Tidskriftsartikel (refereegranskat)abstract
    • During the last three decades, community education programs have been initiated with the purpose of teaching community citizens cardiopulmonary resuscitation (CPR). Millions of people have learned the technique. However, the frequency of bystander initiated CPR prior to emergency medicine service (EMS) arrival is still very low. This can lead one to ask if CPR training is optimal. Perhaps motivational aspects and psychological inhibitors to starting CPR should be included in CPR training. So far, CPR training has been skills oriented and has assumed that a bystander competent in CPR will intervene when required. However, this does not seem to be the case, as there are indications in recent research, for example, that the will to help and the courage to intervene are also needed. Bystanders who intervene in a cardiac arrest event improve the victim's chance of survival. However, there is little knowledge regarding the rescuers' reactions concerning their performance and whether they will overcome the trauma of the event and be prepared to do it again.
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9.
  • Bellman, Christina, et al. (författare)
  • Achievement of secondary preventive goals after acute myocardial infarction : a comparison between participants and nonparticipants in a routine patient education program in Sweden
  • 2009
  • Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 24:5, s. 362-368
  • Tidskriftsartikel (refereegranskat)abstract
    • BACKGROUND: Modification of risk factors such as smoking, obesity, physical inactivity, and hypertension after acute myocardial infarction (AMI) has been shown to reduce mortality and morbidity. Therefore, most hospitals in Sweden invite patients with myocardial infarction to an educational program, the "Heart School," where they can learn about lifestyle changes. Whether this kind of education program applied in routine care increases the proportion of patients achieving secondary prevention goals is unknown. METHODS: A cohort of consecutive patients treated for AMI and included in a quality registry was followed up during 1 year. The main aim was to study the effects of taking part in the Heart School on smoking habits, blood pressure and low-density lipoprotein cholesterol levels, exercise habits, cardiac symptoms, quality of life, and readmissions to hospital. Patients included in the national quality register of secondary prevention after AMI who had participated in the educational program were compared with those who had not participated in the program. Achievements of secondary prevention goals 1 year after the myocardial infarction were evaluated. The study included 2,822 patients. RESULTS: The result showed that patients who participated in the Heart School stopped smoking more often than those who did not participate (adjusted odds ratio, 2.01; 95% confidence interval, 1.46-2.78). The Heart School had no effects on the other variables that were examined. CONCLUSION: The interventions currently used in the Swedish Heart School seem to be insufficient to obtain sustainable lifestyle changes, except for smoking cessation.
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