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Sökning: LAR1:gu > Högskolan i Skövde > (2000-2004)

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1.
  • Bergh, Ingrid, 1956-, et al. (författare)
  • An application of pain rating scales in geriatric patients.
  • 2000
  • Ingår i: Aging (Milan, Italy). - 0394-9532. ; 12:5, s. 380-7
  • Tidskriftsartikel (refereegranskat)abstract
    • This study examined the applicability of three different pain rating scales, the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the Numeric Rating Scale (NRS), in geriatric patients. Data collection was performed in a geriatric clinic at a university hospital. A structured interview was conducted with 167 patients (mean age = 80.5 years). Patients rated their current experience of pain twice with a 5-minute pause in-between on the VAS, GRS and NRS, and were then asked if they experienced pain, ache or hurt (PAH) or other symptoms. The correlations were high and significant both between the ratings of the VAS, GRS and NRS (r = 0.78-0.92; p < 0.001) (alternative-forms reliability), and between the test and retesting (r = 0.75-r = 0.83; p < 0.001) (test-retest reliability). A logistic regression analysis showed that the probability to accomplish a rating on the pain scales decreased with advancing age of the patient, and this was especially marked for the VAS. The probability of agreement between the patients' ratings of pain and the verbal report of PAH tended to decrease with advancing age; this was especially so for the VAS. Patients who verbally denied PAH but reported pain on the scales rated it significant lower (p < 0.001) than those who verbally reported PAH and rated the pain as well. Eighteen percent of patients who denied pain but rated a pain experience verbally expressed suffering or distress. The study suggests that pain rating scales such as the VAS, GRS and NRS can be used to evaluate pain experience in geriatric patients. However, agreement between verbally expressed experience of PAH, and the rated experience of pain tended to decrease with advancing age. This indicates that the pain-evaluating process will be substantially improved by an additional penetration supported by a wide variety of expression of hurt, ache, pain, discomfort and distress.
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2.
  • Bergh, Ingrid, et al. (författare)
  • Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales.
  • 2001
  • Ingår i: Aging (Milan, Italy). - 0394-9532. ; 13:5, s. 355-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected. In connection with the administration of analgesics, the patients were asked to "Mark the point that corresponds to your experience of pain just now at rest" on the VAS, GRS and NRS. This was repeated after 1.5-2 hours, and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. Two comparisons were conducted with each patient. The results show that the probability of accomplishing a rating on the VAS, GRS, NRS, and PRS was lower with advancing age in these elderly fracture patients. The correlations between the ratings of the VAS, GRS and NRS were strong and significant (r=0.80-0.95; p<0.001) both at the initial assessments and at the re-assessments. However, the verbally reported effects of the analgesics were often directly opposite to the changes in rated pain. Therefore, application of the VAS, NRS, GRS and PRS for the purpose of assessing pain relief must be combined with supplementary questions that allow the patient to verbally describe possible experience of pain relief.
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3.
  • Bergh, Ingrid, 1956-, et al. (författare)
  • Pain and its relation to cognitive function and depressive symptoms: a Swedish population study of 70-year-old men and women.
  • 2003
  • Ingår i: Journal of pain and symptom management. - 0885-3924. ; 26:4, s. 903
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate the prevalence of pain and its characteristics, and to examine the association of pain with cognitive function and depressive symptoms, in a representative sample of 70-year-old men and women. Data were collected within the gerontological and geriatric population studies in Göteborg, Sweden (H-70). A sample of 124 men and 117 women living in the community took part in the study. A questionnaire was applied which included four different aspects of pain experience: prevalence, frequency of episodes of pain, duration and number of locations. In close connection to this, depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. The prevalence of pain during the last 14 days was higher in women (79%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />91) than in men (53%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />65) (P&lt;0.001). Women (68%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />78) also reported pain that had lasted for &gt;6 months to a greater extent than men (38%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />46) (P&lt;0.001). The frequency of episodes of pain was also higher among women, 64% (n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />74) reporting daily pain or pain several days during the last 14 days while 37% of the men (n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />45) did so (P&lt;0.001). Women (33%, n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />38) also reported pain experience from ≥3 locations more often than men (11%; n<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />=<img src="http://www.journals.elsevierhealth.com/webfiles/images/transparent.gif" />13) (P&lt;0.001). On the other hand, the association between depressive symptoms and pain experience was more evident in men than in women. Women were taking significantly more antidepressants compared to men (P&lt;0.03). The results show that pain is common in 70-year-old people and especially in women. However, associations between depressive symptoms and the four aspects of pain experience were more pronounced among men
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4.
  • Bergh, Ingrid, 1956- (författare)
  • Pain in the elderly : rating scales, prevalence and verbal expression of pain and pain relief
  • 2003
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Aims: The overall purpose of the studies was to examine the prevalence of pain in elderly people and to evaluate the applicability of pain scales in assessing pain and pain relief in elderly patients.Methods: In Paper I, 167 geriatric patients (M=81 years) rated their current experience of pain twice with a 5-minute interval in between on the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the Numerical Rating Scale (NRS), and were then asked if they experienced pain, ache or hurt or other symptoms. In Paper II, 53 geriatric patients (M=82 years) rated their pain on the VAS, GRS and NRS in connection with the administration of analgesics. This was repeated after 1.5-2 hours and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. The patients also rated pain relief on the Pain Relief Scale (PRS). The study in paper III, was conducted within the framework of the Gerontological and Geriatric Population Studies in Göteborg, Sweden (H70), 241 70-year-old men and women were assessed regarding pain experience, cognitive function and depressive symptoms. In Paper IV, 38 patients who have undergone hip replacement surgery due to Cox arthritis (M=75 years) and 22 patients with a surgically repaired hip fracture (M=81 years) were interviewed on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and a structured interview.Results: In Paper I, 71% of the patients verbally reported pain when at rest and/or when moving. High and significant correlations were obtained both between the ratings on the VAS, GRS and NRS (p&lt;0.001) and between the test and retesting (p&lt;0.001). The probability of accomplishing a rating on the pain scales decreased with advancing age of the patient. The probability of agreement between the patients ratings of pain and the verbal report of pain tended to decrease with advancing age. Those patients who verbally denied having pain but reported pain on the scales, rated it significantly lower (p&lt;0.001) than those who verbally reported pain and rated the pain as well. The results in Paper II show that the probability of accomplishing a rating on the VAS, GRS, NRS and PRS decreased with advancing age of the patient. The correlations between the ratings on the VAS, GRS and NRS were strong and significant (p&lt;0.001) both at the initial assessments and at the re-assessments. The verbally reported effects of the analgesics were often directly contrary to the changes in rated pain. The results in Paper III show that pain is common in 70-year-old people and especially in women. However, associations between depressive symptoms and pain experience were more evident in men. In Paper IV, the majority of the elderly patients who participated in this study verbally reported pain and spontaneously used a large number of the words listed in the Short Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The patients also used a number of additional words that are not found in the SF-MPQ or the POM. Conclusions: The results suggest pain is common in 70-year-old people and in elderly patients as well. Pain scales such as the VAS, GRS, NRS and PRS can be used to assess elderly patients' experience of pain and pain relief in combination with alternative expressions of pain, pain relief, discomfort and distress. The words of the SF-MPQ and POM are to be found in elderly patients descriptions of pain in everyday language.
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5.
  • Bergh, Ingrid, et al. (författare)
  • SMÄRTA HOS ÄLDRE: Skattningsskalor – förekomst och verbala uttryck för smärta och smärtlindring
  • 2003
  • Ingår i: Incitament. ; :7, s. 516-518
  • Tidskriftsartikel (populärvet., debatt m.m.)abstract
    • Smärta är inte en del av det normala åldrandet, men många äldre drabbas av sjukdomar som leder till smärta. Smärta är en subjektiv sensorisk och emotionell obehagsupplevelse med faktisk eller potentiell vävnadsskada. Varje person upplever smärta på sitt sätt och denna uppfattning får avgörande betydelse för hur hälso- och sjukvårdspersonal kan förhålla sig till människor med smärta.Utgångspunkten för denna avhandling var att studera smärtförekomst bland äldre och att evaluera användandet av smärtskalor. Våra resultat visar att skattningsskalor kan vara till hjälp.Artikeln baseras Ingrid Berghs avhandling: Pain in the elderly - Rating scales, prevalence and verbal expression of pain relief
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6.
  • Browall, Maria, et al. (författare)
  • Information needs of women with recently diagnosed ovarian cancer - A longitudinal study
  • 2004
  • Ingår i: European Journal of Oncology Nursing. - Elsevier. - 1462-3889. ; 8:3, s. 200-207
  • Tidskriftsartikel (refereegranskat)abstract
    • The aim of this study was to investigate the information needs among patients with ovarian cancer and whether these information needs change over time. The information needs were evaluated three times, through structured interviews, and were based on the paired comparison approach developed by Degner and colleagues. A consecutive sample of patients (n=82) with recently diagnosed ovarian cancer was asked to participate.Sixty-four patients (78%) chose to participate. The three different measurements of participants' information needs revealed only small changes in these needs. The three most important information needs, in all measurements, were information about the likelihood of cure, information about the stage and spreading of the disease, and information about different treatment options. Information regarding sexual attractiveness was the lowest ranked item in all measurements. Regarding subgroups (age, education) the only significant difference throughout all measurements was that younger patients rated issues of sexual attractiveness higher than older patients (p=0.005).In this longitudinal study patients with ovarian cancer ranked information about the disease and its treatment (i.e. likelihood of cure, stage of disease, and treatment options) highest, and information about psychosocial aspects and self-care lowest. These findings are in accordance with the results from studies of women diagnosed with other types of cancer, which used the same methodology. © 2004 Elsevier Ltd. All rights reserved.
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9.
  • Furåker, Carina, et al. (författare)
  • Quality of care in relation to a critical pathway from the staff's perspective
  • 2004
  • Ingår i: Journal of Nursing Management. ; 12:5, s. 309-319
  • Tidskriftsartikel (refereegranskat)abstract
    • Specific groups with complex nursing requirements, such as patients suffering from stroke, are in greatest need of a critical pathway. Aim To study how the critical pathway is reflected in caring work from the staff's perspective. Method Personnel (n = 16): physicians, care developers, speech therapists, physiotherapists, occupational therapists, nurses, assistant nurses. Content analysis has been used. Two main categories were formed: function of the critical pathway and effects of the critical pathway. Findings The nurse in the stroke ward is seen as the 'spider in the web'. There is a need for more collaboration, both in and between hospitals and primary health care. Many of the staff members feel that they are working in a learning organization. Others say that they have low job satisfaction caused by low manning and, consequently, less time to spend with the patients. Conclusion The critical care chain has not been fully developed in accordance with the care model. It emerges that patients spend a lot of time waiting while the staff have too little time to spend with patients.
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10.
  • Kåberger, Tomas, et al. (författare)
  • Economic Efficiency of Compulsory Green electricity Quotas In Sweden
  • 2004
  • Ingår i: Energy and Environment. - Multi-Science Publishing. - 0958-305X. ; 15:4, s. 675-697
  • Tidskriftsartikel (refereegranskat)abstract
    • Green certificates are not an efficient as a measure to correct for the effect of environmental external costs of fossil fuels and nuclear power. Nor are they efficient as a measure to create markets for new electricity supply technologies.Removing subsidies and introducing environmental taxes on energy sources with undesired external effects more efficiently corrects for incurred environmental costs. It appears that guaranteed feed-in tariffs are a more efficient policy instrument to promote the industrialisation of technologies for new sustainable sources of electricity.Alternatively, the certificate scheme could be reformed in a number of ways to improve performance. However decisions to change or abolish the instrument cannot be taken lightly since instrument stability is very important for the credibility of future policy.
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