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- Ali, Lilas, 1981, et al.
(author)
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Effects of person-centred care via telephone on self-efficacy in patients with chronic obstructive pulmonary disease: Subgroup analysis of a randomized controlled trial
- 2021
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In: Nursing Open. - : Wiley. - 2054-1058. ; 8:2, s. 927-935
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Journal article (peer-reviewed)abstract
- © 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To evaluate the effects of PCC in the form of structured telephone support on self-reported cardiac self-efficacy in patients with COPD. Methods: We enrolled 105 patients, aged ≥50 years, admitted to hospital and diagnosed with COPD from January 2015 to November 2016. The patients received usual care or PCC via telephone added to usual care. The Swedish Cardiac Self-Efficacy Scale comprising three dimensions (control symptoms, control illness and maintain functioning) was used as outcome measure. Data was collected at baseline, and at 3- and 6-month follow-ups. Results: At both the 3- and 6-month follow-ups, the intervention group improved significantly more than the control group in the control illness dimension (p =.012 and p =.032, respectively). No differences were found in the other two dimensions. Conclusions: PCC in the form of structured telephone support increases patients’ confidence in managing their illness and may be a feasible strategy to support patients in their homes.
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- Ali, Lilas, 1981, et al.
(author)
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Person-centred care by a combined digital platform and structured telephone support for people with chronic obstructive pulmonary disease and/or chronic heart failure: study protocol for the PROTECT randomised controlled trial
- 2020
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In: BMJ Open. - : BMJ. - 2044-6055. ; 10:7
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Journal article (peer-reviewed)abstract
- BACKGROUND: A core feature of chronic obstructive pulmonary disorder (COPD) and chronic heart failure (CHF) is that symptoms may change rapidly because of illness progression. Thus, these chronic conditions are associated with high rehospitalisation rates. Person-centred care (PCC) has been shown to have several benefits for patients with COPD or CHF (or both disorders) but it has not yet been investigated through e-health services. AIM: The project aims to evaluate the effects of PCC by a combined digital platform and structured telephone support for people with COPD and/or CHF. METHODS AND ANALYSIS: A randomised controlled trial with open, parallel groups which employs a participatory design process will be used. This project will also include process and health economic evaluation of the intervention. ETHICS AND DISSEMINATION: Ethical approval has been secured from the Regional Ethical Review Board in Gothenburg, Sweden (Dnr 063-17 and T063-18). Results will be presented at conferences and to healthcare professionals, participants and patient organisations. Findings will also be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03183817.
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- Blanck, Elin, et al.
(author)
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Self‐efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease
- 2023
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In: ESC Heart Failure. - 2055-5822.
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Journal article (peer-reviewed)abstract
- Abstract Aims This study aims to explore possible associations between self‐efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person‐centred care delivered by telephone. Methods and results This exploratory analysis uses data from an open randomized controlled trial conducted between January 2015 and November 2016, providing remote person‐centred care by phone to patients with CHF, COPD, or both. Patients hospitalized due to worsening of CHF or COPD were eligible for the study. Randomization was based on a computer‐generated list, stratified for age ≥ 75 and diagnosis. At a 6 month follow‐up, 118 persons remained in a control group and 103 in an intervention group. The intervention group received person‐centred care by phone as an addition to usual care. Trial data were linked to register data on healthcare and drug use. Group‐based trajectory modelling was applied to identify trajectories for general self‐efficacy and direct costs. Next, associations between self‐efficacy trajectories and costs were assessed using regression analysis. Five trajectories were identified for general self‐efficacy, of which three indicated different levels of increasing or stable self‐efficacy, while two showed a decrease over time in self‐efficacy. Three trajectories were identified for costs, indicating a gradient from lower to higher accumulated costs. Increasing or stable self‐efficacy was associated with lower direct costs ( P = 0.0013). Conclusions The findings show that an increased or sustained self‐efficacy is associated with lower direct costs in patients with CHF or COPD. Person‐centred phone contacts used as an add‐on to usual care could result in lower direct costs for those with stable or increasing self‐efficacy.
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- Cederberg, Matilda, et al.
(author)
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Effects of a Person-Centered eHealth Intervention for Patients on Sick Leave Due to Common Mental Disorders (PROMISE Study): Open Randomized Controlled Trial
- 2022
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In: Jmir Mental Health. - : JMIR Publications Inc.. - 2368-7959. ; 9:3
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Journal article (peer-reviewed)abstract
- Background: Sick leave due to common mental disorders (CMDs) is a public health problem in several countries, including Sweden. Given that symptom relief does not necessarily correspond to return to work, health care interventions focusing on factors that have proven important to influence the return to work process, such as self-efficacy, are warranted. Self-efficacy is also a central concept in person-centered care. Objective: The aim of this study is to evaluate the effects of a person-centered eHealth intervention for patients on sick leave due to CMDs. Methods: A randomized controlled trial of 209 patients allocated to either a control group (107/209, 51.2%) or an intervention group (102/209, 48.8%) was conducted. The control group received usual care, whereas the intervention group received usual care with the addition of a person-centered eHealth intervention. The intervention was built on person-centered care principles and consisted of telephone support and a web-based platform. The primary outcome was a composite score of changes in general self-efficacy (GSE) and level of sick leave at the 6-month follow-up. An intention-to-treat analysis included all participants, and a per-protocol analysis consisted of those using both the telephone support and the web-based platform. Results: At the 3-month follow-up, in the intention-to-treat analysis, more patients in the intervention group improved on the composite score than those in the control group (20/102, 19.6%, vs 10/107, 9.3%; odds ratio [OR] 2.37, 95% CI 1.05-5.34; P=.04). At the 6-month follow-up, the difference was no longer significant between the groups (31/100, 31%, vs 25/107, 23.4%; OR 1.47, 95% CI 0.80-2.73; P=.22). In the per-protocol analysis, a significant difference was observed between the intervention and control groups at the 3-month follow-up (18/85, 21.2%, vs 10/107, 9.3%; OR 2.6, 95% CI 1.13-6.00; P=.02) but not at 6 months (30/84, 35.7%, vs 25/107, 23.4%; OR 1.8, 95% CI 0.97-3.43; P=.06). Changes in GSE drove the effects in the composite score, but the intervention did not affect the level of sick leave. Conclusions: A person-centered eHealth intervention for patients on sick leave due to CMDs improved GSE but did not affect the level of sick leave.
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| 6. |
- Cederberg, Matilda, et al.
(author)
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Person-centred eHealth intervention for patients on sick leave due to common mental disorders: study protocol of a randomised controlled trial and process evaluation (PROMISE)
- 2020
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In: BMJ Open. - : BMJ. - 2044-6055. ; 10:9
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Journal article (peer-reviewed)abstract
- INTRODUCTION: The number of people dealing with common mental disorders (CMDs) is a major concern in many countries, including Sweden. Sickness absence resulting from CMDs is often long-lasting and advancing return to work is a complex process impacted by several factors, among which self-efficacy appears to be an important personal resource. Person-centred care (PCC) has previously shown positive effects on self-efficacy however this needs to be further investigated in relation to patients with CMDs and in an eHealth context. METHODS AND ANALYSIS: This study is an open randomised controlled trial comparing a control group receiving standard care with an intervention group receiving standard care plus PCC by telephone and a digital platform. The primary outcome measure is a composite score of changes in sick leave and self-efficacy. Participants will include 220 primary care patients on sick leave due to CMDs and data will mainly be collected through questionnaires at baseline and 3, 6, 12 and 24 months from the inclusion date. Inclusion is ongoing and expected to be completed during the fall of 2020. A process and health economic evaluation will also be conducted. ETHICS AND DISSEMINATION: This study was approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be published in peer-reviewed scientific journals and presented at national and international scientific conferences. This project is part of a broader research programme conducted at the Gothenburg Centre for Person-Centred Care (GPCC), where extensive work is undertaken to disseminate knowledge on and implementation of PCC. TRIAL REGISTRATION NUMBER: NCT03404583.
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| 7. |
- Dudas, Kerstin, 1963, et al.
(author)
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PCC- Impact at admission and discharge process, among patients with chronic heart failure
- 2013
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In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:Supplement 1, s. 66-67
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Conference paper (other academic/artistic)abstract
- Background: Chronic heart failure (CHF) mostly affects the elderly and is a lifelong and progressive disease and the single most common cause of hospitalization with frequent re-admissions. Although many patients with CHF are independent, some patients are fragile and need extra support and care during the hospital stay and after discharge to prevent disability. A person-centred care (PCC) approach to care and planning may help to promote more efficient care and discharge-planning. Aim: To evaluate if PCC-based proactive care-planning, beginning already at admission, leads to improved efficiency in the discharge procedure compared with usual care in patients hospitalized for worsening CHF. Methods: Using a controlled before-and-after design, eligible patients with CHF were randomly assigned to either a usual care group or a PCC intervention group. Development of the PCC care and discharge plan consisted of three steps: 1) a comprehensive narrative was obtained from the patients at admission to identify each patient’s resources for and barriers to recovery; 2) a PCC plan was drawn up based on this and other clinical information and discussed with the patient Downloaded from cnu.sagepub.com at Gothenburg University Library on December 15, 2013 EuroHeartCare 2013 S67 3) the PCC plan was checked and revised where appropriate. The patients’ social situation before admission, their discharge destination, the number of days until the discharge notification was sent to the patients’ community home help service/district nurse were recorded as well as the time interval between notification and start of coordination of care between hospital staff and community home help services and district nurses. Results: 123 in the usual care group and 125 were enrolled. Most of the patients came from independent living (93.2% in the PCC group and 93.5% in the usual care group). The proportion of patients who had community home help service before admission was slightly lower in the PCC group (32.4%) compared to the usual care group (35.8%). The proportion of patients who received care from a district nurse was slightly higher in the PCC group (18.9%) than in the usual care group (13.1%). During hospitalization, the notification to the patients community home help service and/or district nurse were significantly (P = 0.04) more frequently in the PCC-group (33.8%) compared to usual care group (12.1%). Care coordination started within six days in the PCC group whereas the usual care group was more dispersed 1-29 days. Conclusion: PCC improved significantlythe efficiency of the transfer process for patients in need of community home help service and/or district nurse after discharge.
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- Dudas, Kerstin, 1963, et al.
(author)
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Person-centred care inluences the belief in medication in patients with chronic heart failure
- 2013
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In: European Journal of Heart Failure.. - : Wiley. - 1567-4215 .- 1388-9842 .- 1879-0844. ; 12:Supplement 1
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Conference paper (other academic/artistic)abstract
- Purpose: Many patients with chronic heart failure (CHF) seem to fail in adherence to prescribed medication. Confidence in the prescribed medication as well as misconceptions in communication between patient and health care professionals, are well known factors contributing to patients’ adherence. Moreover, patients with CHF have to manage a complex medication treatment and non-adherence seems to be more likely if there is a lack of belief in medication. Person-centered care (PCC) emphasizes partnership between patient and health care professionals including the creation of a common care-plan. Therefore we evaluated if PCC affects patients’ beliefs about prescribed medicines compared to usual care in patients hospitalized for worsening CHF. Methods: Using a controlled before-and-after design, patients hospitalized for worsening CHF were assigned to either a usual care group or a PCC intervention group. Patient-reported belief about their medication was assessed with the Belief about Medication Questionnaire (BMQ). The BMQ consists of three domains: 1) General harm, 2) General overuse, and 3) General Benefit. Results: In total, 248 patients were included in the study; 123 in the usual care group and 125 in the PCC intervention. The PCC group had a significant better score than the usual care group in the BMQ domain General Overuse, mean=9.06 (SD=2.20) vs. mean =9.76, (SD= 4.48) ( p=0.04). There were no differences between the PCC group and the Usual care group in the domain General Harm p=0.70 [mean=12.6 (SD=3.1) vs. mean =12.9 (SD= 3.4)].and General Benefit p=0.31 [mean=16.5 (SD=2.2) vs. mean =16.8 (SD= 2.0]. Conclusion: We found that patients receiving PCC did not belief that medication is overused to the same extent as patients in usual care. These results support our previous findings of less feeling of uncertainty in relation to illness and medication, shorter length of hospital stay and better functional status by applying PCC.
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| 10. |
- Dudas, Kerstin, 1963, et al.
(author)
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Uncertainty in illness among patients with chronic heart failure is less in person-centred care than in usual care
- 2013
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In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:6, s. 521-528
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Journal article (peer-reviewed)abstract
- Background:Many patients with chronic heart failure (CHF) experience uncertainty regarding the treatment and characteristics of their illness. Person-centred care (PCC) emphasizes patient involvement in care. We have previously shown that PCC improved outcomes such as length of hospital stay and activities of daily living in patients with CHF. The impact of PCC on self-reported uncertainty in illness among patients hospitalized for CHF is still unknown.Aim:To evaluate whether PCC is associated with less self-reported uncertainty in illness compared with usual care in patients hospitalized for worsening CHF.Methods:Using a controlled before-and-after design, eligible CHF patients were assigned to either a usual care group or a PCC intervention group. Patient-reported uncertainty in illness was assessed at hospital discharge with the Cardiovascular Population Scale (CPS). The CPS consists of two domains: 1) Ambiguity (about illness severity); and 2) Complexity (of treatment and system of care).Results:Two hundred and forty-eight patients were included in the study; 123 in the usual care group and 125 in the PCC intervention. The PCC group had better scores than the usual care group in the CPS domains complexity (M=15.2, SD=4.7 vs. M=16.8, SD=4.7; p=0.020) and ambiguity (M=27.8, SD=6.6 vs. M=29.8, SD=6.9; p=0.041).Conclusion:Patients with CHF were less uncertain in their illness after PCC, which may help to equip and empower patients to manage their illness. Together with earlier findings of shortened hospital stay and improved activities of daily living, this indicates that PCC should be a standard approach for hospital care of patients with worsening CHF.
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