| 1. |
- Bengtsson, Ulrika, et al.
(författare)
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Aspects of hypertension - a multi-perspective approach on the way towards adherence and self-management
- 2012
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Ingår i: Fifth Geneva conference on person-centerd medicine.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Hypertension is a long lasting condition for which a poor adherence to therapy becomes a substantial threat to the individual and public health. Major efforts have been made to explore reasons for poor adherence but few successful interventions have been designed. There is a need for effective strategies tailored for the unique needs of persons with hypertension. We set out to explore and describe relevant aspects of hypertension and hypertension treatment, from the perspective of persons with hypertension and health care providers. Focus group interviews were performed with 12 persons with hypertension and 15 health care providers and analysed according to thematic analysis. Persons with hypertension perceived trust, relationship to providers, well-being and prevention of complications as important aspects of hypertension care. Further they sought to understand the interplay between symptoms and variation of blood pressure. The providers emphasised accessibility, clear and consistent counselling, prevention of complications and educational efforts but doubted patients’ ability to be participating partners in care. The study presents aspects that persons with hypertension and health care providers deem important in hypertension self-management. Our findings provide input for future outcome measures and may increase the understanding of hypertension and treatment from a person-centred perspective.
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| 2. |
- Bengtsson, Ulrika, et al.
(författare)
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Development of a mobile phone self-report system for persons with hypertension: focus group interviews with patients and providers
- 2013
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Ingår i: Kardiovaskulära Vårmötet 2013.
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Konferensbidrag (refereegranskat)abstract
- Ulrika Bengtsson, Lena Ring, Inger Hallberg, Karin Kjellgren Background: Hypertension is a risk factor for cardiovascular disease for which poor adherence to therapy becomes a substantial threat to health. Major efforts have been made to explore reasons for poor adherence but few successful interventions have been designed. There is a need for effective strategies tailored for the unique needs of persons with hypertension. We set out to explore and describe relevant aspects of hypertension and hypertension treatment, from the perspective of persons with hypertension and health care providers. Methods: Focus group interviews were performed with 15 persons with hypertension and 12 health care providers and analysed according to thematic analysis. Results: Persons with hypertension perceived trust, relationship to providers, well-being and prevention of complications as important aspects of hypertension care. Further they sought to understand the interplay between symptoms and variation of blood pressure. The providers emphasised accessibility, clear and consistent counselling, prevention of complications and educational efforts but doubted patients’ ability to be participating partners in care. Conclusion: The study presents aspects that persons with hypertension and health care providers deem important in hypertension self-management. Our finding provides input for future outcome measures, such as self-reports, and may serve as a foundation for the development of a self-report system for persons with hypertension. It may further increase the understanding of hypertension and treatment, from a person-centred perspective.
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| 3. |
- Bengtsson, Ulrika, et al.
(författare)
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Development of a mobile phone self-report system for persons with hypertension: focus group interviews with patients and providers
- 2013
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Ingår i: HPH 21 st International Conference on Health Promoting Hospitals and Health Services.
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Konferensbidrag (refereegranskat)abstract
- Introduction: Hypertension is a risk factor for cardiovascular disease for which poor adherence to therapy becomes a substantial threat to health. Major efforts have been made to explore reasons for poor adherence but few successful interventions have been designed. There is a need for effective strategies designed to facilitate an increased understanding for the complexity of hypertension and treatment by strengthening of patient participation as well as patient empowerment. Purpose / Methods: The aim of this study was to explore and describe relevant aspects of hypertension and hypertension treatment, from the perspective of persons with hypertension and health care providers. Focus group interviews were performed with 15 persons with hypertension and 12 health care providers and analysed according to thematic analysis. Results: Persons with hypertension perceived trust, relationship to providers, well-being and prevention of complications as important aspects of hypertension care. Further they sought to understand the interplay between symptoms and variation of blood pressure. The providers emphasised accessibility, clear and consistent counselling, prevention of complications and educational efforts but doubted patients’ ability to be participating partners in care. Conclusion: The study presents aspects that persons with hypertension and health care providers deem important in hypertension management. Our finding provides input for future outcome measures, such as self-reports and may serve as a foundation for the development of a self-report system for persons with hypertension. They may further facilitate patient empowerment by increasing the understanding of hypertension and its’ treatment, from a person-centred perspective.
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| 4. |
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| 5. |
- Bengtsson, Ulrika, et al.
(författare)
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Improved Blood Pressure Control Using an Interactive Mobile Phone Support System
- 2016
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Ingår i: The Journal of Clinical Hypertension. - : Wiley. - 1524-6175 .- 1751-7176. ; 18:2, s. 101-108
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Tidskriftsartikel (refereegranskat)abstract
- This explorative, longitudinal study evaluated the effect of the daily use of a mobile phone-based self-management support system for hypertension in reducing blood pressure (BP) among 50 primary care patients with hypertension over 8 weeks. The self-management system comprises modules for (1) self-reports of BP, pulse, lifestyle, symptoms, and well-being; (2) delivery of reminders and encouragements; and (3) graphical feedback of self-reports. Daily use of the support system significantly reduced BP (systolic BP 7 mm Hg, diastolic BP 4.9 mm Hg) between baseline and week 8, with daily improvements leveling off as the study progressed. Three homogenous subsets of patients were identified who, despite different initial BP levels, showed similar decreases in BP during the study, indicating that patients benefited irrespective of baseline BP. In showing significant reductions in BP, our results suggest that the self-management support system may be a useful tool in clinical practice to help patients self-manage their hypertension.
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| 6. |
- Bengtsson, Ulrika, et al.
(författare)
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Links between blood pressure and life-style factors reported via a mobile phone-based self-management support system
- 2018
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Ingår i: Journal of Hypertension. - : Wolters Kluwer. - 0263-6352.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To explore relationships between patients’ self-monitoring of blood pressure and their concurrent self-reports of medication intake, wellbeing stress, physical activity and symptoms.Design and method: This was a prospective study exploring the eight-week effectiveness of a mobile phone based self-management support system for patients with hypertension. 50 patients undergoing treatment for hypertension, from four primary health care centers situated in urban and suburban communities in Sweden, self-reported through the system once daily during eight weeks.Scientific data: Associations between systolic and diastolic blood pressure and 10 self-report lifestyle-related variables.Results: The single strongest association was found between medication intake and systolic blood pressure, where failure to take medications was associated with an estimated 7.44 mmHg higher systolic blood pressure. To a lesser degree, medication intake was also associated with diastolic blood pressure. Wellbeing and stress were consistently associated with systolic blood pressure and diastolic blood pressure, whereas physical activity was associated with only systolic blood pressure. None of the symptoms dizziness, headache, restlessness, fatigue or palpitations were significantly associated with blood pressure.Conclusions: Blood pressure was associated with patients’ blood pressure management behaviors, eg drug intake and experiences of wellbeing and stress. No association was found between blood pressure and side effects. Enabling persons with hypertension to monitor and track their BP in relation to medication intake, symptoms and life-style variables may be a fruitful way to help them gain first-hand understanding of the importance of adherence and persistence to treatment recommendations.
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| 7. |
- Bengtsson, Ulrika, et al.
(författare)
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Patient contributions during primary care consultations for hypertension after self-reporting via a mobile phone self-management support system.
- 2018
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 36:1, s. 70-79
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports on how the clinical consultation in primary care is performed under the new premises of patients’ daily self-reporting and self-generation of data. The aim was to explore and describe the structure, topic initiation and patients’ contributions in follow-up consultations after eight weeks of self-reporting through a mobile phone-based hypertension self-management support system. A qualitative, explorative study design was used, examining 20 audio- (n=10) and video-recorded (n=10) follow-up consultations in primary care hypertension management, through interaction analysis. Clinical trials registry: ClinicalTrials.gov NCT01510301. The consultations comprised three phases: opening, examination and closing. The most common topic was blood pressure (BP) put in relation to self-reported variables, for example, physical activity and stress. Topic initiation was distributed symmetrically between parties and BP talk was lifestyle-centered. The patients’ contributed to the interpretation of BP values by connecting them to specific occasions, providing insights to the link between BP measurements and everyday life activities. Patients’ contribution through interpretations of BP values to specific situations in their own lives brought on consultations where the patient as a person in context became salient. Further, the patients’ and health care professionals’ equal contribution during the consultations showed actively involved patients. The mobile phone-based self-management support system can thus be used to support patient involvement in consultations with a person-centered approach in primary care hypertension management
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| 8. |
- Hallberg, Inger, 1956, et al.
(författare)
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Experiences, expectations and challenges of an interactive mobile phone-based system to support self-management of hypertension: patients’ and professionals’ perspectives
- 2018
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Ingår i: Patient Preference and Adherence. - : DOVE MEDICAL PRESS LTD. - 1177-889X. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Background: A well-controlled blood pressure (BP) reduces cardiovascular complications. Patient participation in care using technology may improve the current situation of only 13.8% of adults diagnosed with hypertension worldwide having their BP under control. Objective: The objective of this study was to explore patients’ and professionals’ experiences of and expectations for an interactive mobile phone-based system to support self-management of hypertension. Methods: The self-management system consists of: 1) a mobile phone platform for self-reports, motivational messages and reminders; 2) a device for measuring BP and 3) graphical feedback of self-reports. Patients diagnosed with high BP (n=20) and their treating professionals (n=7) participated in semi-structured interviews, after 8 weeks use of the system in clinical practice. Data were analyzed thematically. Results: The self-reporting of BP, symptoms, medication use, medication side effects, lifestyle and well-being was perceived to offer insight into how daily life activities influenced BP and helped motivate a healthy lifestyle. Taking increased responsibility as a patient, by understanding factors affecting one’s well-being, was reported as an enabling factor for a more effective care. Based on the experiences, some challenges were mentioned: for adoption of the system into clinical practice, professionals’ educational role should be extended and there should be a reorganization of care to fully benefit from technology. The patients and professionals gave examples of further improvements to the system, for example, related to the visualization of graphs from self-reports and an integration of the system into the general technical infrastructure. These challenges are important on the path to accomplishing adoption. Conclusion: The potential of a more autonomous, knowledgeable and active patient, through use of the interactive mobile system would improve outcomes of hypertension treatment, which has been desired for decades. Documentation and visualization of patients’ self-reports and the possibilities to communicate these with professionals may be a significant resource for person-centered care.
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| 9. |
- Hallberg, Inger, 1956, et al.
(författare)
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Patientmedverkan i behandling av högt blodtryck med hjälp av mobiltelefon
- 2012
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Ingår i: Medicinska riksstämman.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Dålig följsamhet gör att patienter inte får avsedd effekt av läkemedel och/eller livsstilsförändringar vid behandling av högt blodtryck. Det innebär stora ekonomiska förluster för samhället samt påverkar den enskilde patientens hälsa och livskvalitet. Studiens syfte var att analysera erfarenheter och effekter av uppföljning av högt blodtryck med hjälp av mobiltelefon samt undersöka om detta leder till ökad följsamhet och delaktighet i behandlingen. I studien ingick 50 patienter (>30 år) med läkemedel för högt blodtryck. Deltagarna utrustades med en blodtrycksmätare och rapporterade dagligen under 2 månader in blodtryck, välmående, fysisk aktivitet och olika symtom via ett program i sin egen mobiltelefon. De värden som rapporterades i mobiltelefonen var framtagna tillsammans med patienter med högt blodtryck, läkare, sjuksköterskor och farmaceuter. Efter inloggning via internet kunde både patient, behandlande läkare och sjuksköterska se inrapporterade värden i en graf. Uppföljning av erfarenheter av rapportering med mobiltelefon gjordes med intervjuer och inspelade samtal med ljud/video från återbesök för högt blodtryck hos läkare/sjuksköterska. Preliminära analyser visar att både personal och patienter upplevde det värdefullt att kunna se relationen mellan livsstil, symtom, läkemedelsintag och blodtryck, t ex att blodtrycket blev lägre de dagar då de var fysiskt aktiva. Patienterna upplevde att de blev mer delaktiga i det uppföljande återbesöket vilket också bekräftades av personalen. Ett tydligt resultat hittills är att patienterna uppskattar att kunna se hur livsstil påverkar blodtrycket. Detta motiverar en förändrad livsstil och därigenom en bättre följsamhet och ökad delaktighet i behandlingen. Modern informationsteknik kan vara ett stöd till bättre hälsa.
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