| 1. |
- Johansson, Anna, et al.
(författare)
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Perceptions of how sleep is influenced by rest, activity and health in patients with coronary heart disease : A phenomenographical study
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:4, s. 467-475
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Tidskriftsartikel (refereegranskat)abstract
- A framework is needed for identifying internal and external factors essential for the nursing management of psychological supportive health care and education for patients' self-care in sleep. In order to generate more knowledge from the patient's perspective, the aim of this study was to describe how patients with coronary artery disease (CAD) perceive that their sleep is influenced by rest, activity and health in outpatient care. Qualitative interviews were performed with 33 outpatients. The data were analysed using a phenomenographic method. Three descriptive categories of the phenomenon were described: my lifestyle is reflected in my sleep behaviour, handling the practices around tiredness and sleep, and feelings of negative and positive efficacy. Feelings of tiredness, fatigue and sleepiness were different pre-sleep stages, but were also related to the patient's adaptation and recovery. Creating one's own personal time and feelings of efficacy gave an inner sense of strength which is indicated as being particularly important in managing stress and the demands of everyday life in a satisfactory manner. From a contextual, holistic perspective on health, it is important to identify the patient's needs, symptoms and intentional or unintentional self-care management strategies regarding sleep and lifestyle. To promote a positive health outcome it is essential to identify sleeplessness behaviour and perceived self-efficacy for self-care in sleep. © 2007 Nordic College of Caring Science.
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| 2. |
- Johansson, Anna, et al.
(författare)
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Sleep, arousal and health-related quality of life in men and women with coronary artery disease.
- 2011
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Ingår i: Journal of Clinical Nursing. - : Blackwell. - 0962-1067 .- 1365-2702. ; 20:19-20, s. 2787-2801
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To evaluate whether there are gender differences in insomnia, sleep quality, sleep efficiency (%), general arousal, disease-specific and health-related quality of life in patients with coronary artery disease, compared with an age- and gender-matched randomly selected group from the general population. Background. There are gender difference effects of sleep disturbances in the general population, but this perspective among patients with coronary artery disease has been poorly analysed. Design. In this prospective study, comparative, descriptive and model testing designs were used. Method. The patients with coronary artery disease, 556 men and 324 women aged 25–86, were compared with a matched population-based group. Data were collected by validated and reliability-tested questionnaires. Results. The prevalence of severe insomnia varied between 17–44% in all four groups. The severe insomniac coronary artery disease patients displayed a two- or threefold higher presleep arousal, had two hours shorter nocturnal sleep duration/night and were more limited in their physical exercise level than the population-based group. Gender differences in sleep quality, sleep efficiency (%) and general arousal disappeared with increased insomnia severity. Conclusions. Independent of gender, age and comorbidity, physical exercise, general arousal behaviour and delayed poststress recovery after mental stress were found to have a negative impact on the coronary artery disease patients’ sleep quality and sleep efficiency (%), interfering with their health-related quality of life. The variables significantly explained 41% of the sleep quality outcome and 29% of the sleep efficiency (%). Relevance to clinical practice. Insomnia because of hyperarousal behaviour can be an important factor in the development of an individual self-care management programme supported by a healthcare team.
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| 3. |
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| 4. |
- Gellerstedt, Martin, 1966-, et al.
(författare)
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Are patients willing to take a more active role? : Questionnaires to measure patients’ willingness to be empowered
- 2022
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 105:3, s. 741-749
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveOne crucial prerequisite for increased patient empowerment is the willingness among patients to take a more active role. The aim of this study was to develop questionnaires for measuring a patient’s willingness to be empowered in general and by using e-health.MethodsThe study was based on a random sample from an online panel. The 800 responders were Swedish citizens and reflected the internet-using population in Sweden regarding age, gender, income, and education. The measurement properties were evaluated according to the Rasch Measurement Theory.ResultsThe analyses showed two questionnaires with adequate fit to the basic measurement model and with high reliability (PSI 0.84 and 0.89, respectively).ConclusionWe conclude that this study generated two questionnaires with an intuitive order of items illustrating an understandable progression of willingness to be empowered in general as well as for e-health.Practice implicationsThe suggested questionnaires are valuable tools supporting the effort to tailor empowerment strategies to meet the patient’s willingness. Questionnaires will also be valuable for evaluating strategies for supporting willingness, studying factors related to willingness and potential inequalities due to e.g. varying digital literacy, and for enabling identification of patient stereotypes using cluster analyses.
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| 5. |
- Islind, Anna Sigridur, 1985-, et al.
(författare)
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Individualized blended care for patients with colorectal cancer: the patient's view on informational support
- 2021
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Ingår i: Supportive Care in Cancer. - : Springer Science and Business Media LLC. - 0941-4355 .- 1433-7339. ; 29:6, s. 3061-3067
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Tidskriftsartikel (refereegranskat)abstract
- Purpose The number of colorectal cancer patient survivors is increasing. Information and support during and after treatment are requested by patients, but questions remain on what to provide. The aim of this study was to understand what informational needs colorectal cancer patients and survivors have, with a focus on the potential support given by patient peers and the use of blended care. Methods A qualitative study using focus groups was conducted with patients diagnosed at the same hospital at least one year prior to the initiation of the study. The focus group interviews were transcribed verbatim and analyzed using deductive content analysis. Results The need for informational support varied over time and depended on individual patient characteristics. Timing was crucial and patients requested options of blended care and informational support after treatment cessation. The patients felt alone after treatment and requested assistance in communication with their next-of-kin. They also identified the value of peer support, especially to contextualize knowledge provided by healthcare. Conclusion This study showed a need for focus on individualized informational support. Blended care through integrating communication with peers online could be one way to support patients, both to enable shared decision-making as well as to provide person-centered care.
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| 6. |
- Islind, Anna Sigridur, et al.
(författare)
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Invisible Work Meets Visible Work : Infrastructuring from the Perspective of Patients and Healthcare Professionals
- 2021
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Ingår i: Proceedings of the 54th Hawaii International Conference on System Sciences. - : Hawaii International Conference on System Sciences. - 9780998133140 ; , s. 3556-3565
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Konferensbidrag (refereegranskat)abstract
- Increased patient engagement and the use of new types of data, such as patient-generated health data (PGHD) is shifting how work is performed in relation to healthcare. This change enables healthcare professionals to delegate parts of work previously conducted by them to patients. There is a consensus regarding the need for nurses and physicians to work seamlessly together to make healthcare flow, but the role and responsibility of patients are less researched. In this paper, we aim to fill that gap by focusing on the shift of work from healthcare professionals to patients from the perspective of i) patients and ii) healthcare professionals. We use infrastructuring as a lens to understand the design of everyday work and actions from both perspectives. The main contribution is an analysis of, and insights into, how the work of patients can support healthcare professionals along with a conceptualization of how infrastructuring processes within and outside of healthcare are interconnected.
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| 7. |
- Jakobsson, Eva, 1960, et al.
(författare)
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Clinical problems at the end of life in a Swedish population, including the role of advancing age and physical and cognitive function.
- 2008
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Ingår i: Scandinavian journal of public health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 36:2, s. 177-82
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To improve the understanding of specific clinical problems at the end of life, including the role of advancing age, physical function and cognitive function. METHODS: The study is part of an explorative survey of data relevant to end-of-life healthcare services during the last 3 months of life of a randomly selected sample of the population of a Swedish county. Data were selected through retrospective reviews of death certificates and medical records, and comprise information from 12 municipalities and 229 individuals. RESULTS: A range of prevalent concerns was found. Overall deterioration, urinary incontinence, constipation, impaired skin integrity, anxiety and sleep disturbances were significantly associated with dependency on others for activities of daily living; pulmonary rattles and swallowing disturbances were associated with cognitive disorientation; excepting cough, advancing age did not have significant impacts on these prevalent clinical concerns. CONCLUSIONS: A range of distressing conditions constitute a common pathway for many individuals at or near the end of life. The incorporation of health promotion as a principle of palliative care will probably benefit individuals at the end of life, and includes a proactive focus and emphasis on enhanced well-being at the time of diagnosis of a life-threatening illness. For individuals with physical and cognitive limitations imparting a state of dependency, it is reasonable to provide assurance of care for individuals' specific needs by professionals with both training for and competence in this special and sometimes unique clinical environment.
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| 8. |
- Jakobsson, Eva, 1960, et al.
(författare)
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End-of-life in a Swedish population: demographics, social conditions and characteristics of places of death.
- 2006
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 20:1, s. 10-7
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to identify and describe the demographics and social conditions as well as characteristics of the places of death in a randomly selected sample that died in a county in Sweden during 2001. The present study reports part of the findings from a larger study undertaken during 2003 using a survey design of retrospective reviews of death certificates, medical records, and nursing records. Among several noteworthy findings are: first, an examination of these individuals' living arrangements reveal not only a large and vulnerable group that lives alone at the end-of-life but also a group living separated from their partners near end-of-life; second, individuals differ with respect to residence prior to death, that is private homes versus residential care facilities, imparting highly different contexts of care at the end-of-life; and third, a high prevalence of institutionalized deaths demonstrates that places of death other than hospitals and residential care facilities are uncommon, if not rare. It is concluded that increased attention to the social circumstances of the time period surrounding individuals' at the end-of-life is essential. There is need to develop more integrated models of care for dying people. Contemporary services available are not designed to meet a wide range of peoples' needs at the end-of-life. Home-based care, residential care and hospital care must be adapted to the changing patterns of dying. The services available should be organized to the benefit of the users rather than around the providers. This is the first study of its kind of a Swedish sample and while the data are limited to one county in Sweden its findings may contribute to a deeper understanding of demographic and social patterns at the end-of-life in general.
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| 9. |
- Jakobsson, Eva, 1960, et al.
(författare)
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The turning point: Clinical identification of dying and reorientation of care.
- 2006
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Ingår i: Journal of palliative medicine. - : Mary Ann Liebert Inc. - 1096-6218 .- 1557-7740. ; 9:6, s. 1348-58
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Tidskriftsartikel (refereegranskat)abstract
- Palliative care is increasingly organized within the setting of formal health care systems but the demarcation has become unclear between, on the one hand, care directed at cure and rehabilitation and palliative care aimed at relief of suffering on the other. With the purpose to increase the understanding about the turning point reflecting identification of dying and reorientation of care, this study explores this phenomenon as determined from health care records of a representative sample (n = 229). A turning point was identified in 160 records. Presence of circulatory diseases, sporadic confinement to bed, and deterioration of condition had a significant impact upon the incidence of such turning point. The time interval between the turning point and actual death ranged between one and 210 days. Thirty percent of these turning points were documented within the last day of life, 33% during the last 2-7 days, 19.5% during the last 8-30 days, 13% during the last 31-90 days, and 4.5% during the last 91-210 days of life. The time interval between the turning point and actual death was significantly longer among individuals with neoplasm(s) and significantly shorter among individuals suffering from musculoskeletal diseases. Perhaps this reflects a discrepancy between the ideals of palliative care, and a misinterpretation of the meaning of palliative care in everyday clinical practice. The findings underscore that improvement in timing of clinical identification of dying and reorientation of care will likely favour a shift from life-extending care to palliative care.
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| 10. |
- Jakobsson, Eva, et al.
(författare)
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Utilization of health-care services at the end-of-life
- 2006
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Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 82:3, s. 276-287
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Tidskriftsartikel (refereegranskat)abstract
- End-of-life care poses a growing clinical and policy concern since most people who are dying utilize health-care services during this period of life. Hence, end-of-life care is a common and integral part of the care provided by health-care systems. There is a growing call for the implementation of a palliative approach as an integral part of all end-of-life care. The purpose of this study was thus to provide policy-makers, health-care providers and professional caregivers with increased knowledge about mainstream patterns of health-care utilization during end-of-life. The patterns of use of health-care services in a Swedish population who accessed the health-care system during their last 3 months of life were in this study examined through a retrospective examinations of medical and nursing records (n = 229). We found high prevalences of use of both hospital care, primary care and care provided in people's homes and nearly three quarters of the persons included in the study used between two and three health-care services. However, the probability of using different health-care services was found to be strongly depending on demographic, social, functional and disease related characteristics. The study reveals a considerable use of different health-care services during end-of-life. It is hence essential to, on one hand delineate how such health-care services best can support people at the end-of-life, and on the other hand develop policies which facilitate the process of dying, both in hospitals as well as in peoples’ homes. Implications for policy are discussed.
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