| 1. |
- Andreae, Christina, 1969-, et al.
(author)
-
Does problem-based learning improve patient empowerment and cardiac risk factors in patients with coronary heart disease in a Swedish primary care setting? : A long-term prospective, randomised, parallel single randomised trial (COR-PRIM)
- 2023
-
In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 13:2
-
Journal article (peer-reviewed)abstract
- Objectives: To investigate long-term effects of a 1-year problem-based learning (PBL) on self-management and cardiac risk factors in patients with coronary heart disease (CHD).Design: A prospective, randomised, parallel single centre trial.Settings: Primary care settings in Sweden.Participants: 157 patients with stable CHD completed the study. Subjects with reading and writing impairments, mental illness or expected survival less than 1 year were excluded.Intervention: Participants were randomised and assigned to receive either PBL (intervention) or home-sent patient information (control group). In this study, participants were followed up at baseline, 1, 3 and 5 years.Primary and secondary outcomes: Primary outcome was patient empowerment (Swedish Coronary Empowerment Scale, SWE-CES) and secondary outcomes General Self-Efficacy Scale (GSES), self-rated health status (EQ-VAS), high-density lipoprotein cholesterol (HDL-C), body mass index (BMI), weight and smoking. Outcomes were adjusted for sociodemographic factors.Results: The PBL intervention group resulted in a significant improved change in SWE-CES over the 5-year period (mean (M), 39.39; 95% CI 37.88 to 40.89) compared with the baseline (M 36.54; 95% CI 35.40 to 37.66). PBL intervention group increased HDL-C level (M 1.39; 95% CI 1.28 to 1.50) compared with baseline (M 1.24; 95% CI 1.15 to 1.33) and for EQ-VAS (M 77.33; 95% CI 73.21 to 81.45) compared with baseline (M 68.13; 95% CI 63.66 to 72.59) while these outcomes remained unchanged in the control group. There were no significant differences in BMI, weight or scores on GSES, neither between nor within groups over time. The overall proportion of smokers was significantly higher in the control group than in the experimental group.Conclusion: One-year PBL intervention had positive effect on patient empowerment, health status and HDL-C at a 5-year follow-up compared with the control group. PBL education aiming to improve patient empowerment in cardiac rehabilitation should account for sociodemographic factors.
|
|
| 2. |
- Pettersson, Richard, et al.
(author)
-
Diagnosing ADHD in Adults : An Examination of the Discriminative Validity of Neuropsychological Tests and Diagnostic Assessment Instruments
- 2018
-
In: Journal of Attention Disorders. - : SAGE PUBLICATIONS INC. - 1087-0547 .- 1557-1246. ; 22:11, s. 1019-1031
-
Journal article (peer-reviewed)abstract
- Objective: The objective of this study is to investigate the discriminative validity of neuropsychological tests and diagnostic assessment instruments in diagnosing adult ADHD in a clinical psychiatric population. Method: Of 108 patients, 60 were diagnosed with ADHD. The Diagnostic Interview for ADHD in adults (DIVA 2.0) and Adult ADHD Self-Report Scale (ASRS) v.1.1 together with eight neuropsychological tests were investigated. Results: All instruments showed poor discriminative ability except for the DIVA, which showed a relatively good ability to discriminate between the groups (sensitivity = 90.0; specificity = 72.9). A logistic regression analysis model with the DIVA and measures of inattention, impulsivity, and activity from continuous performance tests (CPTs) showed a sensitivity of 90.0 and a specificity of 83.3. Conclusion: Neuropsychological tests have a poor ability to discriminate between patients diagnosed with ADHD and patients not diagnosed with ADHD, but variables from CPT tests can contribute to increasing the specificity by 10% if used in combination with the DIVA.
|
|
| 3. |
- Pettersson, Richard, et al.
(author)
-
Internet-Based Cognitive Behavioral Therapy for Adults With ADHD in Outpatient Psychiatric Care : A Randomized Trial
- 2017
-
In: Journal of Attention Disorders. - : SAGE Publications. - 1087-0547 .- 1557-1246. ; 21:6, s. 508-521
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: The purpose of the study was to evaluate an Internet-based cognitive behavioral therapy (iCBT) program targeting difficulties and impairments associated with adult ADHD.METHOD: Forty-five adults diagnosed with ADHD were randomized to either self-help (iCBT self-help format [iCBT-S]), self-help with weekly group sessions (iCBT group-therapy format [iCBT-G]), or a waiting-list control group. Treatment efficacy was measured at pre- and posttreatment and at 6-month follow-up.RESULTS: Intention-to-treat (ITT) analysis showed a significant reduction in ADHD symptoms for the iCBT-S group in comparison with the waiting-list controls at posttreatment, with a between-group effect size of d = 1.07. The result was maintained at 6-month follow-up. No significant difference was found at posttreatment or 6-month follow-up between the iCBT-S and iCBT-G groups.CONCLUSION: The findings show that a CBT treatment program administered through the Internet can be a promising treatment for adult ADHD. Limitations of the study design and directions for future research are discussed.
|
|
| 4. |
- Soderstrom, Staffan, et al.
(author)
-
Quantitative and subjective behavioural aspects in the assessment of attention-deficit hyperactivity disorder (ADHD) in adults
- 2014
-
In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 0803-9488 .- 1502-4725. ; 68:1, s. 30-37
-
Journal article (peer-reviewed)abstract
- Background: Self-rating scales and cognitive tests are instruments used in the assessment of attention-deficit hyperactivity disorder (ADHD). However, few studies have examined the differential validity of these kinds of instruments in psychiatric samples. Aims: To examine the discriminative validity of two self-report scales (ADHD Self-Report Scale [ASRS v. 1.1], Current Symptom Scale [CSS]) and a continuous performance test with measures of motor activity (QBTest Plus). Methods: The interrelation between the instruments, and their abilities to differentiate between patients with an ADHD diagnosis and non-ADHD patients referred for psychiatric assessment were examined in a naturalistic sample of 61 adult patients. Results: The area under the receiver operating characteristic curve (AUC) for the dichotomized versions of the test variables in all tests ranged from 0.61 to 0.71. The ASRS and CSS exhibited sensitivity of 90.2% and 85.4%, and specificity of 35.0% and 40.0%, respectively. Variables from the QBTest Plus showed the opposite result for the variables QBImpulsivity and QBInattention, with sensitivity of 58.5% and 36.3% and specifi city of 80.0% and 100.0%. Sensitivity and specifi city of QBActivity were 68.3% and 65.0%, respectively. A stepwise discriminant function analysis showed that two variables from the QBTest Plus-QBInattention and QBActivity-accounted for 22.8% of the between-group variability, with the strongest predictor being QBInattention. The function yielded an overall correct classification of 72.1%. The classification correctly identified 87.8% of patients diagnosed with ADHD and 40.0% of non-ADHD patients. Conclusion: The discriminant validity of self-rating scales and the more objective measure of ADHD symptoms are poor and should be integrated generally with other sources of data.
|
|
| 5. |
|
|
