| 1. |
|
|
| 2. |
- Hellström Ängerud, Karin, et al.
(författare)
-
Differences in symptoms in relation to myocardial infarction.
- 2016
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: In myocardial infarction (MI) rapid diagnosis and treatment is crucial for the prognosis. Previous research has found that symptom presentation influence pre hospital delay times but studies about differences in MI symptoms between patients with ST-elevation myocardial infarction (STEMI) and non ST-elevation myocardial infarction (NSTEMI) are sparse and inconclusive. To enhance the understanding of symptom presentation in regard to MI type, we aimed to describe symptoms in relation to MI type and to find predictors of STEMI versus NSTEMI in patients with MI.Methods: Patients with MI (n=694) from the SymTime study were included. SymTime was a multicentre cross-sectional study of symptoms and actions in the prehospital phase of MI and data were collected using a previously validated questionnaire administered to MI patients within 24 h of admission to hospital.Results: Patients with STEMI were younger, more often men and smokers. Patients with NSTEMI were more likely to have a history of hypertension, MI and stroke. Chest pain was the most common symptom in both groups. Pain, discomfort, or pressure located in the jaw or teeth, vertigo/pre-syncope, cold sweat and nausea/vomiting were significantly more frequent in patients with STEMI (Table 1). In a multivariate logistic regression model patients with STEMI were more likely to present with cold sweat (OR 4.13, 95% CI 2.71–6.29) jaw pain (OR 2.14, 95% CI 1.02–4.50), and nausea (OR 2.01, 95% CI 1.20–3.33), and less likely to have a history of stroke (OR 0.35, 95% CI 0.15–0.84), fluctuating symptoms (OR 0.54, 95% CI 0.36–0.83) and anxiety (OR 0.54, 95% CI 0.32–0.92) compared to patients with NSTEMI.Conclusion: Patients with STEMI differed significantly from those with NSTEMI regarding symptom presentation. This knowledge is important for health care personnel to recognize symptoms alarming for STEMI when evaluating patients with MI symptoms.
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
- Israelsson, Johan, et al.
(författare)
-
Factors associated with health status and psychological distress among cardiac arrest (CA) survivors living with an implantable cardioverter-defibrillator (ICD)
- 2017
-
Konferensbidrag (refereegranskat)abstract
- Background: The aim was to explore factors associated with health status and psychological distress among ICD-implanted CA survivors. Materials and methods: This cross-sectional study included all eligible adult ICD-implanted CA survivors in the Swedish ICD and Pacemaker Registry, 2011-2012. Health status and psychological distress were measured with the EQ-5D-5L (EQ index & EQ VAS) and the Hospital Anxiety and Depression Scale (HADS) respectively. Linear regression analyses were used to explore associations between explanatory- and outcome variables.Results: In total, 990 patients (22% women) with a median age of 68 (q1-q3=60-74) were included. Time since the CA varied between 6 months to 23 years. The median values for EQ index and EQ VAS were 0.85 (q1-q3=0.73-1.00) and 80 (q1-q3=69-90) respectively. Gender, comorbidity, receiving ICD-shock/-s, perceived control and personality were independently associated with health status. The final models explained 25% (EQ index) and 30% (EQ VAS) of the total variance (according to the R2 values). The median values for HADS Anxiety and HADS Depression were 3 (q1-q3=1-6) and 2 (q1-q3=1-4) respectively. Age, gender, comorbidity, living alone, ICD-related concerns, perceived control and personality were independently associated with psychological distress. The final models explained 51% (HADS Anxiety) and 44% (HADS Depression) of the total variance.Conclusion: Age, gender, living alone, comorbidity, receiving ICD-shock/-s, ICD-related concerns, perceived control and personality were associated with health status and/or psychological distress. These results contribute to a better understanding of the life situation among CA survivors, and may be important to develop individualized post CA care.
|
|
| 6. |
|
|
| 7. |
- Moser, Debra, et al.
(författare)
-
Shared decision-making about end-of-life care for heart failure patients with an implantable cardioverter defibrillator: a national cohort study.
- 2014
-
Ingår i: Journal of Cardiac Failure. - : Elsevier. - 1071-9164.
-
Konferensbidrag (refereegranskat)abstract
- BackgroundWhether to deactivate an implantable cardioverter defibrillator (ICD) at end-of-life is an important question for patients with an ICD. Expert consensus statements recommend physicians discuss end-of-life issues with ICD patients before and after implantation and promote shared decision-making. The degree to which these recommendations are followed in patients with HF is unknown. The purpose of this study was to compare attitudes and knowledge about the ICD at end-of-life between ICD recipients with and without HF to determine how well HF patients could participate in end-of-life decisions.MethodsEvery ICD patient in Sweden is enrolled in a national registry. We mailed a survey about attitudes, knowledge and experiences (the End-of-Life-ICD Questionnaire) related to the ICD and end-of-life issues to all registry patients. Data on quality of life (Euro-QOL), anxiety and depression (Hospital Anxiety and Depression Scale) were collected to determine if these affected attitudes or knowledge.ResultsOf the 5,535 patients in the registry, 3,067 (1606 with HF; age 66±11 years; 21% women) participated. Despite patients with HF reporting worse quality of life (p<0.001), and greater depression (p<0.001) and anxiety (p<0.001) than their counterparts without HF, their attitudes and knowledge about the ICD at end-of-life were very similar. Only 39% of HF patients discussed illness trajectory with their doctor, fewer (14%)discussed deactivation with their doctor, and only 8% discussed their wishes with their family. A total of 40% of HF patients did not want to discuss deactivation with their doctor, and 64% felt that such discussions were warranted only as their prognosis worsened or they neared end-of-life (70%). Patients with HF had misconceptions about the ICD: 71% incorrectly believed the ICD always delivered shocks at the end-of-life; 27% believed ICD deactivation was the same as active euthanasia; 26% believed the ICD could only be deactivated by surgical removal; and 36% thought the ICD could be deactivated without their knowledge. With regard to deactivation of the ICD, 62% did not want it deactivated or could not make a choice even if they were dying of cancer. With regard to ICD generator replacement if needed, 54% of HF patients wanted it changed or were undecided (34%) in the context of being seriously ill with another condition; 65% wanted it changed or could not make a choice (26%) even if they were of advanced age. None of these attitudes or knowledge items differed from those of patients without HF.ConclusionICD recipients with HF hold many perceptions about the ICD at end-of-life that could interfere with effective decision-making. Without better knowledge about their ICD and its performance at the end-of-life, or without discussions with doctors and family members about these issues, HF patients with an ICD are ill-prepared to engage in shared decision-making about their ICD and its use at the end-of-life.
|
|
| 8. |
- Prytz, Erik, et al.
(författare)
-
Pilot evaluation of a persuasive mobile application to change individuals behavior during recurrent myocardial infarction
- 2019
-
Ingår i: ECCE 2019, Proceedings of the 31st European Conference on Cognitive Ergonomics, ‘Design for Cognition'. - New York, NY, USA : Association for Computing Machinery (ACM). - 9781450371667 ; , s. 192-195
-
Konferensbidrag (refereegranskat)abstract
- Objective: The objective of the current study was to develop and evaluate a persuasive decision-support aiming at reducing pre hospital delay and increasing ambulance service use for patients who suffer from a recurrent myocardial infarction. Materials and methods: The system was developed as a prototype mobile application for smartphones. The system was evaluated by four end-users with previous experience of myocardial infarction. The user tests were complemented with cognitive walkthroughs and heuristic evaluation. Results: A total of 14 persuasive design principles were used to guide the design of the system. The usability was regarded as high with an average score of 82 on the System Usability Scale. The users reported that they found the system highly persuasive. Conclusions: User-centered design together with persuasive design principles through iterative testing and development has resulted in a prototype app with potential to improve patients care seeking behavior. The content in the prototype will be further evaluated before it is integrated in educational interventions.
|
|
| 9. |
|
|
| 10. |
|
|
