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1.
  • Akerman, Eva, et al. (författare)
  • Development of the 3-SET 4P questionnaire for evaluating former ICU patients´physical and psychosocial problems over time : a pilot study
  • 2009
  • Ingår i: Intensive & Critical Care Nursing. - 0964-3397. ; 25:2, s. 80-89
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Current studies reveal a lack of consensus for the evaluation of physical and psychosocial problems after ICU stay and their changes over time.Objectives: The aim was to develop and evaluate the validity and reliability of a questionnaire for assessing physical and psychosocial problems over time for patients following ICU recovery.Patients: Thirty-nine patients completed the questionnaire, 17 were retested.Methods and results: The questionnaire was constructed in three sets: physical problems, psychosocial problems and follow-up care. Face and content validity were tested by nurses, researchers and patients. The questionnaire showed good construct validity in all three sets and had strong factor loadings (explained variance >70%, factor loadings >0.5) for all three sets. There was good concurrent validity compared with the SF 12 (rs > 0.5). Internal consistency was shown to be reliable (Cronbach's α 0.70–0.85). Stability reliability on retesting was good for the physical and psychosocial sets (rs > 0.5).Conclusion: The 3-set 4P questionnaire was a first step in developing an instrument for assessment of former ICU patients’ problems over time. The sample size was small and thus, further studies are needed to confirm these findings.
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2.
  • Akerman, Eva, et al. (författare)
  • Preferred content and usefulness of a photodiary as described by ICU-patients-A mixed method analysis.
  • 2013
  • Ingår i: Australian critical care : official journal of the Confederation of Australian Critical Care Nurses. - ELSEVIER SCIENCE INC. - 1036-7314. ; 26:1, s. 29-35
  • Tidskriftsartikel (refereegranskat)abstract
    • Many ICU-patients have memory-gaps which may affect their recovery. A tool in the recovery can be an ICU-diary to explain and clarify thoughts and events from the ICU-period. There are different standards for the content in the ICU-diary. The aim of this study was to identify the preferred content and usefulness of an ICU-diary as described by ICU-patients. METHOD: A descriptive, exploratory cohort design with a mixed method approach. The patients answered a questionnaire (n=115) and participated in an interview (n=15) six months after the ICU-stay. Data analysis was carried out in three stages; the questionnaire was analysed by descriptive statistics and categorised by content (four open-ended questions) and the interviews were analysed by manifest content analysis. RESULTS: The patients were explained that detailed information about daily activities and medical facts had to be included to understand and give a sense of coherence of what had happened. The content in the ICU-diary had to be chronological in order to follow the process in which photos were an important part. The patients re-read the ICU-diary during the recovery which helped them to fill in the memory gaps and used it as a tool for communication. CONCLUSION: To construct a coherent story, it was essential that the ICU-diary was complete and were amplified by photos, all appearing in a chronological order. The results of this study could form a basis for further developments of standards and guidelines for ICU-diaries.
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3.
  • Algurén, Beatrix, et al. (författare)
  • A Multidisciplinary Cross-Cultural Measurement of Functioning After Stroke : Rasch Analysis of the Brief ICF Core Set for Stroke
  • 2011
  • Ingår i: Topics in Stroke Rehabilitation. - 1074-9357. ; 18:6, s. 573-586
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To investigate the possibility of constructing a multiprofessional cross-cultural measure of functioning after stroke across categories of the International Classification of Functioning, Disability and Health (ICF). Method: Data on 757 stroke survivors from China, Germany, Italy, and Sweden, including ratings of 15 categories from the Brief ICF Core Set for stroke, were analyzed using the Rasch model. Unidimensionality, reliability, fit of the ICF categories to the model, ordering of response options of the ICF qualifier, and presence of differential item functioning (DIF) were studied. Results: Of the 15 ICF categories, response options for 7 categories were collapsed, 5 categories were deleted due to misfit, and 4 ICF categories showed DIF for country and were accordingly split into country-specific categories. The proposed final clinical measure consists of 20 ICF categories (6 categories were country-common) with an overall fit statistic of χ2180 = 184.87, P = .386, and a person separation index of r = 0.72, which indicates good reliability. Based on an individual's functioning after stroke, the ratings across the different ICF categories can be summed on an interval scale ranging from 0 to 100. Conclusion: A construction of a cross-cultural clinical measure after stroke based on ICF categories across body functions, structures, and activities and participation was possible. With this kind of clinical measure, stroke survivors' functional levels can be compared even across countries. Despite the promising results, further studies are necessary to develop definitive measures based on ICF categories.
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4.
  • Algurén, Beatrix, et al. (författare)
  • Factors Associated With Health-Related Quality of Life After Stroke: A 1-Year Prospective Cohort Study.
  • 2011
  • Ingår i: Neurorehabilitation and neural repair. - 1552-6844. ; 26:3, s. 266-274
  • Tidskriftsartikel (refereegranskat)abstract
    • Background. In line with patient-centered health care, it is necessary to understand patients’ perceptions of health. How stroke survivors perceive their health at different time points after stroke and which factors are associated with these feelings provide important information about relevant rehabilitation targets. Objective. This study aimed to identify the independent factors of health-related quality of life (HRQoL) from a biopsychosocial perspective using the methods of multivariate regression at 3 different time points poststroke. Methods. Included in the study were 99 patients from stroke units with diagnosed first-ever stroke. At admission and at 6 weeks, 3 months, and 1 year poststroke, HRQoL was assessed using the EuroQoL-5D Visual Analogue Scale (EQ-5D VAS). Consequences in Body Functions and Activities and Participation, and Environmental Factors were documented using 155 categories of the International Classification of Functioning, Disability and Health (ICF) Core Set for Stroke. Results. For a period of 1 year, problems with recreation and leisure, personality functions, energy and drive functions, and gait pattern functions were repeatedly associated with worse HRQoL. Whereas Body Functions and Activities and Participation explained more than three-fourths of the variances of HRQoL at 6 weeks and 3 months (R 2 = 0.80-0.93), the variation at 1 year was best explained by either Body Functions or Environmental Factors (R 2 = 0.51). Conclusions. The results indicate the importance of Body Functions and Activities and Participation (mainly personality functions and recreation and leisure) on HRQoL within 3 months poststroke, but increased impact of Environmental Factors on HRQoL at 1 year.
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5.
  • Alm, Carin, et al. (författare)
  • Knowing your risk factors for coronary heart disease improves adherence to advice on lifestyle changes and medication
  • 2006
  • Ingår i: Journal of Cardiovascular Nursing. - Lippincott Williams & Wilkins. - 0889-4655. ; 21:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Implementation of guidelines for coronary heart disease prevention is less optimal in clinical practice. The aim of this study was to investigate if specific knowledge (patients' knowledge about their own coronary heart disease risk factors) would correlate to their adherence as measured by self-reported lifestyle changes, reaching defined treatment goals and adhering to treatment with prescribed drugs. The consecutive medical records of 509 men and women younger than 71 years, hospitalized for a cardiac event, were screened. Of these, 392 patients came for an interview and were subjected to a clinical examination. All patients received a questionnaire regarding their specific knowledge of risk factors and their adherence to lifestyle changes, which was completed by 347 patients. In addition, data were collected and analyzed on how their treatment goals were attained in 8 domains and their adherence to drug treatment. There were significant correlations between specific knowledge and self-reported lifestyle changes, the ability to reach treatment goals in all 8 domains, and adherence to prescribed drugs. Patients with coronary heart disease will benefit from increased specific knowledge of risk factors to adhere with lifestyle changes and prescribed medication after a cardiac event.
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6.
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7.
  • Almerud, Sofia, et al. (författare)
  • Acute coronary syndrome : social support and coping ability on admittance
  • 2008
  • Ingår i: British Journal of Nursing. - London : Mark Allen. - 0966-0461. ; 17:8, s. 527-531
  • Tidskriftsartikel (refereegranskat)abstract
    • Aim: To compare social support and coping ability in acute coronary syndrome patients at the time of the cardiac event with a healthy community-based sample, with regard to age, sex, education and marital status.Method: The study comprised 241 patients and 316 healthy controls. The participants answered a self-administered questionnaire that included three well-established scales. Multiple logistic regression was used in the analysis to compare the health situation between the patients and controls.Results: Persons suffering from acute coronary syndrome rated emotional support significantly lower than the healthy controls. However, there were no differences between the two groups in terms of socio-demographic variables.Conclusion: This study indicates that social support may be a predictor of acute coronary syndrome.
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8.
  • Almerud, Sofia, et al. (författare)
  • Beleaguered by technology : care in technologically intense environments.
  • 2008
  • Ingår i: Nursing Philosophy. - 1466-7681. ; 9:1, s. 55-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients' lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.
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9.
  • Almerud, S, et al. (författare)
  • Beleuguered by technology - Care in technologically intense environments
  • 2008
  • Ingår i: Nursing Philosophy. - 1466-7681. ; :9, s. 55-61
  • Tidskriftsartikel (refereegranskat)abstract
    • Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients’ lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.
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10.
  • Almerud, S, et al. (författare)
  • Caught in an artificial split : a phenomenological study of being a caregiver in the technologically intense environment.
  • 2008
  • Ingår i: Intensive & Critical Care Nursing. - 0964-3397. ; 24:2, s. 130-136
  • Tidskriftsartikel (refereegranskat)abstract
    • A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle 'moments' of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs
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