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  • 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.
  • 2008
  • Ingår i: Intensive & Critical Care Nursing. - 0964-3397 .- 1532-4036. ; Aug 7
  • 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 (r(s)>0.5). Internal consistency was shown to be reliable (Cronbach's alpha 0.70-0.85). Stability reliability on retesting was good for the physical and psychosocial sets (r(s)>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.
  • 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. - Elsevier. - 1878-1721 .- 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. <br /> <br /> METHOD: <br /> 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. <br /> <br /> RESULTS: <br /> 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. <br /> <br /> CONCLUSION: <br /> 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.
  • Akerman, Eva, et al. (författare)
  • Psychometric evaluation of 3-set 4P questionnarie
  • 2013
  • Ingår i: Intensive & Critical Care Nursing. - Elsevier. - 0964-3397. ; 29:1, s. 40-47
  • Tidskriftsartikel (refereegranskat)abstract
    • This is a further development of a specific questionnaire, the 3-set 4P, to be used for measuring former ICU patients’ physical and psychosocial problems after ICU and the need for follow-up. The aim was to psychometrically test and evaluate the 3-set 4P questionnaire in a larger population. The questionnaire consists of three sets: “physical”, “psychosocial” and “follow-up”. The questionnaires were sent by mail to all patients with &gt;24 hour length of stay at four ICUs in Sweden. Construct validity was measured with exploratory factor analysis with varimax rotation resulting in “physical set” three factors, “psychosocial set” five factors and “follow-up set” four factors with strong factor loadings and a total explained variance of 62 - 77.5%. Thirteen questions in the SF-36 were used for concurrent validity showing Spearman’s rs 0.3-0.6 in eight and &lt;0.2 in five questions. Test-retest was used for stability reliability. In set follow-up the correlation was strong to moderate and in physical and psychosocial sets the correlations were moderate to fair. This could be due to that the physical and psychosocial status changed rapidly during the test period. All three sets had good homogeneity. In conclusion, the 3-set 4P showed overall acceptable results, but it has to be further modified in different cultures before being an instrument which may be fully operational in clinical practice. 
  • Akerman, Eva, et al. (författare)
  • Use and practice of patient diaries in Swedish intensive care units: a national survey.
  • 2010
  • Ingår i: Nursing in Critical Care. - 1362-1017 .- 1478-5153. ; 15:1, s. 26-33
  • Tidskriftsartikel (refereegranskat)abstract
    • AIMS AND OBJECTIVES: To describe and compare the extent and application of patients&#39; diaries in Sweden. BACKGROUND: Since 1991, patient diaries have been used in intensive care unit (ICU) follow-up in Sweden. There is paucity of relevant data evaluating the effect of this tool and also on what premises patients are enrolled. Likewise, data are sparse on the diaries&#39; design, content structure and the use of photographs. DESIGN: Descriptive explorative design by a semi-structured telephone interview. METHODS: The interview results were analysed with descriptive statistics and differences between the ICU levels were explored by chi(2) analysis. Qualitative manifest content analysis was performed to explore the purpose of diary writing. RESULTS: Of all ICUs (n = 85), 99% responded and 75% used diaries. The source of inspiration was collegial rather than from scientific data. The main reason for keeping a diary was to help the patient to recapitulate the ICU stay. Discrepancies between the different levels of ICUs were detected in patient selection, dedicated staff for follow-up and the use of photographs. Comparison between the chi(2) analysis and the content analysis outcome displayed incongruence between the set unit-goals and the activities for achievement but did not explain the procedural differences detected. CONCLUSION: The uses of diaries in post ICU follow up were found to be common in Sweden. A majority used defined goals and content structure. However, there were differences in practice and patient recruitment among the levels of ICUs. These discrepancies seemed not to be based on evidence-based data nor on ongoing research or evaluation but merely on professional judgement. As ICU follow-up is resource intense and time consuming, it is paramount that solid criteria for patient selection and guidelines for the structure and use of diaries in post-ICU follow-up are defined.
  • Al-Azawy, Mawahib, et al. (författare)
  • Premedication and preoperative information reduces pain intensity and increases satisfaction in patients undergoing ablation for atrial fibrillation : A randomised controlled study
  • 2015
  • Ingår i: Applied Nursing Research. - 0897-1897. ; 28:4, s. 268-273
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundPain and discomfort are common during radiofrequency ablation (RFA) for atrial fibrillation.AimsTo compare and evaluate the effect of premedication, standardised preoperative information and preoperative anxiety on pain intensity, drug consumption and patients’ satisfaction.MethodsPreoperative anxiety at baseline, pain intensity during RFA, and patient satisfaction after the procedure were measured in 3 random groups. Group A (n = 20) received standard pain management, group B (n = 20) received premedication and group C (n = 20) received premedication and standardised preoperative information.ResultsPatients in groups B and C experienced less pain intensity (p &lt; 0.001) and needed fewer anxiolytics (p = 0.023) and analgesics (p = 0.031) compared to group A. Patient satisfaction was higher in group C (p = 0.005) compared to group A. Increased preoperative anxiety is related to elevated drug demand (p &lt; 0.05).ConclusionPremedication alone or combined with preoperative information reduces and higher preoperative anxiety increases pain intensity and drug consumption during RFA. Preoperative information improves patient satisfaction.
  • 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.
  • Algurén, Beatrix, et al. (författare)
  • Factors Associated With Health-Related Quality of Life After Stroke : A 1-Year Prospective Cohort Study
  • 2012
  • Ingår i: Neurorehabilitation and Neural Repair. - 1545-9683. ; 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.
  • 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. - 1550-5049 .- 0889-4655. ; 21:5, s. 24-31
  • 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&#39; 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.
  • Almerud, S, 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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