1.
Schmidt, Manuela, et al.
(författare)
Clinical profiles and temporal patterns of psychiatric emergency room visitors in Sweden
2018
Ingår i: Nordic Journal of Psychiatry. - : Taylor & Francis. - 0803-9488 .- 1502-4725. ; 72:3, s. 197-204
Tidskriftsartikel (refereegranskat) abstract
AIMS: To describe persons visiting the psychiatric emergency room (PER) in Sweden and to compare persons who frequently (PFV) and infrequently (PIFV) visit PERs in terms of group size, age, gender, PER location inside versus outside the home municipality, diagnosis (ICD 10), temporal patterns of visits and hospital admissions.METHODS: This register study included all visits to PERs in one Swedish county over 3 years, 2013-2015 (N = 67,031 visits). The study employed descriptive statistics as well as Chi-square tests combined with Bonferroni correction to compare PFV with PIFV.RESULTS: Of the total of 27,282 visitors, 2201 (8.1%) were identified as PFV (five or more visits within 12 months) and they accounted for 38.1% of the total visits. The study found differences between PFV and PIFV in gender, diagnostic profile, hospital admissions and temporal patterns. Differences were also detected with regard to distance between PERs and home municipalities. However, no age-related differences were found between the two groups.CONCLUSIONS: PFV and PIFV have different clinical profiles and temporal patterns. These results may be important when planning, developing and evaluating interventions targeting the needs of each group, which is in accordance with a person-centred approach. Such an approach might eventually result in fewer visits to PERs.
2.
Stiernman, Mia, et al.
(författare)
Translation and pilot study of the Cleft Hearing Appearance and Speech Questionnaire (CHASQ)
2019
Ingår i: European Journal of Plastic Surgery. - : Springer Science and Business Media LLC. - 0930-343X .- 1435-0130. ; 42:6, s. 583-592
Tidskriftsartikel (refereegranskat) abstract
Background: There has been a lack of a standardized protocol for collection of patient reported outcomes (PRO) and detection of and indication for psychological treatment in cleft care. The objectives of this paper was to translate Cleft Hearing Appearance and Speech Questionnaire (CHASQ) into eight European languages, to investigate whether levels of PRO in patients with cleft lip and/or cleft palate (CL/P) were comparable across countries and to investigate clinician experience of the instrument. Methods: The PRO measure—CHASQ—was translated into Bulgarian, Estonian, Greek, Latvian, Macedonian, Romanian, Serbian and Swedish and implemented with patients in the respective countries. A focus group discussion was conducted to investigate health care professional experience on the use of CHASQ in their clinics. Data was analysed in accordance with the principles of thematic analysis. Results: Analysis showed statistically significant differences between countries and groups of diagnosis in CHASQ scores. CHASQ helped clinicians gain patient information and informed on treatment decisions, broadened the clinicians’ role as caregivers and was perceived as short and easy to use. Limited time and resources in clinics were limitations in implementing the instrument. Conclusions: Translation and utilization of CHASQ facilitated international comparison and cooperation. Linguistically, valid replicas of CHASQ are now available in many European languages. Results from this study show that CHASQ may be used for collection of PRO on patient satisfaction and to spark conversation between clinicians, patients and families. Level of evidence: Not rateable.
3.
Beck, Ingela, et al.
(författare)
Translation and cultural adaptation of the Integrated Palliative care Outcome Scale including cognitive interviewing with patients and staff
2017
Ingår i: BMC Palliative Care. - : Springer Science and Business Media LLC. - 1472-684X. ; 16:1
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: To expand our clinical and scientific knowledge about holistic outcomes within palliative care, there is a need for agreed-upon patient-reported outcome measures. These patient-reported outcome measures then require translation and cultural adaptation, either from country-specific languages to English, or the other way around. The aim of this study was to translate and cross-culturally adapt the Integrated Palliative care Outcome Scale (IPOS) to the Swedish care context.METHODS: Swedish versions of IPOS Patient and IPOS Staff were developed and culturally adapted using recommended guidelines including cognitive interviews with patients (n = 13) and staff (n = 15) from different care contexts including general and specialised palliative care.RESULTS: The comprehension and judgement difficulties identified in the pre-final patient and staff versions were successfully solved during the cognitive interviewing process. IPOS was well accepted by both patients and staff, none of the questions were experienced as inappropriate, and all questions were judged important.CONCLUSIONS: In this study, we translated and culturally adapted the patient and staff versions of IPOS, and demonstrated face and content validity and acceptability of the scale through cognitive interviewing with patients and staff within residential care facility, surgical and specialised palliative home care units. Cognitive interviewing in parallel with patients and staff in rounds, with tentative analysis in between, was a suitable method for identifying and solving challenges with comprehension and evaluation in the pre-final version of IPOS. The Swedish IPOS is now available for use in a variety of clinical care settings.
4.
Bellander, Lisa, et al.
(författare)
Oral assessment and preventive actions within the swedish quality register senior alert: Impact on frail older adults’ oral health in a longitudinal perspective
2021
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:24
Tidskriftsartikel (refereegranskat) abstract
Poor oral health is common among older people in nursing homes. To identify and prevent oral health problems among the residents, ROAG-J (Revised Oral Assessment Guide–Jönköping), a risk-assessment instrument, is used by nursing staff routinely, and the outcome is registered in the web-based Swedish quality register Senior Alert. This study aims to investigate the preventive actions registered when oral health problems are identified and the effect of these actions longitudinally. ROAG-J data registered at nursing homes in Sweden during 2011–2016 were obtained from the Senior Alert database. Out of 52,740 residents (≥65 years), 41% had oral health problems, of whom 62% had preventive actions registered. The most common action was “Assistance with cleaning teeth”. Longitudinally, during the five-year observation period, a slight increase in oral health problems assessed with ROAG-J was found. Registered preventive actions, however, led to significant improvement in the subsequent assessment for the ROAG items lips, tongue, and dentures. Standardised risk assessments like ROAG-J provide an opportunity to detect problems early and establish preventive actions. The study, however, indicates a further need for structured education and a continuous follow-up in ROAG-J. Moreover, increased collaboration between nursing and dental care to improve oral health for older residents at nursing homes is needed.
5.
Jonsson, Oskar, et al.
(författare)
Understanding the wicked problem of providing accessible housing for the ageing population in Sweden
2021
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:3
Tidskriftsartikel (refereegranskat) abstract
While accessible housing is known as important to promote healthy ageing, the societal issue of providing accessible housing for the ageing population bears the characteristics of a “wicked problem”. The aim of this study was to gain a better understanding of crucial variables for decision-making about the provision of accessible housing for the ageing population in Sweden. Materials used for a deductive content analysis were elicited through a research circle involving three researchers and twelve non-academic representatives. Brown and colleagues’ conceptual five-dimension framework to address wicked problems was used for the understanding of crucial variables in decision-making about housing provision. The findings show that such reasoning is dominated by the socioeconomic dimension. Findings in the biophysical dimension reveal well-known challenges pertaining to the definition and interpretation of the concept of accessibility and its operationalization. The dimensions are intertwined in a complex manner, which is essential for effective and efficient decision-making. The findings could make decision-makers aware of the diversity of individual thinking involved when addressing this wicked problem. Acting upon the crucial variables identified in this study could contribute to progressive decision-making and more efficient ways to develop and provide accessible housing to promote health ageing.
6.
Lind, Susanne, et al.
(författare)
The integrated palliative care outcome scale for patients with palliative care needs : Factors related to and experiences of the use in acute care settings
2019
Ingår i: Palliative & Supportive Care. - 1478-9515 .- 1478-9523. ; 17:5, s. 561-568
Tidskriftsartikel (refereegranskat) abstract
ObjectiveImplementation of patient-reported outcome measures for patients with palliative care needs is characterized by both enablers and barriers. The ways in which healthcare professionals experience the use of assessment tools is important. Our aims were to explore factors contributing to or hindering patients with palliative care needs in assessing their symptoms with the Integrated Palliative Care Outcome Scale (IPOS) and to explore healthcare professionals' experiences of the use of IPOS in acute care settings.MethodData were collected as a part of the evaluation of the feasibility of an implementation strategy for introducing IPOS. Data from three participating acute care units were included. We used descriptive and analytical statistics; a qualitative content analysis was also performed.ResultA total of 309 patients were eligible to be offered assessment of symptoms with IPOS. Of these 69 (22%) had completed IPOS. A significant positive association was found between healthcare professionals' participation in training sessions and completed IPOS. The experiences of IPOS were split into two categories: "IPOS acting as a facilitator" and "barriers to the use of IPOS." The use of IPOS was described as contributing to person-centered care of patients with palliative care needs and inspiration to improved routines. Healthcare professionals' feelings of uncertainty about how to approach severely ill patients and their family members appear to have hindered their use of IPOS.Significance of resultsWe found an association between healthcare professionals' participation in training sessions and patients who completed IPOS, indicating the need for a high degree of attendance at the training to achieve successful implementation. The healthcare professionals expressed feelings of insecurity concerning the use of IPOS indicating a need for further education and clinical support in its use of IPOS. Nevertheless, use of IPOS was considered to contribute to improved care of patients with palliative care needs.
7.
Lilja Andersson, Petra, et al.
(författare)
Ethical aspects of undergoing a predictive genetic testing for Huntington's disease
2013
Ingår i: Nursing ethics. - : SAGE Publications. - 1477-0989 .- 0969-7330. ; 20:2, s. 189-199
Tidskriftsartikel (refereegranskat) abstract
The aim of this study was to describe the experiences of undergoing a presymptomatic genetic test for the hereditary and fatal Huntington’s disease, using a case study approach. The study was based on 18 interviews with a young woman and her husband from the decision to undergo the test, to receiving the results and trying to adapt to them, which were analysed using a life history approach. The findings show that the process of undergoing a presymptomatic test involves several closely connected ethical and medical questions, such as the reason for the test, the consequences of the test results and how health-care services can be developed to support people in this situation.
8.
Garmy, Pernilla, et al.
(författare)
Utvärdering av ett samverkansprojekt mellan Cancerreahbiliteringsmottagningen och Försäkringskassan i Kristianstad
2016
Bok (övrigt vetenskapligt/konstnärligt) abstract
Cancerrehabilitering ska vara en integrerad del av svensk cancervård och alla patienter med cancer och deras närstående ska få möjlighet till rehabiliteringsinsatser utifrån sina individuella behov. Försäkringskassans uppdrag är att besluta om och betala ut en stor del av de förmåner som ingår i socialförsäkringen. För att förbättra bemötandet av sjukskrivna personer med cancer, utsågs två handläggare på Försäkringskassan att inrikta sig på sjukskrivna personer med cancer. Dessa två handläggare fick extra utbildning i ämnet, och ett samarbete inleddes mellan Försäkringskassan och cancerrehabiliteringsmottagningen på Centralsjukhuset i Kristianstad. Det övergripandesyftet med studien var att undersöka patienters och medarbetares erfarenheter och upplevelser av Försäkringskassans och Cancerrehabiliteringsmottagningens insatser. Utvärderingens form har teoretiskt inspirerats av metoder som beskriver vikten av att forskningspersoner görs delaktiga i forskning och utvärdering och därmed bidrar till kunskapsutveckling. Datainsamlingen bestod av enkäter och fokusgruppsintervjuer och både kvantitativa och kvalitativa analyser har använts. Slutsatsen är att patienterna är övervägande nöjda med bemötandet från såväl handläggarna på Försäkringskassan och på Cancerrehabiliteringsmottagningen, men att mer insatser krävs för att nå alla patienter.
9.
Norlin, Jenny M., et al.
(författare)
Clinical Impression of Severity Index for Parkinson's Disease and Its Association to Health-Related Quality of Life
2022
Ingår i: Movement Disorders Clinical Practice. - : John Wiley and Sons Ltd. - 2330-1619.
Tidskriftsartikel (refereegranskat) abstract
Background: Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD) is a simple tool that can easily be used in clinical practice. Few studies have investigated the relationship between health-related quality of life and the CISI-PD. Objective : To analyze the association of CISI-PD scores with those of generic (EQ-5D-5L) and Parkinson's disease (PD) disease-specific (Parkinson's Disease Questionnaire–8 [PDQ-8]) health-related quality of life assessments. Methods : Persons with idiopathic PD in the Swedish Parkinson's Disease registry with simultaneous registrations of CISI-PD and EQ-5D-5L and/or PDQ-8 were included. Correlations with EQ-5D dimensions were analyzed. The relationships between the CISI-PD, EQ-5D-5L, and PDQ-8 were estimated by linear mixed models with random intercept. Results : In the Swedish Parkinson's Disease registry, 3511 registrations, among 2168 persons, fulfilled the inclusion criteria. The dimensions self-care, mobility, and usual activities correlated moderately with the CISI-PD (rs = 0.60, rs = 0.54, rs = 0.57). Weak correlations were found for anxiety/depression and pain/discomfort (rs = 0.39, rs = 0.29) (P values < 0.001). The fitted model included the CISI-PD, age, sex, and time since diagnosis. The CISI-PD had a statistically significant impact on the EQ-5D and PDQ-8 (P values < 0.001). Conclusions : The CISI-PD provides a moderate correlation with the EQ-5D and could possibly be useful as a basis for defining health states in future health economic models and serving as outcomes in managed entry agreements. Nonetheless, the limitation of capturing nonmotor symptoms of the disease remains a shortcoming of clinical instruments, including the CISI-PD.
10.
Kumlien, Christine, et al.
(författare)
Evaluation of self-management program outcomes: Adaptation and testing of a Swedish version of the Health Education Impact Questionnaire (heiQ)
2018
Ingår i: Journal of Applied Measurement. - : JAM Press. - 1529-7713. ; 19:3, s. 303-319
Tidskriftsartikel (refereegranskat) abstract
Self-management programs require a range of indicators to evaluate their outcomes. The Health Education Impact Questionnaire (heiQ) was developed to meet this need. The heiQ contains 40 items with 4 response categories, representing eight scales. We developed a Swedish version of the heiQ that was tested by cognitive interviews (n=15) and psychometrically (n=177) using classical test theory (CTT) and Rasch measurement theory (RMT). The Swedish heiQ was easily understood by interviewees and met CTT criteria, with supported scaling assumptions (corrected item-total correlations, ≥0.37) and reliability (ordinal alpha ≥0.78). General support was demonstrated for the measurement properties of the eight heiQ scales by acceptable RMT fit. However, there were signs of malfunctioning response categories for four items in two scales, and of suboptimal item coverage of the measurement continua. The Swedish heiQ appears comparable to other available language versions. Further efforts may be needed to optimize response categories and measurement precision.
