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  • Jakobsson, Sofie, et al. (författare)
  • Performance of the Swedish version of the Revised Piper Fatigue Scale.
  • 2013
  • Ingår i: European journal of oncology nursing : the official journal of European Oncology Nursing Society. - 1532-2122. ; 17:6, s. 808-13
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The Revised Piper Fatigue scale is one of the most widely used instruments internationally to assess cancer-related fatigue. The aim of the present study was to evaluate selected psychometric properties of a Swedish version of the RPFS (SPFS).METHODS: An earlier translation of the SPFS was further evaluated and developed. The new version was mailed to 300 patients undergoing curative radiotherapy. The internal validity was assessed using Principal Axis Factor Analysis with oblimin rotation and multitrait analysis. External validity was examined in relation to the Multidimensional Fatigue Inventory-20 (MFI-20) and in known-groups analyses.RESULTS: Totally 196 patients (response rate = 65%) returned evaluable questionnaires. Principal axis factoring analysis yielded three factors (74% of the variance) rather than four as in the original RPFS. Multitrait analyses confirmed the adequacy of scaling assumptions. Known-groups analyses failed to support the discriminative validity. Concurrent validity was satisfactory.CONCLUSION: The new Swedish version of the RPFS showed good acceptability, reliability and convergent and- discriminant item-scale validity. Our results converge with other international versions of the RPFS in failing to support the four-dimension conceptual model of the instrument. Hence, RPFS suitability for use in international comparisons may be limited which also may have implications for cross-cultural validity of the newly released 12-item version of the RPFS. Further research on the Swedish version should address reasons for high missing rates for certain items in the subscale of affective meaning, further evaluation of the discriminative validity and assessment of its sensitivity in detecting changes over time.
  • Berg, Linda, et al. (författare)
  • Characterisation of Cancer Support and Rehabilitation Programmes: A Swedish Multiple Case Study
  • 2014
  • Ingår i: The open nursing journal. - 1874-4346. ; 8, s. 1-7
  • Tidskriftsartikel (refereegranskat)abstract
    • Cancer support and rehabilitation are suggested to be an integral part of cancer care strategies. This study focuses on comparativeness of cancer support and rehabilitation programmes. The aim of this study was to analyse available cancer support and rehabilitation programmes in Sweden presented as complementary to cancer rehabilitation at cancer clinics. A multiple case study design was chosen in order to inquire the small number of existing supportive and rehabilitative cancer programmes. Based on the structures, processes and outcomes of the nine included programmes, three types of cancer support and rehabilitation programmes were identified: multimodal rehabilitation, comprehensive cancer support and art therapy. Cancer support and rehabilitation programmes offer a variety of activities and therapies which are highly valuable and relevant for people with cancer. The typology of cancer support and rehabilitation programmes and comparability between programmes need further inquiry.
  • Flink, Maria, et al. (författare)
  • Measuring care transitions in Sweden validation of the care transitions measure
  • 2018
  • Ingår i: International Journal for Quality in Health Care. - Oxford University Press. - 1353-4505. ; 30:4, s. 291-297
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To translate and assess the validity and reliability of the original American Care Transitions Measure, both the 15-item and the shortened 3-item versions, in a sample of people in transition from hospital to home within Sweden.Design: Translation of survey items, evaluation of psychometric properties.Setting: Ten surgical and medical wards at five hospitals in Sweden.Participants: Patients discharged from surgical and medical wards.Main outcome measure: Psychometric properties of the Swedish versions of the 15-item (CTM-15) and the 3-item (CTM-3) Care Transition Measure.Results: We compared the fit of nine models among a sample of 194 Swedish patients. Cronbach's alpha was 0.946 for CTM-15 and 0.74 for CTM-3. The model indices for CTM-15 and CTM-3 were strongly indicative of inferior goodness-of-fit between the hypothesized one-factor model and the sample data. A multidimensional three-factor model revealed a better fit compared with CTM-15 and CTM-3 one factor models. The one-factor solution, representing 4 items (CTM-4), showed an acceptable fit of the data, and was far superior to the one-factor CTM-15 and CTM-3 and the three-factor multidimensional models. The Cronbach's alpha for CTM-4 was 0.85.Conclusions: CTM-15 with multidimensional three-factor model was a better model than both CTM-15 and CTM-3 one-factor models. CTM-4 is a valid and reliable measure of care transfer among patients in medical and surgical wards in Sweden. It seems the Swedish CTM is best represented by the short Swedish version (CTM-4) unidimensional construct.
  • Lundgren Nilsson, Åsa, 1965-, et al. (författare)
  • Validation of Fatigue Impact Scale with various item sets – a Rasch analysis
  • 2019
  • Ingår i: Disability and Rehabilitation. - 0963-8288 .- 1464-5165. ; 41:7, s. 840-846
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group Purpose: Fatigue is a symptom in patients with chronic gastrointestinal (GI) and liver diseases. Different instruments have been developed to assess the severity of fatigue and the 40-item Fatigue Impact Scale (FIS) is among the most widely used. Shorter versions of FIS include the 21-item Modified Fatigue Impact Scale (MFIS), and an eight-item version for everyday use. The study aimed to assess construct validity, reliability, and sufficiency of the raw score of the original FIS with 40 items, and examine the sufficiency of the 21 items from the Modified scale and the eight items of the Daily Fatigue Impact Scale (D-FIS), all of which are embedded in the 40-item scale. Methods: Patients with chronic GI or liver disease (n = 354) completed the FIS with 40 items. The majority (57%) was under the age of 55 years and approximately half were females (48%). Various item sets of FIS were derived which showed fit to the Rasch model. Results: Local dependency and multidimensionality in FIS and the 21-item Modified scale were resolved with a testlet solution but the D-FIS showed local dependency and multidimensionality and differential item functioning (DIF) still remained. Two new item sets fulfilling unidimensionality and no DIF are suggested, one with 15 items and a six-item scale for daily use. The transformation table shows score-interval scale estimates for all these item sets. Conclusions: Both the FIS and the Modified scale can be used to measure fatigue albeit requiring some adjustment for DIF. The eight-item D-FIS is more problematic, and its summed score is not valid. Alternative 15- and 6-item versions presented in this paper can offer valid summed scores, and the transformation table allows transformation of raw scores and comparisons across all versions.Implications for rehabilitationThe Fatigue Impact Scale and the Modified Fatigue Impact Scale can be used to measure fatigue after adjustments for differential item functioning.Alternative 15- and 6-item versions of Fatigue Impact Scale offer valid summed scores. The summed score for the Daily Fatigue Impact Scale is not valid.A transformation table with raw scores and Rasch transformed interval scale metric makes it possible to compare scores derived from the Fatigue Impact Scale, the Modified Fatigue Impact Scale and the proposed 15- and 6-item versions of Fatigue Impact Scale for research and/or clinical use.
  • Skärsäter, Ingela, 1952-, et al. (författare)
  • Web-based Support in Long-term Illness – a Person-centred Care Approach
  • 2013
  • Ingår i: Medicine 2.0, 6th World Congress on Social Media, Mobile Apps, Internet/Web 2.0. London, GB; September 23-24, 2013.
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • Introduction: The abstract outlines a research project that aims to develop and evaluate a person-centred model of web-based learning and support for people with long-term illness. Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare the multi-case project captures persons’ needs and expectations in order to develop highly usable web recourses. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care (PCC).Methods: The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and uro-genital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementa-tion, and analysis. An inductive approach characterizes the analysis of the results of the cases. By means of a step-wise analysis a shared knowledge and understanding of each separate case is created followed by the development of central categories (such as types of needs and expectations, types of theories, conceptual framework, etc).Results: To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people’s experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others.Discussion and Conclusion: Person-centred web-based support is a new area and no available study focus on how web-based interventions can contribute to the further development of PCC. In the four cases within this project the evaluation model is characterized by evaluation of web support in real settings, and data will be analysed using both within-case and across-case statistical analyses. Therefore, our multiple-case method, in which overlapping results from different contexts will provide comprehensive experiences, will contribute to the design of a more generally applicable, individually modifiable model. However, the multiple case method is also a challenge of validity, as the use of different case experiences and environments, involves an endeavor to understand what types of experiences are actually being captured in the process of developing a web-based support and what this means in relation to PCC. In summary, the main intention of the project outlined here is to contribute with both a synthesis of results on meta-level from four cases and a substantial contribution to the field person centred care.
  • Elden, Helen, 1959-, et al. (författare)
  • Demanding and challenging: Men's experiences of living with a pregnant woman with pelvic girdle pain: An interview study
  • 2014
  • Ingår i: Clinical Nursing Studies. - 2324-7940. ; 2:4, s. 17-29
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Pelvic girdle pain (PGP) is a universally disabling condition affecting approximately 50% of pregnant women. Qualitative research describes how PGP leads to struggle in women’s daily lives, makes them question and doubt their roles and identities as professionals and mothers, and test their (marital) relationships. The purpose of this study was to describe men’s experiences of living with a pregnant woman with PGP. Methods: Participants were men whose pregnant partners participated in a project containing both qualitative and quantitative studies in 2009 to 2011. Interviews were conducted in person (n=18) or by telephone (n=8), lasting approximately 20-50 minutes. Sixteen men were interviewed during their wive’s pregnancies (M age = 30 years), eight men were re-interviewed within 12 months postpartum and two men were interviewed only postpartum (26 interviews). Results: Three major categories emerged: having no knowledge of PGP, a period of emotional and physical strain, and merging. Pregnancy in a woman with PGP caused men to alter focus from themselves to their partners and family. They expressed worry, powerlessness, inadequacy, and a need for support. They had to adapt and cope, both demanding and challenging. However, they stressed that relationships with their older children improved, and that they and their partners had succeeded in becoming a team. Conclusions: The findings indicated a need for greater focus from midwives and other health care providers on the psychological impact of PGP on the man/partner. This is important, not only for men but for their respective women as well, whereby men influence their partner’s health.
  • Elden, Helen, 1959-, et al. (författare)
  • Feeling old in a young body: Women’s experiences of living with severe consequences of an obstetric anal sphincter rupture: An interview study.
  • 2014
  • Ingår i: Clinical Nursing Studies. - 2324-7940 .- 2324-7959. ; 3:1, s. 20-28
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The incidence of obstetric anal sphincter rupture (OASR) is increasing. It may cause anal incontinence and dyspareunia, leading to reduced quality of life and wellbeing. Qualitative studies are lacking. The aim was to describe experiences of living with ongoing severe consequences of an OASR 8 weeks after childbirth. Method: Twenty women with ongoing severe consequences of an OASR 8 weeks after delivery were interviewed using qualitative content analysis. Results: The experience of complications of an OASR is described in the overall theme ”Feeling old in a young body” and four categories: The body as injured; isolation; inability to function sexually, and anxiety for the future. Participants described how the consequences of OASR totally occupied their lives, making them feel old in a young body. They told of repercussions for their physical, psychological, sexual and social lives; how it affected their roles of mothers and partners, making them fear future childbirths. Diet, use of medicines, coal filters in incontinence pads, timing of toilet visits, use of the environment and mobile phones to conceal flatus and/or feces were strategies participants described. Conclusions: This study can contribute to increased understanding of how women can be affected by an OASR, and may enable healthcare personnel and authorities to meet their needs and organize care so that adequate support is available. It would also be beneficial if the women’s physical strategies were integrated into the information provided by health caregivers involved in follow-up. However, more research in this area is warranted.
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