| 31. |
- Pettersen, T., et al.
(author)
-
Sex differences in incidence of self-reported adverse drug reactions after percutaneous coronary intervention
- 2023
-
In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 44:Supplement_2
-
Journal article (peer-reviewed)abstract
- BackgroundDespite experiencing adverse drug reactions (ADRs) more often than men, the proportion of women participating in clinical drug trials is low. Thus, evidence for sex differences in the incidence of ADRs is limited.AimTo determine sex differences in incidence of self-reported ADRs after percutaneous coronary intervention (PCI). Further, to determine whether receiving information about ADRs is associated with sex.MethodsCONCARDPCI is a prospective multicentre cohort study (N=3417) conducted at seven referral PCI centres in two Nordic countries. Clinical data were collected from patients’ medical records. Socio-demographic characteristics were obtained by self-report after PCI. Two questions from the Heart Continuity of Care Questionnaire (HCCQ) were used to determine if information about potential ADRs was received before hospital discharge. De novo created questions were used to determine if patients reported ADRs from prescribed therapy. Questionnaires were distributed two- (T1), six- (T2), and twelve months (T3) after hospital discharge to assess the incidence of self-reported ADRs in a longitudinal perspective. Logistic regression was utilised to scrutinize the aims, reported as odds ratios (ORs) with 95% confidence intervals (CIs).ResultsPatients were predominantly male (78%), with a mean age of 65 years (SD 11). Female patients were older (68, SD 10). Acute coronary syndrome was the most frequent cause of admission for PCI (62%). At T1, 2656 of the included patients responded to the questions from the HCCQ. Of these, 1019 patients (39%) reported being informed of potential ADRs from prescribed therapy, 1075 patients (42%) reported not having been informed, 511 patients (20%) reported ‘Hard to decide’, and 51 (2%) reported ‘Not applicable’. Patients reporting ‘Hard to decide’ or ‘Not applicable’ were excluded from further analysis. Women were less likely to receive information than men (OR 0.58, CI 0.45 – 0.75, p<0.001). For the total study population, 42%, 49% and 40% reported ADRs at T1-T3 respectively. After adjusting for sociodemographic and clinical variables, the incidence of self-reported ADRs were significantly higher in women compared to men at T1 (OR 1.71, CI 1.36 – 2.15, p<0.001), T2 (OR 1.89, CI 1.49 – 2.38, p<0.001), and T3 (OR 1.79, CI 1.40 – 2.28, p<0.001).ConclusionWomen report significantly more ADRs from prescribed therapy than men after PCI. However, they are less likely to receive information about potential ADRs compared to men. Efforts to improve communication on ADRs and gender equity should be a priority.
|
|
| 32. |
- Rasmussen, Anne Ankerstjerne, et al.
(author)
-
Gender differences in patient-reported outcomes in patients with acute myocardial infarction
- 2022
-
In: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 21:8, s. 772-781
-
Journal article (peer-reviewed)abstract
- Aims Women report worse health-related patient-reported outcomes (PROs) compared with men following acute myocardial infarction (AMI). However, this association is not well established when accounting for demographic and clinical patient characteristics at discharge. This knowledge is essential for clinicians when planning individualised care for patients following AMI. The aim of this study is to examine whether gender is associated with health-related PROs at discharge from a Danish heart centre, combining PROs with data from the national health and administrative registries. Methods and results A cross-sectional study of 2131 patients with AMI discharged from a Danish heart centre responding to the following health-related PRO questionnaires: the Health-survey Short-Form-12 (SF-12), generating a physical component summary (PCS) and a mental component summary (MCS) score; the HeartQoL, providing a global, emotional, and physical score; the EuroQol five-dimensional questionnaire (EQ-5D-5L) and the EQ visual analogue scale (EQ VAS); the Hospital Anxiety and Depression Scale (HADS), generating an anxiety and depression score (HADS-A and HADS-D); the Edmonton Symptom Assessment Scale (ESAS); the Brief Illness Perception Questionnaire (B-IPQ). Patient-reported outcomes were linked to registry-based information adjusting for potential demographic and clinical confounding factors. In adjusted regression models, women reported worse health-related PROs compared with men in SF-12 PCS and SF-12 MCS, HeartQoL global, the HeartQoL emotional and HeartQoL physical score, EQ-5D-5L and EQ VAS, the HADS-A, ESAS, and in six out of eight B-IPQ items. Conclusions Women reported worse health-related PROs compared with men. Health-related PROs have the potential to be further investigated to facilitate a more individualised healthcare follow-up after AMI.
|
|
| 33. |
- Svensson, Anders, 1977-, et al.
(author)
-
Using firefighters as medical first responders to shorten responsetime in rural areas in Sweden
- 2020
-
In: The Australian journal of rural health. - : John Wiley & Sons. - 1038-5282 .- 1440-1584. ; 28:1, s. 6-14
-
Journal article (peer-reviewed)abstract
- Objective: To map out and describe an earlier response by using firefighters as medical first responders on while waiting for the ambulance and first incident person assignments focusing on frequency, event time and survival >30 days after performed cardiopulmonary resuscitation.Design: Retrospective descriptive design.Setting: Ambulance service in a county of southern Sweden with a population of 200 000 inhabitants (23/km2).Participants: Data were collected from four data systems within different organizations; emergency medical communication centre, fire deparment, ambulance services and county hospital analysis unit.Main outcome measure(s): Data from 600 while waiting for the ambulance assignments, whereof 120 with first incident person present, collected between 1 January 2012 and 31 December 2016. Between 1 June 2014 and 1 October 2015, the two fire departments were dually dispatched on out-of-hospital cardiac arrests.Results: Three main findings were made: there was a prolonged process time for dispatching fire fighters on while waiting for the ambulance assignments. Dual dispatches did not shorten the process time for dispatching full-time firefighters, and, in a majority of while waiting for the ambulance assignments where cardiopulmonary resuscitation was performed, firefighters or first incident persons arrived first on the scene.Conclusion: Minimising every minute that delays the performance of life-saving actions is crucial. By dispatching firefighters on while waiting for the ambulance assignments in rural areas, the response time in a majority of assignments was shortened. However, there was substantial delay in dispatching firefighters due to prolonged process time at the emergency medical communication centre. The emergency medical communication centre operator's ability to quickly assess the need for while waiting for the ambulance assignments plays a crucial role in the chain of survival.
|
|
| 34. |
- Valaker, Irene, et al.
(author)
-
Continuity of care and its associations with self-reported health, clinical characteristics and follow-up services after percutaneous coronary intervention
- 2020
-
In: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 20:1
-
Journal article (peer-reviewed)abstract
- Aims: Complexity of care in patients with coronary artery disease is increasing, due to ageing, improved treatment, and more specialised care. Patients receive care from various healthcare providers in many settings. Still, few studies have evaluated continuity of care across primary and secondary care levels for patients after percutaneous coronary intervention (PCI). This study aimed to determine multifaceted aspects of continuity of care and associations with socio-demographic characteristics, self-reported health, clinical characteristics and follow-up services for patients after PCI. Methods: This multi-centre prospective cohort study collected data at baseline and two-month follow-up from medical records, national registries and patient self-reports. Univariable and hierarchical regressions were performed using the Heart Continuity of Care Questionnaire total score as the dependent variable. Results: In total, 1695 patients were included at baseline, and 1318 (78%) completed the two-month follow-up. Patients stated not being adequately informed about lifestyle changes, medication and follow-up care. Those experiencing poorer health status after PCI scored significantly worse on continuity of care. Patients with ST-segment elevation myocardial infarction scored significantly better on informational and management continuity than those with other cardiac diagnoses. The regression analyses showed significantly better continuity (P <= 0.034) in patients who were male, received written information from hospital, were transferred to another hospital before discharge, received follow-up from their general practitioner or had sufficient consultation time after discharge from hospital. Conclusion: Risk factors for sub-optimal continuity were identified. These factors are important to patients, healthcare providers and policy makers. Action should be taken to educate patients, reconcile discharge plans and organise post-discharge services. Designing pathways with an interdisciplinary approach and shared responsibility between healthcare settings is recommended.
|
|
| 35. |
- Wallin, Kim, Doktorand, 1978-, et al.
(author)
-
The ways specialist nursing students understand the work in the ambulance service - a national Swedish phenomenographic study
- 2022
-
In: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis Group. - 1748-2623 .- 1748-2631. ; 17:1
-
Journal article (peer-reviewed)abstract
- ObjectiveTo explore and describe the ways specialist ambulance nursing (SAN) students understand the work in the ambulance service.Design, sample, and measurementsAn explorative descriptive design was carried out through individual interviews with 16 SAN students from all parts of Sweden and analysed in accordance with the phenomenographic tradition.FindingsFive different ways of understanding the work were described and each was assigned a metaphor; The medical role; The practical role; The patient-oriented role; The commanding role; and The comprehensive role. Several aspects concerning personal, organizational, and situational conditions affecting the understanding and the distribution of these roles in the specific care assignment were identified and presented in a hierarchical model of the outcome space.ConclusionsThis study contributes with a new perspective on supporting role clarity for registered nurses (RN) working in the ambulance service (AS). Specialization and experiential learning are needed to support an understanding of all aspects of the work in order to develop a professional competence aligned with the challenges faced in the AS. The development of expertise in the AS needs a contextualized understanding rooted in a theoretical framework that addresses a holistic perspective towards patients’ needs.
|
|
| 36. |
- Lantz, Emelie, et al.
(author)
-
Serving the community while balancing multiple responsibilities – experiences of working as a paid part-time firefighter
- 2023
-
In: International Journal of Emergency Services. - 2047-0894. ; 12:1, s. 17-28
-
Journal article (peer-reviewed)abstract
- Purpose: The purpose of this study was to describe experiences of working as a paid part-time firefighter (PTF) in Swedish rural areas. Design/methodology/approach: An inductive explorative design was used, based on interviews with 18 paid PTFs in Sweden. Data were analyzed using qualitative latent content analysis. Findings: Three themes emerged from the interviews and describe paid PTFs’ experiences. The findings provide insights into how firefighters share a strong commitment, how support plays a crucial role, and how training and call-outs contribute to their experiences. Paid PTFs’ experiences are nuanced, ranging from personal limitations and challenges to satisfaction and the contrast with ordinary life. Practical implications: The implications for fire and rescue service organizations are that they can encourage firefighters’ commitment and pride, as well as the commitment and support of their families and main employers. Further, highlighting the importance of support and facilitating flexibility when on call is crucial. Finally, acknowledging and promoting personal development and facilitating an inclusive culture are important factors for both motivation and satisfaction. Originality/value: Paid PTFs are under-represented in the literature, despite the reliance on them in Sweden, and this study begins to address the knowledge gap. To improve retention, it is vital to understand paid PTFs work situation: what motivates them, what barriers they face, and how those challenges influence their experiences.
|
|
