| 1. |
- Lindström, Rebecca, et al.
(författare)
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Swedish translation and cultural adaptation of the scored Patient-Generated Subjective Global Assessment (PG-SGA©)—A validated tool for screening and assessing malnutrition in clinical practice and research
- 2024
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 38:3, s. 589-601
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a validated tool for the screening, assessment and monitoring of malnutrition, and triaging of interventions. It contains a patient-generated component and a healthcare professional (HCP)-generated component. Aim: To translate the PG-SGA into Swedish, assess the linguistic and content validity of the Swedish version, and ensure conceptional, semantic and operational equivalence to the original English PG-SGA. Methods: In line with the methodology used in previously translated and culturally adapted versions, the standardised 10-step process suggested by the International Society for Health Economics and Outcomes Research (ISPOR) was followed. In step 7, a cross-sectional study targeting patients n = 51 and HCPs n = 52 was performed at a university hospital in Sweden. Using separate questionnaires, patients assessed the patient component and HCPs, the professional component regarding perceived comprehensibility and difficulty (linguistic validity). The HCPs also assessed perceived relevance (content validity) of all items on the PG-SGA. Item indices for comprehensibility (I-CI), difficulty (I-DI) and content validity (I-CVI) were calculated and averaged into scale indices (S-CI, S-DI and S-CVI). Cut-off standards for item and scale indices were used as reference. Results: The Swedish version of the PG-SGA rated excellent for comprehensibility (S-CI 0.96) and difficulty (S-DI 0.93) for the patient component. The professional component rated acceptable for comprehensibility (S-CI 0.89) and below acceptable for difficulty (S-DI 0.70), with the physical examination rated most difficult (I-DI 0.39 to 0.69). Content validity for the full Swedish PG-SGA was rated excellent (S-CVI 0.94). Conclusion: The patient component was considered clear and easy to complete. The full Swedish PG-SGA was considered relevant by HCPs for screening and assessment of malnutrition. Due to perceived difficulty with the physical examination, training of Swedish HCPs in using the PG-SGA is essential before implementing the professional component into clinical practice or research.
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| 2. |
- Johles, Lis, et al.
(författare)
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Is a Brief Body Scan Helpful for Adolescent Athletes' Sleep Problems and Anxiety Symptoms?
- 2023
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Ingår i: Mindfulness. - : Springer. - 1868-8527 .- 1868-8535. ; 14:6, s. 1522-1530
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThe aim of the studywas to compare the effects of a brief body scan with relaxation as an active control group to better understand their respective contributions to the reduction of sleep problems and anxiety symptoms among adolescent athletes.MethodTwo hundred and six adolescent athletes were recruited during the school year 2016/2017 and randomized into four arms: 4 weeks body scan, 8 weeks body scan, 4 weeks relaxation, and 8 weeks relaxation. Sleep problems and anxiety were measured at baseline and 4, 8, and 16 weeks after baseline. Time trends in sleep problems and anxiety were estimated using linear repeated measures models and compared between the four groups.ResultsOverall, there were beneficial time changes for sleep problems and anxiety symptoms in all four intervention groups, but significantly so only for anxiety symptoms. Specifically, the reduction of anxiety symptoms varied between - 11% per month for 8 weeks body scan, - 12% per month for 8 weeks relaxation, - 13% per month for 4 weeks relaxation, and - 16% per month for 4 weeks body scan. However, the time trends did not differ by intervention type or duration.ConclusionsBoth types of interventions had beneficial effects on anxiety independent of length of intervention, suggesting that a brief body scan as well as a brief relaxation could be part of a daily recovery practice for adolescent athletes.PreregistrationThis study was not preregistered.
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| 3. |
- Möllerberg, Marie-Louise, et al.
(författare)
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Evaluation of skin reactions during proton beam radiotherapy – Patient-reported versus clinician-reported
- 2021
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Ingår i: Technical Innovations and Patient Support in Radiation Oncology. - : Elsevier Ireland Ltd. - 2405-6324. ; 19, s. 11-17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Skin reaction is a common side-effect of radiotherapy and often only assessed as clinician-reported outcome (CRO). The aim was to examine and compare patient-reported outcome (PRO) of skin reactions with CRO for signs of acute skin reactions for patients with primary brain tumour receiving proton beam radiotherapy (PBT). A further aim was to explore patients’ experiences of the skin reactions. Methods: Acute skin reactions were assessed one week after start of treatment, mid-treatment and end of treatment among 253 patients with primary brain tumour who underwent PBT. PRO skin reactions were assessed with the RSAS and CRO according to the RTOG scale. Fleiss’ kappa was performed to measure the inter-rater agreement of the assessments of skin reactions. Results: The results showed a discrepancy between PRO and CRO acute skin reactions. Radiation dose was associated with increased skin reactions, but no correlations were seen for age, gender, education, occupation, other treatment or smoking. There was a poor agreement between patients and clinicians (κ = −0.016) one week after the start of PBT, poor (κ = −0.045) to (κ = 0.396) moderate agreement at mid treatment and poor (κ = −0.010) to (κ = 0.296) moderate agreement at end of treatment. Generally, patients’ symptom distress toward skin reactions was low at all time points. Conclusion: The poor agreement between PRO and CRO shows that the patient needs to be involved in assessments of skin reactions for a more complete understanding of skin reactions due to PBT. This may also improve patient experience regarding involvement in their own care. © 2021 The Author(s)
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| 4. |
- Turunen, Jani, et al.
(författare)
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How do children and adolescents of separated parents sleep? : An investigation of custody arrangements, sleep habits, sleep problems, and sleep duration in Sweden
- 2021
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Ingår i: Sleep Health. - : Elsevier. - 2352-7218 .- 2352-7226. ; 7:6, s. 716-722
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: An increasing number of children and adolescents divide their time between their separated parents' homes. Although marital conflict is disadvantageous for children's sleep, little is known about how children of separated parents sleep. The objective was to investigate the association between children's cus-tody arrangements and sleep habits and sleep initiation difficulties. Design: Cross sectional nationally representative samples of adolescents from the WHO study Health Behav-iour in School-aged Children (HBSC) (n = 11,802). Setting: Sweden in 2013/2014 and 2017/2018. Participants: Adolescents in grades 5, 7, and 9 from Swedish compulsory comprehensive school. Measurements: The survey included questions on sleep behaviors including bedtime, wake-up time and fre-quency of sleep onset problems. The analysis methods used were ordinary least squares and logistic regression. Results: The results show differences by custody arrangement, but they are not uniform across the dependent variables. Children and adolescents in sole maternal custody were less likely to sleep as much as recommended (P < .001), more likely to have late bedtimes (P < .001), report sleep initiation difficulties (P < .01) and to report social jetlag between school mornings and weekends (P < .05) compared to those in 2-parent families. Shared physical custody was associated with a higher likelihood of late bedtimes (P < .05) and sleep initiation difficulties (P < .05) compared to those in 2-parent families, but not of sleeping less than recommended or reporting social jetlag. Less-than-equal sharing was generally associated with worse sleep than in 2-parent families. Conclusions: As custody arrangements seem to be associated with sleep, it is important to understand the mechanisms behind the findings.
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| 5. |
- Sjövall, K., et al.
(författare)
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Evaluating patient reported outcomes and experiences in a novel proton beam clinic : challenges, activities, and outcomes of the ProtonCare project
- 2023
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Ingår i: BMC Cancer. - : Springer Nature. - 1471-2407. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The ProtonCare Study Group (PCSG) was formed with the purpose to develop and implement a framework for evaluation of proton beam therapy (PBT) and the related care at a novel clinic (Skandionkliniken), based on patient reported data.METHOD: A logic model framework was used to describe the process of development and implementation of a structured plan for evaluation of PBT for all diagnoses based on patient reported data. After the mission for the project was determined, meetings with networks and stakeholders were facilitated by PCSG to identify assumptions, resources, challenges, activities, outputs, outcomes, and outcome indicators. RESULT: This paper presents the challenges and accomplishments PCSG made so far. We describe required resources, activities, and accomplished results. The long-term outcomes that were outlined as a result of the process are two; 1) Improved knowledge about health outcomes of patients that are considered for PBT and 2) The findings will serve as a base for clinical decisions when patients are referred for PBT. CONCLUSION: Using the logical model framework proved useful in planning and managing the ProtonCare project. As a result, the work of PCSG has so far resulted in long-lasting outcomes that creates a base for future evaluation of patients' perspective in radiotherapy treatment in general and in PBT especially. Our experiences can be useful for other research groups facing similar challenges. Continuing research on patients´ perspective is a central part in ongoing and future research. Collaboration, cooperation, and coordination between research groups/networks from different disciplines are a significant part of the work aiming to determine the more precise role of PBT in future treatment options.
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| 6. |
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| 7. |
- Norbergh, Karl-Gustaf, 1950-, et al.
(författare)
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Omvårdnad på avancerad nivå : kärnkompetenser inom sjuksköterskans specialistområden
- 2013
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Ingår i: Omvårdnad på avancerad nivå. - Lund : Studentlitteratur. - 9789144071459 ; , s. webb artiklar-
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Samlingsverk (redaktörskap) (övrigt vetenskapligt/konstnärligt)abstract
- Denna bok och webb är den efterfrågade och fristående fortsättningen på Omvårdnadens grunder. Redan före sin publicering har Omvårdnad på avancerad nivå varit känd för många under det lekfulla arbetsnamnet Omvårdnadens höjder. Innehållet är två sammanflätade delar: en tryckt bokdel och en digital webbdel. Den senare är helt unik i sitt slag. Ett åttiotal forskande och/eller kliniskt verksamma sjuksköterskor har skapat en digital artikelsamling som beskriver tillämpningen av avancerad omvårdnad inom respektive specialistområde. Webbmaterialet innehåller även sammanfattande ljudklipp, frågor samt den tryckta boken i sin helhet så att den kan läsas på exempelvis iPad. Detta är det första bokverket i Sverige som beskriver huvudområdet omvårdnad på avancerad nivå. Utgångspunkten är de sex kärnkompetenser som är gemensamma för alla professioner inom hälso- och sjukvården och som Svensk sjuksköterskeförening rekommenderar bör utgöra en röd tråd med progression genom utbildningarnas nivåer: Personcentrerad vård Samverkan i team Evidensbaserad vård Förbättringskunskap för kvalitetsutveckling Säker vård Informations- och kommunikationsteknologi Tillsammans bildar bok och webb ett gemensamt och mångfaldigt innehåll för specialistsjuksköterskeutbildningarna. Avsikten är att skapa en grund för dessa utbildningar och deras motsvarigheter där omvårdnad på avancerad nivå kan beskrivas och problematiseras. Instruktioner för hur du kommer åt det digitala materialet finns på omslagets insida.
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| 8. |
- Langegård, Ulrica, 1969, et al.
(författare)
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Development and initial psychometric evaluation of a radiotherapy-related symptom assessment tool, based on data from patients with brain tumours undergoing proton beam therapy
- 2021
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:3, s. 796-804
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Tidskriftsartikel (refereegranskat)abstract
- Background: Currently, no available tool easily and effectively measures both the frequency, intensity and distress of symptoms among patients receiving radiotherapy. A core symptom set (fatigue, insomnia, pain, appetite loss, cognitive problems, anxiety, nausea, depression, constipation, diarrhoea and skin reaction) has been identified and assessed across oncology research to better understand the pattern of symptoms and treatment side effects.Aim: The aim was to develop a tool measuring the multiple‐symptom experience in patients undergoing radiotherapy and evaluate its psychometric properties (validity, reliability and responsiveness).Design: This study has a prospective, longitudinal and quantitative design.Methods: We developed a patient‐reported outcome questionnaire, the Radiotherapy‐Related Symptoms Assessment Scale to assess the frequency, intensity and distress associated with symptoms. Patients (n = 175) with brain tumours undergoing proton beam therapy completed the Radiotherapy‐Related Symptoms Assessment Scale and the health‐related quality of life questionnaire (EORTC QLQ‐C30) during treatment. We assessed the validity, reliability and responsiveness of the Radiotherapy‐Related Symptoms Assessment Scale and evaluated the validity against QLQ‐C30.Results: There were significant questionnaire–questionnaire correlations regarding selected items, primarily fatigue, insomnia and pain, indicating satisfactory criterion‐related validity. The Radiotherapy‐Related Symptoms Assessment Scale had fair to good retest reliability.Conclusion: The Radiotherapy‐Related Symptoms Assessment Scale is a valid instrument for assessing symptom intensity and distress in patients with brain tumour undergoing PBT, with psychometric properties within the expected range. The Radiotherapy‐Related Symptoms Assessment Scale provides nurses with substantial information on symptom experience but requires little effort from the patient. Additional studies are required to further assess the psychometric properties in patients with different cancer diagnoses receiving conventional radiotherapy.
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| 9. |
- Sjövall, Katarina, et al.
(författare)
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To become part of the team-patient experiences of participating in decision-making for a new treatment (proton beam therapy)
- 2024
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Ingår i: Supportive Care in Cancer. - : Springer Nature. - 0941-4355 .- 1433-7339. ; 32:7
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to explore patients' experience of participation in the treatment decision of proton beam therapy versus conventional radiotherapy. BACKGROUND: Proton beam therapy (PBT) has become a treatment option for some cancer patients receiving radiotherapy. The decision to give PBT instead of conventional radiotherapy (CRT) needs to be carefully planned together with the patient to ensure that the degree of participation is based on individuals' preferences. There is a knowledge gap of successful approaches to support patients' participation in the decision-making process, which is particularly important when it comes to the situation of having to choose between two treatment options such as PBT and CRT, with similar expected outcomes.METHOD: We conducted a secondary analysis of qualitative data collected from interviews with patients who received PBT for their brain tumor. Transcribed verbatims from interviews with 22 patients were analyzed regarding experiences of participation in the decision-making process leading to PBT.FINDINGS: Participants experienced their participation in the decision-making process to a varying degree, and with individual preferences. Four themes emerged from data: to be a voice that matters, to get control over what will happen, being in the hand of doctors' choice, and feeling selected for treatment.CONCLUSION: A decision for treatment with PBT can be experienced as a privilege but can also cause stress as it might entail practical issues affecting everyday life in a considerable way. For the patient to have confidence in the decision-making process, patients' preferences, expectations, and experiences must be included by the healthcare team. Including the patient in the healthcare team as an equal partner by confirming the person enables and facilitates for patients' voice to be heard and reckoned with. Person-centered care building on a partnership between patients and healthcare professionals should provide the right basis for the decision-making process.
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| 10. |
- Gunnarsson, Gunnar, et al.
(författare)
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Zero Prevalence of Influenza A Virus in Two Raptor Species by Standard Screening
- 2010
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Ingår i: Vector-borne and zoonotic diseases. - : Mary Ann Liebert Inc. - 1530-3667 .- 1557-7759. ; 10:4, s. 387-390
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Tidskriftsartikel (refereegranskat)abstract
- Disease can have sever impact on animal populations, especially in rare species. Baseline data for atypical host species are missing for a range of infectious diseases, although such hosts are potentially more affected than the normal vectors and reservoir species. If highly pathogenic avian influenza strikes rare birds of prey, this may have crucial impact on the predator species itself, but also on the food web in which it interacts. Here we present the first large-scale screening of raptors that regularly consume birds belonging to the natural reservoir of influenza A viruses. Influenza A virus prevalence was studied in two rare raptors, the white-tailed sea eagle (Haliaetus albicilla) and the peregrine falcon (Falco peregrinus). Nestlings were screened for active (181 white-tailed sea eagles and 168 peregrine falcons) and past (123 white-tailed sea eagles and 6 peregrine falcons) infection in 2006-2007, and an additional 20 succumbed adult white-tailed sea eagles were sampled in 2003-2006. Neither high- nor low-pathogenic influnza infections were found in our sample, but this does not rule out that the former may have major impact on rare raptors and their food webs.
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