| 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. |
- 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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| 3. |
- 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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| 4. |
- 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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| 5. |
- 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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| 6. |
- Sofrata, Abier H, et al.
(författare)
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Strong antibacterial effect of miswak against oral microorganisms associated with periodontitis and caries.
- 2008
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Ingår i: Journal of periodontology. - : Wiley. - 0022-3492 .- 1943-3670. ; 79:8, s. 1474-9
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The chewing stick (miswak) is used for oral hygiene in many parts of the world. In addition to the mechanical removal of plaque, an antibacterial effect has been postulated; however, tests of miswak extract from Salvadora persica (Arak) disclosed only low to moderate antibacterial effects. This may be attributable to the extraction process. Our aim was to test in vitro the antibacterial effect of miswak pieces, without extraction, on bacteria implicated in the etiology of periodontitis and caries. METHODS: Miswak pieces were standardized by size and weight (0.07 and 0.14 g) and tested against Streptococcus mutans, Lactobacillus acidophilus, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and, as a reference, Haemophilus influenzae. The miswak pieces were tested in two ways: embedded in the agar plate or suspended above the agar plate. RESULTS: The inhibitory effect was most pronounced on P. gingivalis, A. actinomycetemcomitans, and H. influenzae, less on S. mutans, and least on L. acidophilus. Suspended miswak had comparable or stronger effects than miswak embedded in agar. The 0.14-g suspended miswak exhibited significantly greater inhibition on A. actinomycetemcomitans and H. influenzae than the 0.14-g miswak embedded in agar (P<0.01 and P<0.001, respectively). CONCLUSIONS: Miswak embedded in agar or suspended above the agar plate had strong antibacterial effects against all bacteria tested. The antibacterial effect of suspended miswak pieces suggests the presence of volatile active antibacterial compounds.
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| 7. |
- Brante, Göran, 1951, et al.
(författare)
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To double a recipe : interdisciplinary teaching and learning of mathematical content knowledge in a home economics setting
- 2014
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Ingår i: Education Inquiry. - : Routledge. - 2000-4508. ; 5:2, s. 301-318
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Tidskriftsartikel (refereegranskat)abstract
- This study examines if interdisciplinary teaching can be said to facilitate the learning and use of fractions by Swedish 12-year-old pupils. Home and Consumer Studies is well suited to interdisciplinary teaching, and young people can therefore find it interesting to study maths since the setting is relevant to them. Building on variation theory and a learning study, we examined pupils' (n18) ability to double fractions greater than ½ when using a recipe. The general results show that what is to be learned benefits if it is presented in different ways, that teachers should not take pupils' knowledge for granted, and mathematically that it is not necessary to divide something to be able to double it. We argue that the study shows that genuine problems based on pupils' interest and life world can enhance motivation and, in turn, learning.
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| 8. |
- Brunosson, Albina, 1986-, et al.
(författare)
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To use a recipe - not a piece of cake. Students with mild intellectual disabilities' use of recipes in home economics.
- 2014
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Ingår i: International Journal of Consumer Studies. - : Wiley. - 1470-6423 .- 1470-6431. ; 38, s. 412-418
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Tidskriftsartikel (refereegranskat)abstract
- Recipes are not only part of today's cooking culture, they are also part of the Swedish syllabus of home economics. The aim of this study was to investigate what kinds of difficulties students with mild intellectual disabilities have using recipes during cooking lessons in home economics. We conducted an ethnographically inspired approach, with a total of 44h of accompanying observations. Three compulsory schools for students with intellectual disabilities were enrolled in the study, and 37 students and three teachers were included. The socio-cultural theory of learning has been used as a theoretical framework. The findings reveal both that recipes are central artefacts during the cooking lessons and that the students have various difficulties using the recipes. The difficulties vary, and they concern both how the recipes are designed and the purport of the recipes. Difficulties in relation to the design included, for example, the separation of ingredients and instructions in the text and the large amount of information given in both the whole and the parts of the recipes. The difficulties in relation to the purport – that is, the meaning or sense of the recipe – were the ingredients, the kitchen utensils and the knowledge of how to perform a specific task. These difficulties can be considered special in relation to the use of the recipes. We suggest the concept of ‘recipe literacy’ to capture the complex knowledge of using recipes.
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| 9. |
- Granberg, Albina, 1986-, et al.
(författare)
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Knowing how to use and understand recipes: What arithmetical understanding is needed when students with mild intellectual disabilities use recipes in practical cooking lessons in Home Economics?
- 2017
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Ingår i: International Journal of Consumer Studies. - : Wiley. - 1470-6423 .- 1470-6431. ; 41:5, s. 494-500
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore what arithmetical understanding is needed when students with mild intellectual disabilities use recipes during practical cooking lessons in Home Economics. The settings were compulsory schools in Sweden attended by students with intellectual disabilities. Sixteen lessons in Home Economics during which cooking took place were observed. In total, 37 students and three teachers participated. All students had a mild intellectual disability. Their ages varied, but most were between 13 and 14 years old. The sociocultural perspective on learning, combined with a literacy framework, was used as a theoretical foundation for the study. Main findings are that students need an arithmetical understanding of (i) how to interpret numbers, (ii) how to interpret and use units, and (iii) how to compute when using recipes. The knowledge and skills needed to be able to use a recipe are featured in the concept recipe literacy, capturing both theoretical, declarative knowledge and the more practical, procedural knowledge. Recipe literacy can be used to theorize the use of recipes when learning to cook, as in Home Economics.
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| 10. |
- Langegård, Ulrica, 1969, et al.
(författare)
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Health-related quality of life in patients with primary brain tumors during and three months after treatment with proton beam therapy
- 2021
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Ingår i: Technical Innovations & Patient Support in Radiation Oncology. - : Elsevier BV. - 2405-6324. ; 17, s. 5-17
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Tidskriftsartikel (refereegranskat)abstract
- Background Proton beam therapy (PBT) is increasingly administered to patients with primary brain tumors. Benefits of new treatments must be weighed against side effects and possible deterioration in health-related quality of life (HRQoL). The aim of this study was to describe and compare HRQoL, including acute symptom experiences and associated factors, in patients with malignant and benign brain tumors treated with PBT. Materials and Methods Adult PBT-treated patients with primary brain tumors (n=266) were studied. HRQoL was assessed with EORTC QLQ-C30, QLQ-BN20, HADS, ISI and MFI before, during and three months after treatment. Associations with demographic and medical factors were explored. Results Between baseline and three months post-treatment: HRQoL decreased significantly in the global health/QOL domains physical functioning, role functioning and cognitive functioning in the malignant group, global health/QOL and physical functioning decreased significantly in the benign group, more comorbidity was significantly associated with increased motor dysfunction, leg weakness, headache and future uncertainty. Fatigue and depression were the most frequent symptoms in both groups. Independent predictors of risk factor recognition were age, sex, chemotherapy, comorbidity and education level. Discussion Global health/QOL in patient with brain tumors is very complex and multidimensional. Symptoms are interrelated and related to patient, tumor and treatment factors. It is important to identify aspects of HRQoL that may be affected by treatment. These include both benefits, expected to improve HRQoL, and negative changes such as symptom experience and influencing factors. Evidence-based guidelines are needed for symptom management, and for high quality of care for patients experiencing low PBT-related HRQoL.
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