| 1. |
- Hansson, Anders, 1953-, et al.
(författare)
-
Flawed communications: Health professionals' experience of collaboration in the care of frail elderly patients
- 2018
-
Ingår i: Scandinavian Journal of Public Health. - : SAGE Publications. - 1403-4948 .- 1651-1905. ; 46:7, s. 680-689
-
Tidskriftsartikel (refereegranskat)abstract
- Aims: Frail elderly patients who have multiple illnesses do not fare well in modern health care systems, mainly due to a lack of care planning and flawed communication between health professionals in different care organisations. This is especially noticeable when patients are discharged from hospital. The aim of this study was to explore health care professionals' experience of obstacles and opportunities for collaboration. Methods: Health professionals were invited to participate in three focus groups, each consisting of a hospital physician, a primary care physician, a hospital nurse, a primary care nurse, a municipal home care nurse or an assistant officer, a physical or occupational therapist and a patient or a family member representative. These individual people were then asked to discuss the obstacles and opportunities for communication between themselves and with the patients and their relatives when presented with the case report of a fictitious patient. Content analysis was used to identify categories. Results: Several obstacles were identified for effective communication and care planning: insufficient communication with patients and relatives; delayed collaboration between care-givers; the lack of an adequate responsible person for care planning; and resources not being distributed according to the actual needs of patients. The absence of an overarching responsibility for the patient, beyond organisational borders, was a recurring theme. These obstacles could also be seen as opportunities. Conclusions: Obstacles for collaboration were found on three levels: societal, organisational and individual. As health care professionals are well aware of the problems and also see solutions, management for health care should support employees' own initiatives for changes that are of benefit in the care of frail elderly patients with multiple illnesses.
|
|
| 2. |
- Hansson, Anders, et al.
(författare)
-
Vem tar bollen? : går vården för de mest sjuka äldre att förbättra?
- 2016
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund Flera svenska rapporter visar att de mest sjuka äldre ofta far illa på grund av bristande samordning och oklar ansvarsfördelning mellan olika behandlingsinstanser. Primärvården, hemtjänsten och den kommunala hemsjukvården anses i otillräcklig omfattning ta över ansvaret efter utskrivningen av de sjuka äldre från sjukhuset. Svenska erfarenheter stämmer väl med vad man funnit i flera internationella studier: sjukvården är illa rustad för att möta de mest sjuka äldres komplexa behov av vård och omsorg.
|
|
| 3. |
- Nunstedt, Håkan, 1956-, et al.
(författare)
-
Patients' Variations of Reflection About and Understanding of Long-term Illness : Impact of Illness Perception on Trust in Oneself or Others
- 2017
-
Ingår i: Open Nursing Journal. - : Bentham Science Publishers Ltd.. - 1874-4346. ; 11, s. 43-53
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Patients' understanding of their illness is of great importance for recovery. Lacking understanding of the illness is linked with the patients' level of reflection about and interest in understanding their illness. Objective: To describe patients’ variations of reflection about and understanding of their illness and how this understanding affects their trust in themselves or others. Method: The study is based on the “Illness perception” model. Latent content analysis was used for the data analysis. Individual, semi-structured, open-ended and face-to-face interviews were conducted with patients (n=11) suffering from a long-term illness diagnosed at least six months prior to the interview. Data collection took place in the three primary healthcare centres treating the participants. Results: The results show variations in the degree of reflection about illness. Patients search for deeper understanding of the illness for causal explanations, compare different perspectives for preventing complication of their illness, trust healthcare providers, and develop own strategies to manage life. Conclusion: Whereas some patients search for deeper understanding of their illness, other patients are less reflective and feel they can manage the illness without further understanding. Patients' understanding of their illness is related to their degree of trust in themselves or others. Patients whose illness poses an existential threat are more likely to reflect more about their illness and what treatment methods are available.
|
|
| 4. |
- Nunstedt, Håkan, 1956-, et al.
(författare)
-
Strategies for healthcare professionals to facilitate patient illness understanding.
- 2017
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 26:23-24, s. 4696-4706
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To describe how healthcare professionals facilitate patient illness understanding.BACKGROUND: Healthcare professionals and patients differ in their illness understanding. If the information provided by healthcare professionals is not adapted to the patient's daily life it may be unusable for the patient. Previous research has found that healthcare professionals should individualise the information to enable the patient to apply the knowledge to the personal situation and to develop illness understanding. However, little is known of how healthcare professionals can facilitate patient illness understanding.METHOD: A qualitative descriptive study based on individual, semi-structured, open-ended and face-to-face interviews was conducted with healthcare professionals (n=11) concerning how they facilitate patients illness understanding. Three health centres were involved during the period of March to November 2014. The interviews were analysed with qualitative content analysis.RESULTS: The result identified a continuous and collaborative process with three strategies used by healthcare professionals to facilitate the patient's illness understanding: 1) assess the patient's illness understanding, 2) interact with the patient to develop illness understanding, and 3) support the patient's personal development for illness understanding. The steps in the process depend on each other.CONCLUSIONS: The results of our analysis indicate that healthcare professionals can use the continuous and collaborative process to enhance the patient's self-care ability and turn his or her knowledge into action for improving illness understanding.RELEVANCE TO CLINICAL PRACTICE: The three continuous and collaborative process strategies involving pedagogical approaches can create conditions for healthcare professionals to obtain a holistic view of the patient's life and to be a key resource for person-centred care. This article is protected by copyright. All rights reserved.
|
|
| 5. |
- Alsén, Pia, 1956-, et al.
(författare)
-
Fatigue after myocardial infarction : Relationships with indices of emotional distress, and sociodemographic and clinical variables
- 2010
-
Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 16:4, s. 326-334
-
Tidskriftsartikel (refereegranskat)abstract
- Fatigue and depressive symptoms are relatively common among patients recovering from myocardial infarction (MI). The symptoms of depression and fatigue overlap. The present study aimed at identifying patient fatigue and at examining the incidence of fatigue, particularly without coexisting depression, after MI. The sample comprised 204 consecutive patients who had completed the questionnaires Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory–20 after MI (1 week and 4 months). The results showed that fatigue had decreased after 4 months compared with the time of MI onset. Compared with the general population, patients reported significantly higher levels of fatigue. Furthermore, fatigue was associated with depression, but 33% of the sample reported fatigue without coexisting depression after 4 months. In order to prevent or treat patients' symptoms of fatigue after MI, the concepts of fatigue and depression should be assessed separately so as to exclude overlapping effects.
|
|
| 6. |
- Alsén, Pia, 1956-, et al.
(författare)
-
Fatigue after myocardial infarction a two-year follow-up study
- 2013
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 22:11-12, s. 1647-1652
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives To investigate changes in self-reported fatigue and depression from four months to two years following a myocardial infarction, as well as to explore gender differences, identify the incidence of fatigue without coexisting depression and finally predict health-related quality of life at a two-year follow-up. Background Depression and fatigue are associated with decreased health-related quality of life after myocardial infarction. Although there is a close relationship between fatigue and depression, it has been shown that symptoms of fatigue can occur without coexisting depression. Design Quantitative and longitudinal design. Methods Participants (n=155) were asked to complete the following questionnaires: the Hospital Anxiety and Depression Scale, the Multidimensional Fatigue Inventory-20 (MFI-20) and the Short Form Survey (SF-36) following myocardial infarction (after four months and two years). Descriptive statistics, paired t-tests and multiple regressions were carried out. Results In the entire group, self-reported fatigue had decreased from four months to two years after myocardial infarction. After two years, 18% of respondents reported depression together with fatigue and 30% reported fatigued without depression. Women scored higher than men on the fatigue dimensions reduced activity, reduced motivation and mental fatigue. Moreover, the physical dimension of health-related quality of life two years after myocardial infarction was predicted by experienced general fatigue at four months. Conclusion Fatigue with or without coexisting possible/probable depression remains as a significant symptom two years after myocardial infarction in nearly half of the entire group. Relevance to clinical practice Fatigue is a problem following myocardial infarction. Therefore, systematic screening and early identification of patients experiencing symptoms of depression and fatigue after myocardial infarction are important for suitable care planning. In contemporary coronary care, strategies aimed at relieving fatigue should be developed.
|
|
| 7. |
|
|
| 8. |
- Alsén, Pia, 1956
(författare)
-
Illness perception and fatigue after myocardial infarction
- 2009
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Treatment of myocardial infarction (MI) has undergone major advances in recent years, including reductions in mortality and hospital stays. To optimize patients’ recovery, secondary preventive strategies are important. However, many patients fail to attend to such programmes. It has been shown that illness perceptions may influence attendance to rehabilitation programmes as well as recovery. Other obstacles are post-MI fatigue and depression. The main focus of the present thesis was to explore illness perception and fatigue after MI. A secondary aim was to investigate the levels of illness perceptions and fatigue and their relationships with demographic/clinical variables, depression, anxiety and health-related quality of life (HRQoL). In Study I, patients’ illness perception of MI was explored. The methodology used was grounded theory (25 informants interviewed). The core categories illness reasoning and trust in oneself vs. trust in others were found to be fundamental in viewing the MI either as an acute isolated heart attack or as a sign of a chronic condition. In Study II, the aim was to gain a deeper understanding of what fatigue means to patients with recent MI and how they managed to deal with the consequences of fatigue. Grounded theory was applied also in this study (19 informants interviewed). A central theme was labelled living with incomprehensible fatigue. This core category was featured by several properties: different kind of tiredness, unrelated to effort, unpredictable occurrence, and unknown cause. In Study III, the incidence of fatigue in 204 consecutive MI patients was examined and compared to reference populations. Gender differences in fatigue were also examined, as well as changes over time and the relationships between fatigue versus clinical and demographic variables and measures of emotional distress. The Hospital Anxiety and Depression Scale (HADS) and the Multidimensional Fatigue Inventory (MFI-20) were used. MI patients reported higher levels of fatigue compared with the general population, depression and fatigue overlapped, but 33% reported fatigue without coexisting depression. No gender differences were found. In Study IV, illness perceptions in 204 consecutive MI patients were examined using the Illness Perception Questionnaire (IPQ-R) and compared to reference populations. Changes in illness perceptions over time were also examined, as well as the relationships between illness perceptions and anxiety/depression (HADS), fatigue (MFI-20), somatic health problems (SHCQ) and HRQoL (SF-36). It was shown that illness perceptions changed over time, from viewing the MI as an acute event to a more chronic condition, and that the beliefs in personal and treatment control of MI decreased. These negative beliefs were associated with fatigue and lowered HRQoL. In conclusion, the studies contribute to our understanding of how patients perceive their MI, and particularly that fatigue is a notable symptom affecting patients´ lives. Individualized secondary preventive strategies could start with identifying patient’s unique illness perception. It is also important to identify patients who are fatigued to provide adequate treatment as well as to prevent progression from fatigue to exhaustion.
|
|
| 9. |
- Alsén, Pia, 1956-, et al.
(författare)
-
Illness perceptions after myocardial infarction : relations to fatigue, emotional distress, and health-related quality of life
- 2010
-
Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 25:2, s. E1-E10
-
Tidskriftsartikel (refereegranskat)abstract
- Background and RESEARCH Objective: Health-related quality of life (HRQoL) is impaired in patients after a myocardial infarction (MI), and fatigue and depression are common health complaints among these patients. Patients' own beliefs about their illness (illness perceptions) influence health behavior and health outcomes. The aim of the present study was to examine illness perception and its association with self-reported HRQoL, fatigue, and emotional distress among patients with MI. Subjects and Methods: The sample consisted of 204 patients who had had MI and who completed the questionnaires during the first week in the hospital and 4 months after the MI. The questionnaires used were the Illness Perception Questionnaire, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and the Short Form Health Survey (SF-36). Results: Patient's illness perception changed over time from a more acute to a more chronic perception of illness, and beliefs in personal and treatment control of MI had decreased. Furthermore, these negative beliefs were associated with worse experiences of fatigue and lowered HRQoL. Conclusions: Patients' illness perceptions influence health outcomes after an MI. Supporting MI patients in increasing their perception of personal control could be a primary nursing strategy in rehabilitation programs aimed at facilitating health behavior, decreasing experiences of fatigue, and increasing HRQoL. Copyright © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
|
|
| 10. |
- Alsén, Pia, 1956, et al.
(författare)
-
Illness perceptions after myocardial infarction: relations to fatigue, emotional distress, and health-related quality of life.
- 2010
-
Ingår i: Journal of Cardiovascular Nursing. - 1550-5049. ; 25:2
-
Tidskriftsartikel (refereegranskat)abstract
- Background and Research Objective: Health-related quality of life (HRQoL) is impaired in patients after a myocardial infarction (MI), and fatigue and depression are common health complaints among these patients. Patients' own beliefs about their illness (illness perceptions) influence health behavior and health outcomes. The aim of the present study was to examine illness perception and its association with self-reported HRQoL, fatigue, and emotional distress among patients with MI. Subjects and Methods: The sample consisted of 204 patients who had had MI and who completed the questionnaires during the first week in the hospital and 4 months after the MI. The questionnaires used were the Illness Perception Questionnaire, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and the Short Form Health Survey (SF-36). Results: Patient's illness perception changed over time from a more acute to a more chronic perception of illness, and beliefs in personal and treatment control of MI had decreased. Furthermore, these negative beliefs were associated with worse experiences of fatigue and lowered HRQoL. Conclusions: Patients' illness perceptions influence health outcomes after an MI. Supporting MI patients in increasing their perception of personal control could be a primary nursing strategy in rehabilitation programs aimed at facilitating health behavior, decreasing experiences of fatigue, and increasing HRQoL.
|
|
