| 1. |
- Berglund Kristiansson, Elisabeth, et al.
(författare)
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A qualitative study of older persons’ experiences of getting individual support with digital needs in the context of home ID 281
- 2024
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Ingår i: The first Global Conference on Person-Centred Care. - : University of Gothenburg Centre for Person-Centred Care. - 9789153106708 ; , s. 216-216
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Konferensbidrag (refereegranskat)abstract
- Background: Digitalization is seen as a necessity to manage the increasing burden on the health care system and is accordingly considered an important tool in the transformation to integrated care (Swedish Nära vård). However, when health care is digitalized older persons are at increased risk of being marginalized and dependent on others due to their generally lower digital competence. To address this, several Swedish municipalities offer individual support to older persons in their own home, a service called Digital Coach (DC). As this service is new, the aim is to describe older persons’ experiences of getting individual support with digital needs in the context of home. Method: Semi-structured interviews (n=14) were conducted with older persons who have had DC support in their home. The focus was on older persons’ experiences of the support. Data was analyzed with qualitative content analysis. Results, preliminary: The overall theme, to be a valued person in the digital society, represents a feeling of being taken seriously and worth investing resources in to gain access to society. Three categories emerged: (1) The need to keep up with the times which means to understand and navigate the new digital landscape with the opportunity for independence and participation, (2) Support and respect in the learning situation, is crucial for feeling comfortable to expose insufficient knowledge, and (3) Increased digital competence empowers autonomy and is manifested as the ability to handle the digital tools and services by your own creates a feeling of joy and satisfaction and increases the opportunity to participate in both social and community activities. Conclusion: The result shows that individual support with digital needs in the context of home increase digital competence in older persons and create feelings of being valued and included in the digital society, which can extend to integrated person-centered care.
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| 2. |
- Glimelius, Bengt, et al.
(författare)
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Prediction of irinotecan and 5-fluorouracil toxicity and response in patients with advanced colorectal cancer
- 2011
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Ingår i: The Pharmacogenomics Journal. - : Springer Science and Business Media LLC. - 1470-269X .- 1473-1150. ; 11:1, s. 61-71
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Tidskriftsartikel (refereegranskat)abstract
- Irinotecan and 5-fluorouracil (5-FU) are used to treat metastatic colorectal cancer. Irinotecan's active metabolite is inactivated by UDP-glucuronosyltransferase 1A1 (UGT1A1), which is deficient in Gilbert's syndrome. Irinotecan and metabolites are transported by P-glycoprotein, encoded by ABCB1. 5-FU targets folate metabolism through inhibition of thymidylate synthase (TYMS). Methylenetetrahydrofolate reductase (MTHFR) generates active folate necessary for haematopoiesis. We retrospectively genotyped 140 Swedish and Norwegian irinotecan and 5-FU-treated colorectal cancer patients from the Nordic VI clinical trial for selected variants of UGT1A1, ABCB1, TYMS and MTHFR. We found an increased risk of clinically relevant early toxicity in patients carrying the ABCB1 3435 T/T genotype, Odds ratio (OR)=3.79 (95% confidence interval (CI)=1.09-13.2), and in patients carrying the UGT1A1(*)28/(*)28 genotype, OR=4.43 (95% CI=1.30-15.2). Patients with UGT1A1(*)28/(*)28 had an especially high risk of neutropenia, OR=6.87 (95% CI=1.70-27.7). Patients who had reacted with toxicity during the first two cycles were in total treated with fewer cycles (P<0.001), and less often responded to treatment (P<0.001). Genetic variation in ABCB1 was associated with both early toxicity and lower response to treatment. Carriers of the ABCB1 1236T-2677T-3435T haplotype responded to treatment less frequently (43 vs 67%, P=0.027), and survived shorter time, OR=1.56 (95% CI=1.01-2.45).
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| 3. |
- Nilsson, Christina, et al.
(författare)
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Varför vårdvetenskap?
- 2008
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Ingår i: Vårdvetenskapliga vägskäl. - Växjö : Växjö universitet. ; , s. 49-60
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Rapport (övrigt vetenskapligt/konstnärligt)
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| 4. |
- Andersson, Susanne, 1957-, et al.
(författare)
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Experiences of specially trained personnel of group education for patients with type 2 diabetes : A lifeworld approach
- 2019
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Ingår i: Nursing Open. - : Wiley-Blackwell Publishing Inc.. - 2054-1058. ; 6:2, s. 635-641
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Tidskriftsartikel (refereegranskat)abstract
- Aim:To describe how the group education process for people with type 2 diabetes is experienced by diabetes nurses and dietitians who support the patients’ learning, in a primary care setting.Design:The project took place at two primary care settings in the south of Sweden.Methods:Data collected from focus‐group interviews and reflection notes were subjected to phenomenological analysis.Results:The specially trained personnel experienced that group education made it possible for the patients to learn through reflection concerning their own and others’ experiences. Furthermore, group education entailed increased knowledge for the trained personnel. When the patients were challenged to make changes in their lives with the illness, the personnel experienced that both patients and personnel supported each other. The study concludes that the trained personnel person‐centred approach, with help of the didactic model, get tools to support patients learning.
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| 5. |
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| 6. |
- Berglund, Annika, et al.
(författare)
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Face Arm Speech Time Test use in the prehospital setting, better in the ambulance than in the emergency medical communication center
- 2014
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Ingår i: Cerebrovascular Diseases. - Basel, Switzerland : S. Karger. - 1015-9770 .- 1421-9786. ; 37:3, s. 212-216
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Prehospital identification of acute stroke increases the possibility of early treatment and good outcome. To increase identification of stroke, the Face Arm Speech Time (FAST) test was introduced in the Emergency Medical Communication Center (EMCC). This substudy aims to evaluate the implementation of the FAST test in the EMCC and the ambulance service.METHODS: The study was conducted in the region of Stockholm, Sweden during 6 months. The study population consisted of all calls to the EMCC concerning patients presenting at least one FAST symptom or a history/finding making the EMCC or ambulance personnel to suspect stroke within 6 h. Positive FAST was compared to diagnosis at discharge. Positive predictive values (PPV) for a stroke diagnosis at discharge were calculated.RESULTS: In all, 900 patients with a median age of 71 years were enrolled, 667 (74%) by the EMCC and 233 (26%) by the ambulances. At discharge, 472 patients (52%) were diagnosed with stroke/transient ischemic attack (TIA), 337 identified by the EMCC (71%) and 135 (29%) by the ambulances. The PPV for a discharge diagnosis of stroke/TIA was 51% (CI 47-54%) in EMCC-enrolled and 58% (CI 52-64%) in ambulance-enrolled patients. With a positive FAST the PPV of a correct stroke/TIA diagnosis increased to 56% (CI 52-61%) and 73% (CI 66-80%) in EMCC- and ambulance-enrolled patients, respectively. Positive FAST from EMCC was also found in 44% of patients with a nonstroke diagnosis at discharge. A stroke/TIA diagnosis at discharge but negative FAST was found in 58 and 27 patients enrolled by the EMCC and ambulances, respectively.CONCLUSIONS: The PPV of FAST is higher when used on the scene by ambulance than by EMCC. FAST may be a useful prehospital tool to identify stroke/TIA but has limitations as the test can be negative in true strokes, can be positive in nonstrokes, and FAST symptoms may be present but not identified in the emergency call. For the prehospital care situation better identification tools are needed.
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| 7. |
- Berglund, Annika, et al.
(författare)
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Factors facilitating or hampering nurses identification of stroke in emergency calls
- 2015
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 71:11, s. 2609-2621
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Tidskriftsartikel (refereegranskat)abstract
- Aims. To explore the factors that facilitate or hamper identification of stroke in emergency calls concerning patients with stroke who have fallen or been in a lying position.Background. Early identification of stroke in emergency calls is vital but can be complicated as the patients may be unable to express themselves and the callers generally are bystanders. In a previous study, we found presentation of fall or the patient being in a lying position to be the major problem in 66% of emergency calls concerning, but not dispatched as acute stroke.Design. A qualitative study using interpretive phenomenology.Methods. Analysis of transcribed emergency calls concerning 29 patients with stroke diagnoses at hospital discharge, in 2011 and presented with fall/lying position.Findings. Patients' ability to express themselves, callers' knowledge of the patient and of stroke, first call-takers' and nurses' authority, nurses' coaching and nurses' expertise skills facilitated or hindered the identification of stroke. Certain aspects are adjustable, but some are determined by the situation or on callers' and patients' abilities and thus difficult to change. Nurses' expertise skills were the only theme found to have a decisive effect of the identification of stroke on its own.Conclusion. To increase identification of stroke in emergency calls concerning stroke, the first call-takers' and nurses' action, competence and awareness of obstacles are crucial and if strengthened would likely increase the identification of stroke in emergency calls. In complicated cases, nurses' expertise skills seem essential for identification of stroke.
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| 8. |
- Berglund, Annika, et al.
(författare)
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Higher prehospital priority level of stroke improves thrombolysis frequency and time to stroke unit : the Hyper Acute STroke Alarm (HASTA) study
- 2012
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Ingår i: Stroke. - New York : American Heart Association. - 0039-2499 .- 1524-4628. ; 43:10, s. 2666-2670
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Early initiated treatment of stroke increases the chances of a good recovery. This randomized controlled study evaluates how an increased priority level for patients with stroke, from level 2 to 1, from the Emergency Medical Communication Center influences thrombolysis frequency, time to stroke unit, and whether other medical emergencies reported negative consequences.METHODS: Patients aged 18 to 85 years in Stockholm, Sweden, with symptoms of stroke within 6 hours were randomized from the Emergency Medical Communication Center or emergency medical services to an intervention group, priority level 1, immediate call of an ambulance, or to a control group with standard priority level, that is, priority level 2 (within 30 minutes). Before study start, an educational program on identification of stroke and importance of early initiated treatment was directed to all medical dispatchers and ambulance and emergency department personnel.RESULTS: During 2008, 942 patients were randomized of which 53% (n=496) had a final stroke/transient ischemic attack diagnosis. Patients in the Emergency Medical Communication Center randomized intervention group reached the stroke unit 26 minutes earlier than the control group (P<0.001) after the emergency call. Thrombolysis was given to 24% of the patients in the intervention group compared with 10% of the control subjects (P<0.001). The higher priority level showed no negative effect on other critical ill patients requiring priority level 1 prehospital attention.CONCLUSIONS: This randomized study shows negligible harm to other medical emergencies, a significant increase in thrombolysis frequency, and a shorter time to the stroke unit for patients with stroke upgraded to priority level 1 from the Emergency Medical Communication Center and through the acute chain of stroke care.
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| 9. |
- Berglund, Annika, et al.
(författare)
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Identification of stroke during the emergency call : a descriptive study of callers' presentation of stroke
- 2015
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Ingår i: BMJ Open. - London, UK : BMJ Publishing Group Ltd. - 2044-6055. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate symptoms presented by the caller during emergency calls regarding stroke, and to assess if symptoms in the Face-Arm-Speech-Time Test (FAST) are related to identification of stroke.SETTING: Emergency calls to the Emergency Medical Communication Center (EMCC) concerning patients discharged with stroke diagnosis in a large teaching hospital in Stockholm, Sweden, in January-June 2011.PARTICIPANTS: The emergency calls of 179 patients who arrived at hospital by ambulance, and who were discharged with a stroke diagnosis and consented to participate were included in the study.OUTCOME MEASURES: Frequencies of stroke symptoms presented and a comparison of symptoms presented in calls with dispatch code stroke or other dispatch code.RESULTS: Of the 179 emergency calls analysed, 64% were dispatched as 'Stroke'. FAST symptoms, that is, facial or arm weakness or speech disturbances, were presented in 64% of the calls and were spontaneously revealed in 90%. Speech disturbance was the most common problem (54%) in all calls, followed by fall/lying position (38%) and altered mental status (27%). For patients with dispatch codes other than stroke, the dominating problem presented was a fall or being in a lying position (66%), followed by speech disturbance (31%) and altered mental status (25%). Stroke-specific symptoms were more common in patients dispatched as stroke. FAST symptoms were reported in 80% of patients dispatched as stroke compared with 35% in those dispatched as something else.CONCLUSIONS: This study implicates that fall/lying position and altered mental status could be considered as possible symptoms of stroke during an emergency call. Checking for FAST symptoms in these patients might uncover stroke symptoms. Future studies are needed to evaluate if actively asking for FAST symptoms in emergency calls presenting falls or a lying position can improve the identification of stroke.TRIAL REGISTRATION NUMBER: Stroke2010/703-31/2.
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| 10. |
- Berglund, A., et al.
(författare)
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Sex differences in the presentation of stroke
- 2017
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Ingår i: Maturitas. - Amsterdam, Netherlands : Elsevier. - 0378-5122 .- 1873-4111. ; 99, s. 47-50
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Forskningsöversikt (refereegranskat)abstract
- Stroke affects both men and women of all ages, although the condition is more common among the elderly. Stroke occurs at an older age among women than among men; although the incidence is lower among women than among men, as women have a longer life expectancy their lifetime risk is slightly higher. Ischemic stroke is the most common type of stroke; and reperfusion treatment is possible if the patient reaches hospital early enough. Thrombolysis and thrombectomy are time-sensitive treatments - the earlier they are initiated the better is the chance of a positive outcome. It is therefore important to identify a stroke as soon as possible. Medical personnel can readily identify typical stroke symptoms but the presentation of non-traditional stroke symptoms, such as impaired consciousness and altered mental status, is often associated with a significant delay in the identification of stroke and thus delay in or inability to provide treatment. Non-traditional stroke symptoms are reported to be more common in women, who are thereby at risk of delayed recognition of stroke and treatment delay.
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