| 1. |
- Billing, Ewa, et al.
(författare)
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Adaptation of the Psoriatic Arthritis Quality of Life (PsAQoL) instrument for Sweden
- 2010
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Ingår i: Scandinavian Journal of Rheumatology. - : Informa UK Limited. - 0300-9742 .- 1502-7732. ; 39:3, s. 223-228
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire is the first disease-specific patient-derived instrument for assessing QoL in patients with PsA and has been extensively validated in this population. The aim of the adaptation process reported here was to develop a Swedish version of the PsAQoL that was equivalent to, and met the same psychometric and acceptability standards as, the original instrument, which was developed in the UK. Method:Translation of the original questionnaire into Swedish was performed by a professional and a lay panel. Field testing for face and content validity was performed by interviewing 13 patients. Finally, 123 patients with PsA were included in a test-retest postal survey designed to test reproducibility and construct validity. The PsAQoL was administered on two occasions approximately 2 weeks apart. The Nottingham Health Profile (NHP) was used as a comparator instrument. Results: The Swedish version of the PsAQoL questionnaire showed good reliability at both time points and, as expected, correlated with the NHP. The scale was able to distinguish between groups based on self-reported general health and flare-up. Patients with active symptoms of both arthritis and psoriasis had worse QoL. The results also indicated that duration of disease has a progressive impact on PsAQoL scores. Conclusions: This study provides evidence that the adapted PsAQoL can be used for clinical studies in Swedish patients. The instrument provides valuable information on the long-term effects of PsA on QoL.
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| 2. |
- Billing, Ewa
(författare)
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Psychosocial factors in patients with ischemic heart disease
- 1996
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of the study was to evaluate psychosocial variables in patients with ischemic heart disease and the relationships between psychosocial variables and severity and prognosis of disease. Patients with stable angina pectoris and patients with a first myocardial infarction were included, and the evaluations were performed by two different methods. The angina population consisted of 767 patients (236 women) <70 years, who participated in the Angina Prognosis Study In Stockholm (APSIS), where treatment with two anti-ischemic drugs, metoprolol or verapamil were compared. Psychosocial variables were evaluated by structured interviews, concerning psychosomatic symptom, sleep disturbances, overall life satisfaction, job strain, type-A behaviour and previous life events, at their inclusion into the study and at their last visit, (follow-up time 6 - 75 months). The population with myocardial infarction included male patients in two different countries (98 patients in Sweden and 87 patients in Israel) < 60 years with a first myocardial infarction. The patients were interviewed during their hospital stay, and after 6 months, as were the patient's spouse and treating physician. The three groups were asked two questions: "Why do youthink the myocardial infarction happened to you/him?" and "What will help you/him cope with it?", and they replied by using two sets of Q-sort cards with 20 possible answers to either question, the "causal attribution". The patients were furthermore asked if they had experienced any previous serious life events, and at the same time their level of denial and depression was rated on a three degree scale by the interviewer. Psychosocial variables which are previously discussed as being risk factors for myocardial infarction, are more common in patients with stable angina pectoris than in controls, and differ between female andmale patients. Ex-smokers had a better prognosis than smokers and non-smokers, and sexual problems were significantly related to cardiovascular death. Problems with sexual life were not related to age or severity of angina. The severity of angina pectoris did not seem to relate to life satisfaction or attitudes towards the future. In the population of patients with myocardial infarction some common background factors were shown to be of prognostic value. Furthermore, the patients' and their spouses' attribution concerning what caused the myocardial infarction and their ideas about coping predicted the patients' ability to make life style changes, and the subjective and objective outcome 6 months after the myocardial infarction. The physicians who more attributed the patients' myocardial infarction to medical causes, did not predict the patients' outcome to the same extent. Psychosocial variables are shown to be important for the development of ischemic heart disease. Correlations between psychosocial variables and objective signs of ischemic heart disease are poor, although psychosocial variables also heavily influence outcome and prognosis.
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| 3. |
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| 4. |
- Franzen-Dahlin, Asa, et al.
(författare)
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Post-stroke depression - effect on the life situation of the significant other
- 2006
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 20:4, s. 412-416
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the life situation among,significant others' to patients with post-stroke depression, and to identify associations between the life situation of the significant others and patient characteristics. Seventy-one dyads consisting of patients with a diagnosed post-stroke depression and their significant others were included. The patients were assessed for depression with the Montgomery-angstrom sberg Depression Rating Scale and diagnosed according to the DSM-IV. The assessments of significant others included their own life situation and proxy assessments of the patients' state of depression, anger, change of personality, and need of assistance. Significant others of male stroke patients reported a more negative impact on their life situation, than did significant others of female stroke patients (p = 0.04). There was a significant association between the patient's level of depression and physical function [activities of daily living (ADL)], with those with less impaired ADL having more major depression than those with more impaired ADL (p = 0.007). This study indicates that major post-stroke depression is more common among patients with limited functional deficits. This highlights the importance of assessment for depression also among seemingly recovered stroke patients in order to treat and support those in need. This study also stresses the importance of identifying different needs of the significant others in order to provide appropriate support in their caregiving role.
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| 5. |
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| 6. |
- Franzén-Dahlin, Åsa, et al.
(författare)
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A randomized controlled trial evaluating the effect of a support and education programme for spouses of people affected by stroke
- 2008
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 22:8, s. 722-30
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine whether a nurse-led support and education programme for spouses of patients affected by stroke improved the psychological health of the spouses.DESIGN: A longitudinal, open, randomized controlled trial.SAMPLE: One hundred spouses of stroke patients were randomly assigned to either an intervention or a control group.SETTING: The study was conducted in a hospital setting.INTERVENTION: The intervention consisted of six group meetings during six months, with a follow-up after further six months. Comparison between the intervention and the control groups was made at baseline, after six and 12 months using analysis with repeated measures.MAIN MEASURES: The Comprehensive Psychopathological Rating Scale--Self-Affective for psychological health.RESULTS: No significant difference was found between the intervention and control groups concerning overall psychological health. However, a subanalysis revealed that those who participated more frequently in the group meetings (five or six times) had significantly stronger psychological health (P<0.05). Knowledge about stroke increased over time in both groups, but participants in the intervention group learned more (P=0.041).CONCLUSION: Encouraging participation in the group meetings of a support programme might have a positive effect on psychological health.
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| 7. |
- Franzén-Dahlin, Åsa, et al.
(författare)
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Predictors of life situation among significant others of depressed or aphasic stroke patients
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:12, s. 1574-1580
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The aim of this study was to examine predictors of the life situation of the significant other of depressed or aphasic stroke patients.BACKGROUND: Depression and aphasia are common consequences of stroke, and both may put pressure on the significant other who have to deal not only with a possible physical handicap but also with communication and/or serious psychiatric difficulties.DESIGN: Descriptive, cross-sectional study.METHODS: The participants were significant others of 71 depressed and 77 aphasic stroke patients. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorder, and degree of aphasia was diagnosed with the Amsterdam Nijmegen Everyday Language Test. Assessments of the life situation, state of depression and aggression, personality change and need of assistance were made through questionnaires issued to the significant others.RESULTS: Perceived need of assistance was the only common predictor of life situation of the significant other in both groups (p < 0.001). With respect to the aphasic patients, perceived personality change (p < 0.001) and living with the patient (p = 0.004) were factors that had a negative effect on the life situation of the significant other.CONCLUSIONS: This study highlights that the perception of the patient's need of assistance is an important factor in predicting the life situation among spouses of depressed as well as aphasic stroke patients. A comparison of the two groups to explain the life situation of the significant others revealed greater explanatory power for the aphasic group.RELEVANCE TO CLINICAL PRACTICE: Assessments of the spouses' perception as well as of the patients' factual situation may identify those significant others at risk. With this new approach, necessary steps may be taken to alleviate pressure on the significant other.
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| 8. |
- Franzén-Dahlin, Åsa, et al.
(författare)
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Predictors of psychological health in spouses of persons affected by stroke
- 2007
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:5, s. 885-891
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To identify predictors of psychological health and examine if these predictors change over time in spouses of stroke patients during the first year after stroke. A second aim was to identify gender differences in psychological health among the spouses.BACKGROUND: The impact of burden in long-term caregivers may result in psychological consequences for the spouse. The rehabilitation process for the patient can be negatively affected by a stressed caregiver and result in long-term hospitalization. To identify spouses at risk for physical and psychological distress is, therefore, essential to support those in need.DESIGN: Longitudinal, comparative study.METHODS: One hundred spouses of stroke patients were assessed at baseline, as well as after six and 12 months, regarding psychological health, well-being, own illness, need of assistance from general practitioner and/or district nurse, social network and knowledge about stroke. Stepwise multiple regression analyses were conducted for baseline, six- and 12-month assessments, respectively, with psychological health as the dependent variable.RESULTS: General well-being and presence of illness in spouse were the most prominent predictors of psychological health, throughout the first year.CONCLUSIONS: Enhancing psychological health and preventing medical problems in the caregiver are essential considerations to enable patients with stroke-related disabilities to continue to live at home.RELEVANCE TO CLINICAL PRACTICE: Evaluating the situation for spouses of stroke patients is an important component when planning for the future care of the patient.
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| 9. |
- Fridlund, Bengt, et al.
(författare)
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Cardiac rehabilitation and psychosocial gender differences
- 2002
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Ingår i: Vård i Norden. - København : Sjuksköterskornas samarbete i Norden (SSN). - 0107-4083 .- 1890-4238. ; 22:3, s. 48-51
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Tidskriftsartikel (refereegranskat)abstract
- Tertiary prevention comprising treatment, care and rehabilitation of patients with heart disease is an important task for nurses and other health care professionals. This is achieved through a combination of medico-physical and psychosocial interventions, related to the male or female patient's personal, expressed problems and the personnel's know ledge. Therefore, the aim of this literature study was to highlight the comprehensiveness of the cardiac rehabilitation concept from a Nordic perspective and with focus on psychosocial gender differences. The Nordic examples of cardiac rehabilitation programmes, involving a multidisciplinary team and comprising health education, physical exercise and stress management, include no specific efforts for women. However, the efficacy of out-patient programmes is still poorly documented and there is a need to increase the attendance of eligible patients, particularly women, in these programmes. There are differences between the genders concerning the need for support from personnel and laymen in order to better reach patient's compliance. Taking the psychosocial characteristics specific to women into account, could be the first step towards increased attendance rates for women as well as reaching the proximal and distal targets with regards to cardiac rehabilitation.
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| 10. |
- Kahan, Thomas, et al.
(författare)
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Risk prediction in stable angina pectoris
- 2013
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Ingår i: European Journal of Clinical Investigation. - : Wiley. - 0014-2972 .- 1365-2362. ; 43:2, s. 141-151
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Although stable angina pectoris often carries a favourable prognosis, it remains important to identify patients with an increased risk of cardiovascular (CV) complications. Many new markers of disease activity and prognosis have been described. We evaluated whether common and easily accessible markers in everyday care provide sufficient prognostic information.MATERIALS AND METHODS:The Angina Pectoris Prognosis Study in Stockholm treated 809 patients (248 women) with stable angina pectoris with metoprolol or verapamil double blind during a median follow-up of 3·4 years, with a registry-based extended follow-up after 9·1 years. Clinical and mechanistic variables, including lipids and glucose, renal function, ambulatory and exercise-induced ischaemia, heart rate variability, cardiac and vascular ultrasonography, and psychosocial variables were included in an integrated analysis. Main outcome measures were nonfatal myocardial infarction (MI) and CV death combined.RESULTS: In all, 139 patients (18 women) suffered a main outcome. Independent predictive variables were (odds ratio [95% confidence intervals]), age (1·04 per year [1·00;1·08], P = 0·041), female sex (0·33 [0·16;0·69], P = 0·001), fasting blood glucose (1.29 per mM [1.14; 1.46], P < 0·001), serum creatinine (1·02 per μM [1·00;1·03], P < 0·001) and leucocyte counts (1·21 per 106 cells/L [1·06;1·40], P = 0·008). Smoking habits, lipids and hypertension or a previous MI provided limited additional information. Impaired fasting glucose was as predictive as manifest diabetes and interacted adversely with serum creatinine. Sexual problems were predictive among men.CONCLUSIONS:Easily accessible clinical and demographic variables provide a good risk prediction in stable angina pectoris. Impaired glucose tolerance and an elevated serum creatinine are particularly important.
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