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- Agren Bolmsjö, I, et al.
(författare)
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From cure to palliation: agreement, timing, and decision making within the staff
- 2007
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Ingår i: The American journal of hospice & palliative care. - : SAGE Publications. - 1049-9091 .- 1938-2715. ; 24:5, s. 366-70
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Tidskriftsartikel (refereegranskat)abstract
- Important issues in the transition From curative treatment to palliative care are agreement, timing, and decision making. A survey oF 309 nurses and 415 physicians in Sweden showed that 61% oF the nurses and 83% oF the physicians thought agreement was current practice. None said that the decisions were made too early, but 19% oF the nurses and 14% oF the physicians thought that they oFten were made too late. Very Few respondents stated that such decisions are changed, 0% and 1%, respectively. More than halF oF the inFormants made detailed comments on such transitions indicating that awareness and Flexibility are desirable to make well-inFormed decisions. Three themes that emerged From the analysis concerning the decision to stop curative treatment and Focus on palliative care were that the staFF members should (iF possible) make such decisions in agreement and should sometimes make the decisions earlier and that well-based reasons are required to make changes.
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| 2. |
- Bolmsjö, Beata Borgström, et al.
(författare)
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Factors influencing deprescribing for residents in Advanced Care Facilities : insights from General Practitioners in Australia and Sweden
- 2016
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Ingår i: BMC Family Practice. - : Springer Science and Business Media LLC. - 1471-2296. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: General Practitioners (GPs) are responsible for primary prescribing decisions in most settings. Elderly patients living in Advanced Care Facilities (ACFs) often have significant co-morbidities to consider when selecting an appropriate drug therapy. Careful assessment is required when considering appropriate medication use in frail older patients as they have multiple diseases and thus multiple medication. Many physicians seem reluctant to discontinue other physicians' prescriptions, resulting in further polypharmacy. Therefore it is relevant to ascertain and synthesise the GP views from multiple settings to understand the processes that might promote appropriate deprescribing medications in the elderly. The aims of this study were to 1) compare and contrast behavioural factors influencing the deprescribing practices of GPs providing care for ACF residents in two separate countries, 2) review health policy and ACF systems in each setting for their potential impact on the prescribing of medications for an older person in residential care of the elderly, and 3) based on these findings, provide recommendations for future ACF deprescribing initiatives. Methods: A review and critical synthesis of qualitative data from two interview studies of knowledge, attitudes, and behavioural practices held by GPs towards medication management and deprescribing for residents of ACFs in Australia and Sweden was conducted. A review of policies and health care infrastructure was also carried out to describe the system of residential aged care in the both countries. Results: Our study has identified that deprescribing by GPs in ACFs is a complex process and that there are numerous barriers to medication reduction for aged care residents in both countries, both with similarities and differences. The factors affecting deprescribing behaviour were identified and divided into: intentions, skills and abilities and environmental factors. Conclusions: In this study we show that the GPs' behaviour of deprescribing in two different countries is much dependent on the larger health care system. There is a need for more education to both GPs and ACF staff as well as better cooperation between the different health care systems and appropriate monetary incentives for elderly care to achieve better conditions for deprescribing practice.
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| 3. |
- Hjörleifsdottir, Elisabet, et al.
(författare)
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Distress and coping in cancer patients: feasibility of the Icelandic version of BSI 18 and the WOC-CA questionnaires.
- 2006
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 1365-2354 .- 0961-5423. ; 15:1, s. 80-89
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to test the feasibility of two instruments within an Icelandic context, the Brief Symptom Inventory 18 (BSI 18) and the Ways of Coping Inventory – Cancer Version (WOC-CA) with specific focus on gender and type of treatment and coping techniques among cancer patients during time of treatment. The sample consisted of 40 cancer patients in three oncology outpatient clinics in Iceland, 53% were women and 47% men. The majority of the participants belonged to the age group 51–70. Cronbach alpha, means, confidence intervals and standard deviations were used for analysis as well as Mann–Whitney U-test for testing differences between genders in relation to psychological distress and coping. Anxiety was the factor causing the greatest distress, mainly reported by patients receiving chemotherapy. More women experienced depression than men, women (18.4%), men (8.3%). Distancing was the most frequently reported coping strategy, and men seemed to focus on the positive side more often than women did (P < 0.01). Although the results should be approached with caution, as the sample size was small, they do provide support for the strength of the measurements. Also the findings indicate that gender differences should be taken into account.
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