| 1. |
- Andersson Shams Hakimi, Caroline, et al.
(författare)
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Effects of fibrinogen and platelet supplementation on clot formation and platelet aggregation in blood samples from cardiac surgery patients.
- 2014
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Ingår i: Thrombosis research. - : Elsevier BV. - 1879-2472 .- 0049-3848. ; 134:4, s. 895-900
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Tidskriftsartikel (refereegranskat)abstract
- Bleeding after cardiac surgery may be caused by surgical factors, impaired haemostasis, or a combination of both. Transfusion of blood products is used to improve haemostasis, but little is known about what combination is optimal. We hypothesized that addition of both fibrinogen and platelets to blood samples from cardiac surgery patients would improve clot formation and platelet aggregation to a greater extent than if the components were added separately.
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| 2. |
- Bian, Li, et al.
(författare)
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Rutinmässig screening med APTT är inte indicerad före operation : [Routine screening with APTT is not indicated before surgery
- 2022
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Ingår i: Läkartidningen. - : Sveriges Läkarförbund. - 0023-7205 .- 1652-7518. ; 119
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Forskningsöversikt (refereegranskat)abstract
- Activated partial thromboplastin time (APTT) is widely practiced in preoperative screening. The value of using this test to predict the risk of perioperative bleeding is not well documented in Sweden. In this article, a literature review is performed to determine whether unselected APTT testing can predict abnormal perioperative bleeding. The current literature does not support coagulation screening with APTT in routine perioperative bleeding assessment, as preoperative screening with APTT has a low sensitivity for detection of clinically significant bleeding disorder. While a comprehensive bleeding history is crucial, the APTT test should only be performed on patients with a history of increased bleeding tendency. The conclusion of this literature review is that patients with a negative bleeding history do not require routine screening with APTT prior to surgery, which, if implemented, would lead to a more cost-effective perioperative routine.
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| 3. |
- Björkström, Monica, 1953-
(författare)
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Den professionella sjuksköterskan : i relation till den akademiska sjuksköterskeutbildningen
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The Professional Nurse in Relation to Academic Nursing EducationThe increasing demands on the nurse’s competence in the society are reflected in laws and ordinances as well as in the transition of the nursing education to universities. The overall aim of this thesis was to illuminate, describe and understand nurses’ professional awareness in relation to academic nursing education.The longitudinal studies I and II of the thesis included novice nursing students (n= 164/163), senior students (n=123/124), and nurses three to five years after graduating (n=83/82). Study III of the thesis covered a nationally random selection of nurses graduated during four different years before and after the implementation of the academic education (n=289). Study IV focused on senior students (n=155). The data were collected by means of three questionnaires: open questions where the respondents were asked to describe their views of a good nurse and a bad nurse (I); a scale for assessing the professional self in relation to others (modified Nurse Self Description Form) (II); and finally, a questionnaire designed to asses the nurses’ (III) and the students’ (IV) attitudes to and awareness of research within nursing (as developed in study III). The data were analysed by means of content analysis (I) and parametric and non-parametric statistical methods (II, III, IV), and factor analysis (III).The result was that the characteristic of a good nurse ”to do good for others” emerged strongly and retained its dominant position throughout the education and beyond. ”To be competent and skilled” was also highly favoured and gained ground during and after the training. ”To have professional courage and pride” and ”to seek professional development” were considerably less prominent but increased slightly in importance over time (I). The professional self in relation to others in similar situations were generally rated as both strong among students and experienced nurses (II). Also in this respect there was an emphasis on the aspect of doing good for others. The professional self grew stronger over time in the areas of drive, objectivity, flexibility, ability to teach, ability to communicate and sociability, whereas the desire to contribute through research and knowledge mastery decreased over time (II). The process of developing into an experienced nurse, however, entailed increased awareness of the complexity of the nursing profession. The instruments for measuring attitudes to nursing research were validated through factor analysis, which generated seven factors termed ”research language,” ”need of research knowledge,” ”participation,” ”the profession,” ”meaningfulness,” ”study literature,” and ”developing–resources” (III). Nurses (III) as well as students (IV) expressed a positive attitude to nursing research and its application to the nursing profession. However, the nurses in particular stated that they seldom read scientific journals and seldom applied nursing research in their daily work.To sum up, the research in this thesis shows that students and nurses only to a moderate extent displayed the professional awareness that the academic nursing education aims for. The traditional image of a good nurse was the most clearly manifested form of awareness, whereas insufficient awareness was registered in areas related to own responsibility for research-based practice. The result indicates a need for further collaboration between the nursing education and the health care sector, as well as for academically highly qualified nurses as resource persons in nursing practice, to support quality development in nursing, and serve as role models for students.
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| 4. |
- Ekman, Inger, 1952, et al.
(författare)
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Can treatment with ACE-inhibitors in elderly patients with moderate to severe heart failure be improved by a nurse-monitored structured care program?
- 2003
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Ingår i: Heart & Lung. - 0147-9563. ; 32:1, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- Can treatment with angiotensin-converting enzyme inhibitors in elderly patients with moderate to severe chronic heart failure be improved by a nurse-monitored structured care program? A randomized controlled trial. OBJECTIVE: The purpose of this study was to examine whether a nurse-monitored structured care program resulted in a more effective use of angiotensin-converting enzyme (ACE) inhibitors in elderly patients compared with standard care in patients with chronic heart failure (CHF). METHODS: Hospitalized patients were screened to identify individuals with CHF, age more than 65 years, New York Heart Association classification III to IV, and no contraindications to ACE inhibitor treatment. One hundred forty-five patients were randomized to a nurse-monitored structured care program that included uptitration of enalapril to a target dose of 10 mg twice a day or to standard care. Six-month follow-up data were collected. RESULTS: The mean age of the randomized patients was 81 years. Although the proportion of patients treated with an ACE inhibitor did not differ between structured care (70%) and standard care (64%), the number of patients with the target ACE inhibitor dose was significantly higher in the structured care group (26% versus 11% in the standard care group; P <.018). Treatment had to be discontinued in 26% of the patients because of adverse effects. CONCLUSION: The patients in this study were older than in previous intervention studies and had considerable comorbidity and reduced tolerance for ACE inhibitors. ACE inhibitor treatment was underused but improved with the structured care program, although achieved treatment levels were below those in the large intervention trials in patients with CHF.
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| 5. |
- Ekman, Inger, 1952, et al.
(författare)
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Feasibility of a nurse-monitored, outpatient-care programme for elderly patients with moderate-to-severe, chronic heart failure
- 1998
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Ingår i: European Heart Journal. - London, United Kingdom : W. B. Saunders Co. Ltd.. - 0195-668X .- 1522-9645. ; 19:8, s. 1254-60
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To evaluate the feasibility of a nurse-monitored, outpatient-care program for elderly patients previously hospitalized with chronic heart failure.Methods and results: Patients with chronic heart failure hospitalized in the medical wards were screened to find those eligible for a randomized study to compare the effect of a nurse-monitored, outpatient-care programme aiming at symptom management, with conventional care. The inclusion criteria were patients classified in New York Heart Association classes III-IV, age 65 years, and eligibility for an outpatient follow-up programme. The total in-hospital population of patients discharged with a heart-failure diagnosis was surveyed. Eighty-nine per cent of all the hospitalized patients (n=1541) were 65 years old. Of these, 69% (n=1058) were treated in the medical wards which were screened. The study criteria were met by 158 patients (15%). No visits to the nurse occurred in 23 cases among the 79 patients randomized to the structured-care group (29%), mainly on account of death or fatigue. The numbers of hospitalizations and hospital days did not differ between the structured-care and the usual-care groups.Conclusions: Given the selection criteria and the outline of the interventions, the outpatient, nurse-monitored, symptom-management programme was not feasible for the majority of these elderly patients with moderate-to-severe, chronic heart failure, mainly because of the small proportion of eligible patients and the high drop-out rate. Management of these patients would have to be more adjusted to their home situation.
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| 6. |
- Ekman, Inger, 1952, et al.
(författare)
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Health-related quality of life and sense of coherence among elderly patients with severe chronic heart failure in comparison with healthy controls
- 2002
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Ingår i: Heart & Lung. - 0147-9563. ; 31:2, s. 94-101
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe health-related quality of life (QoL) and sense of coherence (SOC) in a group of elderly people with moderate to severe chronic heart failure and to make comparisons with a healthy sex- and age-matched control group. METHODS: Patients (n = 94), with a mean age of 81 years, hospitalized for chronic heart failure with New York Heart Association functional classification III to IV were age- and sex-matched to a healthy control group. The instruments used were the 36-Item Short Form Health Survey (SF-36) and SOC. RESULTS: The patients had lower levels of health-related QoL scores (SF-36) but high and similar scores of SOC compared with the controls. There were, however, significant positive correlations between the SOC scores and the emotional dimensions in the SF-36 instrument. CONCLUSION: The findings from this study indicate that old age and severe chronic heart failure were associated with limited functional abilities and impaired health-related QoL but also with internal resources such as SOC.
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| 7. |
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| 8. |
- Ekman, Inger, et al.
(författare)
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Outpatient care programmes for the elderly
- 1999
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Ingår i: European Heart Journal. - London, United Kingdom : W. B. Saunders Co. Ltd.. - 0195-668X .- 1522-9645. ; 20:5, s. 393-4
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Tidskriftsartikel (refereegranskat)
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| 9. |
- Ekman, Inger, 1952, et al.
(författare)
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The clinical implications of cognitive impairment in elderly patients
- 2001
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Ingår i: Journal of Cardiovascular Nursing. - 0889-4655. ; 16:1, s. 47-55
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to examine whether cognitive dysfunction was associated with poor participation in an outpatient treatment program for patients with chronic heart failure and if it was related to specific patient characteristics. Cognitive function was measured with the Mini Mental State Examination (MMSE). Twenty-three of 78 (29%) patients randomized to structured care did not participate in this program and nonparticipation during 6-month follow-up was associated with an MMSE score below the median and a low calculated creatinine clearance (CrCl) (R2=0.15, p=0.0025) at entry. In the entire group long duration of heart failure and low blood hemoglobin concentration were independently associated with an MMSE score below the median at entry (R2=0.14, p < 0.0001). Among elderly patients hospitalized with moderate-severe chronic heart failure, judged to be eligible for a nurse-directed outpatient program after discharge, a low MMSE score predicted nonparticipation in such a program. Cognitive dysfunction, which was related to the duration of heart failure, should be evaluated in the treatment of patients with chronic heart failure.
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| 10. |
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