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- Bergqvist, Anette, et al.
(författare)
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Preventing the development of metabolic syndrome in people with psychotic disorders-difficult, but possible : experiences of staff working in psychosis outpatient care in sweden
- 2013
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Ingår i: Issues in Mental Health Nursing. - : Informa Healthcare. - 0161-2840 .- 1096-4673. ; 34:5, s. 350-358
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore mental health staffs' experiences of assisting people with psychotic disorders to implement lifestyle changes in an effort to prevent metabolic syndrome. Qualitative interviews were conducted with 12 health care professionals working in psychosis outpatient care in Sweden. Data were analysed using a qualitative content analysis. The results illustrate that implementation of lifestyle changes among people with psychotic disorders was experienced as difficult, but possible. The greatest obstacles experienced in this work were difficulties due to the reduction of cognitive functions associated with the disease. Guidelines available to staff in order to help them identify and prevent physical health problems in the group were not always followed and the content was not always relevant. Staff further described feelings of uncertainty about having to motivate people to take anti-psychotic medication while simultaneously being aware of the risks of metabolic deviations. Nursing interventions focusing on organising daily routines before conducting a more active prevention of metabolic syndrome, including information and practical support, were experienced as necessary. The importance of healthy eating and physical activity needs to be communicated in such a way that it is adjusted to the person's cognitive ability, and should be repeated over time, both verbally and in writing. Such efforts, in combination with empathic and seriously committed community-based social support, were experienced as having the best effect over time. Permanent lifestyle changes were experienced as having to be carried out on the patient's terms and in his or her home environment.
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- Foldemo, Anniqa, et al.
(författare)
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Between hope and worry : a phenomenological study of parents of outpatients with schizophrenia
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: In recent decades, most of the care for the severely mentally ill has shifted from hospital care to care in the community. In the community, the families' responsibilities for care and support has increased. The objectives of the present study were to describe the experiences and strategies when being a parent of an outpatient with schizophrenia. Two researchers interviewed eight parents of outpatients with schizophrenia. A phenomenological perspective guided the study and the analysis was performed in accordance with the Empirical Phenomenological Psychological Method (EPP). Four themes created the meaniog of liviog with a mentally ill child. These themes were: emotions in parenthood, change in the families, interaction with others and adaptation to the illnessThe results have been interpreted and discussed io the light of the first onset of the ilioess, loss and grief and the creation of meaning and hope. Conclusion: these results suggest that atl the parents in the present study experienced a loss of their former child, underwent a grief process, needed to interact with others and used emotionally focused coping strategies.
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- Foldemo, Anniqa, et al.
(författare)
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Health-related quality of life and metabolic risk in patients with psychosis
- 2014
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Ingår i: Schizophrenia Research. - : Elsevier. - 0920-9964 .- 1573-2509. ; 152:1, s. 295-299
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Tidskriftsartikel (refereegranskat)abstract
- Improved Health-related quality of life (HRQoL) is an alternative treatment goal for individuals with psychosis, who have up to two times greater prevalence of type 2 diabetes, hypertension and obesity than the general population. Aim: to compare HRQoL in patients with psychosis, especially schizophrenia, with a reference sample and explore the relationship between HRQoL and metabolic risk factors in these patients. Methods: a prospective cohort study was carried out in specialized psychiatric outpatient departments in Sweden. The patients were invited consecutively. A prospective population-based study of public health in the south-east of Sweden served as reference group. Patients were assessed with psychiatric questionnaires that included Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the questionnaire EQ5D, both for patients and the population, and several other health status outcomes were used. Results: At 73%, schizophrenia and schizoaffective disorder were the most common diagnoses in the patient group. The results in patients (n = 903) and population (n = 7238) showed significant differences in lower EQ5D among patients. According to the definition by the International Diabetes Federation (IDF), elevated blood pressure was the only metabolic risk associated with lower HRQoL in patients. Raised LDL-cholesterol levels were also significantly related to lower HRQoL. Conclusion: patients suffering from psychosis had significantly lower HRQoL regarding all components in EQ5D, except for the pain/discomfort component. Almost half of the patient group met the criteria for metabolic syndrome. According to the IDF criteria, elevated blood pressure was the only metabolic risk factor that had an impact on HRQoL.
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- Foldemo, Anniqa, 1953-
(författare)
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Living with schizophrenia from the perspective of outpatients and their parents
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to investigate how outpatients with schizophrenia experienced their situation in terms of need and quality of life. A further aim was to investigate how their parents experienced the need of their daughter or son and how it influenced their own life. In order to investigate need and quality of life of outpatients with schizophrenia according to DSM-III-R, (n=19) at baseline and five-year follow-up (n=17) the outpatients completed the following questionnaires: Camberwell Assessment of Need (CAN-R), the Quality of Life Scale (QLS-100), the Global Assessment of function (1) and the Clinical Global Impression (CGI) at follow-up the Insight Scale (2). In study II, outpatients with schizophrenia according to DSM-IV (n=32) and their parents (n=44) and staff (n=31) were included. To investigate the outpatients' need both the patients, their parents and staff completed the CAN-R questionnaire. In study III, the quality of life of the parents (n=38) was investigated with the help of the questionnaire Quality of Life Index (QLI), which was completed by the parents and a reference group (n=689). In addition, the questionnaire Burden Assessment Scale (BAS) was used in order to describe the parents' burden. In order to better understand how living with outpatients with schizophrenia (n=8) influenced parents, the parents were interviewed and data were analysed according to the Empirical Phenomenological Psychological (EPP) method. The total number of needs in study I, according to CAN, was 7.1 ± 3.2 at the baseline and 6.3 ± 2.8 at the follow-up. Using our cut-off point, 5 patients at the baseline and 1 at the follow-up had greater problems. The outpatients were more satisfied with their quality of life after five years than baseline (p< 0.05). The need ranking of key workers and patients showed a correlation rho=0.68 (p<0.05) at the baseline and rho=0.74 (p<0.05) at the follow-up. The difference in number of needs was that the key workers identified more topics where the patients had needs than the patients did themselves. The outpatients in study II, rated the total score of the severity of needs at a mean of 7 ± 4, while the mean score for both parents and the staff was 9 ± 5. The unmet needs in mean values for the patients were 2 ± 2 and 4 ± 5 for both parents and the staff. The needs ranking between patients and parents and patients and staff both showed a correlation of rho=0.65 (p<0.01). The correlation between parents and staff was rho=0.95 (p<0.01). Parents and staff rated needs in different areas. There was a correlation between the total number of needs and how the patients functioned rho=0.53 (p <0.01) and the severity of illness rho=0.64 (p<0.01), respectively, assessed by GAF and CGI. The parents were significantly less satisfied with their overall quality of life with a mean value of 19.5 ± 4.0 compared with the reference group, which had a mean value of 21.2 ± 4.1 (p<0.05); however, when divided into age groups, there was no significant difference in quality of life in the oldest age group 71-80. There were significant correlations between lower overall quality of life and higher burden r=0.58 (p<0.01) as well as between lower psychological/spiritual values and higher burden r=0.42 (p<0.05). The experience of living with a mentally ill daughter or son includes both emotions and changed reality that parents must adapt to. Four points relating to the general structure of themes were identified; emotions in parenthood, changes in the families, interaction with others and adaptation to the illness. All the themes included also five subthemes: confusion following the first appearance of the illness, interpreting the illness and loss in terms of grief, the importance of support, adaptation to the loss and feelings about the future in terms of worry and hope. In order to support the outpatients and their parents, it is important to assess need, listen more on their experiences and increase our knowledge about their situation.
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- Foldemo, Anniqa
(författare)
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Mötet med individer med psykisk ohälsa i olika öppenvårdsformer
- 2010
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Ingår i: Omvårdnad vid psykisk ohälsa. - : Studentlitteratur. - 9789144056463 - 914405646X ; , s. 483-
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Omvårdnad vid psykisk ohälsa - på grundläggande nivå presenterar översiktlig kunskap om psykisk ohälsa, psykiatriska sjukdomar och individers problematik rörande psykisk ohälsa. Den första delen fokuserar på de mest förekommande ohälsoproblemen inom psykiatrisk vård. Bokens senare del belyser viktiga områden som har betydelse för hur vården kring patienten kan förstås och hanteras, såsom vårdens miljö och organisation, attityder kring psykiska dilemman, närståendes medverkan och kvalitets arbete inom psykiatrisk vård. I bokens fokus står den unge, den vuxna och den äldre individen och dennes problematik. Utgångspunkten är ett omvårdnadsperspektiv med hänvisningar till omgivande områden såsom medicin, sociologi, farmakologi och psykologi. Det genomgående perspektivet är omvårdnad vid psykisk ohälsa även om de konkreta åtgärder som beskrivs också kan inspirera och vägleda andra professioner i deras hälsoarbetare. Boken vänder sig främst till studenter i grundutbildningen till sjuksköterska, men den kan också med fördel användas inom utbildningar med inriktning mot folkhälsa och av kliniskt verksamma sjuksköterskor inom kommunal, primär- eller specialistvård. Boken innehåller en individuell aktiveringskod som ger tillgång till ett pedagogiskt webbkomplement. För att säkerställa att du som köpare får den unika koden säljs boken inplastad.
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