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- Henriksson, Catrin, 1961-
(författare)
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Coronary Heart Disease and Early Decision Making, from Symptoms to Seeking Care : Studies with Focus on Pre-hospital Delay in Acute Myocardial Infarction Patients
- 2011
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Despite several investigations and interventions aimed at decreasing the time from symptom onset to medical care seeking in acute myocardial infarction patients, the delay time is still too long for best treatment outcomes. In this thesis, investigations aimed at improving our understanding of the factors influencing delay time are evaluated, as well as attitudes to medical care seeking in patients, relatives and the general public. Additionally, an evaluation was performed to examine whether health-related quality of life had any influence on delay time and re-admissions. Participating patients, relatives and representatives of the general public were generally knowledgeable about acute myocardial infarction (AMI) and its symptomatology. The majority of participants knew about the importance of receiving fast treatment when an AMI occurs. Despite people’s knowledge, several patients and relatives felt uncertain of symptom origin and how to act at symptom onset. Patients commonly consulted an additional person when symptoms did not disappear. However, people appeared to act more appropriately if someone else had chest pain compared to self-experienced symptoms. In patients who had suffered from more than one AMI, poor total health status increased the risk of delaying for more than two hours, but no independent association was found between total health status and re-admissions within the first year post-AMI.
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| 2. |
- Henriksson, Catrin, 1961-
(författare)
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Influence of health-related quality of life in myocardial infarction with regard to the time from symptom onset to hospital arrival, and the risk of re-admission
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Despite increased awareness of the importance of early treatment in acutemyocardial infarction (AMI), the delay from symptom onset until hospital arrival is still too longand re-hospitalisations are frequent. Little is known about how health-related quality of life(HRQL) affects delay time and the frequency of re-admissions.Method: We used quality registers to investigate whether patients’ HRQL has any impact ondelay time with a new AMI, and on the rate of re-admissions during the first year. AMI-patients<75 years, with HRQL assessed with EQ-5D at one-year follow-up, and who thereafter had anew AMI registered, were evaluated for the correlation between HRQL and delay time (n=454).The association between HRQL and re-admissions was evaluated among those who had anadditional one-year follow-up registration after the new AMI (n=216).Results: Patients who reported poor total health status (EQ-VAS ≤50), compared to those whoreported EQ-VAS 81-100, had tripled risk to delay ≥2 hours from symptom onset to hospitalarrival (adjusted OR 3.01, 95% CI: 1.43-6.34). Patients scoring EQ-VAS ≤50 had a higher riskof re-admissions in the univariate analysis (OR 3.08, 95% CI: 1.71-5.53). However, thecorrelation did not remain significant after adjustment (OR 1.99, 95% CI: 0.90-4.38). EQ-indexwas not independently associated with delay time or re-admissions.Conclusion: Aspects of total health status post-AMI were independently associated with delaytime to hospital arrival in case of a new AMI. However, the influence of total health status on therisk of re-admissions was less clear.
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| 3. |
- Henriksson, Catrin, 1961-
(författare)
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Knowledge about Acute Myocardial Infarction (AMI) and attitudes to medical care seeking : a comparison between patients and the general public
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Patients with acute myocardial infarction often have long decision times beforeseeking medical care. The decision time is influenced by knowledge of AMI-symptoms,psychological factors and the response of people near the patient to the symptoms.Aim: To investigate and compare the knowledge of AMI, intended actions in response to AMIsymptomsand attitudes toward seeking medical care of patients and the general public.Method: This was a multi-centre study with descriptive and comparative design, usingquestionnaires as an instrument. The population consisted of AMI-patients and representatives ofthe general public.Results: There was good knowledge about typical AMI-symptoms among the participants. Themajority thought an AMI always starts suddenly. Patients did not know more about the timedependencyof treatment outcome than the general public. A greater proportion of the generalpublic would contact an additional person before consulting medical professionals.Conclusions: Patients had no better knowledge about AMI than the general public, but wouldmore commonly act appropriately in case of AMI-symptoms.
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| 4. |
- Henriksson, Catrin, 1961-, et al.
(författare)
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Patients’ experiences of clinical trial participation involving a product remotely assessing study drug adherence
- 2024
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Ingår i: Contemporary Clinical Trials Communications. - : Elsevier. - 2451-8654. ; 40
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Tidskriftsartikel (refereegranskat)abstract
- Background: The participation of patients in clinical trials is crucial for the development of healthcare. There are several challenges in the recruitment of trial participants with acute medical conditions. The registry-based randomized DAPA-MI clinical trial recruited patients during hospitalization for myocardial infarction and provided study drugs in bottles with smart caps that used wireless technology to transmit monitoring data. This interview study aimed to investigate patients’ experience of participation in a clinical trial and their attitude to the new bottle cap technology. Methods: A subset of patients participating in the DAPA-MI trial were recruited from four hospitals in Sweden. Semi-structured interviews were conducted and analysed using manifest content analysis. Results: Video interviews were performed including 21 patients (four women and 17 men). The median age was 59 years (range 44–80). Four categories of patients' experiences were identified. A willingness to contribute consisted of patients’ positive attitudes to participation and to be a part of development and research. The perception of information emphasized the value of the oral information as well as the importance of time for reflection. Be in a vulnerable condition highlighted the impaired ability to perceive and remember in the acute medical condition. Adaptation to a new technology described the overall positive experiences of the smart bottle cap to evaluate adherence. Conclusions: Patients’ experiences of trial participation were in general positive but some challenges in the acute setting of a myocardial infarction were revealed. The smart bottle cap was well accepted, despite some handling difficulties.
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| 5. |
- Perk, Joep, et al.
(författare)
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Ny vårdmodell för prevention efter akut kranskärlssjukdom
- 2016
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Ingår i: Läkartidningen. - : Läkartidningen Förlag. - 0023-7205 .- 1652-7518. ; 113
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Tidskriftsartikel (refereegranskat)abstract
- Kardiologföreningens arbetsgrupp för levnadsvanor och arbetsgruppen för SPICI-studien har tillsammans med Riksförbundet HjärtLung tagit fram en ny vårdmodell för prevention/rehabilitering vid kranskärlssjukdom.I modellen ingår: Kunskap hos staben för perkutan kranskärlsintervention (PCI) och övriga professioner om att preventionen börjar redan vid diagnosen.Utskrivning företrädesvis tillsammans med patientens närstående.Ett besök hos sjuksköterskan inom 1–2 veckor med personlig hälsoplan/individuell preventions- och rehabiliteringsplanering, även här med närstående.Hälsoplanen innehåller personliga mål/fem kvalitetsdelmål, för rökning, träning, kost, blodtryck och blodfetter.Tillgång till utbildningsmaterial/webbaserade plattformar och övriga delar i ett hälsofrämjande preventions- och hjärtrehabiliteringsprogram.Avslutande besök hos läkare och sjuksköterska efter 6–12 månader med avrapportering till kvalitetsregistret SEPHIA (sekundärpreventionsregistret).
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| 6. |
- Stenberg, Jenny, 1976-, et al.
(författare)
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Perspectives on clinical use of bioimpedance in hemodialysis : focus group interviews with renal care professionals.
- 2018
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Ingår i: BMC Nephrology. - : Springer Science and Business Media LLC. - 1471-2369. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Inadequate volume control may be a main contributor to poor survival and high mortality in hemodialysis patients. Bioimpedance measurement has the potential to improve fluid management, but several dialysis centers lack an agreed fluid management policy, and the method has not yet been implemented. Our aim was to identify renal care professionals' perceived barriers and facilitators for use of bioimpedance in clinical practice.METHODS: Qualitative data were collected through four focus group interviews with 24 renal care professionals: dieticians, nephrologists and nurses, recruited voluntarily from a nation-wide selection of hemodialysis centers, having access to a bioimpedance-device. The participants were connected to each other and a moderator via equipment for telemedicine and the sessions were recorded. The interviews were semi-structured, focusing on the participants' perceptions of use of bioimpedance in clinical practice. Thematic content analysis was performed in consecutive steps, and data were extracted by employing an inductive, interactive, comparative process.RESULTS: Several barriers and facilitators to the use of bioimpedance in clinical practice were identified, and a multilevel approach to examining barriers and incentives for change was found to be applicable to the ideas and categories that arose from the data. The determinants were categorized on five levels, and the different themes of the levels illustrated with quotations from the focus groups participants.CONCLUSIONS: Determinants for use of bioimpedance were identified on five levels: 1) the innovation itself, 2) the individual professional, 3) the patient, 4) the social context and 5) the organizational context. Barriers were identified in the areas of credibility, awareness, knowledge, self-efficacy, care processes, organizational structures and regulations. Facilitators were identified in the areas of the innovation's attractiveness, advantages in practice, and collaboration. Motivation, team processes and organizational capacities appeared as both barriers and facilitators.
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