| 1. |
- Dozet, Alexander, et al.
(författare)
-
Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden
- 2016
-
Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell. - 1356-1294 .- 1365-2753. ; 22:6, s. 994-1001
-
Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectives: The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations.Methods: This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skane, Sweden.Results: From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography.Conclusion: Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients.
|
|
| 2. |
- Eklund, Karin, et al.
(författare)
-
Positive Experience of a Mobile Radiography Service in Nursing Homes.
- 2012
-
Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 58, s. 107-111
-
Tidskriftsartikel (refereegranskat)abstract
- Background: For elderly people living in nursing homes, a transport to hospital for a radiological examination can lead to increased anxiety, disorientation and other problems related to the new environment. Objective: To investigate the usefulness of a mobile radiography service for radiological assessment of patients in nursing homes from the patient and staff perspectives. Methods: Lightweight equipment with a digital flat-panel detector was used for mobile radiography on nursing home patients in their own rooms. Data on patient and staff experiences from the service were collected using a questionnaire with closed and open-ended questions. Image quality was evaluated by the radiographer and a radiologist. Results: The majority of 241 radiography examinations were of the musculoskeletal system (94%). Twelve of 123 patients had pathology that required hospital treatment, while 22 patients with radiographic pathology could be treated locally. The main beneficial factors were security and comfort, acceptance from the patients, no need for transportation, no need for staff to be absent from the nursing homes. Conclusion: Mobile radiography in nursing homes is technically feasible, with good image quality. The most beneficial results were that patients avoided unnecessary transport back and forth to the hospital, and that the majority of patients could be treated locally.
|
|
| 3. |
- Ivarsson, Bodil, et al.
(författare)
-
Experiences of group education : A qualitative study from the viewpoint of patients and peers, next of kin and healthcare professionals
- 2011
-
Ingår i: Vård i Norden. - Köpenhamn : SSN [Sjuksköterskornas samarbete i Norden. - 0107-4083 .- 1890-4238. ; 31:2, s. 35-39
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Group education is intended to strengthen the ability of patients with long-term illnesses to cope in everyday life. Aim: To describe how patients and peers, next of kin and healthcare professionals experienced group education sessions. Methods: A qualitative, critical incident technique was used. Thirty patients, 9 peers, 41 next of kin and 12 healthcare professionals were asked to describe in writing their experiences of group education, inspired by the Norwegian Vifladt & Hopen model. The answers were then analyzed and categorized. Findings: Three hundred and eleven critical incidents were identified and two main areas emerged in the analyses: Experiences related to the group education and Impact of the group education programs. Experiences related to the group education described The course, Knowledge and support, and Becoming closer. Impact of the group education programs described Output and Advice to the healthcare organizations. Conclusion: This kind of group education is valuable because the participants benefited from listening to and learning from each other. Patients and NoK had the opportunity to find new strategies for managing daily life. The study also showed that it is important to plan and implement the education and meetings in cooperation between healthcare professionals and experienced peers
|
|
| 4. |
|
|
| 5. |
- Jakobsson, Ulf, et al.
(författare)
-
Old people in pain: A comparative study.
- 2003
-
Ingår i: Journal of Pain and Symptom Management. - 1873-6513. ; 26:1, s. 625-636
-
Tidskriftsartikel (refereegranskat)abstract
- To investigate the prevalence of pain in older people (75+), compare those in pain to those without regarding demographics, social network, functional limitations, fatigue, sleeping problems, depressed mood and quality of life (QOL), and identify variables associated with pain, a cross-sectional, prospective survey was conducted in an age-stratified sample of 4,093 people aged 75–105 years old. Those reporting pain (n = 1,654) were compared with those who did not (n = 2,439). Pain was more common with higher age, as were all complaints among those in pain and among those without, except sleeping problems. Lower QOL was found with higher age, as well as with pain. Pain was found to be associated with functional limitations, fatigue, sleeping problems, depressed mood, and QOL. These data highlight the importance of identifying old people in pain. Those who are older and those affected by pain are at greater risk of also being troubled by other problems, such as functional limitations and lowered QOL.
|
|
| 6. |
- Klefsgård, Rosemarie, et al.
(författare)
-
A 1-year follow-up quality of life study after hemodynamically successful or unsuccessful surgical revascularization of lower limb ischemia
- 2001
-
Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 1097-6809 .- 0741-5214. ; 33:1, s. 114-122
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The impact of hemodynamically successful or unsuccessful bypass grafting or angioplasty on patients' quality of life was assessed throughout the first year postsurgery. METHODS: A total of 146 patients, 97 patients who underwent successful revascularization and 49 patients who underwent unsuccessful revascularization, were assessed for quality of life with the Nottingham Health Profile. RESULTS: Hemodynamically successful revascularization resulted in an immediate and lasting impact on the patients' quality of life. Despite hemodynamic failure, patients had improvements in pain, emotional reactions, sleep, and family relationships at the 1-year follow-up assessment. A successful revascularization in patients with claudication demonstrated the most marked quality of life benefits, including all health dimensions that were not normal at baseline. Patients with critical ischemia had improved quality of life for pain, sleep, and physical mobility. High ankle pressure, in the claudicant group, and a high sense of coherence were significantly associated with high quality of life. CONCLUSION: The treatment of lower limb ischemia resulted in an immediate and relatively lasting improvement in patients' quality of life. Patients who underwent hemodynamically successful bypass grafting procedures or angioplasty demonstrated higher quality of life benefits than patients who underwent a failed bypass grafting procedure. Quality of life was further determined by means of the patients' sense of coherence.
|
|
| 7. |
- Klefsgård, Rosemarie, et al.
(författare)
-
Nottingham Health Profile and Short-Form 36 Health Survey questionnaires in patients with chronic lower limb ischemia: Before and after revascularization.
- 2002
-
Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 1097-6809 .- 0741-5214. ; 36:2, s. 310-317
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The purpose of this study was to compare the usefulness of the Nottingham Health Profile (NHP) and the Short-Form 36 Health Survey (SF-36) as general outcome measures after vascular intervention for lower limb ischemia with respect to patients' quality of life, on the basis of validity, reliability, and responsiveness analyses. Patients and Methods: Eighty patients, 40 with claudication and 40 with critical ischemia, were assessed before and one month after revascularization by using comparable domains of the NHP and the SF-36 questionnaires. RESULTS: The SF-36 scores were less skewed and were distributed more homogeneously than the NHP scores. Discriminate validity results showed that NHP was better than SF-36 in discriminating among levels of ischemia with respect to pain and physical mobility. For both questionnaires, the reliability standards were satisfactory in most respects. The NHP was more responsive than the SF-36 in detecting within-patient changes. All of the NHP domains not zero at baseline were improved significantly one month after hemodynamically successful revascularization for patients with claudication, whereas patients with critical ischemia showed significant abatement of pain and improvements in physical mobility and social isolation. The SF-36 scores indicated a significant decrease in bodily pain and improvements in physical functioning and vitality for patients with claudication, and decrease in bodily pain and improvement in physical functioning for patients with critical ischemia. CONCLUSIONS: The findings indicated that both NHP and SF-36 were reliable. The SF-36 scores were less skewed than the NHP scores, whereas NHP discriminated better among levels of ischemia and was more responsive in detecting quality-of-life changes over time than SF-36 in these particular patients.
|
|
| 8. |
- Klefsgård, Rosemarie, et al.
(författare)
-
Quality of life associated with varying degrees of chronic lower limb ischaemia: comparison with a healthy sample
- 1999
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 17:4, s. 319-325
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess quality of life in patients with varying degrees of ischaemia in comparison with controls, and to determine whether the degree of lower limb ischaemia and sense of coherence were associated with quality of life. MATERIALS AND METHODS: 168 patients, including 93 claudicants and 75 patients with critical ischaemia and 102 controls were studied. Quality of life was assessed using the Nottingham Health Profile in addition to the Sense of Coherence scale. MAIN RESULTS: Patients with lower limb ischaemia scored significantly reduced quality of life in all aspects compared to controls. Pain, physical mobility and emotional reactions were the significant independent factors when using logistic regression analysis. The grade of disease and low sense of coherence were significantly associated with low quality of life. Increasing lower limb ischaemia significantly conferred worse pain, sleeping disturbances and immobility. CONCLUSION: This study showed that the quality of life was impaired among patients with lower limb ischaemia, in all investigated respects. The degree to which quality of life was affected seems to represent an interplay between the grade of ischaemia and the patient's sense of coherence. This suggests the need for a multidimensional assessment prior to intervention.
|
|
| 9. |
- Klefsgård, Rosemarie
(författare)
-
Quality of life in patients with cronical lower limb ischaemia: Before and after revascularisation.
- 2000
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to assess quality of life in patients with varying degrees of lower limb ischaemia before and after revascularisation, to assess quality of life in relation to the degree of ischaemia and the respondents’ sense of coherence (SOC) and in comparison with a healthy control group, and to compare two different quality of life instruments regarding their usefulness as outcome measures. Patients were assessed using the Nottingham Health Profile (NHP) and the SOC scale before and six months after successful revascularisation and compared with 102 healthy controls. The Kruskal-Wallis analysis of variance and the Mann-Whitney U test were used for comparison of the NHP part I and the chi-squared test was used for part II of the NHP. The effects of haemodynamically successful revascularisation at six months were analysed by Wilcoxon signed ranks test. Quality of life after haemodynamically successful or unsuccessful revascularisation was investigated at baseline, six and twelve months using Friedman’s two-way analysis of variance (part I) and the Cochran test (part II). Eighty patients were assessed before and one month after revascularisation, using comparable domains of the NHP and the Short-Form 36 (SF-36) questionnaire. The ability of the two instruments to discriminate among levels of lower limb ischaemia was analysed using the Mann-Whitney U test and the responsiveness in detecting within-subject changes over time was analysed by the Wilcoxon signed rank test. Internal consistency was measured using Cronbach’s alpha. Quality of life was markedly impaired at baseline among patients with lower limb ischaemia in all investigated respects, and compared with controls, mostly as regards pain, low energy and restricted mobility as revealed by a logistic regression analysis. Quality of life represented an interplay between the degree of ischaemia and the patients’ SOC. Haemodynamically successful revascularisation led to significantly improved quality of life at six months, in particular with regard to pain, sleep, physical mobility, hobbies and holidays and to a level similar to healthy controls in sleep, social isolation, work and family relationships. Critical ischaemia patients did not reach the same level of quality of life as the claudicants or the controls. The intervention resulted in an immediate and relatively lasting improvement in quality of life at the one-year follow-up. Despite haemodynamic failure, patients had significant improvements regarding pain, emotional reactions and sleep. A haemodynamically successful revascularisation for claudicants demonstrated the most marked quality of life benefits, including all health dimensions that were not normal at baseline, while critical ischaemia patients had improved quality of life with regard to pain, sleep and physical mobility. NHP and SF-36 were both found to be reliable measures. The SF-36 scores were less skewed than the NHP scores, while NHP discriminated better among levels of ischaemia and was more responsive in detecting changes over time than SF-36. Thus, the findings showed that success of the intervention is multidimensional in its nature requiring information through traditionally used measures of medical effectiveness, the walking ability of the patients and valuing quality of life and aspects like that measured by the SOC scale. These findings may form a basis for future treatment planning, decision-making and evaluation of treatment for lower limb ischaemia patients.
|
|
| 10. |
- Klefsgård, Rosemarie, et al.
(författare)
-
The effects of successful intervention on quality of life in patients with varying degrees of lower-limb ischaemia
- 2000
-
Ingår i: European Journal of Vascular and Endovascular Surgery. - : Elsevier BV. - 1532-2165 .- 1078-5884. ; 19:3, s. 238-245
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: to assess the quality of life after successful intervention among patients with varying degrees of lower-limb ischaemia in comparison with healthy controls and the respondents>> degree of sense of coherence. MATERIALS AND METHODS: one hundred and twelve patients and 102 healthy controls were assessed for quality of life (Nottingham Health Profile) and sense of coherence. MAIN RESULTS: successful angioplasty or surgical intervention led to an improved quality of life at 6 months, in particular with regard to pain, sleep, physical mobility, hobbies and holiday and to a level similar to healthy controls in sleep, social isolation, paid employment and family relationships. It remained at a significantly lower level than that of healthy controls with regard to pain, emotional reactions, physical mobility, energy, housework, hobbies, holidays, sex and social life. Critical ischaemia patients did not reach the same level of quality of life as the claudicants or the healthy controls. CONCLUSION: successful treatment for chronic limb ischaemia improved the quality of life significantly, more so in claudicants than in patients with critical ischaemia. The degree to which the quality of life improved was associated with the patients>> sense of coherence and their ankle pressure.
|
|
