| 1. |
- Ask, Samuel, et al.
(författare)
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The effect of psychosocial interventions for sexual health in patients with pelvic cancer : a systematic review and meta-analysis
- 2024
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Ingår i: Acta Oncologica. - : Medical Journals Sweden AB. - 0284-186X .- 1651-226X. ; 63:1, s. 230-239
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Forskningsöversikt (refereegranskat)abstract
- Aim: The aim of this systematic review and meta-analysis was to explore and evaluate the effect of psychosocial interventions in improving sexual health outcomes among post-treatment patients with pelvic cancer.Methods: Inclusion and exclusion criteria were pelvic cancer survivors; psychosocial interventions; studies with a control group and measures of sexual health. Five databases were searched for literature along with an inspection of the included studies' reference lists to extend the search. Risk of bias was assessed with the RoB2 tool. Standardised mean difference (SMD) with a random effects model was used to determine the effect size of psychosocial interventions for sexual health in patients with pelvic cancers.Results: Thirteen studies were included, with a total number of 1,541 participants. There was a large heterogeneity regarding the type of psychosocial intervention used with the source found in a leave one out analysis. Six studies showed statistically significant improvements in sexual health, while three showed positive but non-significant effects. The summary effect size estimate was small SMD = 0.24 (95% confidence interval [CI]: 0.05 to 0.42, p = 0.01).Discussion: There is limited research on psychosocial interventions for sexual health in pelvic cancer patients. There are also limitations in the different pelvic cancer diagnoses examined. Commonly, the included articles examined physical function rather than the whole sexual health spectrum. The small effect sizes may in part be due to evaluation of psychosocial interventions by measuring physical dysfunction. Future research should broaden sexual health assessment tools and expand investigations to more cancer types.
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| 2. |
- Backåberg, Sofia, 1979-, et al.
(författare)
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Tidöavtalet hotar den sömlösa vården av äldre
- 2022
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Ingår i: Sydsvenskan. - : Sydsvenska dagbladets aktiebolag. - 1652-814X. ; :2022-11-09
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Rätt till fast läkarkontakt kan absolut vara bra, speciellt för diagnostik, bedömning och medicinsk behandling. Men det räcker inte, skriver forskare och lärare vid Linnéuniversitetet.
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| 5. |
- Bertilsson, Emilie, et al.
(författare)
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Usage of do-not-attempt-to-resuscitate orders in a Swedish community hospital : patient involvement, documentation and compliance
- 2020
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Ingår i: BMC Medical Ethics. - : Springer. - 1472-6939. ; 21:1, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Background: To characterize patients dying in a community hospital with or without attempting cardiopulmonary resuscitation (CPR) and to describe patient involvement in, documentation of, and compliance with decisions on resuscitation (Do-not-attempt-to-resuscitate orders; DNAR).Methods: All patients who died in Kalmar County Hospital during January 1, 2016 until December 31, 2016 were included. All information from the patients’ electronic chart was analysed.Results: Of 660 patients (mean age 77.7 ± 12.1 years; range 21–101; median 79; 321 (48.6%) female), 30 (4.5%) were pronounced dead in the emergency department after out-of-hospital CPR. Of the remaining 630 patients a DNAR order had been documented in 558 patients (88.6%). Seventy had no DNAR order and 2 an explicit order to do CPR. In 43 of these 70 patients CPR was unsuccessfully attempted while the remaining 27 patients died without attempting CPR. In 2 of 558 (0.36%) patients CPR was attempted despite a DNAR order in place. In 412 patients (73.8%) the DNAR order had not been discussed with neither patient nor family/friends. Moreover, in 75 cases (13.4%) neither patient nor family/friends were even informed about the decision on code status.Conclusions: In general, a large percentage of patients in our study had a DNAR order in place (88.6%). However, 27 patients (4.3%) died without CPR attempt or DNAR order. DNAR orders had not been discussed with the patient/surrogate in almost three fourths of the patients. Further work has to be done to elucidate the barriers to discussions of CPR decisions with the patient.
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| 6. |
- Djukanovic, Ingrid, et al.
(författare)
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Taking command of continuity : An interview study with agency nurses
- 2023
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Ingår i: Nursing Open. - : Wiley-Blackwell. - 2054-1058. ; 10:4, s. 2477-2484
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of the study was to describe continuity from the perspective of working as an agency nurse (AN).Design: Qualitative design was applied using individual semi-structured interviews. Method: Individual interviews with fifteen registered nurses working at agency companies were conducted in 2020. The interviews were analyzed with thematic analysis. The study followed the guidelines addressed in the COREQ (Consolidated Criteria for Reporting Qualitative Research) framework.Results: Thematic analysis yielded one theme – standing strong and taking command – and four categories: being competent and experienced, being prepared and at ease, ensuring an unbroken chain of care, and belonging on my own terms. The categories illustrated the engagement, professionalism, and natural leadership showed by the ANs to uphold quality and continuity.
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| 7. |
- Djukanovic, Ingrid, et al.
(författare)
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The meaning of continuity of care from the perspective of older people with complex care needs - A scoping review
- 2024
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Ingår i: Geriatric Nursing. - : Elsevier. - 0197-4572 .- 1528-3984. ; 55, s. 354-361
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Tidskriftsartikel (refereegranskat)abstract
- People aged 65 years or older with complex care needs are at risk of fragmented care. This may jeopardise patient safety. Complex care needs are defined as care needs that require the performance of time-consuming processes such as reviewing medical history, providing counselling, and prescribing medications. A scoping review was conducted with the aim of mapping the literature regarding continuity of care from the perspective of older people with complex care needs. Search results from seven databases (PubMed, Cinahl, PsycInfo, ASSIA, Web of Science, Google Scholar, Scopus, DOAJ), grey literature (BASE), and a hand-search search of key journals were used. A deductive analysis based on aspects of continuity of care was performed. The search resulted in 5704 records. After a title and abstract screening, 93 records remained. In total, 18 articles met the inclusion criteria and were included in the scoping review. Older people's sense of continuity of care increases when fewer healthcare workers are involved in their care but help from skilled professionals is more important than meeting the same person. It is vital for older people's feeling of continuity of care that discharge planning involves them, their families, and care providers in an organised way. (c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
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| 8. |
- Ekstedt, Mirjam, et al.
(författare)
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Enhanced patient activation in cancer care transitions : protocol for a randomized controlled trial of a tailored eectronic health intervention for men with prostate cancer
- 2019
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Ingår i: JMIR Research Protocols. - : JMIR Publications. - 1929-0748. ; 8:3, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prostate cancer has increased in incidence worldwide and is the leading cause of cancer death in 24 countries. The most common treatment is radical prostatectomy. However, surgery is associated with postoperative complications such as urinary incontinence and sexual dysfunction, causing decreased quality of life. If survivors are encouraged to be more active in self-care management, the symptom burden may decrease and quality of life may improve. An electronic health (eHealth) intervention based on motivational behavioral theory has been developed for this purpose.Objective: This study aimed to compare the effectiveness of standard care in combination with a tailored eHealth and mobile health self-management support system, electronic Patient Activation in Treatment at Home (ePATH), with standard care of adverse effects of prostate cancer treatment (urinary incontinence and sexual functioning) in men undergoing radical prostatectomy. The secondary aim was to test the effect on patient activation, motivation, overall well-being, and health literacy over time in and between groups.Methods: A pragmatic multicenter, block-randomized controlled trial with 2 study arms, standard care (control) and eHealth-assisted standard care (intervention), for patients undergoing radical prostatectomy. For 80% power, a sample of 242 men will need to be recruited.Results: Recruitment started in January 2018 and is expected to be completed by August 2019. Data collection will be completed in August 2020. The first cross-sectional results from this trial are anticipated to be published in January 2020.Conclusions: With the increasing number of prostate cancer survivors, attention should be paid to rehabilitation, psychosocial care, and support for endurance of self-care to reduce suffering from adverse treatment effects, poor quality of life, and depression because of postoperative complications. This project may increase knowledge of how patients can be supported to feel involved in their care and returning to as normal a life as possible. The anticipated effects of ePATH could improve health outcomes for individuals and facilitate follow-up for health care professionals.
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| 9. |
- Ekstedt, Mirjam, Professor, et al.
(författare)
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‘We just have to make it work’ : a qualitative study on assistant nurses’ experiences of patient safety performance in home care services using forum play scenarios
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective Safety is essential to support independent living among the rising number of people with long-term healthcare and social care needs. Safety performance in home care leans heavily on the capacity of unlicensed staff to respond to problems and changes in the older patients’ functioning and health. The aim of this study is to explore assistant nurses’ adaptive responses to everyday work to ensure safe care in the home care context.Design A qualitative approach using the drama-based learning and reflection technique forum play with subsequent group interviews. The audio-recorded interviews were transcribed and analysed with thematic analysis.Setting Home care services organisations providing care to older people in their private homes in two municipalities in southern Sweden.Participants Purposeful sampling of 24 assistant nurses and three managers from municipal home care services and a local geriatric hospital clinic.Results Home care workers’ adaptive responses to provide safe home care were driven by an ambition to ‘make it work in the best interests of the person’ by adjusting to and accommodating care recipient needs and making autonomous decisions that expanded the room for manoeuvrability, while weighing risks of a trade-off between care standards and the benefits for the community-dwelling older people’s independent living. Adaptations to ensure information transfer and knowledge acquisition across disciplines and borders required reciprocity.Conclusions Safety performance in home care service is dependent on the staff closest to the older people, who deal with safety risks and ethical dilemmas on a day-to-day basis and their access to information, competence, and resources that fit the demands. A proactive leadership characterised by mutual trust and adequate support for decision making is suggested. Managers and decision-makers across healthcare and social care need to consider how they can develop interprofessional collaborations and adaptive routines supporting safety from a broader perspective.
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| 10. |
- Ericsson, Carin, et al.
(författare)
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Can patients contribute to safer care in meetings with healthcare professionals? : A cross-sectional survey of patient perceptions and beliefs
- 2019
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Ingår i: BMJ Quality and Safety. - : BMJ Publishing Group Ltd. - 2044-5415 .- 2044-5423. ; 28:8, s. 657-666
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate patients’ perceptions of their meetings with healthcare professionals and the extent to which they believe they can influence patient safety in these meetings.Design Cross-sectional survey of patients using a study-specific questionnaire. Data were analysed using both parametric and non-parametric statistics.Setting The study was conducted in primary and secondary care in three county councils in southeast Sweden by means of a survey questionnaire despatched in January 2017.Participants Survey data were collected from 1445 patients, 333 of whom were complainants (patients who had filed a complaint about being harmed in healthcare) and 1112 regular patients (patients recruited from healthcare units).Main outcome measures Patients’ perceptions of meetings with physicians and nurses, beliefs concerning patients’ contributions to safer care and whether the patients had suffered harm in healthcare during the past 10 years.Results Most respondents reported that it was easy to ask physicians and nurses questions (84.9% and 86.6%) and to point out if something felt odd in their care (77.7% and 80.7%). In general, complainants agreed to a higher extent compared with regular patients that patients can contribute to safer care (mean 1.92 and 2.13, p<0.001). Almost one-third (31.2%) of the respondents (both complainants and regular patients) reported that they had suffered harm in healthcare during the past 10 years.Conclusions Most respondents believed that healthcare professionals can facilitate patient interaction and increase patient safety by encouraging patients to ask questions and take an active part in their care. Further research will need to identify strategies to support such questioning in routine practice and ensure that it achieves its intended goals.
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