| 1. |
- Almborg, Ann-Helene, et al.
(författare)
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Discharge planning of stroke patients : the relatives' perceptions of participation
- 2009
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Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. - 0962-1067 ; 18:6, s. 857-865
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Tidskriftsartikel (refereegranskat)abstract
- To describe relatives' perceived participation in discharge planning for patients with stroke and identify correlates to perceived participation. Stroke affects both patients and their relatives and previous research shows that relatives were often dissatisfied with their perceived involvement in discharge planning and the information they get. Prospective cross-sectional study. The study comprised 152 consecutively enrolled relatives (mean age = 60.8 years) of acute stroke patients admitted to a stroke unit in southern Sweden during 2003-2005. Data were collected through interviews 2-3 weeks after discharge using 'Relative's Questionnaire about Participation in Discharge planning'. This instrument measures perceived participation in three subscales: R-Information-Illness, R-Information-Care/support, and R-Goals and Needs. The Overall Rating of Relative's Perceived Participation in Discharge Planning was measured by a visual analogue scale (VAS) (1-10 score). Among the relatives, 56-68% reported positively according to R-Information-Illness, but 46-53% perceived that they did not receive any information about care/medication/rehabilitation/support. About 80% perceived no participation at all in goals and needs. The mean value of the VAS was 3.89 (SD 3.40) score. Regression analyses revealed that longer stay at hospital, patients with higher education, and relatives of female patients and female relatives were associated with relatives' perceptions of higher participation in discharge planning. Relatives perceived that they needed more information and knowledge about stroke and care/medication/rehabilitation/support. They also needed to be more involved in goal-setting and in identifying patient needs. Professionals should take into consideration these associated variables to improve relatives' perceived participation. Clinicians should give more attention to the altered situation of stroke patients' relatives when planning for continuing care and when setting postdischarge goals for the patients. The professionals need to develop strategies to involve relatives in sharing information, goal-setting and needs assessment in discharge planning.
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| 2. |
- Almborg, Ann-Helene, et al.
(författare)
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Patients' perceptions of their participation in discharge planning after acute stroke
- 2009
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 18:2, s. 199-209
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe stroke patients' perceptions of their participation in the discharge planning process and identify correlates of perceived participation. Background. Patients have the right to participate in discharge planning, but earlier research has shown that they are often dissatisfied with the information they receive and their involvement in goal-setting during discharge planning. Design. Cross-sectional study. Methods. The sample consisted of 188 persons (mean age 74 years, SD 11·2) with acute stroke who were admitted to a stroke unit at a hospital in southern Sweden during 2003–2005. Data was collected by face-to-face interviews 2–3 weeks after discharge using the 'Patients' Questionnaire on Participation in Discharge Planning'. This instrument measures perceived participation in discharge planning in three subscales: P-Information, P-Medical Treatment, P-Goals and Needs. Results. The percentage of patients who perceived that they had participated in discharge planning was as follows: 72–90% according to P-Information, 29–38% according to P-Medical Treatment and 15–47% according to P-Goals and Needs. Age, education and performance of activities of daily living were significantly related to perceived participation as measured by different subscales. Conclusions. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal-setting. Professionals need to pay more attention to patients in different subgroups to facilitate their participation in discharge planning. Relevance to clinical practice. To facilitate and increase patients' participation in discharge planning, methods should be implemented for goal-setting and identifying patients' needs. Methods that foster patient participation may improve goal-orientated care, services and rehabilitation after discharge.
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| 3. |
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| 4. |
- Bengtsson, Mariette, et al.
(författare)
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Development and psychometric testing of the Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS)
- 2007
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Ingår i: BMC Gastroenterology. - : BioMed Central (BMC). - 1471-230X .- 1471-230X. - 1471-230X ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to develop and psychometrically test a short, patient-reported questionnaire to be used in clinical practice for patients with Irritable Bowel Syndrome (IBS). The Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) questionnaire was designed to measure the treatment response of symptoms and well-being in patients suffering from IBS. Methods: The VAS-IBS was psychometrically tested for content and criterion validity, scale acceptability, item-reduction, internal reliability consistency, simplicity, and speed. Two samples were used. One expert panel (five physicians and four registered nurses), who gave their opinion on the content validity, and one of 71 patients with IBS (mean age 38 years SD + 13, range 19-65), who completed the VAS-IBS, as well as the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being Index for criterion validity. Results: The items in the VAS-IBS capture the main physical concerns women with IBS might present and the psychometric testing confirmed that the VAS-IBS is an acceptable homogeneous patient-reported questionnaire indicated by Cronbach's alpha internal consistency reliability coefficient, with a value of 0.85. All correlations to test the criterion validity performed by using Pearson's correlation test, were statistically significant (p < 0.0001) and in the expected directions. The VAS-IBS is easy to complete and unproblematic to calculate. Conclusion: The VAS-IBS appears to be reliable and user-friendly, for patients as well as for health professionals. The final version of the VAS-IBS including nine items needs to be further tested in clinical practice cross-culturally in women as well as in men.
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| 5. |
- Bengtsson, Mariette, et al.
(författare)
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Women with irritable bowel syndrome and their perception of a good quality of life
- 2007
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Ingår i: Gastroenterology Nursing. - 1042-895X .- 1538-9766. ; 30:2, s. 74-82
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Tidskriftsartikel (refereegranskat)abstract
- Irritable bowel syndrome has a negative impact on a person's quality of life, but only a few existing studies have been based on patients' own perceptions. This study therefore aimed to collect information on the view of female patients with irritable bowel syndrome regarding what constitutes a good quality of life for them and to create a healthcare model for these patients. For the study, 30 women with irritable bowel syndrome (median age, 38.5 years; range, 20-65 years) responded in writing to a single, all-inclusive question: What is your perception of a good quality of life? When the questionnaires were returned, there was time for a short dialogue, and notes of the conversations were made. Data were analyzed qualitatively according to Burnard's method of thematic content analysis. The answers also were counted and thereby quantified. The women's perception of a good quality of life could be divided into five categories: (a) physical and mental health, (b) social well-being, (c) welfare, (d) strength and energy, and (e) self-fulfillment. According to the results, a healthcare model for patients with irritable bowel syndrome should include four main areas: (a) treatment of the patient's symptoms, (b) confirmation of the patient, (c) confirmation of the diagnosis, and (d) instruction for the patient. The healthcare model should be focused on the primary care level and should include a longitudinal plan of healthcare that also describes the secondary care level.
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| 6. |
- Hommel, Ami, et al.
(författare)
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A study of a pathway to reduce pressure ulcers for patients with a hip fracture
- 2007
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Ingår i: Journal of Orthopaedic Nursing. - : Elsevier. - 1361-3111 .- 1873-4839 .- 1878-1241. ; 11:3-4, s. 151-159
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Tidskriftsartikel (refereegranskat)abstract
- Due to an ageing population the numbers of patients with hip fractures are increasing. They often suffer from concomitant diseases and are therefore prone to be affected by complications such as pressure ulcers. The prevention of pressure ulcers among patients with a hip fracture is crucial. The aim of this study was to improve the quality of care and patient safety in patients with a hip fracture. A new evidence based clinical pathway was introduced to prevent hospital acquired pressure ulcers. Furthermore, the purpose was to bring attention to pressure ulcer prevention and to facilitate changes in clinical practice to improve quality of care and patient safety. A total of 478 patients with a hip fracture were consecutively included between April 2003 and March 2004. The new evidence based clinical pathway was introduced on October 1st 2003. The results from the first 210 patients in the control group and the last 210 patients in the intervention group are presented in this article. In the intervention group, hospital acquired pressure ulcers decreased by 50% (p < 0.007). It is possible to reduce the development of hospital acquired pressure ulcers among elderly patients with a hip fracture even though it is not possible to eliminate the effect of factors such as increased age and the patients’ medical status which are often the two main risk factors.
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| 7. |
- Hommel, Ami, et al.
(författare)
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Differences in complications and length of stay between patients with a hip fracture treated in an orthopaedic department and patients treated in other hospital departments
- 2008
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Ingår i: Journal of Orthopaedic Nursing. - 1361-3111 .- 1873-4839. ; 12:1, s. 13-25
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Tidskriftsartikel (refereegranskat)abstract
- The health care system has to deal with substantial health care costs, which are expected to continue to rise due to increasingly elderly populations. One way of saving has been a reduction of the number of beds in hospitals. The consequence is that acute patients are inappropriately admitted to non-specialized wards because of limited beds. These patients are also known as ‘‘outliers’’. In this study, consecutive patients with a hip fracture treated at the orthopaedic department (n = 273) are compared with patients treated at other departments (n = 147) according to the incidence of complications and the length of stay (LOS) before and after the introduction of an evidence-based clinical pathway. There was no medical difference between the populations. However, the strict demands of saving costs, with limited beds, have resulted not only in economic consequences with prolonged hospitalization, but also in patient suffering and the inconvenience of increased postoperative complications.Patients treated at non-specialized wards had an extra LOS of 3.7 days in the acute hospital settings and furthermore, 13.6 days of LOS including rehabilitation compared to patients treated at the orthopaedic department. In addition, we consider the implemented evidence-based clinical pathway to be successful since the number of complications was reduced. It is a major challenge to establish effective treatment and rehabilitation for patients after a hip fracture aiming to avoid complications and reduce LOS. These fragile patients with a hip fracture ought to be treated at the orthopaedic department, or at departments with geriatric and rehabilitation knowledge. Physiotherapists, occupational therapists and nurses specialising in orthopaedics and geriatricians should take an active part in the care of these patients.
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| 8. |
- Hommel, Ami, et al.
(författare)
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Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year
- 2008
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Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 39:10, s. 1164-1174
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Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
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| 9. |
- Hommel, Ami, et al.
(författare)
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Nutritional status among patients with hip fracture in relation to pressure ulcers
- 2007
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Ingår i: Clinical Nutrition. - : Elsevier. - 0261-5614 .- 1532-1983. ; 26:5, s. 589-596
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Tidskriftsartikel (refereegranskat)abstract
- Background & aims Patients with a hip fracture often have a poor nutritional status that is associated with increased risk of complications, morbidity and mortality. The aim of this study was to investigate the effects of an improved care intervention in relation to nutritional status and pressure ulcers. An intervention of best practices for patients with hip fracture was introduced, using the available resources effectively and efficiently with a not too complicated or expensive intervention. Methods A quasi-experimental study of 478 patients consecutively included between April 1, 2003 and March 31, 2004. A new evidence-based clinical pathway was introduced on October 1, 2003. The results from the first 210 patients in the control group and the last 210 patients in the intervention group are presented in this article. Results The total number of patients with a hospital-acquired pressure ulcer was in the intervention group, 19 patients, and in the control group, 39 patients (p=0.007). No patient younger than 65 years developed a pressure ulcer. There were no statistical significant differences between the groups with respect to blood biochemical variables at inclusion. Patients in the control group had higher arm muscle circumference (AMC) (p=0.05), calf circumference (CC) (p=0.038) and body mass index (BMI) (p=0.043) values. Abnormal anthropometrical tests of BMI, triceps skin fold (TSF) <10th percentile and AMC <10th percentile were found in 12 patients in the control group and in 4 patients in the intervention group. None of the 4 patients in the intervention group developed pressure ulcers. However, 2 of the 12 patients in the control group were affected. Conclusions It is possible to reduce the development of hospital-acquired pressure ulcers among elderly patients with a hip fracture even though they have poor prefracture nutritional status. Results in this study indicate the value of the new clinical pathway, as number of patients who have developed pressure ulcers during their stay in hospital has been reduced by 50%.
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| 10. |
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