| 1. |
- Angelhoff, Charlotte, 1974-, et al.
(författare)
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Parental mood when staying overnight at hospital with their sick child
- 2015
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Konferensbidrag (refereegranskat)abstract
- Parental mood when staying overnight at hospital with their sick childObjectiveto describe mood in parents, staying with their sick children overnight at the hospital.MethodologyA descriptive design, including 75 parents staying overnight at hospital with their sick child, was used. The parents filled out Mood-scale the morning after staying overnight at the hospital. The Mood-scale is a validated and reliable self-administered instrument measuring six dimensions of mood; control, calmness, social orientation, pleasantness, activation, and extraversion (Sjöberg L, 1979). The study is a part of a larger project, with focus on mood, stress and sleep in parents staying with their sick children overnight at the hospital.ResultsThe result will describe how parents report their total mood and how they report the different dimensions when they stay with their sick children overnight at the hospital. A comparison will be made between the parent´s mood and gender and the child´s age. Data is under analysis and will be presented as preliminary data. ConclusionAccording to UNICEF Convention on the Rights of the Child, children in hospital have the right to have their parents with them at all times and parents should be offered accommodation and be encouraged to stay. However, the hospital environment, in combination with having a sick child, might affect the parent´s mood, which in turn might affect the ability to handle the situation and the child´s care. Therefore it is of importance to study parental mood and find ways to help the families during their hospital stay.
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| 2. |
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| 3. |
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| 4. |
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| 5. |
- Angelhoff, Charlotte, 1974-, et al.
(författare)
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Perceptions of sleep quality and stress by parents of children enrolled in hospital organized home-care
- 2013
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Ingår i: Nordic Advances in Health Care Sciences Research, Lund, 2013. ; , s. 56-56
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionCaring for a sick child creates much greater demands for parents than those associated with raising a healthy child. Parents of chronically ill children reports higher levels of parental stress as a consequence of the substantial social, emotional and personal demands associated with caring. Sleep quality is an important aspect of wellbeing and is strongly related to stress and quality of life. In some Swedish counties families are offered hospital organized home-care for sick children. Caring for a child at home gives the family the opportunity to be together in an environment they know well and where they can feel comfortable and secure. On the other hand it includes several sleep disturbances during the night which affects the ability to handle the situation and support their child. No other study is found about how parents sleep when their child is enrolled in hospital organized home-care. AimTo explore parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care. MaterialFifteen parents (11 mothers and 4 fathers) with children enrolled in hospital organized home-care from one university hospital and one general hospital in South-eastern Sweden were included. The children ranged in age 0-12 years. MethodParents were interviewed with open-ended questions. Data was analysed with a phenomenographic method according to Marton and Both. ResultsFour descriptive categories in the phenomenon of parents’ perceptions of sleep quality and stress when they sleep at home with a child enrolled in hospital organized home-care were identified; Routines helps to manage the situation, Time for oneself and the partner, Feelings of isolation and Need of support ConclusionSleep is important for the parents in several aspects. They are in a stressful situation with high demands both from the society and from themselves and there is often a lack of support from relatives and friends. Nurses need to acknowledge and promote parents’ sleep when they care for their sick children at home and support them in the caregiving.
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| 6. |
- Angelhoff, Charlotte, medicine doktor, 1974-, et al.
(författare)
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Sleep quality and mood in mothers and fathers accommodated in the family-centred paediatric ward
- 2018
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 27:3-4, s. e544-e550
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectivesTo describe sleep quality and mood in parents accommodated with their sick child in a family‐centred paediatric ward. Secondary aims were to compare mothers’ and fathers’ sleep quality and mood in the paediatric ward and to compare the parents’ sleep quality and mood between the paediatric ward and in a daily‐life home setting after discharge.BackgroundFrequent interruptions, ward noise and anxiety affect parents’ sleep quality and mood negatively when accommodated with their sick child in paediatric wards. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, and to care for their sick child.MethodsThis was a prospective and descriptive study. Eighty‐two parents (61 mothers and 21 fathers) with children (median age 6.25 years) admitted to six paediatric wards participated in the study. Uppsala Sleep Inventory, a sleep diary and the Mood Adjective Checklist were used to measure sleep quality and mood.ResultsThe parents had a good sleep quality in the paediatric ward even though they had more nocturnal awakenings compared to home. Moreover, they were less alert, less interested and had reduced concentration, and were more tired, dull and passive in the hospital than at home after discharge. Vital sign checks, noises made by the staff and medical treatment were given reasons influencing sleep. Poor sleep quality correlated with negative mood.ConclusionParents’ sleep quality in family‐centred paediatric care is good. However, the habitual sleep efficacy before admittance to the hospital is lower than expected and needs to be further investigated.Relevance to Clinical PracticeThe healthcare professionals should acknowledge parents’ sleep and mood when they are accommodated with their sick child. Further should care at night be scheduled and sleep promoted for the parents to maintain health and well‐being in the family.
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| 7. |
- Angelhoff, Charlotte, medicine doktor, 1974-, et al.
(författare)
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The cortisol response in parents staying with a sick child at hospital
- 2019
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Ingår i: Nursing Open. - : Wiley-Blackwell Publishing Inc.. - 2054-1058. ; 6:2, s. 620-625
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Tidskriftsartikel (refereegranskat)abstract
- AimTo study the cortisol response in parents staying with their child in paediatric wards, to compare the parents’ cortisol levels between the paediatric ward and at home 4 weeks after discharge and to compare the parents’ cortisol levels with data of an adult reference population, reported by Wust et al., as there are few studies investigating parental cortisol.DesignThis study has a descriptive and prospective comparative design.MethodThirty‐one parents participated. Saliva samples were collected in the paediatric ward and 4 weeks later at home.ResultsThe parents had lower morning awakening cortisol levels in the paediatric ward than at home after discharge. There were no statistically significant differences in postawakening cortisol or cortisol awakening response (CAR). The child's age, diagnosis or previously diagnosed chronic condition did not affect the parents’ cortisol levels. The morning and postawakening cortisol levels were lower than those of the reference population.ConclusionThe hospital stay with a sick child affects parents’ cortisol levels. Parental stress needs more attention to find interventions to prevent the risk of stress‐related complications that subsequently can affect the care of the child.
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| 8. |
- Angelhoff, Charlotte, medicine doktor, 1974-, et al.
(författare)
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"To Cope with Everyday Life, I Need to Sleep" - A Phenomenographic Study Exploring Sleep Loss in Parents of Children with Atopic Dermatitis.
- 2018
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Ingår i: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 43, s. E59-E65
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The whole family is affected when a child has atopic dermatitis (AD), and parents experience sleep disruption related to the child's condition leading to physical and mental exhaustion, mood swings, loss of concentration and lower job performance. This study aimed to explore and describe perceptions of sleep in parents of children <2 years old with AD, consequences of parental sleep loss, and what strategies the parents used to manage sleep loss and to improve sleep.DESIGN AND METHODS: This qualitative interview study had an inductive and descriptive design. Twelve parents (eleven mothers and one father) participated in the study. Data analysis was performed using a phenomenographic approach.RESULTS: Three categories of description were found: Acceptance and normalization of parental sleep loss; Changed routines and behavior to compensate for sleep loss; and Support is needed to gain sleep and manage daily life.CONCLUSIONS: Sleep loss due to the child's AD affected the parents' emotional state, mood, well-being, cognitive function, ability to concentrate and take initiative, and sensitivity to stress and sound negatively. The parents managed their sleep loss mainly by changing their behavior and creating new routines, by taking me-time and through support from partners.PRACTICE IMPLICATIONS: Pediatric nurses should acknowledge sleep loss in parents of small children with AD in time to prevent negative consequences, which affect the well-being of the entire family. Advice on how to improve sleep should be given early to increase the parents' understanding, make them feel safer and strengthen them in their parenthood.
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| 9. |
- Angelhoff, Charlotte, 1974-
(författare)
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What about the parents? : Sleep quality, mood, saliva cortisol response and sense of coherence in parents with a child admitted to pediatric care
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Parents experience many stressful situations when their child is ill and needs medical care, irrespective of the child’s age, diagnosis or the severity of the illness. Poor sleep quality and negative mood decrease the parents’ ability to sustain attention and focus, to care for their ill child, and to cope with the challenges they face.The overall aim of this thesis was to evaluate sleep, mood, cortisol response, and sense of coherence (SOC) in parents caring for children in need of medical care, and to identify factors that may influence parents’ sleep.This thesis includes four original studies; two of these are quantitative, prospective, descriptive and comparative studies including parents (n=82) accommodated in six pediatric wards with their ill child, using questionnaires and sleep logs to measure sleep, mood and SOC, and saliva cortisol to measure cortisol response. A follow-up was performed four weeks later at home, after hospital discharge. The other two studies are qualitative, inductive and explorative interview studies, including parents (n=12) staying overnight with their preterm and/or ill infant in three neonatal intensive care units, and parents (n=15) with a child receiving hospital-based home care in two pediatric outpatient clinics. The interviews were analyzed with a phenomenographic method.Being together with one’s family seems beneficial for sleep and may decrease stress. The ability to stay with the child, in the hospital or at home, was highly appreciated by the parents. When caring for a child with illness, parents’ sleep quality was sufficient in the hospital; however, sleep quality improved further (p<0.05) at home after discharge. The parents reported frequent nocturnal awakenings in the hospital caused by the child, medical treatment and hospital staff. Concern and anxiety about the child’s health, and uncertainty about the future were stressors affecting the parents’ sleep and mood negatively. The parents had lower (p=0.01) morning awakening cortisol levels in the pediatric ward compared to at home, and parents accommodated for more than one night had lower (p<0.05) post-awakening cortisol levels compared to parents staying their first night.The findings of this thesis conclude that being together as a family is important for the parents’ sleep. The ability to be accommodated in the hospital and gather the family around the child may have given the parents time for relaxation and recovery, that in turn may lead to a less stressful hospital stay. When it is beneficial for the child, the whole family should be included in the pediatric care. Moreover, pediatric nurses must acknowledge parents’ sleep, in hospital and at home. Medical treatment and care at night should be scheduled and sleep promoted for the parents in order to maintain health and well-being in the family.
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| 10. |
- Dahl, Å, et al.
(författare)
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Nurses' clinical experiences of the inverse bed position on a neurointensive care unit - A phenomenographic study
- 2003
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Ingår i: Intensive & Critical Care Nursing. - 0964-3397 .- 1532-4036. ; 19:5, s. 289-298
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Tidskriftsartikel (refereegranskat)abstract
- Our knowledge of unstable critically ill patients placed in an inverse bed position on the neurointensive care unit (NICU) is fairly limited. The purpose of this study was to ascertain the variation in nurses' conceptions of the impact of clinical experiences on the care and working environments among patients with the head towards the centre of the room on an NICU. An important research question was: how is the nursing care of patients facing inwards on an NICU perceived? Interviews were conducted and analysed with 15 nurses, using the method of phenomenography. From a nursing perspective, four descriptive categories were found, which partly distinguished the nursing psychosocial environment from the physical environment. These were safety and security of mobile computer tomography (CT) on the NICU, availability and overview, integrated holistic view in an open nursing psychosocial environment and adaptation of practical equipment. In conclusion, inverse bed position is important for more individualised neurointensive nursing care among unstable patients subjected to frequent CT scans on the unit. More stable patients should be turned back to the traditional bed position in order to promote their recovery process. This new knowledge is important for the development of quality assurance, with regard to, amongst other things, the patient's dignity. ⌐ 2003 Elsevier Ltd. All rights reserved.
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| 11. |
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| 12. |
- Eckerblad, Jeanette, et al.
(författare)
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Nurses conceptions of facilitative strategies of weaning patients from mechanical ventilation-A phenomenographic study
- 2009
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 0964-3397. ; 25:5, s. 225-232
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Tidskriftsartikel (refereegranskat)abstract
- Background: Mechanical ventilator withdrawal can amount up to 40% of total ventilator time. Being on a mechanical ventilator is associated with risk of anxiety, post-traumatic stress syndrome, nosocomial pneumonia and premature mortality. Purpose: The purpose of the present study was to describe different conceptions of nurses facilitating decision-making strategies regarding weaning patients from mechanical ventilations cared for in intensive care unit (ICU). Method: Semi-structured interviews were analysed within the phenomenographic framework. Twenty ICU nurses were interviewed. Findings: The findings revealed three main categories of nurses facilitating decision-making strategies: "The intuitive and interpretative strategy" featured nurses pre-understandings. "The instrumental strategy" involved analysis and assessment of technological and physiological parameters. "The cooperative strategy" was characterised by interpersonal relationships in the work situation. Absence of a common strategy and lack of understanding of others strategies were a source of frustration. The main goals were to end mechanical ventilator support, create a sense of security, and avoid further complications. Conclusion: Although these findings need to be confirmed by further studies we suggest that nurses variable use of individual strategies more likely complicate an efficient and safe weaning process of the patients from mechanical ventilation.
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| 13. |
- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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A gender perspective on sleeplessness behavior, effects of sleep loss, and coping resources in patients with stable coronary artery disease
- 2006
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 35:2, s. 75-89
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary aim of this study was to systematically compare perceived sleep quality, sleeplessness behavior, sense of mastery, self-esteem, depression, subjective health, and effects of sleep loss in men and women with stable coronary artery disease (CAD). Further aims were to determine possible predictors of poor sleep quality and sense of mastery, as well as the consequences of too little sleep. METHODS: Comparative-correlation and predictive design were used. Patients with a history of stable angina pectoris scheduled to undergo coronary angiography at Linköping University Hospital in Sweden were included. There were 47 women and 88 men (mean age 62.4 years) with CAD. Structured interviews using validated questionnaires covered sleep quality and sleep habits, effects of sleep loss, psychologic resources, and depression. RESULTS: Multiple stepwise regression analysis showed that sleeplessness behavior, depressed mood, female gender, and pharmacologic treatments with inflammation inhibitors significantly (P < .0001) accounted for the variance of poorer sleep quality. The analysis also showed that the following factors in descending order significantly accounted (P < .0001) for the outcome of sleep quality: inability to feel refreshed by sleep, difficulty in maintaining sleep, gastrointestinal problems, too little sleep, final morning awakening time, sleep onset latency, lying down because of daytime tiredness, and daytime physical tiredness. CONCLUSIONS: Compared with men, women with stable CAD may be especially at risk of experiencing poor sleep quality, even when sleeplessness behavior and pharmacologic treatments with inflammation inhibitors are controlled. It is also possible that they may be more at risk of depressed mood. Copyright © 2006 by Mosby, Inc.
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| 14. |
- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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Anxiety, depression and sleep in male patients undergoing coronary artery bypass surgery
- 1999
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Ingår i: Scandinavian Journal of Caring Sciences. - : Taylor and Francis Ltd. - 0283-9318 .- 1471-6712. ; 13:2, s. 137-143
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to examine the prevalence of depression and anxiety following coronary artery bypass surgery (CABG) and to see how those patients with depression and anxiety differ in sleeping pattern. The individual reaction to sleep loss was tested as a predictor of certain emotional symptoms in the follow-up period. Thirty-eight males, between 45 and 68 years, were interviewed prior to, and 1 month after, surgery, and received a questionnaire at the 6-month follow-up. Eighty per cent scored moderate anxiety prior to surgery and six patients were depressed. An anxiety-prone individual reactivity persisted in the same patients in 38.9% (n = 14) following CABG, with significantly more sleep disturbances, firedness, energy deficits, immobility, and lower degree of quality of life (QoL). Sad/depressed mood or cognitive/behavioural fatigue symptoms as reactions to sleep loss were predictors of sleep problems and daytime sequelae, whereas a higher postoperative NYHA class was predicted by cognitive/behavioural fatigue and dysphoria reactions. Being less refreshed by sleep on final awakening prior to surgery related to 44.5% of the variance in QoL outcome 6 months following surgery. In conclusion, an anxiety-prone individual reactivity is significantly associated with sleep disturbances. Reactions to sleep loss prior to surgery are associated with emotional distress after surgery.
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| 15. |
- Edéll Gustafsson, Ulla, 1947-, et al.
(författare)
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Effects of sleep loss in men and women with insufficient sleep suffering from chronic disease : a model for supportive nursing care.
- 2003
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Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 9:1, s. 49-59
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated self-reported subjective health and effects of sleep loss according to perceived interfering cognitive anxiety related to falling asleep in patients with and without insufficient sleep and gender differences in these aspects 5 years after coronary artery bypass graft and transluminal coronary angioplasty. A total of 145 patients, five years after intervention, responded to a mailed questionnaire. Nearly 60% had severe combined sleep disturbances, 35.9% of these had complained of insufficient sleep and 15% also perceived difficulty falling asleep related to cognitive anxiety. Measurable gender differences were small. A theoretical framework is presented which can increase understanding among nurses, patients and their relatives concerning the quality and quantity of sleep and sleep loss related to quality of life. These results suggest that there are significant relationships between sleep quality, resilience to stress and coping strategy in patients with a chronic disease, indicating the need for more individualised supportive nursing care.
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| 16. |
- Edéll-Gustafsson, Ulla, 1947-, et al.
(författare)
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Fragmented sleep and tiredness in males and females one year after percutaneous transluminal coronary angioplasty (PTCA)
- 2001
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 34:2, s. 203-211
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Tidskriftsartikel (refereegranskat)abstract
- Aim. Reported sleep quality was examined in relation to anxiety, depression, selected psycho-physiological sleep disturbing symptoms, daytime dysfunctions according to poor sleep, and quality of life 1 year after percutaneous transluminal coronary angioplasty (PTCA). Furthermore, females were compared with age-matched males to examine any differences in sleep quality, psycho-physiological symptoms and quality of life. Study design. A descriptive comparative study. Sample. Twenty-two females, mean age 62.7 (SD 5.7) and 70 men, mean age 60.4 (SD 6.7), were consecutively recruited. Method. A mailed questionnaire was distributed, including the Uppsala Sleep Inventory, Spielberger State Anxiety scale, Zung's Self-rating Depression Scale and the Nottingham Health Profile instrument. Results. Forty-six per cent of the patients had a history of myocardial infarction and 40.2% hypertension. Seventy-two per cent of the patients were anxious and 30.4% depressed. Difficulty in getting to sleep was related to intrusive thoughts with increased feelings of anxiety and sensitivity. Difficulty in maintaining sleep was the most common sleep complaint (42.4%) and physical tiredness/fatigue was the greatest consequence of disturbed sleep (51.1%). Those with pain, palpitations or respiratory nocturnal sleep-disturbing symptoms were characterised by shorter sleep duration, emotional distress, cognitive dysfunction, tiredness and reduced quality of life. Greater difficulties initiating sleep and worse health related quality of life were revealed in females compared with aged-matched males. Conclusion. fragmented sleep is a problem partly because of psycho-physiological symptoms 1 year after PTCA, with reduced resilience to stress, increasing vulnerability or diminished coping ability and poorer quality of life.
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| 17. |
- Edéll-Gustafsson, Ulla, et al.
(författare)
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Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study
- 2015
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 24:5-6, s. 717-727
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES:To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.BACKGROUND:Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centred care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) 24 hours a day. Lack of sleep may affect new parents' ability to cope with the many challenges they face on a daily basis.DESIGN:A phenomenographic study with an inductive and exploratory design.METHODS:Semi-structured interviews were conducted with twelve parents of infants in neonatal care between January-March 2012. To describe variations in perception of the phenomenon, data were analysed using phenomenography.FINDINGS:Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care: impact of stress on sleep; how the environment affects sleep; keeping the family together improves sleep; and, how parents manage and prevent tiredness.CONCLUSION:Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance and practical support. Skin-to-skin care was perceived as a stress-reducing factor that improved relaxation and sleep and should be encouraged by the nurse. The parents also mentioned the importance of being together. Having a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation.RELEVANCE FOR CLINICAL PRACTICE:Improved parental sleep in neonatal care may help the families cope with the situation and facilitate problem-solving, emotional regulation and the transition to parenthood.
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| 18. |
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| 19. |
- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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Hyperarousal, depression and quality of life - Validity and reliability of the Swedish version of the Hyperarousal Scale
- 2006
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 20:1, s. 58-67
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Research focusing on hyperarousability in association with general sensitivity to stress has increased. This study aimed to: (i) describe values for self-reported hyperarousal behaviour traits, depression, sleeplessness behaviour and health-related quality of life [The Short Form 36 Health Survey Questionnaire (SF-36)] in a gender-stratified random sample from the Swedish population, and (ii) test the validity and reliability of the Swedish version of the Hyperarousal Behavioural Trait Scale (H-scale). Methods: In this study, 402 women and 391 men from Sweden were included. A test-retest study was performed on 297 subjects. Results: The total mean score on the H-scale was 29.5 (SD 10.0, 95% CI 28.8-30.2). Compared to men, women scored higher on the H-scale (total score, sub-scales and many items), whereas no evidence of an age trend was seen. The H-scale has proven to be a valid and reliable scale. Pearson's correlation coefficient showed similar magnitude and direction between the H-scale and the Zung's Self-rating Depression Scale, as between the H-scale and the Vicious Cycle of Sleeplessness Behaviour Scale, Vitality, Mental Health and the Mental Component Summary index on the SF-36 respectively. The Cronbach's alpha for the H-scale was 0.84 and estimated stability test-retest point of time varies between 0.73 and 0.80. Conclusions: This study indicates gender differences in response style in association with altered health-related quality of life. The H-scale is a valid and reliable self-reported scale for measuring hyperarousal behavioural trait research outcome in clinical practice. © 2006 Nordic College of Caring Science.
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| 20. |
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| 21. |
- Edéll-Gustafsson, Ulla, 1947-
(författare)
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Insufficient sleep, cognitive anxiety and health transition in men with coronary artery disease : A self-report and polysomnographic study
- 2002
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 37:5, s. 414-422
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Tidskriftsartikel (refereegranskat)abstract
- Aims. To explore possible links between sleep quality, cognitive anxiety and the effects of sleep disturbances on health, daytime functioning and quality of life, for assessment in a larger study. Hypotheses were: (a) patients with coronary artery disease have insufficient sleep as measured by self-reported sleep and by polysomnography, (b) self-reported sleep is associated with polysomnographically measured sleep, (c) reduced sleep quality is associated with physical and mental health, and interferes with quality of life as measured by means of interviews and polysomnography, (d) reduced sleep quality is associated with reduced resilience to stress. Background. It has become increasingly evident that poor sleep with sleep initiation difficulties is an independent risk factor for cardiac events among men, and requires more attention in clinical nursing practice. Design. Descriptive, correlative and explorative study. Sample. Forty-four men, aged 45-70, about to undergo coronary artery bypass surgery at a Swedish University Hospital. Research methods. Interviews and 24-hour continuous ambulatory polysomnography were performed. For the interviews, the Uppsala Sleep Inventory, Spielberger State Anxiety Scale and the Nottingham Health Profile instruments were used. Results. Seventeen patients (38╖6%) had insufficient sleep and 12 had sleep initiation difficulties. Logistic regressions revealed that reduced stage 3-4 sleep predicted poorer overall health, initiation of sleep difficulties, predicted insufficient sleep and involuntary thoughts predicted fragmented sleep. Poorer quality of life was predicted by reduced deep sleep. Independent predictors for emotional distress were sleep efficiency below 85%, fragmented sleep and a daytime nap longer than 15 minutes. Conclusions. Objective sleep was associated with several subjective sleep variables. The results provide empirical support for significant variables included in a theoretical framework relating to sleep quality, cognitive anxiety, health and quality of life. A larger study is recommended that includes both men and women.
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| 22. |
- Edell-Gustafsson, Ulla, 1947-
(författare)
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Kvalitetsindikatorer för patienter med störd sömn
- 2013. - 6
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Ingår i: Kvalitetsindikatorer inom omvårdnad. - Stockholm : Gothia Förlag AB. - 9789172058576 ; , s. 134-149
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Bokkapitel (populärvet., debatt m.m.)abstract
- Sjuksköterskor har ett ansvar att ge god omvårdnad, men också att utveckla och förbättra vården för patienter och vårdtagare samt den organisation och de system som de verkar i. Svensk sjuksköterskeförening vill medverka till att indikatorer för omvårdnad utvecklas och arbetar för att vara ett stöd i sjuksköterskors professionella utveckling. Ett resultat av detta arbete är denna bok som nu publiceras i en sjätte utökad upplaga
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| 23. |
- Edell-Gustafsson, Ulla, 1947-
(författare)
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Kvalitetsindikatorer för patienter med störd sömn
- 2007. - 4
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Ingår i: Kvalitetsindikatorer inom omvårdnad. - Växjö : Gothia : Svensk sjuksköterskeförening. - 9789172055193 ; , s. 103-122.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- En självklar del i sjuksköterskans ansvar är att ständigt utveckla omvårdnadsarbetet i syfte att förbättra vården för patienter och vårdtagare. Med hjälp av en indikator, eller ett kvalitetsmått, kan vårdens resultat och genomförande följas och mätas. I boken presenteras förslag på kvalitetsindikatorer inom olika omvårdnasområden. Syftet är att ge verktyg för registrering, utvärdering och förbättring av omvårdnadskvaliteten. Förhoppningen är att boken ska motivera sjuksköterskor att använda kvalitetsindikatorer så att omvårdnaden kan beskrivas och utvärderas. Denna femte upplaga är utökad med en kvalitetsindikator för fall och fallskadeprevention.
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| 24. |
- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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Measurement of sleep and quality of life before and after coronary artery bypass grafting : A pilot study
- 1997
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Ingår i: International Journal of Nursing Practice. - : Wiley. - 1322-7114 .- 1440-172X. ; 3:4, s. 239-246
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to: (i) test different instruments that focused on sleep, quality of life and personal adjustment in order to evaluate the usefulness of these instruments in a larger study; and (ii) to describe self perceptions of sleep and life situation by patients who had undergone coronary artery bypass grafting (CABG). A one-group pre-test repeated post-test design was used. Six men aged between 51 and 70 years were interviewed, and 24 h polysomnographic recordings were performed before and after the operation. The interviews indicated disturbed sleep and changes in behaviour and mental state immediately postoperatively. Postoperatively the polysomnographic recordings revealed a significant decrease in mean duration of sleep, mean percentage of stage 3-4 sleep and mean rapid eye movement (REM) sleep. One month after surgery the quality of life was improved, while moderate anxiety and sensation of incisional pain persisted. The measurements used in this pilot study provide valuable information into the understanding of altered sleep, quality of life and personal adjustment following CABG.
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| 25. |
- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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Nurses´ notes on sleep pattern in patients undergoing artery bypass surgery : a retrospective valuation of patient records
- 1994
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Ingår i: Journal of Advanced Nursing. - : Elesvier. - 0309-2402 .- 1365-2648. ; 20, s. 331-336
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Tidskriftsartikel (refereegranskat)abstract
- In this study, patient records from 80 male patients, aged 43-76, undergoing first-time coronary artery bypass surgery were evaluated with regard to nurses' documentation on sleep during the first four postoperative days. This documentation was classified into descriptions of quality and quantity of sleep. Notations on sleep were found in 69-86% of patient records each night, and was most common the second night. Descriptions of both quality and quantity of sleep occurred in only 12 out of 320 patient-nights. Notes regarding duration of sleep were found for 146 patient-nights (45.6%), of which 103 (32.2%) contained sleep disturbances. Information on quality of sleep was given for 116 patient-nights (36.3%), with only 38 patient-nights (11.9%) of sleep disturbances. For 72 patient-nights, documentation of the patients' sleep was lacking. Frequent awakening was the most common sleep disturbances noted during all but the first night, when continuous awakening dominated. We conclude that the nurses' documentation regarding sleep and sleep disturbances varied over a wide range, with a mixture of quantitative and qualitative information, and that more structured descriptions are needed.
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| 26. |
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| 27. |
- Edell-Gustafsson, Ulla, et al.
(författare)
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Parents’ perceptions of sleeping in a neonatal intensive care unit
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionSleep is important for mental and emotional health. For parents staying in the hospital with their preterm and/or sick infant, lack of sleep may affect their ability to handle the situation, supporting their infant, and participate in decision-making. Moreover, when a child is born preterm, parents may experience stress that potentially affects their ability to interact and bond with the infant. PurposeTo describe parents’ perceptions of what it is like to sleep in a neonatal intensive care unit (NICU) in a room nearby or in the same room as their infant. MaterialTwelve parents (eight mothers and four fathers) of infants born between week 29 and 36, in three different hospitals, were included. Eight of the parents slept in the same room as their infants and four parents slept in parents’ rooms in the NICU. MethodsParents were interviewed with open-ended questions. Data was analysed with a phenomenographic method according to Marton and Both. ResultsFive descriptive categories in the phenomenon of parents’ perception of how it is to sleep in a NICU were identified; Transition to parenthood, How parents perceive and manage their tiredness, A feeling of being out of control, Different forms of support and Environment. ConclusionsParents in the NICU are vulnerable, in a stressful situation, with an infant in need of neonatal intensive care. At the same time they are going through a complicated transition to parenthood. Hence sleep is important for the parents in several aspects, and NICU staff needs to acknowledge and promote parents’ sleep.
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| 28. |
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| 29. |
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| 30. |
- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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Self-reported sleep quality, strain and health in relation to perceived working conditions in females
- 2002
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 16:2, s. 179-187
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to examine self-reported sleep quality, perceived strain and health in relation to working conditions, the prevalence and severity of sleep disturbances and daytime distress arising from poor sleep in women on different work shifts. Furthermore, to see whether females with gastrointestinal symptoms, joint-, back- or muscle-pain and who are dissatisfied with working hours differ with regard to the above aspects. Finally, degree of strain-related symptoms and sleep difficulties were tested as predictors of sleep quality and general health outcome. Important research questions are whether registered nurses and those on rotating work shifts have greater sleep problems than others. A total of 156 females, aged 20-59 years, working at three different casualty departments, answered structured questionnaires. The results showed a persistently high rate of psycho-physiological long-term effects of stress related to working conditions. Thirty-four per cent were dissatisfied with their working hours, and exhibited significantly more mental strain, fatigue/excessive tiredness and inability to relax after work because of involuntary thoughts, in relation to working conditions than others did. Sixty-two females (39.7%) complained of insufficient sleep. The sleep quality outcome was significantly predicted by difficulty falling asleep (odds ratio 8.4), difficulty in falling asleep after nocturnal awakening (odds ratio 3.4) and perceived exhaustion (odds ratio 2.6). Females suffering from gastrointestinal symptoms and joint-, back- and muscle symptoms for several days in a week or even everyday were especially sensitive to worse sleep quality. Independent of work shifts, registered nurses exhibited a higher degree of mental strain and prolonged recovery in comparison with others. In conclusions, sleep initiation difficulties, troubled sleep and exhaustion significantly predicted reduced sleep quality outcome with decreased resilience to stress and vulnerability to psycho-physiological disorders in females working within the health care system.
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| 31. |
- Edell-Gustafsson, Ulla, et al.
(författare)
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Sleep-activity profile and quality of life in patients with stable coronary disease
- 2003
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Ingår i: Sleep. - Westchester, IL, United States : Associated Professional Sleep Societies, Llc. - 0161-8105 .- 1550-9109. ; 26:Abstract supplement, s. A357-A357
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Previous studies have examined the relationship between initiation sleep difficulties and quality of life. However, when reviewing the literature in this area we found no reports of a relationship between evening physical activity and health related quality of life in patients with coronary disease. This study was designed to investigate assumed sleep, circadian rhythm, evening physical activity and health related quality of life.Methods: Twenty-six men and 21 women, mean age 64.0 (SD 8.9) years and 63 (SD 9.3) years, respectively, with stable angina pectoris were included. For assessment of health related quality of life the patients completed the SF36 questionnaire. The data were compared with those for men and women in the general Swedish population. Physical activity was continuously recorded at home, using actigraphy with an integral light recorder (Model AW-L, Cambridge Neurotechnology Ltd, UK) in 1-minute epochs during one week. The data were downloaded by Actiwatch Reader and imported to the Actiwatch software for Windows 98.Results: Average time of going to bed was 22.37, sleep latency 27 minutes, assumed sleep duration 7.59 hr, time in bed 8.56 hr and sleep efficiency 79.2%. No differences were found during the seven nights. Nonparametric analysis of the circadian rhythm showed that 39 of 47 patients had the lowest 5-hour count activity onset at 00.00 p.m. and 41of 47 patients had the maximal 10 hr count onset 08.00 a.m. or later. Sleep analysis indicated reduced activity in the evening (p.m. 06.00-09.00). Some actigraphic parameters of the evening activity associated significantly with circadian rhythm parameters. Compared to the general Swedish population, the patients ́ health related quality of life waspoor. Linear stepwise regression analysis showed that reduced activity 3 evenings/week significantly explained health related quality of life in32.3% of role function outcome, due to physical causes (p=0.0001) and in 24.7% (p<0.01) of social function, whereas reduced activity 2 evenings/week explained 20% (p<0.01) of body pain.Conclusions: These data indicate that sleep-activity profile is associated with health related quality of life in patients with stable angina pectoris.
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| 32. |
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| 33. |
- Edéll-Gustafsson, Ulla, et al.
(författare)
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Sleep and quality of life assessment in patients undergoing coronary artery bypass grafting
- 1999
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 29:5, s. 1213-1220
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine sleep before and after coronary artery bypass grafting (CABG) as well as measuring of quality of life (QoL), and to see if changes in subjectively rated sleep can be shown objectively by polysomnographic recordings. Sample: A consecutive sample of 38 male patients, aged 45-68, underwent CABG, Twenty-two patients were graded in New York Heart Association (NYHA) classes III or IV, and 16 in class I-II before surgery. METHODS: 24-hour polysomnographic recordings, using the Oxford Medilog 9000 recorder, were performed 2 days prior to surgery, on the first 2 post-operative days and 1 month after surgery. The Nottingham Health Profile instrument (NHP) was used to measure QoL before and after surgery. RESULTS: Following surgery there was a profound decrease in sleep at night, and an increase in daytime sleep. During the second post-operative recording period nocturnal sleep duration was reduced to 253.6 +/- 94.1 minutes, with suppressed stages 3 and 4 sleep and lack, or slight recovery, of REM sleep. Even though there were evident changes in both the distribution and nature of sleep at night, daytime sleep increased and the total duration of sleep during the 24-hour period was not significantly changed. The total sleep time was 421.1 +/- 76.8 minutes before surgery, 483.2 +/- 201.2 in the first period, 433.2 +/-201.4 minutes in the second 24-hour period post-operatively and 443.2 +/- 44.0 minutes at the 1-month follow-up. The NHP instrument demonstrated that 6 months after surgery the quality of life was significantly improved. Polysomnographically measured slow wave sleep was compared with the sleep section in the NHP instrument both before surgery and at 1 month post-operatively. CONCLUSIONS: In the immediate period following CABG, there is a change in distribution of sleep, with reduction in nocturnal sleep duration and an increase in daytime sleep, which had almost returned to pre-operative values 1 month after surgery. QoL scores were improved 6 months after surgery. This study demonstrates the importance of careful assessment of sleep and sleep disturbances for more individualized nursing care in order to promote sleep in the immediate post-operative period.
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| 34. |
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| 35. |
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| 36. |
- Edéll-Gustafsson, Ulla, et al.
(författare)
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Sleep in patients with coronary artery disease : a polysomnographic study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- OBJECTIVES: To describe reported sleep and po1ysomnographically measured sleep andinvestigate its re1ationship. DESIGN: A descriptive compa1'ative study. SETTlNG: On the waiting-list for heart surgery. PATIENTS: A consecutive sample, 44 men, aged 45-70. OUTCOME MEASURES: Sleep and CAD. RESULTS: Twenty-two patients (50 %) had combined complaints of sleep difficulties.Po1ysomnographically recorded nocturnai sleep duration was 368 ± 72 minutes anddaytime sleep 35 minutes. Subjective1y and objective1y measured sleep were similar. Ahighe1' anxiety 1eve1 was associated with more stage 1 sleep (r=0.39, p CONCLUSION: Po1ysomnographically recorded sleep pattems we1'e consistent withreported sleep. Sleep disturbances are common in patients with verified obstructive CAD.
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| 37. |
- Edell-Gustafsson, Ulla, 1947-
(författare)
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Sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this thesis sleep, psychological symptoms and quality of life (Qol) in patients undergoing coronary artery bypass grafting (CABG) at the University Hospital in Linköping were evaluated. Interviews and 24-hour polysomnography were performed prior to surgery, immediately after surgery and again at one month, with a six-month-follow-up mailed questionnaire. Habitual sleep was evaluated using the Uppsala Sleep Inventory questionnaire and a diary the recorded mornings. The Spielberger State of Anxiety Scale and the Zung's Self-rating Depression Scale were used to measure anxiety and depression, respectively. Physical functional capacity was assessed according to the New York Heart Association's (NYHA) classes and Qol, with the Nottingham Health Profile instrument (NHP).A retrospective evaluation of nurse's documentation about sleep was also performed. In addition, the quality and quantity of sleep were assessed before surgery and in the immediate postoperative period in a pilot study, with a one-month follow-up interview. The results indicated disturbed sleep, and changes in behaviour and mental state after surgery due to fragmented sleep, pain and anxiety.Forty-four patients were examined prior to surgery. The results showed that almost two-fifths experienced too little sleep habitually and 50 % had a combination of at least two sleep problems. Poorer health, higher level of anxiety and increased difficulties maintaining sleep (DMS) were consistent with significantly longer sleep latency, increased fragmented sleep, and reduced stages 3 and 4 and RIM sleep measured by polysomnography. The level of Qol on the NBP was significantly associated with objectively measured sleep.In the immediate period following CABG there is a changed distribution of sleep, with a reduction of nocturnal sleep duration and an increase in daytime sleep, which had almost returned to preoperative values one month after surgery. Qol was significantly improved six months after surgery compared to before surgery.It was noted that patients with a more anxiety prone reactivity during six months following CABG had significantly more sleep disturbances, reduced energy and functional physical capacity, and lower quality of life, compared to those without such reactivity. Significantly more sleep disturbances, reduced energy and lower quality of life were more prominent among those with sadness/depression or cognitive/behavioural fatigue as reactions to sleep loss. A higher degree of cognitive/behavioural fatigue and dysphoria reactions were associated with a higher NYHA class.In conclusion, patients with coronary artery disease have poor quantity and quality of sleep. Increased psychological symptoms in patients with CAD prior to surgery were associated with greater symptoms six months after surgery. Physical functional capacity and quality of life were significantly improved six months after surgery.
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| 38. |
- Edéll-Gustafsson, Ulla, 1947-
(författare)
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Sleep quality and responses to insufficient sleep in women on different work shifts
- 2002
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 11:2, s. 280-288
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Tidskriftsartikel (refereegranskat)abstract
- ò The aim of this study was to examine degrees of cognitive behavioural effects of fatigue, mood changes and somatic responses to sleep loss in women with and without sufficient sleep, and to explore possible links between effects of sleep loss and specific sleep disturbances in selected groups. ò A total 156 women working in a casualty department on different work shifts responded to a questionnaire which measured sleep quality, strain and symptoms related to working conditions, as well as effects of sleep loss. ò About 40% of the women had perceived insufficient sleep during the last 6 months. They perceived significantly worse sleep quality and a higher degree of strain according to working conditions than the others. Palpitation and dysphoria as effects of sleep loss were independently predicted by sleep quality. Dysphoria was also predicted by difficulty in falling asleep. Cognitive behavioural effects of fatigue was predicted by disturbed sleep. Palpitation effects led to a 10-fold increase in the probability of cognitive behavioural effects of fatigue. The effects were most prominent among women suffering from gastrointestinal problems of long duration and chronic pain. ò Responses to reduced sleep quality in women constitute a form of stress, with sympathetic activation, increased susceptibility to infection, moderate cognitive impairment, mood changes and somatic distress.
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| 39. |
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| 40. |
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| 41. |
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| 42. |
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| 43. |
- Johansson, Anna, et al.
(författare)
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Evaluation of an individualised programme to promote self-care in sleep-activity in patients with coronary artery disease - a randomised intervention study
- 2014
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 23:19-20, s. 2822-2834
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To evaluate the effectiveness of an individualised programme to promote self-care in sleep-activity in patients with coronary artery disease. Background: Recent scientific findings have shown that low physical exercise and stress interfere with coronary artery disease patients' sleep quality and sleep efficiency independent of gender, age and co-morbidity. Design: A randomised pretest-post-test control design. Methods: Forty-seven patients who had undergone a coronary revascularisation procedure and/or pharmacological treatment three to seven weeks earlier at a general hospital were randomised to either an intervention group or a control group. Data collection was carried out by questionnaires, a study-specific sleep diary and actigraphy registration for 10 consecutive 24-hour periods, with a follow-up after three to four months. The intervention group underwent a nurse-led individualised education programme to promote self-care of sleep-activity. Sleep habits and sleep-related lifestyle together formed the basis for setting up individual goals together with the nurse. Individual advice on physical training, relaxation exercise and a CD-based relaxation programme was provided by a physiotherapist. Both groups received a brochure about sleep and stress. Results: At a three- to four-month follow-up, the main improvements were seen in the intervention group regarding sleep quality, sleep duration and sleep efficiency in the sleep diary and sleep efficiency in actigraphy. Statistical improvements in health-related quality of life were revealed. This was not so obvious in the control group. Conclusions: An individualised intervention programme to promote self-care of sleep-activity including relaxation in patients with coronary artery disease led by a nurse may improve sleep quality. However, a longitudinal study to promote self-care in sleep-activity should be performed using a larger sample and multiple sites with continuous follow-ups to determine whether any positive effects remain stable over time. Relevance to clinical practice: Implementation of a multiprofessional individualised programme to promote self-care of sleep-activity including relaxation based on patients' needs, supported by a healthcare team and led by nurses, is important in clinical practice. © 2014 John Wiley & Sons Ltd.
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| 44. |
- Johansson, Anna, 1965-, et al.
(författare)
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Evaluation of an individualized non-pharmacological programme to promote self-care in sleep-activity in patients with coronary artery disease - a randomized intervention pilot study
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Aim. This randomized intervention pilot study aimed to evaluate the effectiveness of an individualized non-pharmacological programme to promote self-care in sleep-activity in patients with coronary artery disease (CAD) following treatment. Background. Recent scientific findings have shown that physical exercise and stress interfere with CAD patients' sleep quality and sleep efficiency independent of gender, age and co-morbidity. Methods. A pretest- posttest control design. Fifty-three CAD patients were randomized to either an intervention group (I-group) or to a control group (C-group) 3 to 7 weeks after treatment. They filled in questionnaires, kept a sleep diary and performed actigraphy for 10 days, with a follow-up after 3-4 months. The I-group underwent an individualized non-pharmacological education programme to promote self-care of sleep-activity led by a nurse. Individual advice on physical training, relaxation exercise and a CD-based relaxation programme were provided by a physiotherapist. Both groups received a brochure about sleep and stress. Results: At a 3-4 month follow-up results indicated that the interventions improved patients’ sleep quality, sleep duration and sleep efficiency. In the I-group the main improvements were seen in sleep quality, sleep duration and SE% in the sleep diary for 10 days and SE% in actigraphy. Statistical improvements in HRQoL were revealed. This was not so obvious in the control group. Conclusions: These preliminary findings suggest that an individualized non-pharmacological programme to promote self-care of sleep-activity including relaxation in patients with CAD supported by a nurse can improve sleep quality. However,
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| 45. |
- Johansson, Anna, et al.
(författare)
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Perceptions of how sleep is influenced by rest, activity and health in patients with coronary heart disease : A phenomenographical study
- 2007
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 21:4, s. 467-475
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Tidskriftsartikel (refereegranskat)abstract
- A framework is needed for identifying internal and external factors essential for the nursing management of psychological supportive health care and education for patients' self-care in sleep. In order to generate more knowledge from the patient's perspective, the aim of this study was to describe how patients with coronary artery disease (CAD) perceive that their sleep is influenced by rest, activity and health in outpatient care. Qualitative interviews were performed with 33 outpatients. The data were analysed using a phenomenographic method. Three descriptive categories of the phenomenon were described: my lifestyle is reflected in my sleep behaviour, handling the practices around tiredness and sleep, and feelings of negative and positive efficacy. Feelings of tiredness, fatigue and sleepiness were different pre-sleep stages, but were also related to the patient's adaptation and recovery. Creating one's own personal time and feelings of efficacy gave an inner sense of strength which is indicated as being particularly important in managing stress and the demands of everyday life in a satisfactory manner. From a contextual, holistic perspective on health, it is important to identify the patient's needs, symptoms and intentional or unintentional self-care management strategies regarding sleep and lifestyle. To promote a positive health outcome it is essential to identify sleeplessness behaviour and perceived self-efficacy for self-care in sleep. © 2007 Nordic College of Caring Science.
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| 46. |
- Johansson, Anna, et al.
(författare)
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Self-care strategies to facilitate sleep in patients with heart disease : A qualitative study
- 2012
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Ingår i: International Journal of Nursing Practice. - : Wiley-Blackwell. - 1322-7114 .- 1440-172X. ; 18:1, s. 44-51
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Tidskriftsartikel (refereegranskat)abstract
- Johansson A, Karlsson J, Brödje K, Edell-Gustafsson U. International Journal of Nursing Practice 2012; 18: 44-51 Self-care strategies to facilitate sleep in patients with heart disease-A qualitative study This study aimed at exploring and describing the self-care management strategies used by patients with coronary artery disease to facilitate sleep. Qualitative interviews in a dialogue manner, in a phenomenographic reference frame analyzed according to manifest and latent principles of qualitative content analysis, were performed. A purposeful sampling technique was used including 11 patients with coronary heart disease in a Heart Medical Unit in a general hospital setting. Two main themes were identified: sleep-rhythm and sleep-hygiene including four descriptive categories. The categories reveal five basic responses including emotions, cognition, physical symptoms (reactions), behaviours and/or the sleep environment, which were related to perceived or actual presence of sleep-wake problems and health that were the underlying reason for the self-care management strategies. Basically, intervention studies that address these five responses for choice of non-pharmacological methods based on cognitive behavioural therapy provided by nurses are needed.
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| 47. |
- Johansson, Anna, et al.
(författare)
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Sleep, arousal and health-related quality of life in men and women with coronary artery disease.
- 2011
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Ingår i: Journal of Clinical Nursing. - : Blackwell. - 0962-1067 .- 1365-2702. ; 20:19-20, s. 2787-2801
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To evaluate whether there are gender differences in insomnia, sleep quality, sleep efficiency (%), general arousal, disease-specific and health-related quality of life in patients with coronary artery disease, compared with an age- and gender-matched randomly selected group from the general population. Background. There are gender difference effects of sleep disturbances in the general population, but this perspective among patients with coronary artery disease has been poorly analysed. Design. In this prospective study, comparative, descriptive and model testing designs were used. Method. The patients with coronary artery disease, 556 men and 324 women aged 25–86, were compared with a matched population-based group. Data were collected by validated and reliability-tested questionnaires. Results. The prevalence of severe insomnia varied between 17–44% in all four groups. The severe insomniac coronary artery disease patients displayed a two- or threefold higher presleep arousal, had two hours shorter nocturnal sleep duration/night and were more limited in their physical exercise level than the population-based group. Gender differences in sleep quality, sleep efficiency (%) and general arousal disappeared with increased insomnia severity. Conclusions. Independent of gender, age and comorbidity, physical exercise, general arousal behaviour and delayed poststress recovery after mental stress were found to have a negative impact on the coronary artery disease patients’ sleep quality and sleep efficiency (%), interfering with their health-related quality of life. The variables significantly explained 41% of the sleep quality outcome and 29% of the sleep efficiency (%). Relevance to clinical practice. Insomnia because of hyperarousal behaviour can be an important factor in the development of an individual self-care management programme supported by a healthcare team.
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| 48. |
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| 49. |
- Johansson, Anna, 1965-
(författare)
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Sleep-Wake-Activity and Health-Related Quality of Life in Patients with Coronary Artery Disease and evaluation of an individualized non-pharmacological programme to promote self-care in sleep
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sleep is a basic need, important to physical and psychological recovery. Insomnia implies sleep-related complaints, such as difficulty falling asleep, difficulty staying asleep, early awakening, or non-restorative sleep (NRS) in an individual who has adequate circumstances and opportunity to sleep. Insomnia is also related to impairment of daytime functions. The prevalence of reported sleep disturbances varies between 15% and 60% in patients with coronary artery disease (CAD) up to five years after intervention. Disturbed sleep may have a negative impact on self-care capacity and behaviours. Little attention has been given to evaluation of sleep promotion through individualized non-pharmacological interventions among CAD patients.The overall aim of this thesis was to describe the impact of sleep quality and disrupted sleep on health-related quality of life (HRQoL) in patients with stable CAD, in comparison to a population-based group. The objective was also to evaluate an individualized non-pharmacological programme to promote self-care in sleep.Four studies were conducted during seven years, starting in 2001. Patients from six hospitals in the south of Sweden were invited to participate. In addition, an age and gender matched population-based group was randomly selected during the same period as the patients and was used for comparison with the CAD patients in two of the studies. Data was collected through interviews, self-reported questionnaires, a study specific sleep diary and actigraphy registrations. A pretest-posttest control design was used to evaluate whether an individualized non-pharmacological intervention programme could promote self-care in sleep-activity in CAD patients.The results showed a high prevalence of insomniac CAD patients out of whom a large proportion were non-rested insomniacs. This showed that NRS is one of the core symptoms of insomnia. On the other hand there were weak or non-significant gender differences with increasing insomnia severity. Severe insomniac CAD patients displayed a two or threefold higher presleep arousal or anxiety score and were more limited in taking physical exercise than the general population. Generally low sleep efficiency (SE%) was revealed in the studies, particularly among severe non-rested insomniac CAD patients.Among CAD patients, the individualized non-pharmacological programme to promote self-care in sleep-activity indicated improvements in sleep and HRQoL.This thesis elucidates the importance of focusing on the individual’s perception of their sleep-activity and health in their local context and supporting self-care management. Furthermore, it is of importance that nurses set individual goals together with the patient in order to increase self-efficacy to promote HRQoL.
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| 50. |
- Johansson, Anna, 1965-, et al.
(författare)
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Sleep-wake-activity rhythm and health-related quality of life among patients with coronary artery disease and in a population-based sample –an actigraphy and questionnaire study
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this study was to explore whether there are gender differences in sleep and health related quality of life in patients with coronary artery disease CAD and a matched population-based sample and to see how subjectively rated sleep is associated with actigraphy. Secondly, whether factors that predict patients´ sleep quality could be identified. Fifty-seven patients with stable CAD and forty-seven participants from a population-based sample were included. All participants completed the Uppsala Sleep Inventory (USI), the Epworth Sleepiness Scale and the SF-36. Actigraphy recordings and a sleep diary were performed for 7 days. Multiple stepwise regression analysis showed that sleep duration, sleep onset latency, nocturnal awakenings, vitality (SF-36) and BMI explained 60% of the sleep quality outcome (USI) (P<0.0001). Sleep duration, sleep efficiency and fragmentation index assessed with actigraphy and sleep diary accounted for 36% of the sleep quality outcome (diary, P<0.0001). The result can form the basis for a non-pharmacological, self-care programme supported and led by nurses.
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