| 1. |
- Andreae, Christina, 1969-, et al.
(författare)
-
Depressive Symptoms Moderate the Association Between Appetite and Health Status in Patients With Heart Failure
- 2018
-
Ingår i: Journal of Cardiovascular Nursing. - : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 33:2, s. E15-E20
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Decreased appetite and depressive symptoms are clinical problems in patients with heart failure. Both may result in impaired health status. Objective: The aims of this study were to investigate the association between appetite and health status in patients with heart failure and to explore whether depressive symptoms moderate this association. Methods: In this cross-sectional study, patients with heart failure (n = 186; mean age, 71 years), New York Heart Association class II to IV, participated. Data on appetite (Council of Nutrition Appetite Questionnaire), depressive symptoms (Patient Health Questionnaire-9), and health status (EQ-5D 3-level scale [EQ-5D-3L] descriptive system, EQ-5D-3L index, and EQ Visual Analog Scale) were collected by self-rating questionnaires. Pearson correlation was used to investigate the association between appetite and health status. Multiple regression was performed to examine whether depressive symptoms moderate the association between appetite and health status. Results: There was a significant association between appetite and health status for EQ-5D-3L descriptive system, mobility (P < .001), pain/discomfort (P < .001), and anxiety/depression (P < .001). This association was also shown in EQ-5D-3L index (P < .001) and EQ Visual Analog Scale (P < .001). Simple slope analysis showed that the association between appetite and health status was only significant for patients without depressive symptoms (B = 0.32, t = 4.66, P < .001). Conclusions: Higher level of appetite was associated with better health status. In moderation analysis, the association was presented for patients without depressive symptoms. Decreased appetite is an important sign of poor health status. To improve health status, health professionals should have greater attention on appetite, as well on signs of depressive symptoms.
|
|
| 2. |
|
|
| 3. |
- Berterö, Carina, et al.
(författare)
-
Social support as described by foreign-born persons diagnosed with type 2 diabetes mellitus and living in Sweden
- 2010
-
Ingår i: Nursing and Health Sciences. - : Wiley-Blackwell. - 1441-0745 .- 1442-2018. ; 12:4, s. 507-514
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore and describe the meaning of support and its impact on the life situation of foreign-born persons diagnosed with type 2 diabetes mellitus and living in Sweden in relation to gender, age, and the duration of the disease. Mixed methods were used on a purposive sample of 34 foreign-born adults who had been diagnosed with type 2 diabetes mellitus. Qualitative data were collected by semi-structured interviews and quantitative data were collected by the Norbeck Social Support Questionnaire (NSSQ). The meaning of “support” was described by the participants as medical support, information support, and aiding support to learn to manage diabetes. Support influenced the participants' entire life and their need for it was related to the severity of the diabetes and differences regarding age and gender. The participants scored low on the NSSQ regarding total emotional support, total aid, and total function and 42% had lost an important relationship during the last year. Their marital status had no impact on emotional support but aid was significant. Medical support, with regular follow-up and information, is important in obtaining affirmation and aids in learning to manage diabetes mellitus.
|
|
| 4. |
- Bini, Christina, et al.
(författare)
-
How patients with insomnia interpret and respond to the consensus sleep diary : a cognitive interview study
- 2024
-
Ingår i: Journal of Patient-Reported Outcomes. - : Springer Nature. - 2509-8020. ; 8:1
-
Tidskriftsartikel (refereegranskat)abstract
- Objective/BackgroundThe Consensus Sleep Diary (CSD) is widely used to assess subjective sleep. Psychometric evaluations and focus-groups support its validity and clinical usefulness, but further research into its validity is needed. The aim of the study was to evaluate a Swedish translation of the CSD regarding test content and response processes in patients with insomnia.Patients/MethodsIn connection with translating the CSD into Swedish, we used cognitive interviewing to evaluate test content and the response process, that is, how people make decisions when responding to survey items. Cognitive interviews were conducted with 13 primary health care patients with insomnia disorder (mean age, 49 years; SD 15.5). Iterative, reparative analysis was used to investigate test content. Descriptive deductive analysis was used to investigate interview transcripts for the themes of the cognitive model: comprehension, retrieval, decision process, and judgement. Together, the themes explain the response process when responding to a patient-reported outcome measure.ResultsThe overall comprehension of the CSD could be affected by poor adherence to the instructions (comprehension). Patients had difficulty with recall if they did not complete the diary immediately in the morning and just before bedtime (retrieval). They could have problems deciding how to respond to certain items because they imbued sleep-related concepts with extra meaning (decision process), and had trouble finding response alternatives nuanced enough to describe their experience of sleep and tiredness (judgement).ConclusionsThis study contributes knowledge on how the instrument is perceived and used by care-seeking patients with insomnia. In this context, the CSD exhibits known flaws such as memory lapses if the diary is not filled in directly in the morning. To increase the accuracy of patients' responses, therapists should support patients in reading the instructions.
|
|
| 5. |
- Björklund, Niklas, et al.
(författare)
-
Snytbaggen : åtgärder för lyckade planteringar
- 2014
-
Annan publikation (populärvet., debatt m.m.)abstract
- Barrträdsplantor som planterats efter avverkning blir ofta dödade av snytbaggens gnag. Men genom olika åtgärder kan skadorna minskas till en acceptabel nivå. Vilka metoder du bör välja beror bland annat på var i landet hygget ligger. Denna broschyr syftar till att förklara vilken effekt på plantskadorna olika åtgärder ger och hur de kan kombineras i olika delar av Sverige.
|
|
| 6. |
|
|
| 7. |
- Engwall, Magnus, 1965-, et al.
(författare)
-
Levels of dioxin-like compounds in sewage sludge determined with a bioassay based on EROD induction in chicken embryo liver cultures
- 1999
-
Ingår i: Chemosphere. - 0045-6535 .- 1879-1298. ; 38:10, s. 2327-2343
-
Tidskriftsartikel (refereegranskat)abstract
- A bioassay for the detection of dioxin-like compounds was used to estimate levels in sewage sludge from Swedish sewage treatment plants (STPs). The sludge extracts were HPLC-separated into three fractions containing a) monoaromatic/aliphatic, b) diaromatic (e.g. polychlorinated biphenyls [PCBs], polychlorinated dibenzodioxins and polychlorinated dibenzofurans [PCDDs/Fs]), and c) polyaromatic compounds (e.g. polycyclic aromatic hydrocarbons [PAHs]). The bioassay, which is based on EROD (7-ethoxyresorufin O-deethylase) induction in cultured chicken embryo livers detected dioxin-like activity in all unfractionated extracts and in the di- and polyaromatic fractions of all sludge extracts, but not in the monoatomatic/aliphatic fractions. The levels ranged between 6 and 109 pg bio-TEQ/g sludge (d.w.). In sediment samples from rural lakes in Sweden, levels of about 5 pg bio-TEQ/g (d.w.) have been found. The polyaromatic fractions of the sludge samples were potent in the bioassay, probably due to various PAHs and other polyaromatics in the sludge. The levels of six PAHs that are screened for in the sludge at Swedish STPs accounted for only 3-10% of the observed EROD-induction by the polyaromatic fractions. Consequently, many other polyaromatic EROD-inducing compounds were present in the sludge. Inclusion of a biological test like the chicken embryo liver bioassay in the screening of sludge would improve the ability to detect the presence of bioactive dioxin-like compounds. A theoretical estimation of bio-TEQ concentrations in farm-soil following long-term application of sludge with bio-TEQ concentrations similar to those observed in this investigation indicated that the bio-TEQ levels in soil would increase very slowly over time. The chicken embryo liver bioassay proved useful in assessing levels of dioxin-like compounds in sewage sludge and it gives valuable complementary information to chemical analysis data.
|
|
| 8. |
- Forslund, Ola, et al.
(författare)
-
Mycoplasma genitalium and macrolide resistance-associated mutations in the Skåne Region of Southern Sweden 2015
- 2017
-
Ingår i: Acta Dermato-Venereologica. - : Medical Journals Sweden AB. - 0001-5555. ; 97:10, s. 1235-1238
-
Tidskriftsartikel (refereegranskat)abstract
- Mycoplasma genitalium is a sexually transmitted infection ordinarily treated with azithromycin. Emerging resistance to macrolide is linked to mutations in the 23S rRNA gene. We analysed the frequency of such mutations of M. genitalium isolates from patients that were symptomatic, and from sexual partners of symptomatic individuals, from October to December of 2015, in the Skåne Region of Sweden. Mutations were analysed by the use of DNA sequencing. Overall, 11.9% (145/1,311) and 17.0% (116/704) of females and males were positive for M. genitalium, respectively. Macrolide resistant mutations were detected in 13% (31/239) of M. genitalium isolates from first-test patient samples. Twenty-one (8.8%) and 10 (4.2%) of the isolates had point mutations of the 23S-gene at position 2072 and 2071, respectively. Two different M. genitalium isolates were detected simultaneously in two cases. In summary, we found a relatively low rate of macrolide-resistant M. genitalium in the region of Southern Sweden.
|
|
| 9. |
|
|
| 10. |
- Hellström, Amanda, et al.
(författare)
-
Sleep in cardiac arrest survivors
- 2023
-
Ingår i: Nursing in Critical Care. - : Wiley-Blackwell. - 1362-1017 .- 1478-5153. ; 28:6, s. 870-877
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Insomnia, sleep apnoea and sleep loss are risk factors for the develop- ment of cardiovascular diseases. Most research on sleep disturbances includes patients with heart failure, while the role of sleep in sudden cardiac arrest survivors (SCA) has been only partially investigated and understood. Sleep-related breathing disorders and obstructive sleep apnoea increase illness and mortality in the aftermath of SCA. Also, post-traumatic stress is evident in SCA survivors, where sleep disruptions are some of the main symptoms of the condition. Consequently, it is important to identify sleep problems in SCA survivors at an early stage to avoid unnecessary suffering.Purpose: The aim of this study was to investigate registered nurses' perceptions of SCA survivors' sleep, both in hospital and after discharge.Methods: This was an explorative interview study with a phenomenographic approach. Nineteen registered nurses (RNs) varying in age, sex and years in the profession participated.Findings: The nurses' perceptions of SCA survivors' sleep were categorized as: “The observer – noticing behaviours, emotions and habits of the patient that affect sleep”, “The oblivious witness – attitudes that hinder the ability to recognise sleep behav- iours”, and “The practitioner – advising and medicating for sleep”. The outcome space showed that the nurses detected both obvious and subtle signs relating to patients' sleep. However, attitudes hindering the recognition of sleep behaviours were independent of acting as an observer or practitioner. If nothing unforeseen was observed, or if the patient did not spontaneously raise the subject, sleep was considered less important than other health problems in SCA survivors.Conclusions: Although the nurses knew that SCA survivors suffered from poor sleep, they failed to reflect on the consequences for the patient. Nurses' feelings of insuffi- cient knowledge about sleep, as well as their omittance of sleep in the follow-up doc- umentation could leave sleep issues unaddressed and cause unnecessary patient suffering.Relevance to clinical practice: Nurses need increased knowledge and training to enable them to detect subtle signs of sleep problems in SCA survivors.
|
|
| 11. |
- Hellström, Amanda, et al.
(författare)
-
Sömn hos hjärtstoppsöver- levare ur sjuksköterskans perspektiv
- 2022
-
Ingår i: Sömn och Hälsa. - : Nätverket Sömn och Hälsa. - 2003-234X .- 2003-2501. ; :8, s. 51-64
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Plötsligt hjärtstopp är ett globalt hälsoproblem, som tyvärr har en låg överlevnadsgrad. Ungefär 20 % överlever ett hjärtstopp om det sker inne på ett sjukhus, endast hälften så många (ca 10 %) överlever om det sker utanför sjukhus. I Sverige är statistiken något bättre där ca 37 % överlever vid ett hjärtstopp på sjukhus och 11 % om det sker utanför sjukhus. Trots detta är det ett tillstånd som i de flesta fall leder till döden.
|
|
| 12. |
- Hellström, Patrik, et al.
(författare)
-
Is insomnia associated with self-reported health and life satisfaction in cardiac arrest survivors? : A cross-sectional survey
- 2023
-
Ingår i: Resuscitation Plus. - : Elsevier. - 2666-5204. ; 15
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Insomnia symptoms seem to be common in cardiac arrest survivors but their associations with important outcomes such as self reported health and life satisfaction have not previously been reported during the early post-event period. Therefore, the aim of the study was to investigate whether symptoms of insomnia are associated with self-reported health and life satisfaction in cardiac arrest survivors six months after the event.Methods: This multicentre cross-sectional survey included cardiac arrest survivors =18 years. Participants were recruited six months after the event from five hospitals in southern Sweden, and completed a questionnaire including the Minimal Insomnia Symptom Scale, EQ-5D-5L, Health Index, Hospital Anxiety and Depression Scale, and Satisfaction With Life Scale. Data were analysed using the Mann-Whitney U test, linear regression, and ordinal logistic regression. The regression analyses were adjusted for demographic and medical factors.Results: In total, 212 survivors, 76.4% males, with a mean age of 66.6 years (SD = 11.9) were included, and of those, 20% reported clinical insomnia. Insomnia was significantly associated with all aspects of self-reported health (p < 0.01) and life satisfaction (p < 0.001), except mobility (p = 0.093), self-care (p = 0.676), and usual activities (p = 0.073).Conclusion: Insomnia plays a potentially important role for both health and life satisfaction in cardiac arrest survivors. Screening for sleep problems should be part of post cardiac arrest care and follow-up to identify those in need of further medical examination and treatment.
|
|
| 13. |
- Hendriks, Jeroen, et al.
(författare)
-
Cardiac disease and stroke : Practical implications for personalised care in cardiac-stroke patients. A state of the art review supported by the Association of Cardiovascular Nursing and Allied Professions
- 2020
-
Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 19:6, s. 495-504
-
Forskningsöversikt (refereegranskat)abstract
- Cardiac and stroke conditions often coexist because of common risk factors. The occurrence of stroke may have significant consequences for patients with cardiac conditions and their caregivers and poses a major burden on their lives. Although both cardiac and stroke conditions are highly prevalent, primary stroke prevention in cardiac patients is crucial to avert disabling limitations or even mortality. In addition, specific interventions may be needed in the rehabilitation and follow-up of these patients. However, healthcare systems are often fragmented and are not integrated enough to provide specifically structured and individualised management for the cardiac-stroke patient. Cardiac rehabilitation or secondary prevention services are crucial from this perspective, although referral and attendance rates are often suboptimal. This state of the art review outlines the significance of primary stroke prevention in cardiac patients, highlights specific challenges that cardiac-stroke patients and their caregivers may experience, examines the availability of and need for structured, personalised care, and describes potential implications for consideration in daily practice.
|
|
| 14. |
- Hjelm, Carina, et al.
(författare)
-
Association between sleep-disordered breathing, sleep–wake pattern, and cognitive impairment among patients with chronic heart failure
- 2013
-
Ingår i: European Journal of Heart Failure. - : Oxford University Press (OUP): Policy B. - 1388-9842 .- 1879-0844. ; 15:5, s. 496-504
-
Tidskriftsartikel (refereegranskat)abstract
- Aims Chronic heart failure (CHF) and sleep-disordered breathing (SDB) are often co-existing problems among the elderly. Apnoeic events may cause cognitive impairment. The aim of the study was to compare sleep and wake patterns, insomnia, daytime sleepiness, and cognitive function in community-dwelling CHF patients, with and without SDB, and to investigate the association between sleep-related factors and cognitive dysfunction.Methods and results In this cross-sectional observational study, SDB was measured with an ApneaLink device and defined as an apnoea–hypopnoea index (AHI) ≥15/h of sleep. Sleep and wake patterns were measured with actigraphy for 1 week. Insomnia was measured with the Minimal Insomnia Symptom Scale, daytime sleepiness with the Epworth Sleepiness Scale, and cognitive function with a neuropsychological test battery. A total of 137 patients (68% male, median age 72 years, 58% NYHA functional class II) were consecutively included. Forty-four per cent had SDB (AHI ≥15). The SDB group had significantly higher saturation time below 90%, more difficulties maintaining sleep, and lower levels of daytime sleepiness compared with the non-SDB group. Cognitive function and sleep and wake patterns did not differ between the SDB and the non-SDB group. Insomnia was associated with decreased global cognition.Conclusion The prevalence of cognitive dysfunction was low in this population with predominantly mild to moderate CHF. This might have influenced the lack of associations between cognitive function and SDB. Insomnia was the only sleep-related factor significantly influencing cognition.
|
|
| 15. |
- Hjelm, Carina, 1964-
(författare)
-
Cognitive function in elderly patients with chronic heart failure
- 2013
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionApproximately 1-2% of the adult population in developed countries suffer from heart failure (HF), with the prevalence rising to more than 10% among patients 80 years of age or older. The HF syndrome is associated with elevated mortality and morbidity, and decreased quality of life. Cognitive dysfunction has been reported in patients suffering from a variety of cardiovascular disorders. However, few studies have systematically assessed cognitive performance in HF patients, its prevalence and other factors influencing cognition in HF patients. Further, it is of great interest to understand the relationship between self-care in HF and cognition. It may be important to screen for cognitive dysfunction as it may influence HF patients’ ability to perform self-care, e.g. make lifestyle changes, adhere to medical treatment and monitor, evaluate and treat symptoms of deterioration.AimThe overall aim of this thesis was to explore cognitive function in elderly patients with chronic heart failure with focus on prevalence, risk factors, sleep and self-care.Design and methodThis thesis is based on four quantitative studies. The data from study I and II were collected in a prospective longitudinal design, including Swedish same-sex twin pairs born in 1913 or earlier in Sweden. The study was conducted 1991-2002 and a total of 702 individuals aged 80 and older were included.Study III and IV had a cross- sectional design and included stable HF patients, median 72 years of age, living in the community in the south of Sweden. Data were collected between 2009 and 2012. Study III included a total of 137 patients and Study IV included 142 patients.ResultsStudy I found that octogenarians with HF had significantly poorer spatial performance and episodic memory, and that the episodic memory declined more over time compared to a non-HF population of the same ages.Study II showed that octogenarians with HF had a significantly higher prevalence of vascular dementia, 16% vs. 6%, and all types of dementia, 40% vs. 30%, than those not diagnosed with HF. Factors related to dementia in individuals with HF were depression, hypertension and increased levels of homocysteine. Diabetes was associated with an increased risk for vascular dementia.In study III we found that HF patients with sleep disordered breathing (SDB) (apnoea-hypopnoea index >15) had significantly higher saturation time < 90%, more difficulties maintaining sleep and lower levels of daytime sleepiness compared to those in the non-SDB group. Cognitive function did not differ between the SDB and the non-SDB-group. Only insomnia was associated with a decreased global cognititive function measured with the Mini Mental State Examination instrument.Finally, in study IV, the relationship between self-care and different dimensions of cognitive function was explored. Psycho- and visuomotor function (speed and attention) was the only dimension of cognitive function associated with self-care.ConclusionOctogenarians suffering from HF have a decreased performance in spatial and episodic memory and they also have a higher risk for developing dementia. Cognitive dysfunction as well as higher prevalence of dementia can contribute to decreased adherence to prescribed therapy and self-care management, and lead to other socio-behavioural problems. Self-care was found to be associated with psychomotor speed. This may influence sustained attention negatively and the ability to carry out more than one task at the same time. This may lead to decreased attention for receiving and understanding information on self-care.
|
|
| 16. |
|
|
| 17. |
|
|
| 18. |
|
|
| 19. |
- Hjelm, Carina, et al.
(författare)
-
Factors associated with increased risk for dementia in individuals age 80 years or older with congestive heart failure
- 2014
-
Ingår i: Journal of Cardiovascular Nursing. - : Wolters Kluwer. - 0889-4655 .- 1550-5049. ; 29:1, s. 82-90
-
Tidskriftsartikel (refereegranskat)abstract
- Background and research objective: An increasing body of evidence shows that individuals diagnosed with congestive heart failure (CHF) are at a higher risk for dementia. However, the prevalence rate of dementia among persons with CHF in very old individuals has not been previously reported, and little is known about the comorbidities that place old persons with CHF at a higher risk for dementia. The aim of this study was to compare the prevalence of dementia in individuals 80 years or older who have CHF with that in individuals without CHF and to identify factors related to dementia in individuals diagnosed with CHF.Methods: A total of 702 participants from a Swedish population-based longitudinal study (Octogenerian Twin) were included. The group consisted of same-sex twin pairs, age 80 years or older, and 138 participants had CHF. Dementia was diagnosed according to criteria in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Generalized estimating equations including gender, age and educational level, waist circumference, diabetes, hypertension, smoking, depression, and blood values were used in a case-control analysis.Results: Individuals with CHF had a significantly higher prevalence of vascular dementia, 16% vs 6% (P < 0.001), and of all types of dementia, 40% vs 30% (P < 0.01), than those not diagnosed with CHF. The generalized estimating equation models showed that depression, hypertension, and/or increased levels of homocysteine were all associated with a higher risk for dementia in individuals with CHF. Diabetes was specifically associated with an increased risk for vascular dementia.Conclusions: The prevalence of dementia was higher among individuals with CHF than in those without CHF. Diabetes, depression, and hypertension in patients with CHF require special attention from healthcare professionals because these conditions are associated with an elevated risk for dementia. Higher levels of homocysteine were also found to be a marker of dementia in patients with CHF. Further research is needed to identify the factors related to dementia in individuals 80 years or older diagnosed with CHF.
|
|
| 20. |
- Hjelm, Carina, 1964-, et al.
(författare)
-
From insecurity to perceived control over the heart failure disease–A qualitative analysis
- 2019
-
Ingår i: Nursing & Care Open Access Journal. - : MedCrave. - 2572-8474. ; 6:3, s. 101-105
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: The objective in our study was to explore chronic heart failure patients’ perceived control over their heart disease.Background: Higher levels of perceived control over one’s chronic heart disease are associated with lower levels of psychological distress and a higher quality of life.Design: The study has an explorative and descriptive design using a directed manifest qualitative content analysis according to Marring.Methods: The analysis was based on nine interviews with four men and five women aged between 62-85 years, diagnosed with chronic heart failure. The study followed consolidated criteria for reporting qualitative research (COREQ).Results: Five categories emerged in the analysis, mirroring a step-by-step process. The first step, insecurity, was followed by evaluation, management and adjustment. The patients finally reached a higher level of perceived control over their lives in relation to their heart disease.Conclusions: Most of the patients stated that they could assess and manage symptoms and had adapted to their condition, which increased their level of perceived control.Relevance to clinical practice: These findings suggest that managing symptoms is important for strengthen the patients with chronic heart failure. The findings can help health care professionals in communication with the patient planning for self-care actions.
|
|
| 21. |
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
- Hjelm, Carina, et al.
(författare)
-
The association between cognitive function and self-care in patients with chronic heart failure
- 2015
-
Ingår i: Heart & Lung. - New York : Elsevier. - 0147-9563 .- 1527-3288. ; 44:4, s. 113-119
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To test the relationship between cognitive function and self-care in patients with heart failure after adjusting for the contribution of age, education, functional status, myocardial stress, sleep and depression. Further, the relationship between cognitive function and self-care was explored with depression and sleep as moderators.Background: Self-care can significantly impact functional capacity, well-being, morbidity, and prognosis in patients with heart failure (HF). However, self-care requires the cognitive ability to learn, perceive, interpret and respond. The influence of demographics and clinical symptoms on the relationship between cognition and self-care needs to be further understood.Design: Descriptive, cross-sectional study.Methods: The study included 142 patients with chronic HF (68% male, median age 72 years, 61% in NYHA II). Self-care was measured with the European Heart Failure Self-Care Behavior Scale. Cognitive function was evaluated with neuropsychological tests measuring global cognitive dysfunction, psychomotor speed, executive function, visual-spatial perception/construct, spatial performance, semantic and episodic memory.Findings: Psychomotor function (speed and attention) measured with the Trail Making A was the only dimension of cognitive function significantly associated with self-care. Neither depressive symptoms, nor sleep disturbances moderated the relation between cognitive function and selfcare.Conclusion: Deficits in psychomotor speed have implications for how patients should be educated and supported to perform self-care. A decrease in sustained attention and ability to carry out more than one task at a same time could lead to difficulties in self-care. Screening for psychomotor speed is therefore advocated for patients with HF.
|
|
| 25. |
|
|
| 26. |
- Hjelm, Carina, et al.
(författare)
-
The influence of heart failure on longitudinal changes in cognition among individuals 80 years of age and older
- 2012
-
Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 21:7-8, s. 994-1003
-
Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this study was to examine the relationship between heart failure and specific cognitive abilities in octogenarians with regard to level and change over time.Background. Cognitive impairment is influenced by many factors, and the impact of heart failure is debated. Intact cognitive ability is crucial for successful self-care in patients with heart failure. Middle-aged patients with heart failure seem to have an increased risk of cognitive impairment. No studies have examined the association between heart failure and longitudinal cognitive changes in octogenarians (individuals 80 years and older).Design. A prospective longitudinal design.Methods. Cognitive tests were carried out five times (1991–2002) in 702 octogenarians from the Swedish Twin Registry, including same-sex twin pairs. The test battery included the measurement of processing speed, visuospatial ability, short-term, episodic and semantic memory. Latent growth curve modelling was employed to measure change and performance over time and compares the group diagnosed with heart failure to individuals without a heart failure diagnosis.Results. At baseline, the participants’ mean age was 83·5 years, 67% were women and 13% suffered from heart failure. Individuals diagnosed with heart failure scored significantly lower in spatial abilities and episodic memory than participants not diagnosed with heart failure. Moreover, measures of episodic memory declined more over time in individuals diagnosed with heart failure. There were no significant differences between the groups in other cognitive tests.Conclusion. Spatial problems and episodic memory have implications for everyday life. This might contribute to decreased adherence to prescribed therapy and self-care management and lead to socio-behavioural problems because of an impaired capacity to drive, read and write.Relevance to clinical practice. Nurses should take into account in their assessment that cognitive impairment may restrain elderly heart failure patient’s ability to make decisions and perform self-care actions. Patient education strategies should also be adapted to cognitive ability.
|
|
| 27. |
- Hjelm, Eva, et al.
(författare)
-
An inevitable journey by train : Nurses' narratives about palliative care
- 2007
-
Ingår i: Journal of Hospice and Palliative Nursing. - 1522-2179 .- 1539-0705. ; 9:4, s. 206-211
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this article is to explore the meaning of palliative care in the context of the caring relationship described by nurses providing such care in the home. Eleven nurses were interviewed, and the transcripts were analyzed using the hermeneutic narrativism method. The study found that the nurses'' narrative account of a caring relationship can be represented by a metaphor: an inevitable journey by train, characterized by the three themes of transit points, time, and guidance. Each journey passes through the same four points in chronological order. Time always moves forward, but the duration of the journey can be either long or short. Having more time creates better conditions for developing a caring relationship. The nurse provides guidance through a journey that she has made before, although each journey is unique. A caring relationship signifies commitment and involvement. © 2007 Lippincott Williams & Wilkins, Inc.
|
|
| 28. |
- Hjelm, Katarina, 1958-, et al.
(författare)
-
Dissimilarities in Social Support as Described by Swedish- and Foreign-Born Persons Diagnosed with Type 2 Diabetes and Living in Sweden
- 2014
-
Ingår i: Open Journal of Nursing. - : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 4:3, s. 211-222
-
Tidskriftsartikel (refereegranskat)abstract
- Diabetes (DM) requires self-care that is demanding and may cause stress. Social support canbuffer effects of stress. No previous study has been found comparing perceptions of foreign-bornpersons with DM, concerning the content of and need for social support with a population of origin.The aim was to compare the meaning of support and its impact on the life situation in Swedishandforeign-born persons diagnosed with type 2 DM living in Sweden. A purposive sample of 74persons; 34 foreign- and 40 Swedish-born, aged 32 - 80 years, diagnosed with type 2 DM, was included.The foreign-born persons were mostly Middle Eastern and Ex-Yugoslavian refugees. Mixedmethods were used and data were collected by qualitative interviews and quantitative data collectedby the Norbeck Social Support Questionnaire (NSSQ). Studying the figures measured byNSSQ, no significant differences were found according to gender but foreign-born men scoredlower than Swedish, especially in emotional support and aid. The main findings showed that respondents,irrespective of origin, described the meaning of the concept of support mainly as informationsupport in learning to manage DM. However, foreign-born persons also focused onmedical support with regular follow-ups while Swedes emphasized the need for emotional support.Foreign- and Swedish-born persons are in general more similar than dissimilar in describingthe meaning, need and impact of support. Irrespective of origin they want to learn to manage theirdisease and thus desire and need regular follow-up and information immediately from being diagnosed.Further studies are needed as the study is based on a limited sample.
|
|
| 29. |
|
|
| 30. |
- Hjelm, Katarina, 1958-, et al.
(författare)
-
Social support as described by Swedish people diagnosed with type 2 diabetes mellitus.
- 2009
-
Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 10:1, s. 26-37
-
Tidskriftsartikel (refereegranskat)abstract
- Social support can buffer the level and effects of stress. Diabetes mellitus (DM) requires self-care that is demanding and might cause stress. No previous studies focusing perceptions of persons with DM from their own perspective on the content, need and desire they might have for social support. Aim: To identify and describe the meaning of support and its impact on the life-situation of people diagnosed with Tye 2 DM in relation to gender, age, and duration of DM. Methods: Mixed Methods design combining Qualitative data collected by semi-structured interviews and quantitative data collected by Norbeck Social Support Questionnaire (NSSQ). Purposive sample – explore a complex concept 40 Swedish persons diagnosed Type 2 DM Aged 32-80 years (Md 59 yrs),24 men and 16 women. Duration of DM 0.5-39 yrs. Findings: Heterogenous sample according to age, employment, duration of DM but Homogenous picture of findings. Meaning of the concept of support/social support: focus mainly on informative and emotional support. Non-supportive situations were described concerning the relationship and communication with the physician. Physicians not listening to the patient and whom informants perceived lacked competence in diabetes care were often described. Support experienced while being diagnosed with DM was expressed by ♀, irrespective of duration of DM and yr diagnosed, as limited or non-existent negatively affecting their entire life- situation. Many claimed lack of support when diabetes was detected. Often diagnosed at health care centres in primary health care. Lack of informative support expressed as lack of competence and limited knowledge about DM in health care staff. When being managed at diabetes clinics adequate support was experienced. Need for support w as perceived as individual, varying and differing with regard to gender. Men were perceived to need more support than women, as women were considered having better networks. Young were stated to need more than older, as they have less experience and are going to live longer. Men scored higher on emotional support (p=0.021), aid (p=0.045) and network (p=0.026) than women More women were married but no differences in emotional support, social status and aid. Differences for those with grandchildren in emotional support (p=0.039) and in functional network properties (p=0.047) but not in aid. 20% of informants had lost an important relationship previous year. Mean number of people in network 6.5, r 1-20. In conclusion, DM demands knowledge about managing the disease and self-care, why informative and emotional support is important to gain control over the situation. Informants had perceived lack of support, particularly during the process of diagnosis of DM, in their contact with physicians and with primary health care.
|
|
| 31. |
- Hultsjö, Sally, 1973-
(författare)
-
Caring for foreign‐born persons with psychosis and their families : Perceptions of psychosis care
- 2009
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to describe and analyse perceptions of psychosis care among those involved in care, foreign-born persons with psychoses, their families and health care staff, and further to reach agreement about core components in psychosis care. This was in order to find out whether current psychosis care in Sweden is suitable for foreign-born persons and their families. The study design was explorative and descriptive. Health care staff (n=35), persons with psychosis (n=22) and families (n=26) of persons with psychosis were chosen from different regions in Southern Sweden. To capture health care staff’s experiences and to explore whether specific needs occurred within psychiatric care, nine focus group interviews were held. The perspectives of psychosis care among persons with psychoses and their families were captured through individual interviews. Finally, a study was accomplished all over Sweden in which staff, foreign-born persons with psychosis and foreign-born families of persons with psychoses answered a questionnaire to identify core components in psychosis care of foreign-born persons and their families. There was agreement that the core components in psychosis care concern general psychiatric caring, even though varying perceptions were identified. Asking about foreign-born persons’ religious and ethnic background or having the possibility to decide whether care should be provided by male or female staff were agreed to be less important. No agreement could be reached concerning the importance of considering different perceptions of psychosis care, treatments and different ways of managing the psychosis. Nor could agreement be reached as to whether staff should have specific cultural knowledge and whether interpreters should be unknown to the family but speak the right dialect. Perceptions among staff in somatic and psychiatric care as well as perceptions among foreign- and Swedish-born persons with psychosis and their families were more similar than different. General psychiatric care is important for Swedish-born as well as foreign-born persons with psychosis and their families, indicating the importance of not letting culturally determined perceptions dictate the care and take away energy from health care staff and make them lose their focus on the basic elements in general psychiatric care. However, within the general care there were individual perceptions on whose importance those involved in care did not agree. Further development suggested is to illuminate the importance of identifying individual perceptions which may differ between different persons and could be related to cultural background. Staff need to acquire strategies so they can easily manage to encounter and offer general care to foreign-born persons. Development must be achieved on both an organizational level and an individual level.
|
|
| 32. |
- Hultsjö, Sally, et al.
(författare)
-
Core components in the care of immigrants with psychoses: : A Delphi survey of patients, families, and health-care staff.
- 2011
-
Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 20:3, s. 174-184
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to identify core components in the care of immigrants with psychosis in Sweden. Experts (n = 43) from different perspectives (immigrants, families, and health-care staff) were assembled and used to score the importance of statements regarding components in the care for a person with psychosis in three questionnaire rounds. After each round, the opinions were consolidated and compared to identify whether consensus was reached. Consensus was reached about the importance of being treated on equal terms, regardless of country of birth. Staff interest and respect, shown in different ways of understanding, was valued. Consensus could not be reached on approximately half of the statements, of which four tended to be ranked towards unimportant. Those included that staff should have specific cultural knowledge or that the patient should be allowed to decide whether to be cared for by male or female staff. Nor was it regarded as important to identify a person's religious or ethnic background. The results illustrate the importance of fundamental psychiatric nursing, which should enable nurses to identify and meet the basic needs of all patients, regardless of country of origin. Areas for which consensus was not reached illustrate a future challenge for health-care staff to identify situations when cultural clashes could appear. Staff should have strategies to accomplish cultural negotiations to build an effective treatment alliance with the patient, as well as the family, to meet individual needs.
|
|
| 33. |
- Hultsjö, Sally, et al.
(författare)
-
Foreign-born and Swedish-born families' perceptions of psychosis care.
- 2009
-
Ingår i: International Journal of Mental Health Nursing. - : Wiley. - 1445-8330 .- 1447-0349. ; 18:1, s. 62-71
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe how foreign-born and Swedish born families living in Sweden perceive psychosis care. Methods: Eleven foreign-born and 15 Swedish-born family members were interviewed. Data were analyzed using a phenomenographic approach. Findings: Three main descriptive categories were found: taking responsibility, access to care, and attitudes to psychosis. The degree of responsibility in the family decreased if there was easy access to care and support from health-care staff. Knowledge of psychosis was considered to be important in order to counteract prejudiced attitudes in the family and the community. Foreign-born families did not want to be treated differently from Swedes and stressed the importance of finding ways to communicate despite communication barriers. Foreign-born families also were affected by their experiences of psychiatric care and different beliefs about psychosis in their home country. Conclusion: The results indicate how important it is that health-care staff members treat families on equal terms. It is necessary to take the time to identify how to communicate in a good manner and to identify families' previous experiences of and beliefs about psychosis care in order to help families face prejudice in society and to see beyond the psychosis.
|
|
| 34. |
- Hultsjö, Sally, 1973-, et al.
(författare)
-
Identifying core components in care of foreign-born persons with psychosis and their families : Using the Delphi technique
-
Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this study was to let persons involved in psychosis care (foreign-born persons, families and health care staff) identify the core components in care of foreign-born persons with psychosis and their families in Sweden. The results from three previous qualitative studies consisting of perceptions of psychosis care were reformulated and structured into statements in a questionnaire which was delivered to 43 persons involved in psychosis care. The statements were scored in terms of perceived importance in two rounds using the Delphi technique. The results revealed agreement about the importance of general psychiatric care. Individual perceptions on which importance there was no agreement, suggested that staff must seek to understand a person’s individual perceptions to gain insight about ways to build an effective care alliance with foreign born persons with psychosis and their families.
|
|
| 35. |
- Hultsjö, Sally, 1973-, et al.
(författare)
-
Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders
- 2007
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 60:3, s. 279-288
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper is a report of a study to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders. BACKGROUND: Research from different countries reports a high-incidence of psychosis among migrants. The risk-factors discussed are social disadvantages in the new country. To understand and meet the needs of people from different countries, their perspective of psychiatric care must be illuminated and taken into consideration. METHOD: A phenomenographic study was conducted in 2005-2006 using semi-structured interviews with a convenience sample of 12 foreign-born people and 10 Swedish-born people with psychosis. FINDINGS: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born people differed from Swedish-born people in that they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and had religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important. CONCLUSION: It is important to identify individual perceptions and needs, which may be influenced by cultural origins, when caring for patients with psychosis. Previous experience of care, different ways of relating to staff, and individual needs should be identified and met with respect. Social needs should not be medicalized but taken into consideration when planning care, which illustrates the importance of multi-professional co-operation.
|
|
| 36. |
- Hultsjö, Sally, et al.
(författare)
-
Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.
- 2007
-
Ingår i: Journal of Advanced Nursing: Perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.. ; 16:1, s. 168-78
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: to explore different perceptions of psychiatric care among foreign- and Swedish-born people with psychotic disorders.Method: A phenomenographic study was conducted in 2005–2006 using semi-structured interviews with a sample of 12 foreign-born and 10 Swedish-born persons with psychosis.Findings: Three categories were identified: personal and family involvement in care; relating to healthcare staff; and managing illness and everyday life. Foreign-born differed from Swedish-born persons as they struggled to attain an everyday life in Sweden, relied on healthcare staff as experts in making decisions, and held religious beliefs about mental illness. Among Swedish-born people, the need for more support to relatives and help to perform recreational activities was important.
|
|
| 37. |
|
|
| 38. |
- Larsson, Karin, et al.
(författare)
-
Differences in self-reported health between cardiac arrest survivors with good cerebral performance and survivors with moderate cerebral disability : a nationwide register study
- 2022
-
Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:7
-
Tidskriftsartikel (refereegranskat)abstract
- Objective The aim was to compare self-reported health between cardiac arrest survivors with good cerebral performance (CPC 1) and survivors with moderate cerebral disability (CPC 2). Methods This comparative register study was based on nationwide data from the Swedish Register of Cardiopulmonary Resuscitation. The study included 2058 in-hospital and out-of-hospital cardiac arrest survivors with good cerebral performance or survivors with moderate cerebral disability, 3-6 months postcardiac arrest. Survivors completed a questionnaire including the Hospital Anxiety and Depression Scale (HADS) and EQ-5D five-levels (EQ-5D-5L). Data were analysed using ordinal and linear regression models. Results For all survivors, the prevalence of anxiety and depression symptoms measured by the HADS was 14% and 13%, respectively. Using the EQ-5D-5L, the cardiac arrest survivors reported most health problems relating to pain/discomfort (57%), followed by anxiety/depression (47%), usual activities (46%), mobility (40%) and self-care (18%). Compared with the survivors with good cerebral performance, survivors with moderate cerebral disability reported significantly higher symptom levels of anxiety and depression measured with HADS, and poorer health in all dimensions of the EQ-5D-5L after adjusting for age, sex, place of cardiac arrest, aetiology and initial rhythm (p<0.001). Conclusions These findings stress the importance of screening for health problems in all cardiac arrest survivors to identify those in need of professional support and rehabilitation, independent on neurological outcome.
|
|
| 39. |
- Larsson, Karin, et al.
(författare)
-
Ways of understanding cognitive impairment in cardiac arrest survivors : a phenomenographic study
- 2021
-
Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 63
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe the variation in ways that registered nurses perceive and understand cognitive impair- ment in cardiac arrest survivors.Design: A qualitative, inductive design with individual semi-structured interviews was applied. Data was analysed using a phenomenographic approach.Setting: The participants were nineteen Swedish registered nurses, experienced in cardiovascular care and providing follow-up care.Findings: The nurses perceived the cognitive impairment of the survivors in qualitatively different ways, as illustrated in two categories: ‘The perceptible and obvious’ and ‘The elusive and challenging’. The nurses perceived a variety of signs of cognitive impairment, emotional expressions related to these, and recovery from cognitive impairment. They perceived confidence in capturing cognitive function when they understood the signs of cognitive impairment as severe and obvious. However, it was per- ceived as difficult to assess cognitive function when impairments were subtle, resulting in uncertainty in terms of how to make assessments. Nurses made use of their own strategies for assessments, which were sometimes found to be inadequate when they understood that they had misinterpreted the sur- vivors’ cognitive impairment.Conclusion: Nurses feel uncertainty regarding detecting mild impairment in cardiac arrest survivors. By involving next of kin, nurses will gain a broader understanding of survivors’ cognitive function.
|
|
| 40. |
- Mårtensson, Sophie, et al.
(författare)
-
Caring Behavior Coding Scheme based on Swanson’s Theory of Caring – development and testing among undergraduate nursing students
- 2021
-
Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:4, s. 1123-1133
-
Tidskriftsartikel (refereegranskat)abstract
- Rationale: To maintain patients’ dignity and well-being and alleviate suffering, it is essential that healthcare providers engage in caring behaviours. Yet, every year patient boards receive an increasing number of complaints from patients and significant others regarding healthcare providers’ non-caring behaviours. Defining and measuring both verbal and nonverbal caring and non-caring behaviour in healthcare delivery is vital to address such complaints. However, no studies were found that incorporated a comprehensive theory of caring to code encounters between healthcare providers and patients.Aim: The aim was to develop and test a Caring Behavior Coding Scheme based on Swanson’s Theory of Caring.Method: An instrument development process was used for behavioural coding including observational data from thirty-eight video recordings collected in an undergraduate nursing course at a Swedish University. The observational data involved interactions between undergraduate nursing students and a standardised patient.Result: The Caring Behavior Coding Scheme (the CBCS), contains seventeen verbal and eight nonverbal behavioural codes, categorised as caring and non-caring in accordance with Swanson’s Theory of Caring. Content and face validity were assessed. Timed-event sequential continuous coding was performed in INTERACT software. The coder achieved excellent agreement with the developed gold standard (k = 0.87) and excellent mean inter-rater reliability (k = 0.82). All domains in Swanson’s Theory of Caring were observed and coded in the interaction.Discussion/Conclusion: The CBCS is a theory-based instrument that contributes to research on healthcare providers’ behavioural encounters. It uses verbal and nonverbal caring and non-caring behavioural codes to assess the alignment of both the theory and practice of caring. The CBCS can contribute to both development and measurement of interventions focused on improving healthcare providers’ caring behaviour with the intended outcome of patient well-being.
|
|
| 41. |
- Radon, Anita, et al.
(författare)
-
What happens when retail meets research? : Special session
- 2016
-
Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- special session InformationWe are witnessing the beginning of a seismic shift in retail due to digitalization. However, what is meant by digitalization is less clear. Sometimes it is understood as means for automatization and sometimes it is regarded as equal to e-commerce. Sometimes digitalization is considered being both automatization and e-commerce trough new technology. In recent years there has been an increase in Internet and mobile devise usage within the retail sector and e-commerce is growing, encompassing both large and small retailers. Digital tools such as, new applications are developing rapidly in order to search for information about products based on price, health, environmental and ethical considerations, and also to facilitate payments. Also the fixed store settings are changing due to digitalization and at an overall level; digitalization will lead to existing business models being reviewed, challenged and ultimately changed. More specifically, digitalization has consequences for all parts of the physical stores including customer interface, knowledge creation, sustainability performance and logistics. As with all major shifts, digitalization comprises both opportunities and challenges for retail firms and employees, and these needs to be empirically studied and systematically analysed. The Swedish Institute for Innovative Retailing at University of Borås is a research centre with the aim of identifying and analysing emerging trends that digitalization brings for the retail industry.
|
|
| 42. |
|
|
| 43. |
- Tamás, Éva, 1968-, et al.
(författare)
-
Gender and Assigned Role Influences Medical Students´ Learning Experience in Interprofessional Team Training Simulations
- 2017
-
Ingår i: MedEdPublish. - Dundee, UK : Association for Medical Education in Europe. - 2312-7996. ; 6:1
-
Tidskriftsartikel (refereegranskat)abstract
- The advantages of providing standardized education avoiding exposure of real patients to interventions by novices are appealing both from patient safety and teaching aspects, thus medical simulation has become an integrated part of the healthcare curriculum.We explored the impact of gender and an acting vs. an observing role in simulation on students’ perceptions of learning outcomes, and of simulation as a learning activity.A prospective survey for graduating medical students participating in a full day simulated team training session was conducted over three terms. The questionnaire addressed issues related to the session, teamwork and simulation training in general. Participation was voluntary and the study was approved by the regional ethics committee.The overall response rate was 90.8 %. Authenticity and relevance were considered to be high, though male students scored significantly higher both for authenticity and for relevance. Communication and teamwork were considered to be different, depending on gender and assigned role. Female students and students in an acting role were more ready to discuss knowledge gaps, experienced “good” communication significantly more often, and defined their work as teamwork more frequently. The scenarios were found to be more stimulating and motivating by female students and acting individuals. Self-confidence and self-awareness were declared to be more enhanced for male students and for those who were acting during the simulation sessions. Observers and female students scored significantly lower as regards satisfaction with both the extent of the reflection and the individual feedback.The perceptions of authenticity and relevance of simulation sessions and students’ readiness to discuss knowledge gaps differed between genders. Furthermore, perceived changes in self-confidence and self-awareness seemed to be different. The observing role implies a different kind of learning process, which is not necessarily inferior to learning by acting.
|
|
| 44. |
|
|
| 45. |
|
|
| 46. |
|
|
| 47. |
- Ågren, Susanna, 1964-, et al.
(författare)
-
Dyads affected by chronic heart failure : a randomised study evaluating effects of education and psychosocial support to patients and their partners
- 2012
-
Ingår i: Journal of Cardiac Failure. - : Elsevier BV. - 1071-9164 .- 1532-8414. ; 18:5, s. 359-366
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic heart failure (HF) may cause great suffering for both patients and their partners. High marital quality with sufficient emotional support has been found to influence long-term survival in patients with chronic HF. However, emotional reactions of burden, stress and depression have been found to be associated with the partner’s new role. Psychosocial support, and patients-partner education is usually not included in standard chronic HF care despite recommendations in international guidelines. Aim: To evaluate the effects of an integrated dyad care programme with education and psychosocial support to patients with chronic HF and their partners during a post-discharge period of 3 months after acute deterioration of chronic HF. Methods: A randomised, controlled design with a follow up assessment after 3 months was used. The dyads in the control group received care as usual. The experimental group participated in an integrated care intervention, delivered in three modules through nurse-led face-to-face counselling, a computer-based CD-ROM program and other written teaching materials. Results: The intervention improved perceived control (P<0.05) in patients, but not in the partners. There were no other significant differences between the groups with regard to the dyads’ health related quality of life and depressive symptoms, patients’ self-care behaviour and partners’ experiences of caregiver burden. Conclusion: This is the first major randomised study evaluating a programme focusing on the development of problem solving skills to assist the dyads in managing heart failure. The intervention significantly improved the level of perceived control in the patient group.
|
|
| 48. |
- Årestedt, Liselott, et al.
(författare)
-
Context Factors Facilitating and Hindering Patient Participation in Dialysis Care : A Focus Group Study With Patients and Staff
- 2020
-
Ingår i: Worldviews on Evidence-Based Nursing. - : John Wiley & Sons. - 1545-102X .- 1741-6787. ; 17:6, s. 457-464
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundSafe health care of good quality depends on structured and unceasing efforts to progress, promoting strategies tailored to the context, including elements such as patients' preferences. Although patient participation is a common concept in health care, there is yet limited understanding of the factors that facilitate and hinder it in a healthcare context.AimsThis paper identifies what patients and health professionals depict in terms of enablers and barriers for patient participation in dialysis care.MethodsAn explorative qualitative design was applied with seven focus group discussions with patients, staff, and managers across different types of hospitals, with the texts analyzed with content analysis.ResultsThe dialysis context represents three key elements-people, resources, and interactions-that can both enable and hinder patient participation. Both barriers and facilitators for patient participation were found to reside at individual, team, and organizational levels, with a greater number of enabling factors implied by both patients and staff.Linking Evidence to ActionWhile the dialysis context comprises opportunities for progress in favor of patient participation, a shared understanding of the concept is needed, along with how contextual factors can facilitate conditions for participation by patient preferences. In addition, the most favorable strategy for implementing person-centered care is not yet known, but to facilitate patient participation from a patient perspective, creating opportunities to enable staff and patients to share a common understanding is needed, along with tools to facilitate a dialogue on patient participation.
|
|
| 49. |
- Årestedt, Liselott, et al.
(författare)
-
Patient participation in dialysis care : a qualitative study of patients’ and health professionals’ perspectives
- 2019
-
Ingår i: Health Expectations. - : John Wiley & Sons. - 1369-6513 .- 1369-7625. ; 22:6, s. 1285-1293
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Background and objective End-stage renal disease (ESRD) affects a multitude of aspects in the patient's daily life, often entailing their own involvement in various aspects of the treatment. Although patient participation is a core health-care value, what the concept signifies is not yet fully known. The purpose of this paper is to conceptualize patient participation in dialysis care, depicting patients? and health-care professionals? perspectives. Design This explorative study employed qualitative interviews and content analysis. Setting and participants Seven focus group discussions engaging 42 key informants were performed, including patients, staff and managers with experience of dialysis care. Results In dialysis care, patient participation connotes a sharing of information and knowledge, the learning of and planning of care, including partaking in shared decisions with regards to treatment and management, and being involved in the management of one's own health-care treatment and/or self-care activities. Although these attributes were illustrated by all stakeholders, their significance varied: patients suggested that their preferences regarding primary aspects of participation vary, while staff considered patients? performance of dialysis to be the ultimate form of participation. Further, while patients considered multiple ways to execute participation, staff suggested that aspects such as sharing information were a route to, rather than actual, involvement. Conclusions Without a common understanding to denote the idea of patient participation, staff and patients are exposed to a potential deficit in terms of facilitating patient participation in everyday encounters of dialysis treatment. Further studies and means to serve a mutual understanding are needed.
|
|
