| 1. |
- Brännström, Margareta, et al.
(författare)
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Sexual knowledge in patients with a myocardial infarction and their partners
- 2014
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Ingår i: Journal of Cardiovascular Nursing. - Philadelphia : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 29:4, s. 332-339
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sexual health and sexual activity are important elements of an individual's well-being. For couples, this topic is often affected after a myocardial infarction (MI). It has become increasingly clear that, after an MI, patients are insufficiently educated on how to resume normal sexual activity. However, sufficient data on the general knowledge that patients and partners have about sexual activity and MI are lacking.OBJECTIVE: The aims of this study were to explore and compare patients' and partners' sexual knowledge 1 month after a first MI and 1 year after the event and to compare whether the individual knowledge had changed over time. A second aim was to investigate whether patients and their partners report receiving information about sexual health and sexual activity from healthcare professionals during the first year after the event and how this information was perceived.SUBJECTS AND METHODS: This descriptive, comparative survey study enrolled participants from 13 Swedish hospitals in 2007-2009. A total of 115 patients with a first MI and their partners answered the Sex After MI Knowledge Test questionnaire 1 month after the MI and 1 year after the event. Correct responses generated a maximum score of 75.RESULTS: Only 41% of patients and 31% of partners stated that they had received information on sex and relationships at the 1 year follow-up. The patients scored 51 ± 10 on the Sex After MI Knowledge Test at inclusion into the study, compared with the 52 ± 10 score for the partners. At the 1-year follow-up, the patients' knowledge had significantly increased to a score of 55 ± 7, but the partners' knowledge did not significantly change (53 ± 10).CONCLUSIONS: First MI patients and their partners reported receiving limited information about sexual issues during the cardiac rehabilitation and had limited knowledge about sexual health and sexual activity.
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| 2. |
- Dozet, Alexander, et al.
(författare)
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Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden
- 2016
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell. - 1356-1294 .- 1365-2753. ; 22:6, s. 994-1001
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectives: The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations.Methods: This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skane, Sweden.Results: From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography.Conclusion: Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients.
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| 3. |
- Eklund, Karin, et al.
(författare)
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Positive Experience of a Mobile Radiography Service in Nursing Homes.
- 2012
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Ingår i: Gerontology. - : S. Karger AG. - 1423-0003 .- 0304-324X. ; 58, s. 107-111
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Tidskriftsartikel (refereegranskat)abstract
- Background: For elderly people living in nursing homes, a transport to hospital for a radiological examination can lead to increased anxiety, disorientation and other problems related to the new environment. Objective: To investigate the usefulness of a mobile radiography service for radiological assessment of patients in nursing homes from the patient and staff perspectives. Methods: Lightweight equipment with a digital flat-panel detector was used for mobile radiography on nursing home patients in their own rooms. Data on patient and staff experiences from the service were collected using a questionnaire with closed and open-ended questions. Image quality was evaluated by the radiographer and a radiologist. Results: The majority of 241 radiography examinations were of the musculoskeletal system (94%). Twelve of 123 patients had pathology that required hospital treatment, while 22 patients with radiographic pathology could be treated locally. The main beneficial factors were security and comfort, acceptance from the patients, no need for transportation, no need for staff to be absent from the nursing homes. Conclusion: Mobile radiography in nursing homes is technically feasible, with good image quality. The most beneficial results were that patients avoided unnecessary transport back and forth to the hospital, and that the majority of patients could be treated locally.
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| 4. |
- Hagberth, V, et al.
(författare)
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Older women with a serious cardiac event experience support with a Vifladt & Hopen inspired patient group education programme
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:2, s. 140-146
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Older women are less likely to be invited to access cardiac rehabilitation programmes. The Vifladt & Hopen model for patient education is aimed to strengthen the ability of patients with long-term illnesses to cope in everyday life. AIMS: To examine how this model was experienced by older women (>70 years) treated with percutaneous coronary intervention. METHODS: A one-year follow-up of the education programme was conducted by means of focus group interviews (n=13). A qualitative descriptive design using content analysis was used. RESULTS: Two main categories emerged: views on topics and matter, and views on form. Experiences of heart event, stress and anxiety were important topics. The women experienced advantages and benefits by meeting others in a similar situation. CONCLUSION: A focus on knowledge exchange instead of knowledge transfer encourages talking about self-experienced needs. The women expressed the benefits of the education programme since the discussions emerged from themselves. For the health care professionals there are gains to be made from obtaining the women's point of view and learning more about their needs.
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| 5. |
- Hasselberg, Daniella, et al.
(författare)
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The handling of peripheral venous catheters - from non-compliance to evidence-based needs.
- 2010
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 19, s. 3358-3363
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To study nurses' compliance to national guidelines (Sweden) for peripheral venous catheters and to establish the complication frequency connected to time in situ and bore size. Background. Worldwide, there are no standard peripheral venous catheters guidelines, and the need for elective replacement has been challenged. Furthermore, the time interval and need for elective change of peripheral venous catheters has cost implications for hospitals. Design. Prospective register study. Methods. The health care professionals in one surgical ward in a university hospital in the south of Sweden prospectively registered peripheral venous catheters parameters. Four hundred and thirteen peripheral venous catheters were registered for time in situ, size and complications. A cost analysis was performed. Non-parametric statistics were used, and p < 0·05 was regarded as significant. Result. Compliance to the guideline of time in situ was 30·2%, and the frequency of thrombophlebitis was 6·5%. Peripheral venous catheters left in situ for more than 72 hours caused more thrombophlebitis (p = 0·03). There was no difference in thrombophlebitis rate when peripheral venous catheters were changed within 24 hours compared with peripheral venous catheters that were changed within 72 hours. No difference was seen regarding complications between peripheral venous catheters sized 0·9 mm/22 gauge or 1·1 mm/20 gauge. Conclusion. The present Swedish national guidelines, advocating peripheral venous catheter change every 24 hours, should be altered since peripheral venous catheters left in situ for up to 72 hours were not found to be related to a greater risk of developing thrombophlebitis. Nor is it compatible with a greater risk to use a peripheral venous catheter of 1·1 mm/20 gauge instead of 0·9 mm/22 gauge. The change in guidelines would decrease money spent, 250 100 Euro in Sweden, thus allowing time for the nurses to do other tasks and save discomfort for the patients. Relevance to clinical practice. National guidelines should be based on evidence and current facts, and evaluation of guidelines should be given priority.
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| 6. |
- Ivarsson, Bodil, et al.
(författare)
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Adherence and medication belief in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension : A nationwide population-based cohort survey
- 2018
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Ingår i: Clinical Respiratory Journal. - : Wiley. - 1752-6981 .- 1752-699X. ; 12:6, s. 2029-2035
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare diseases with a gradual decline in physical health. Adherence to treatment is crucial in these very symptomatic and life threatening diseases. Objective: To describe PAH and CTEPH patients experience of their self-reported medication adherence, beliefs about medicines and information about treatment. Methods: A quantitative, descriptive, national cohort survey that included adult patients from all PAH-centres in Sweden. All patients received questionnaires by mail: The Morisky Medication Adherence Scale (MMAS-8) assesses treatment-related attitudes and behaviour problems, the Beliefs about Medicines Questionnaire-Specific scale (BMQ-S) assesses the patient's perception of drug intake and the QLQ-INFO25 multi-item scale about medical treatment information. Results: The response rate was 74% (n = 325), mean age 66 ± 14 years, 58% were female and 69% were diagnosed with PAH and 31% with CTEPH. Time from diagnosis was 4.7 ± 4.2 years. More than half of the patients (57%) reported a high level of adherence. There was no difference in the patients' beliefs of the necessity of the medications to control their illness when comparing those with high, medium or low adherence. Despite high satisfaction with the information, concerns about potential adverse effects of taking the medication were significantly related to adherence. Conclusions: Treatment adherence is relatively high but still needs improvement. The multi-disciplinary PAH team should, together with the patient, seek strategies to improve adherence and prevent concern.
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| 7. |
- Ivarsson, Bodil, et al.
(författare)
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Change in health-related quality of life at early follow-up in patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension
- 2024
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Ingår i: Pulmonary Circulation. - 2045-8932. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- Symptoms associated with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) impact patient's health-related quality of life (HRQoL). Studies on change and if a minimal clinically important difference (MCID) in HRQoL is reached within a year after diagnosis are lacking. The aim was to investigate the change in HRQoL as well as the proportion of patients that reached MCID at an early postdiagnosis visit. The study included adult patients from the Swedish PAH & CTEPH registry, diagnosed 2008–2021, with Cambridge Pulmonary Hypertension Outcome Review (CAMPHOR) at time of diagnosis and a follow-up. Data were analyzed as total population and dichotomized for sex, age (<65 vs. ≥65 years), time of diagnosis (≤2015 vs. >2015) and pulmonary hypertension (PH) subgroups. Data reported as median, interquartile range (IQR), and proportions (%). There were 151 patients (PAH = 119, CTEPH = 32) with an available CAMPHOR score at diagnosis and follow-up. CAMPHOR total sum was 31 (IQR: 21–43) and 25 (14–36); (p < 0.001) at diagnosis and follow-up, respectively. At follow-up, 56% had reached MCID in total sum, while for domains activity, symptoms, and QoL 27%, 33%, and 39% reached MCID, respectively. These results were independent of PH subgroup, diagnosis before or after 2015 and sex. Age below 65 years was related to improvements in activity and worsening of symptoms. In conclusion on a group level, improvements in CAMPHOR total sum as well as all domains were seen in the first year after diagnosis, however, only slightly more than half of the patients reached MCID for CAMPHOR total sum.
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| 8. |
- Ivarsson, Bodil, et al.
(författare)
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Coping, social support and information in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension : A 2-year retrospective cohort study
- 2018
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 6, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension are severe diseases with complicated treatment that need care at specialist clinics. The aim was to investigate changes in the patients' perceptions on coping, social support and received information when attending a newly started nurse-coordinated pulmonary arterial hypertension-outpatient clinic.Methods: The present study was a descriptive, questionnaire-based cohort study including 42 adult patients. To evaluate coping, the Pearlin Mastery Scale was used. Social support, information and health-related quality of life were measured using Social Network and Support Scale, QLQ-INFO25 and the EQ-5D.Results: Attending the pulmonary arterial hypertension-outpatient clinic increased coping ability (Mastery Scale) significantly (baseline 16.0 ± 3.3 points vs 2-year follow-up 19.6 ± 5.2 points, p < 0.001) while there was no difference in social network and support or in perception of received information after. Patients who improved their coping ability (67%) were younger, had better exercise capacity, experienced better health-related quality of life and were more satisfied with received information about treatment and medical tests than those who reduced the coping ability. There was no difference in gender, diagnosis, time since diagnose, pulmonary arterial hypertension-specific treatment, education level or civil status between the two groups.Conclusion: This study suggests that the pulmonary arterial hypertension-team, in partnership with the patient, can support patients to take control of their disease and increase their health-related quality of life.
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| 9. |
- Ivarsson, Bodil, et al.
(författare)
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Everyday life experiences of spouses of patients who suffer from pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension
- 2019
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Ingår i: ERJ Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 5:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Spouses play a crucial role, both physically and psychologically, for patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Our aim was to investigate the spouse's experiences when living with a partner diagnosed with PAH or CTEPH.Methods: We used a qualitative interview study design based on open-ended questions analysed using qualitative content analysis.Results: 14 spouses were interviewed. Two categories that describe spouses' experiences of dealing with everyday life were identified: "Living in an insecure life situation" and "Providing and receiving information and support". The experiences reported by the spouses were that their life situation was insecure, and that they had challenges in providing and receiving information and support. Most spouses also wanted and felt a need to be more involved in the care.Conclusion: The spouses were only partly satisfied with their life situation. To support the spouse's participation, the PAH/CTEPH team should encourage the patient to bring their spouse along, and offer them the opportunity to participate in the contacts with healthcare and provide information on an individual family perspective.
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| 10. |
- Ivarsson, Bodil, et al.
(författare)
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Experiences of group education : A qualitative study from the viewpoint of patients and peers, next of kin and healthcare professionals
- 2011
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Ingår i: Vård i Norden. - Köpenhamn : SSN [Sjuksköterskornas samarbete i Norden. - 0107-4083 .- 1890-4238. ; 31:2, s. 35-39
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Tidskriftsartikel (refereegranskat)abstract
- Background: Group education is intended to strengthen the ability of patients with long-term illnesses to cope in everyday life. Aim: To describe how patients and peers, next of kin and healthcare professionals experienced group education sessions. Methods: A qualitative, critical incident technique was used. Thirty patients, 9 peers, 41 next of kin and 12 healthcare professionals were asked to describe in writing their experiences of group education, inspired by the Norwegian Vifladt & Hopen model. The answers were then analyzed and categorized. Findings: Three hundred and eleven critical incidents were identified and two main areas emerged in the analyses: Experiences related to the group education and Impact of the group education programs. Experiences related to the group education described The course, Knowledge and support, and Becoming closer. Impact of the group education programs described Output and Advice to the healthcare organizations. Conclusion: This kind of group education is valuable because the participants benefited from listening to and learning from each other. Patients and NoK had the opportunity to find new strategies for managing daily life. The study also showed that it is important to plan and implement the education and meetings in cooperation between healthcare professionals and experienced peers
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| 11. |
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| 12. |
- Ivarsson, Bodil, et al.
(författare)
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Experiences of supportive care when waiting for a lung re-transplantation
- 2017
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Ingår i: SAGE Open. - : SAGE Publications. - 2158-2440 .- 2050-3121. ; 5, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients' and next of kin's experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs.METHODS: Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation.RESULTS: The experiences of supportive care were captured in one main category: 'once again haunted by death' and three sub-categories: 'when life turns and death once again snorts down your neck', 'the importance of information', and 'perceptions of support'. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown.CONCLUSION: This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.
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| 13. |
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| 14. |
- Ivarsson, Bodil, et al.
(författare)
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From hope and expectation to unexpected death after cardiac surgery.
- 2008
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 1532-4036 .- 0964-3397.
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Relatives of patients undergoing cardiac surgery expect successful outcome but sometimes complications cause death. The aim was to interview relatives of patients who have died in connection with cardiac surgery and describe their experiences of information, reception and care. METHODS: Data were obtained from semi-structured interviews with 18 relatives of deceased patients and then analysed using qualitative content analysis. RESULTS: Two main groups emerged: "Analysing the situation" with the sub-groups: knowledge of cardiac disease, the road to operation, hope and despair, information and choice and "The thin thread of life" with the sub-groups, reception, life is over, care, death as a relief, cause of death and support. CONCLUSION: Most relatives were satisfied with the information and care in connection with the operation and at the end of life. However, some aspects such as inadequate pain control and transportation of critically ill patients to other wards and hospitals could be improved. One way is to introduce a co-ordinator in order to better support patients, next of kin and colleagues without experience of cardio-thoracic surgery who need help during the patients' way from diagnosis and acceptance of cardiac surgery and through the treatment and postoperative care.
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| 15. |
- Ivarsson, Bodil, et al.
(författare)
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Health professionals' views on sexual information following MI
- 2010
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Ingår i: British Journal of Nursing. - : MA Healthcare. - 0966-0461 .- 2052-2819. ; 19:16, s. 1052-1054
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Tidskriftsartikel (refereegranskat)abstract
- Following myocardial infarction (MI), patients often have unanswered questions about resuming sexual activity. Coronary care nurses can play an important role in counselling. However, this sensitive area is frequently neglected in nursing practice. This article discusses patient and nurse perceptions of such discussions and explores ways to increase nurses' awareness, so that they might offer sexual counselling to patients post-MI. Health professionals representing 18 Swedish coronary care units answered two open-ended questions, and their answers were analysed and categorized by content. Two main categories were identified: 'Difficulties and challenges' and 'Future needs'. These two categories were further divided into subcategories respectively: 'Information flow', 'Patients' responsibility', 'Information to partners' and 'Cooperating with other experts'; and 'Preparing information tools' and 'Highlighting sexual issues'. It was found that when sexual concerns arise, contact with medical social workers, urologists and gynaecologists is scarce. It was also found that the current written information is insufficient. Responsibility currently falls on patients to ensure that both they and their partners have been adequately informed regarding any sexual concerns. It is essential that health professionals are well-educated and have the necessary skills to inform patients and their partners about sexual issues following MI.
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| 16. |
- Ivarsson, Bodil, et al.
(författare)
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Health-related quality of life, treatment adherence and psychosocial support in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension
- 2019
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Ingår i: Chronic Respiratory Disease. - : SAGE Publications. - 1479-9723 .- 1479-9731. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) share similar quality of life impairment. The aim of the present study was to investigate health-related quality of life (HRQoL) and its relation to the perception of treatment and psychosocial support among PAH and CTEPH patients. All adult PAH or CTEPH patients in the Swedish Pulmonary Arterial Hypertension Register were invited to participate in a national cohort survey. The survey included the EuroQol 5-dimensions (EQ-5D) instrument that measures an individual's HRQoL; the Beliefs about Medicines Questionnaire-Specific Scale that assesses the perception of PAH-specific treatment; the Mastery scale that evaluates the feeling of control and ability to cope with the disease; and the Social Network and Support Scale that maps the social support network. Of the 440 invited patients, 74% responded. Mean age was 66 ± 14 years, 58% were female and 69% diagnosed with PAH. Patients with PAH were younger, more often female and had a lower EQ-5D index (0.67 ± 0.29 vs. 0.73 ± 0.25, p = 0.050) than patients with CTEPH. Patients with a low EQ-5D index had more concerns about treatment ( p = 0.004), lower coping ability ( p < 0.001), less emotional support ( p = 0.003) and less accessible social network ( p = 0.002). In conclusion, patients with an impaired HRQoL also reported negative effects on their social support network, ability to handle stressors and concerns about treatment.
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| 17. |
- Ivarsson, Bodil, et al.
(författare)
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Heart or lung transplanted patients' retrospective views on information and support while waiting for transplantation.
- 2013
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 22:11-12, s. 1620-1628
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To describe the patients' retrospective experiences of the information and support they received while on the heart or lung transplant waiting list. BACKGROUND: Patients differ in the way that they cope with the time spent waiting for a heart or lung transplant. Patients must already before the transplantation be taught about a new lifestyle, risk factors, medication, food restrictions and exercise, so they can take an active role and responsibility for disease management after transplantation. Little is known about patients' experiences of information and support in these situations. DESIGN: Qualitative descriptive design. METHODS: Sixteen patients (16-67 year) were strategically selected from one transplant centre in Sweden and interviewed six months after heart or lung transplantation. Using content analysis, transcribed data were organised into subcategories that reflected emerging categories. RESULTS: Three categories that describe patients' experiences of information and support have been identified: 'Achieving confidence and trust by information and support', 'Experiencing a lack of input and understanding' and 'Struggling with a life-threatening illness and an insecure future'. Each category consists of different subcategories. CONCLUSIONS: Information and support in connection to heart or lung transplantation are a complex and multifaceted issue involving patient-related, family-related, disease-related and treatment-related factors as well as experiences related to the social situation, the healthcare system and society. Transplant patients are very vulnerable, and a deeper understanding of patients' experiences should help healthcare providers in optimising the care for these very sick patients. RELEVANCE TO CLINICAL PRACTICE: A holistic approach to the patient is necessary in meeting the needs of patients with chronic illness, especially patients with children at home, as well as the needs of their families. An important implication is the necessity to enhance awareness about transplant patients in society in general, in particular in other institutions, by sharing knowledge and by improving cooperation.
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| 18. |
- Ivarsson, Bodil, et al.
(författare)
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Information and/or medical technology staff experience with regulations for medical information systems and medical devices
- 2016
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Ingår i: Health Policy and Technology. - : Elsevier BV. - 2211-8837. ; 5:4, s. 383-388
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Regulations heavily control medical technology (MT), which often includes information technology (IT), but staff experiences related to these regulations are unknown. The study aim was to assess Swedish IT/MT staff experiences regarding regulations for medical devices and medical information systems. Methods An anonymous, ten-item, self-report questionnaire was administered to IT and MT staff (N=228) who attended a 3-h training course on IT and information security and MT regulations in 2014. Results Most of the 228 (86%) IT and MT staff who completed the survey strongly agreed that IT security and MT security are relevant to patient safety. One third of the IT staff reported feeling that their knowledge about regulations within MT was sufficient. Less than half of the respondents experienced that healthcare professionals generally had sufficient knowledge of IT or MT regulations (41% versus 46%, IT and MT regulations, respectively). Conclusions Although IT/MT staff felt that they had knowledge of regulations for medical devices and medical information systems, they reported that maintaining and increasing this knowledge is important and that there is a need for recurring training programs in IT and MT regulations. Improved knowledge in IT and MT regulation, and a better understanding of clinical healthcare, could lead to an increased quality in the daily operations and support to the healthcare professionals. Healthcare professionals may need education to develop their knowledge of IT or MT regulations, which in turn will ensure higher patient safety.
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| 19. |
- Ivarsson, Bodil, et al.
(författare)
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Information experiences and needs in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension.
- 2014
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437. ; 2014
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Tidskriftsartikel (refereegranskat)abstract
- Background. Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are fatal, noncurable, but treatable diseases that strongly affect the patients. Objective. To describe patients' experience of information relating to PAH or CTEPH. Methods. A qualitative method using content analysis was applied. Seventeen patients (thirteen women and four men) aged 28-73 years from a regional PAH centre were individually interviewed. Results. Three categories that describe patients' experiences of information emerged: handling of information, struggling with feelings that also affect others, and vulnerability associated with uncertainty. The patients would have welcomed more information to relatives from the healthcare professionals. Shortcomings on communicating a prognosis were experienced. The mediated information and knowledge gave the patients insight into physical or psychosocial problems. Mutual exchange of information between patients and healthcare professionals were marred by different experiences of attitudes, behaviour, and ownership. Conclusions. In the future, healthcare organizations must struggle to achieve a holistic healthcare by making it more person-centred, and they must also promote cooperation between PAH centres and local healthcare providers. It is essential to determine the most appropriate and valuable path of information and communication and, thereby, the most cost-effective management of PAH or CTEPH.
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| 20. |
- Ivarsson, Bodil, et al.
(författare)
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Information from health care professionals about sexual function and coexistence after myocardial infarction : a Swedish national survey
- 2009
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Ingår i: Heart & Lung. - : Elsevier. - 0147-9563 .- 1527-3288. ; 38:4, s. 330-335
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: After a myocardial infarction (MI), many patients and their partners experience problems with marital and sexual life.METHODS: A Swedish national survey was carried out to obtain knowledge on the information provided by cardiac health care professionals on the subject of sexual function and coexistence after an MI. It consisted of a questionnaire that was designed, tested, and sent to 121 coronary care units.RESULTS: The coronary care unit teams rarely provided oral or written information about sexual function and coexistence to patients with MI or their partners. The health care professionals lacked competence in these areas.CONCLUSION: It is essential that health care professionals are educated on and inform the patient with MI about the significance of sexual function and coexistence. Further research is required regarding patients' and their partners' need for information and support in this area.
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| 21. |
- Ivarsson, Bodil, et al.
(författare)
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Information, social support and coping in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension-A nationwide population-based study
- 2017
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 100:5, s. 936-942
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) decrease life expectancy for affected patients. The aim was to describe the perceptions of received information regarding diagnosis, treatment and management, as well as social support and coping perceived by patients with PAH or CTEPH. Methods: A descriptive, national cohort survey that included patients from all PAH-centres in Sweden. A quantitative methodology was employed where all patients received three questionnaires, QLQ-INFO25, Mastery Scale and Social Network & Support Scale. Results: The response rate was 74% (n. =325), mean age 66. ±. 14. years, 71% were female and 69% were diagnosed with PAH and 31% with CTEPH. Sixty percent of respondents were satisfied with the received information and felt it was helpful. Best experiences were of information in the areas of medical tests (70%) and the disease (61%). Forty-five percent wanted more information. Men described their social network as more accessible than women (p. =0.004). Those living alone had a lower coping ability. Conclusion: Despite a high level of satisfaction with the received information, almost half of the patients wanted more information. Practice implications: Regular repeating or giving new information should be an ongoing process in the care of patients at the PAH-centres.
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| 22. |
- Ivarsson, Bodil, et al.
(författare)
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Novel Insight into How Nurses Working at PH Specialist Clinics in Sweden Perceive Their Work
- 2020
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Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 8:2
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Tidskriftsartikel (refereegranskat)abstract
- Outpatient pulmonary hypertension (PH) specialist centers have an important role in the optimal management of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The aim of the present study was to gain an understanding of the work facing nurses at the outpatient PH specialist centers in Sweden. All nurses (n = 14) working at the outpatient PH specialist centers in Sweden were included. Qualitative content analysis was employed to analyze the interviews, wherein an overarching theme emerged: "Build and maintain a relationship with the patient". Three categories described the nurses' experiences: "Ambiguous satisfaction regarding information and communication", "Acting as a coordinator" and "Professional and personal development". To provide good patient care, the nurses described the key components as the ability to give information on all aspects of the disease and their availability by phone for patients, their relatives, and other healthcare resources. This requires evidence-based, specialist knowledge about the disease, its care, and treatments as well as experience. In conclusion, working as a nurse at the outpatient PH specialist centers highlight the advantages, expectations, and difficulties in working with patients with a rare and life-threatening illness. The overall knowledge and skills were high, but the nurses expressed a need for in-depth and continued training.
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| 23. |
- Ivarsson, Bodil, et al.
(författare)
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Patient reactions to cancelled or postponed heart operations.
- 2002
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 1365-2834 .- 0966-0429. ; 10:2, s. 75-81
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim was to survey the rate and cause of cancellations of planned cardiac operations at a Swedish clinic during 1999, and to study how the patients were affected. Design Questionnaires were distributed to 74 patients who had their operations cancelled. Their mood after discharge was measured with The Hospital Anxiety and Depression scale. Ninety-three patients, who were operated on without postponement, served as controls. Results Sixty-one percent of the patients in the cancellation group reacted negatively, especially if the reason for cancellation was organizational (P = 0.03). The women in the cancellation group had a significantly higher degree of depression than men (P = 0.01) and both women (P = 0.02) and men (P = 0.003) in the control group. Most of the patients, however, were satisfied with the nursing staff's reception and information. Conclusions The patients reacted negatively to the cancellation, especially if it had organizational reasons. Women subjected to cancellation had a significantly higher degree of depression than other patients. To be avoided, organizational and medical problems must be identified in time. One way to do this is to introduce a preadmission nurse clinic.
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| 24. |
- Ivarsson, Bodil, et al.
(författare)
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Patientens perspektiv på att leva med PAH eller CTEPH i Sverige : Enkätstudie visar på betydelsen av adekvat och upprepad information
- 2019
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Ingår i: Läkartidningen. - 0023-7205. ; 116:18, s. 803-803
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Tidskriftsartikel (refereegranskat)abstract
- For patients living with chronic conditions, the daily life will change due to symptoms, drug treatment, and psychosocial factors caused by the disease. Our studies show that Swedish patients with PAH or CTEPH are satisfied with the information they have received, but still have a wish for more. Therefore, it is important to repeat the information on a regular basis and to make sure that patients have understood and remember the messages. In order to increase the knowledge about their disease, improve compliance with treatment and quality of life, patients and next of kin should continuously be informed by the multidisciplinary team at the PAH/CTEPHspecialist care centers.
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| 25. |
- Ivarsson, Bodil, et al.
(författare)
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Patients experiences of information and support during the first six months after heart or lung transplantation.
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:4, s. 400-406
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Heart or lung recipients are taught about a new lifestyle, risk factors, medication, food restrictions and exercise so they can take an active role and responsibility for disease management after transplantation. However, little is known about patients' experiences of information and support in these situations. OBJECTIVE: The aim of the study was to illuminate how patients, six months after a heart or lung transplantation, experienced the information and support they received in connection with the transplantation. METHODS: Sixteen patients were included in the study, and interviews were analysed using a qualitative content analysis method. RESULTS: The findings are presented in three themes: Alternating between gratitude and satisfaction and resignation, Striving to follow treatment strategies and Returning to a relatively normal life. The patients expressed gratitude when their health improved markedly but resignation when complications or side effects occurred due to the lack of information and support they received. CONCLUSIONS: Healthcare professionals can make specific improvements in the information they provide to patients to increase their preparedness. Information and support should be provided regularly so as to avoid non-adherence to essential guidelines. To return to a normal life, patients need support from healthcare organizations, families, employers and society in general. These findings should be taken into account in the clinical management of transplant patients, particularly those with dependent children or failing social networks.
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| 26. |
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| 27. |
- Ivarsson, Bodil, et al.
(författare)
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Patients perceptions of information about risks at cardiac surgery
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 67:1-2, s. 32-38
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to describe the patients' own experiences of risk information in connection with cardiac surgery and it's outcome. Methods: Questionnaires were answered prior to and 8 weeks after cardiac surgery. Data were analysed using qualitative content analysis. Patients in the intervention group (n = 55) received standard information and a newly written extended information brochure about risks in connection with cardiac surgery. Patients in the control group (n = 44) only received standard information. Results: Three categories emerged: attitude towards information, deficiencies and advantages of the information and concerns related to cardiac surgery. Patients in both groups pointed out the importance of information when they were put on the waiting list. Patients in the control group missed information about complications and some patients thought that their complications were caused by maltreatment. Patients having complications in the intervention group were more understanding about their situation. Conclusion: Much can be done for the patients on their path from diagnosis and being accepted for cardiac surgery and throughout the treatment period regarding the provision of information. Practice implications: If patients become carefully and thoroughly informed by the health care professionals, they are more satisfied and better prepared if complications occur. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
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| 28. |
- Ivarsson, Bodil, et al.
(författare)
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Perceptions of received information, social support, and coping in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension.
- 2014
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Ingår i: Clinical medicine insights. Circulatory, respiratory and pulmonary medicine. - 1179-5484. ; 8, s. 21-28
-
Tidskriftsartikel (refereegranskat)abstract
- Patients with a life-limiting diagnosis of pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) need disease-specific information, ability to cope, and functioning social networks. This cohort study investigated the experiences of PAH and CTEPH patients who received information about their diagnosis, treatment, and management, in addition to coping and social support. Sixty-eight adult patients (mean ± SD, age 67 ± 14; 66% women) were included. A total of 54% of the patients wanted more information. Patients received information mostly in areas concerning medical test procedures, the diagnosis, disease severity, possible disease causes, and how to manage their disease. Coping ability was significantly better in patients who were satisfied with the received information (P = 0.0045). The information given to PAH or CTEPH patients and their communication with healthcare professionals can be greatly improved. Gaps in information and misunderstandings can be avoided by working in cooperation with the patients, their relatives, and within the PAH team.
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| 29. |
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| 30. |
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| 31. |
- Ivarsson, Bodil, et al.
(författare)
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Recently accepted for the waiting list for heart or lung transplantation - patients' experiences of information and support.
- 2011
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Ingår i: Clinical Transplantation. - : Wiley. - 1399-0012 .- 0902-0063. ; 25, s. 664-671
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to describe the patients' experiences of the information and support they received after being placed on the waiting list for a heart or lung transplant. The design was qualitative, and the critical incident technique was used. Incidents were collected via interviews with 21 patients. A total of 357 important events, both positive and negative, were identified and divided into two main groups: Body and mind and Information and support. The following subgroups emerged: chronic illness affects the patients, attitudes towards the future, impact of information, support from public organizations, and support from the private sphere. The patients showed knowledge of and involvement in the upcoming transplantation, which indicates that healthcare professionals managed to convey information and support effectively. By identifying the importance of factors such as body and mind and information and support for patients recently accepted for heart or lung transplantation, healthcare professionals are able to make specific improvements in the information and support that they provide. An important implication is to enhance the knowledge regarding transplant patients in other institutions and improve cooperation. Specific support programs to assist patients who have dependent children should be developed. Society needs to become more enlightened about organ donation and transplantation patients.
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| 32. |
- Ivarsson, Bodil, et al.
(författare)
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Relative's experiences before and after a heart or lung transplantation
- 2014
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Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 43:3, s. 198-203
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Tidskriftsartikel (refereegranskat)abstract
- Background: Relatives take on great responsibilities during patients' heart or lung transplant process and an understanding for their situation is required. Objective: To describe relative's experiences before and during the patient's hospital stay as well as during the first 6 months after a heart or lung transplantation. Methods: Using qualitative content analysis, 15 relatives (eight women and seven men) aged 36-65 years were interviewed within 6 months of a heart or lung transplantation. Result: Three categories that illuminate relatives' experiences have been identified: "Navigate specific circumstances," "Facilitate throughout the transplantation journey" and "Experiences of strength and weakness of information and support." The relatives reported involvement in the transplantation decision, peer support, information seeking, burden and coping. Conclusion: Greater awareness about relatives' experiences with identification of appropriate support and information exchange between health care professionals and relatives is important. This awareness could provide benefits for heart or lung transplant patients, families and health care organizations. (C) 2014 Elsevier Inc. All rights reserved.
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| 33. |
- Ivarsson, Bodil, et al.
(författare)
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Reply to Mishra.
- 2005
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Ingår i: European Journal of Cardio-Thoracic Surgery. - : Oxford University Press (OUP). - 1010-7940. ; 28:6, s. 911-911
-
Tidskriftsartikel (refereegranskat)
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| 34. |
- Ivarsson, Bodil, et al.
(författare)
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Serious complications in connection with cardiac surgery-Next of kin's views on information and support.
- 2011
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 1532-4036 .- 0964-3397. ; 27:6, s. 331-337
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Next of kin (NoK) to patients undergoing cardiac surgery expect successful outcomes but sometimes serious complications occur and this affects their NoK. To describe NoK's experiences of information and support when serious complications occur during the first 30 days after cardiac surgery. METHODS: A qualitative, critical incident technique was used. Forty-two NoK were asked to describe their experiences of information and support. RESULTS: Three main areas emerged from the analysis. The first main area, Confidence during the waiting period, described how NoK could not participate in the forthcoming operation and how the NoK were informed. The second main area, Involvement during the hospital stay, described how the NoK feel trust in the healthcare professionals and dissatisfaction with the care in relation to the operation. The third main area, Sense of abandonment, described problems with the rehabilitation. CONCLUSIONS: These findings show the importance of pre- and post operative contacts between healthcare professionals, patients and NoK. When the NoK and the patients are well informed it constitutes a basis for fruitful conversations between them and the healthcare professionals, and everyone can be better prepared if complications occur.
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| 35. |
- Ivarsson, Bodil, et al.
(författare)
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Support Experienced by Patients Living with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension
- 2016
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Ingår i: Heart, Lung and Circulation. - : Elsevier BV. - 1443-9506 .- 1444-2892. ; 25:1, s. 35-40
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Tidskriftsartikel (refereegranskat)abstract
- Background As pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are debilitating and fatal diseases it is essential to increase the understanding of patients' experience of support. The aim was to describe patients' experiences of support while living with PAH or CTEPH. Methods Seventeen patients (13 women and four men) aged 28-73 years were strategically selected from a regional PAH centre and individually interviewed. The answers were analysed using qualitative content analysis. Results Three categories that describe patients' experiences of support emerged: Support linked to the healthcare; support linked to the private sphere; and support linked to persons outside the private sphere. Conclusion Healthcare practitioners must work more in collaboration to detect patients' need for support and to develop the patient's own skills to manage daily life. The PAH teams should tailor interventions to provide emotional, informational and instrumental support and guidance to patients and their families.
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| 36. |
- Ivarsson, Bodil, et al.
(författare)
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The experiences of pre- and in-hospital care in patients with hip fractures : A study based on Critical incidents
- 2018
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Ingår i: International Journal of Orthopaedic and Trauma Nursing. - : Elsevier. - 1878-1241 .- 1878-1292. ; 30, s. 8-13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hip fractures are described to have a significant impact on patients' well-being and different fasttrack concepts could result in a reduction of the patient's psychological and emotional reactions before pre- and intrahospital care. Aims and objectives: This study aimed to elucidate perceived situations of significance experienced by patients with hip fracture during the prehospital-and in-hospital care. Design: The study used a qualitative approach using a critical incident technique (CIT), 14 patients with hip fractures were included. Methods: All informants had undergone surgery for a hip fracture, were able to communicate in Swedish and had no cognitive impairment. Results: The main area Oscillating between being satisfied and to endure a new demanding situation emerged from five categories: Pain and pain management, Feeling fear and satisfaction in perioperative care, Experiencing continuity in care, Considering information and Felling confirmed. Conclusion: Experiences of prehospital care shows a positive impact though the patients experienced this part of the pathway professionally. However, the patients described critical incidents according to their experiences of pain seems to have significant damagingly impact on the patients' well-being. The patient also describe a sense of uncertainty in their individual involvement of care.
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| 37. |
- Ivarsson, Bodil, et al.
(författare)
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The Odyssey from Symptom to Diagnosis of Pulmonary Hypertension from the Patients and Spouses Perspective
- 2021
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Ingår i: Journal of Primary Care and Community Health. - : SAGE Publications. - 2150-1319 .- 2150-1327. ; 12
-
Tidskriftsartikel (refereegranskat)abstract
- Introduction/objective: Diagnostic delays in pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are related to increased morbidity and mortality. The risk of a delayed, or even a missed, diagnosis is high as the conditions are rare. The aim was to describe patients’ and spouses’ experiences of the journey from the first symptom to an established diagnosis. Methods: A secondary analysis of 31 transcripts, based on 2 primary datasets containing interviews with 17 patients and 14 spouses, was carried out and analyzed according to qualitative content analysis. Results: One overarching category was revealed from the content analysis; “The journey from doubt and hope to receive the diagnosis.” Five subcategories were identified as: overall experiences; ignoring symptoms; seeking primary care/hospital specialty care; blame and stigma; and finding a pulmonary hypertension specialist clinic. The main finding was that both patients and spouses experienced that waiting for a diagnosis and the deteriorating state of health led to anxiety and frustration. The knowledge about rare diseases among health professionals needs to be improved to enable a timelier diagnosis and initiation of treatment. Conclusion: Patients’ and spouses’ lives were negatively affected by having to search for a correct diagnosis. In order for health care to identify rare diseases earlier, a well-functioning and responsive health care system, in primary care as well as in specialist care, is needed. Symptoms like breathlessness and fatigue are often unspecific but should not be ignored. Keeping the patient and spouse in the loop, and providing information that the search for an answer might take time is essential for health care providers to create trust.
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| 38. |
- Ivarsson, Bodil, et al.
(författare)
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The subject of pedagogy from theory to practice - The view of newly registered nurses
- 2009
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Ingår i: Nurse Education in Practice. - : Elsevier BV. - 1471-5953 .- 1873-5223. ; 29:5, s. 510-515
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe, from the newly registered nurses’ perspective, specific events when using their pedagogical knowledge in their everyday clinical practice. The design was qualitative and the critical incident technique was used. Data was collected via interviews with ten newly registered nurses who graduated from the same University program 10 months earlier and are now employed at a university hospital.Two categories emerged in the analyses. The first category was “Pedagogical methods in theory” with the sub-categories Theory and the application of the course in practice, Knowledge of pedagogy and Information as a professional competence. The second category was “Pedagogical methods in everyday clinical practice” with sub-categories Factual knowledge versus pedagogical knowledge, Information and relatives, Difficulties when giving information, Understanding information received, Pedagogical tools, Collaboration in teams in pedagogical situations, and Time and giving information. By identifying specific events regarding pedagogical methods the findings can be useful for everyone from teachers and health-care managers to nurse students and newly registered nurses, to improve teaching methods in nurse education.
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| 39. |
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| 40. |
- Ivarsson, Bodil, et al.
(författare)
-
Waiting for cardiac surgery-support experienced by next of kin.
- 2005
-
Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 4:2, s. 52-145
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Next of kin (NoK) play a crucial role for patients waiting for cardiac surgery. Aim: To describe experience of support, in the form of important events, by next of kin while their intimates were waiting for a heart operation. Methods: The design was qualitative and the “critical incident” technique was used. Incidents were collected via interviews with 23 next of kin to patients waiting for heart surgery and the informants were chosen by the patient themselves. Findings: In all, 224 important events, both positive and negative, were identified in the interviews and two main areas emerged in the analysis: internal factors and external factors. Positive internal factors were associated with finding strength, whereas negative factors were associated with uncomfortable feelings. Positive external factors were associated with participating in care and receiving attention, whereas negative factors were associated with dissatisfaction with the health-care organization and failing social network. Conclusion: This study shows that next of kin experienced positive support when they received attention and information and felt involvement in the care. An important implication for the health-care professionals and public authorities is the understanding of the experience of support expressed by next of kin, to provide them with optimal information and support.
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| 41. |
- Ivarsson, Bodil
(författare)
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Waiting For Heart Surgery.
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Patients waiting for cardiac surgery often consider the period from the decision for surgery to the time for the operation as long, heavy and dreary. Therefore, it is important that patients are supplied with structured oral and written information regarding their disease and its treatment, so that they are able to understand and discuss the forthcoming operation, the risk of complications and the possibility that surgery may be delayed. Next of kin play a crucial role for patients waiting for cardiac surgery and are often forgotten by health care personnel. The overall aims of this thesis were to describe experiences of support while waiting for heart surgery, from the perspective of patients and their next of kin, and to describe the patients? experiences of information received about the risks of complications in relation to the surgery. A further aim was to investigate the frequency of postponements and cancellations and to study how these affected the patients. A total of 531 patients admitted to bypass surgery or valve replacement and 23 next of kin were included in these five studies. Data were collected through questionnaires and semi-structured interviews using the critical incident technique (CIT). Degree of anxiety and depression was measured using the HADS, and distress was measured using the IES. Both patients and next of kin described experiences as positive when they received attention and information and felt involved in the care, and negative when they were dissatisfied with the health care organization and lacked a supportive social network (Study I and II). Patients who received written extended information about the risk of complications in connection with cardiac surgery were satisfied with the information without being more affected by anxiety, depression or distress than patients who received traditional written information (Study III). Patients reacted negatively to postponement of surgery, especially if due to organizational reasons, which were also the most common reasons for postponements. Some patients experienced physical or psychosomatic symptoms and some feared cardiovascular problems after postponement or cancellation of their operation. Women in the cancellation group had a significantly higher degree of depression than men in the same group, and than both men and women in the control group (Studies IV and V). Patients and next of kin were generally satisfied with the reception from the health care professionals (Studies I-V). Implications of these studies are that organizational and medical problems must be identified in time to avoid postponements, and that patients and their next of kin must be allowed to participate in the care and must receive attention from health care professionals. If patients and their next of kin are carefully and thoroughly informed, they are more satisfied and probably better prepared if complications occur.
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| 42. |
- Ivarsson, Emma, et al.
(författare)
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Effect of inclusion level of chicory (Cichorium intybus L) and ribwort (Plantago lanceolata L) forage in a cereal-based diet on dietary fibre digestibility in weaned piglets of different age
- 2010
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Ingår i: Livestock Science. - : Elsevier BV. - 1871-1413 .- 1878-0490. ; 134, s. 202-204
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-five weaned (35 days old) castrated male piglets from five different litters were used to evaluate the effect of chicory (C) and ribwort (R) forage inclusion in a cereal-based diet on the coefficient of total tract apparent digestibility (CTTAD) of organic matter (OM) and the dietary fibre fraction at 3 and 5 weeks post-weaning.Inclusion of chicory and ribwort had a negative impact on the CTTAD of OM (P<0.05), while diet had no effect (P>0.05) on the CTTAD of NDF and total non-starch polysaccharides (NSP). In contrast, the CTTAD of uronic acid increased (P<0.05) with inclusion of both chicory and ribwort. The CTTAD of OM, total NSP, arabinoxylans, arabinose, xylose and uronic acid was higher at 5 than at 3 weeks after weaning (P<0.01). (C) 2010 Elsevier B.V. All rights reserved.
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| 43. |
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| 44. |
- Ivarsson, Emma, et al.
(författare)
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Growth performance, digestibility and faecal coliform bacteria in weaned piglets fed a cereal-based diet including either chicory (Cichorium intybus L) or ribwort (Plantago lanceolata L) forage
- 2011
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Ingår i: Animal. - 1751-7311 .- 1751-732X. ; 5, s. 558-564
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-five weaned 35-day-old piglets were used in a 35-day growth experiment to evaluate the effect of inclusion of chicory and ribwort forage in a cereal-based diet on growth performance, feed intake, digestibility and shedding of faecal coliform bacteria. A total of seven experimental diets were formulated, a cereal-based basal diet (B), and six diets with inclusion of 40, 80 and 160 g/kg chicory (C40, C80 and C160) or ribwort (R40, R80 and R160). Piglets had ad libitum access to feed and water throughout the experiment. Three and five weeks post-weaning faeces samples for determination of digestibility were collected once a day for five subsequent days. Additional faeces samples for determination of coliform counts were collected at days 1, 16 and 35 post-weaning. Piglets fed diet R160 had the lowest average daily feed intake (DFI) and daily weight gain (DWG), and differed (P < 0.05) from piglets fed diets B, R40 and R80. There were no differences in DFI and DWG between the chicory diets and diet B. Inclusion of chicory or ribwort had a minor negative impact on the coefficient of total tract apparent digestibility (CTTAD) of dry matter, organic matter and crude protein, whereas inclusion of both chicory and ribwort resulted in higher CTTAD of non-starch polysaccharides and neutral detergent fibre (NDF). The CTTAD of arabinose were higher for diets C160 and R160 than for diet B (P, 0.05), and the CTTAD of uronic acid was higher for diets C40, C80, C160, R80 and R160 than for diet B (P < 0.05). Age affected the CTTAD for all parameters (P < 0.05) except for NDF, with higher values at 5 than at 3 weeks post-weaning. The coliform counts decreased with increasing age (P < 0.05), but was not affected by treatment. The results indicate that inclusion of up to 160 g/kg of chicory do not negatively affect performance, whereas high inclusion of ribwort have a negative impact on feed consumption and consequently on growth rate. Both herbs have a higher digestibility of fibre compared to cereal fibre. Chicory and ribwort are both promising as feedstuffs to weaned piglets, but the low palatability of ribwort limits the inclusion level.
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| 45. |
- Johansson, Anders, et al.
(författare)
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General Practitioners’ Experiences of Digital Written Patient Dialogues : A Pilot Study Using a Mixed Method
- 2020
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Ingår i: Journal of Primary Care and Community Health. - : SAGE Publications. - 2150-1319 .- 2150-1327. ; 11
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The path between patients and health care providers has adopted new advanced information technologies. However, opinions vary about the digital care meeting. Physicians have expressed concerns about increased workload, changes in working methods, and information security. Purpose: To explore physicians’ experiences and satisfaction of digital primary health care. Method: A convergent mixed method was used. First, participants completed a quantitative questionnaire survey with fixed response options described as index values (IV, 0-1.0), supplemented with a 10-point Likert-type scale, estimating satisfaction. Second, a qualitative interview used critical incident technique (CIT) to offer more complete context. Data were collected during 2 months in 2019; 6 general practitioners (GPs) participated. Results: The GPs described good experiences of the concept (IV 0.65), corresponding to a median satisfaction value of 6.5 (interquartile range 5-9,). CIT emerged into 2 main areas; “Hovering between traditional and digital primary health care” and “Using active strategies to handle the digital care system.” GPs experienced that the concept offered a good flow, an asynchronous working approach was used. GPs also stated present chat design was a good complement to traditional forms of primary health care, and the benefits of being able to read patients’ self-described history were considered a significant patient safety factor. However, the GPs felt that a predetermined symptom list were not suitable for all patients. Conclusion: Study results suggest the present design using digital written patient dialogues complements traditional primary healthcare. GPs described satisfaction and expressed good experiences of the concept, although further development of the design is needed.
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| 46. |
- Johansson, Anders, et al.
(författare)
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Nurse Telephone Counseling Services as a “Gatekeeper” in an Internet-Based Digital Doctor Reception : A Mixed Questionnaire Survey
- 2019
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Ingår i: Journal of Primary Care and Community Health. - : SAGE Publications. - 2150-1319 .- 2150-1327. ; 10
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: A large number of different types of digital innovations for health and medical care have been developed in Sweden under the concept of eHealth. Employees’ interest is of great importance in determining the success of different new digital interventions and technologies. Purpose: In this study, we aimed to elucidate the nurses’ experiences as a first “gatekeeper” in an Internet-based Digital Doctor Reception (DDR) concept. Methods: Our 16 informants were recruited among nurses who participated in a DDR pilot project that was completed in April 2019. A mixed questionnaire survey was used to elucidate the nurses’ experiences of collaboration & challenges, technical functionality, and DDR as an activity. The results were descriptively summarized with index values (IVs, 0-1.0), supplemented with a 10-point Likert-type scale that estimated satisfaction and views regarding personal experiences. Results: Collaboration and challenges were experienced as fairly good (IV, 0.58), and technical functionality was experienced as good (IV, 0.80). The experience of DDR as an activity was described positively with an IV of 0.75. The overall experience of the concept (IV, 0.68), corresponds well to the median satisfaction value of 6.5 (interquartile range, 6-9). Content analysis identified 2 main categories: “Facilitators in using DDR experienced by nurses” and “Barriers in using DDR experienced by nurses.” Nurses generally felt positive about participating in the development of an eHealth service. However, they suggested that DDR triaging should take place at the health care center level. The nurses also observed that certain patient groups were excluded from the DDR concept, and sometimes experienced this new way of triaging as less challenging. Conclusion: The informants in our study generally described satisfaction and an overall good experience with the DDR concept. However, some informants felt that the concept was sometimes more stressful and less challenging compared with normal working methods.
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| 47. |
- Johansson, Anders, et al.
(författare)
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Patients’ Experiences With a Digital Primary Health Care Concept Using Written Dialogues : A Pilot Study
- 2020
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Ingår i: Journal of Primary Care and Community Health. - : SAGE Publications. - 2150-1319 .- 2150-1327. ; 11
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The changing health care environment promotes the adoption of new information technologies to connect patients and health care providers. However, individuals greatly vary in their ability to use new digital systems, and in their feelings regarding integrity and validation. Caregivers in southern Sweden plan to implement a new digital primary health care (DPHC) service, and patients’ experiences must be studied to guide the best possible implementation of this service. Purpose: To examine the patients’ experiences with DPHC using written dialogues. Method: Patients were consecutively recruited from June 2018 to April 2019. This prospective pilot study used questionnaires with fixed response options, summarized as index values (IV, 0-1.0) in the following domains: communication, technical functionality, and general experience of DPHC. Results: Participants included 286 patients with a mean age of 40 ± 15 years. The response rate was 49% (n = 140), including 40 men (29%) and 100 women (71%). Communication using DPHC was experienced as fairly good (IV, 0.58), technical functionality was experienced as good (IV, 0.80), and the general experience of DPHC was positive with an IV of 0.76. The overall experience of the concept (IV, 0.71), corresponds to a median satisfaction value of 8.0 (interquartile range, 6-9). The patients felt well-prepared and experienced reasonable time aspects. Of the responding patients, 81% would recommend DPHC to others, and a notable reason for satisfaction was availability. However, patients expressed some uncertainty regarding the physician’s ability to assess correct care needs. Conclusion: The patients in our pilot study described their satisfaction and expressed good experiences with the concept of DPHC using written dialogues.
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| 48. |
- Johansson, Anders, et al.
(författare)
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Technical feasibility and ambulance nurses’ view of a digital telemedicine system in pre-hospital stroke care – A pilot study
- 2019
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Ingår i: International Emergency Nursing. - : Elsevier BV. - 1755-599X. ; 44, s. 35-40
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Tidskriftsartikel (refereegranskat)abstract
- Background: High-quality telemedicine in cases of suspected stroke has comparable precision with on-site medical examinations. A novel technical concept was developed in order to deliver a video/audio system to achieve more efficient patient assessment and diagnostic support. Aims and objectives: The aim of the present pilot-study was to evaluate in a clinical setting the quality of a linked image and sound transmission in the prehospital assessment of patients with suspected stroke. In addition, we wanted to elucidate how ambulance nurses experienced the use of this innovative technology. Design: The study used a quantitative method using questionnaires with fixed response options, combined with a qualitative approach to assess complementary statements of prehospital emergency care nurses (PEN)that had used the system. Methods: The study was conducted in one ambulance care office and one hospital in southern Sweden. Six PEN and one neurological specialist (Dr)expressed their perceptions based on 11 cases with suspected stroke. Responses were assessed in the dimensions of the technology (Dr – image quality/sound quality; Dr and PEN), safety, sense of increased control and uniform assessment. A questionnaire technique was used, complemented with a qualitative part of the content analysis (PEN views). Results: In the technology dimension, the Dr evaluated the image quality as Very good to Good (100%)while 75% of PEN answered that the digital stroke concept felt reliable to use and the digital stroke assessment is believed to increase uniform assessment. Asked if the present digital concept should be further developed and if further digital systems should be developed in general, the PEN were split in their responses (50 vs 50%), which could be related to a conception of unclear efficacy of the concept. Descriptions of the decisive comments emerged in three categories; Minor operating interference, Physician's competence crucial and Unclear efficacy. Conclusion: All respondents seem to have confidence in the assessed digital stroke concept. The image quality is perceived suitable in the assessment situation but the nurses expressed ambiguity about the efficiency of the entire concept. The ambulance nurses also highlighted the physician's skills and personality as important factors for further development of the concept.
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| 49. |
- Johansson, David, et al.
(författare)
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Information Technology and Medical Technology Personnel's Perception Regarding Segmentation of Medical Devices : A Focus Group Study
- 2020
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Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Segmentation is one way of improving data protection. The aim of this study was to investigate Information Technology (IT) and Medical Technology (MT) personnel's perception in relation to ongoing segmentation of medical devices and IT infrastructure in the healthcare sector. Methods: Focus group interviews with 9 IT and 9 MT personnel in a county council in southern Sweden were conducted. The interviews focused on two areas: Positive expectations and misgivings. Digital recordings were transcribed verbatim and analyzed using qualitative content analysis. Results: Responses related to 2 main areas: Information security and implementation of segmentation. Informants stated that network segmentation would increase the overall level of cybersecurity for medical devices, addressing both insider and outsider threats. However, it would also increase the need for administration and the need for knowledge of the communication patterns of medical devices from the manufacturer's perspective. Conclusion: IT and MT personnel in a county council in southern Sweden believed that segmentation would increase cybersecurity but also increase administration and resource needs, which are important opinions to take into consideration. The present study can be used as a model for others to increase awareness of opinions of healthcare organizations.
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| 50. |
- Kheladze, Nino, et al.
(författare)
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Experiences of using a continuous glucose monitoring system in children—a descriptive study with parents in the republic of Georgia
- 2021
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Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 9:11
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Tidskriftsartikel (refereegranskat)abstract
- The benefits of medical devices are often multifaceted and may have an important impact on patients’ and relatives’ physical, mental and/or social well-being. Diabetes is a metabolic disorder and a continuous subcutaneous glucose monitoring sensor can suggest increasing treatment satisfaction. The purpose of this study was to describe parents’ experiences during their daily lives and support needs when a child uses a Flash Glucose Monitoring system (FGM). Twenty parents (n = 3 men vs. n = 17 women) to children (age ranged between 22 months and 16 years) with diabetes disease type 1, treated with an FGM unit (used for an average of 7 months (range 1–72)) at home, participated in this study. A qualitative questionnaire survey with open questions including follow-up dialogues was distributed to the parents, and collected data were analysed using qualitative content analysis. Overall satisfaction with the Libre device was Md 10 (IQR 9.25–10). One main theme “Advances in technology significantly improved everyday life” emerged from 2 categories: Improvements in quality of life and Elements of challenges. In conclusion, this qualitative study determined that parents of children with DMT1 experience a great improvement in daily life when given the opportunity to use the Libre device.
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