| 1. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Stroke - en folksjukdom
- 2012
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Ingår i: Stroke - patienters, närståendes och vårdares perspektiv. - 9789144068121 ; 1:1, s. 25-35
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Bokkapitel (populärvet., debatt m.m.)
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| 2. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Strokeenhet
- 2012
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Ingår i: Stroke - patienters, närståendes och vårdares perspektiv. - 9789144068121 ; 1:1, s. 59-72
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Bokkapitel (populärvet., debatt m.m.)
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| 3. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Uppföljning
- 2012
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Ingår i: Stroke - patienters, närståendes och vårdares perspektiv. - 9789144068121 ; , s. 299-312
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Bokkapitel (populärvet., debatt m.m.)
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| 4. |
- Fridlund, Bengt, et al.
(författare)
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Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care : A Systematic Review
- 2014
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Ingår i: Open Journal of Nursing. - Irvine : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 4:3, s. 181-197
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Forskningsöversikt (refereegranskat)abstract
- Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.
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| 5. |
- Hallström, Björn, et al.
(författare)
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Lund Stroke Register: hospitalization pattern and yield of different screening methods for first-ever stroke
- 2007
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 115:1, s. 49-54
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore case ascertainment, hospitalization, characteristics of both hospitalized and non-hospitalized patients in a population-based group of stroke patients. Materials and methods One-year screening in Lund-Orup district for first-ever strokes using multiple prospective and retrospective methods. Results A total of 456 patients with first-ever stroke (n = 412 prospective screening methods, n = 17 primary care, n = 12 hospital registers, n = 10 death register, n = 2 autopsy registers, n = 3 other). Hospitalization proportion within 14 days was 84%. Patients sent home from emergency unit (n = 36) were often males (75%), had low 28-day case-fatality (0%), and less severe strokes (median National Institute of Health Stroke Scale score 2 vs 4 for all). Patients managed solely within primary care (n = 18) were elderly (median age 89 vs 77 years for all), resided in nursing homes (86% vs 8% for all) and had high 28-day-case-fatality (61%). Conclusions Hospitalization was lower than expected. Two main categories of patients were not hospitalized: elderly patients at nursing homes with high case-fatality and patients with mild stroke.
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| 6. |
- Hallström, Björn, et al.
(författare)
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Stroke incidence and survival in the beginning of the 21st century in southern Sweden: comparisons with the late 20th century and projections into the future.
- 2008
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 39:1, s. 10-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: We report trends of stroke incidence and survival up to year 2001/2002 in Lund-Orup, Sweden, and projections of future stroke incidence in Sweden. METHODS: Lund Stroke Register, a prospective population-based study, included all first-ever stroke patients, between March 1, 2001 and February 28, 2002, in the Lund-Orup health care district. Institution-based studies for 1983 to 1985 and 1993 to 1995 were used for comparison. We calculated age-standardized incidence and Cox proportional hazards analysis of survival (stroke subtype, sex, age group, and study period in the analysis). Minimum follow-up was 46 months. Based on our register's stroke incidence and the official Swedish population projection, a projection for future stroke incidence on a national basis was calculated. RESULTS: We included 456 patients with first-ever stroke in 2001/2002. The age-standardized incidence (to the European population) was 144 per 100 000 person-years (95%CI 130 to 158) in 2001/2002, 158 (95%CI 149 to 168) in 1993 to 1995, and 134 (95%CI 126 to 143) in 1983 to 1985. Cox proportional hazard analysis indicated decreased risk of death after stroke in 2001/2002 (hazard ratio 0.80; 95%CI 0.67 to 0.94) compared with 1993 to 1995. Up to year 2050, the annual number of new stroke patients in Sweden may increase by 59% based solely on demographic changes. CONCLUSIONS: Despite possible underestimation of stroke incidence during the previous institution-based studies, the increased stroke incidence between 1983 to 1985 and 1993 to 1995 did not continue in 2001/2002. The long-term survival after stroke continues to improve. As the elderly population is growing in Sweden, stable incidence and increasing survival will result in a rapidly increasing prevalence of stroke patients in Sweden.
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| 7. |
- Johansson, Maria, et al.
(författare)
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Living with companion animals after stroke: experiences of older people in community and primary care nursing.
- 2014
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Ingår i: British Journal of Community Nursing. - : Mark Allen Group. - 1462-4753 .- 2052-2215. ; 19:12, s. 578-584
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Tidskriftsartikel (refereegranskat)abstract
- Older people often have companion animals, and the significance of animals in human lives should be considered by nurses-particularly in relation to older people's health, which can be affected by diseases. The incidence of stroke increases with age and disabilities as a result of stroke are common. This study aimed to explore older people's experiences of living with companion animals after stroke, and their life situation with the animals in relation to the physical, psychological and social aspects of recovery after stroke. The study was performed using individual interviews approximately 2 years after stroke with 17 participants (10 women and 7 men) aged 62-88 years. An overarching theme arising from the content analysis was contribution to a meaningful life. This theme was generated from four categories: motivation for physical and psychosocial recovery after stroke; someone to care for who cares for you; animals as family members; and providers of safety and protection. The main conclusion was that companion animals are experienced as physical and psychosocial contributors to recovery and a meaningful life after stroke.
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| 8. |
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| 9. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Bedöma smärta vid afasi
- 2015
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Ingår i: Tidningen Afasi. - 2001-9564. ; , s. 14-16
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- . Smärta efter stroke kan vara av olika typer och varierande svårighetsgrad . Personer med kommunikationsproblem kan behöva peka ut områdett för smärtan och med ansiktsuttryck visa hur svår smärtan upplevs eller ange smärtnivå på en skala.
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| 10. |
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Falls After Stroke : A Follow-up after Ten Years in Lund Stroke Register
- 2021
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Ingår i: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1532-8511 .- 1052-3057. ; 30:6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To evaluate incidence of self-reported falls and associated factors in a ten-year perspective after stroke.METHODS: From a population-based cohort of first-ever stroke patients (n = 416) included in the Lund Stroke Register between March 1, 2001, and February 28, 2002, we performed a follow up of all 145 survivors ten years after stroke. We collected data on age, gender, main stroke type, living and housing situation, general health status (question 1 in the Short Form Health Survey (SF-36), dizziness, physical activity, Barthel Index, mobility aids, moving ability inside/outside, and health-related quality of life as defined by the EuroQol 3 dimension scale (EQ-5D-3L). Factors that may relate to falls were compared between those who had experienced falls after stroke or not.RESULTS: Ten years after stroke, 49 patients (34 %) reported falls and 96 patients (66 %) reported no falls. Compared to patients with no falls, those who reported falls were older (median age 83.3 years vs 75.6 years; p < 0.001), more often lived alone, were more dependent in daily living, had less physical activity, poorer general health status, more often needed mobility aids, were more often unable to move alone outside, and had poorer health-related quality of life in all items in EQ-5D-3L except pain/discomfort.CONCLUSIONS: Falls had occurred in approximately one third of the participants ten years after the stroke, and were strongly associated with several measures of frailty. Our results indicate that fall prevention should in particular focus on those at high risk of falls.
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| 15. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Functional Status and Patient-Reported Outcome 10 Years After Stroke: The Lund Stroke Register.
- 2014
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 45:6, s. 1784-1790
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Tidskriftsartikel (refereegranskat)abstract
- Long-term studies of outcome after stroke are scarce. Our aim was to study functional status and patient-reported outcome 10 years after a first-ever stroke.Ten-year follow-up was conducted among the survivors from a population-based group of 416 patients included in the Lund Stroke Register, Sweden, between March 1, 2001, and February 28, 2002. The Barthel index was used to assess the functional status and the modified Rankin Scale to assess the degree of disability. The EQ-5D scale was used for survivors’ self-reports about health outcome and the specific Short-Form 36 (SF-36) question for rating their overall health. The patients also reported their frequency of physical activity.Among 145 survivors 10 years after stroke (median age, 78 years), 59% were men, 90% lived in their ordinary housing, 73% were assessed as independent, and 71% had no or slight disability. The need of assistance with mobility and self-care was reported by 14% and with usual activities by 22%. Moderate pain was reported by 39%, and 4% had a high degree of pain. Moderate anxiety/depression was reported by 28% and high degree only by 1%. Overall health status was reported in positive terms by more than two thirds of the survivors. Almost half the cohort reported the same frequency of physical activity (≥4× weekly) as before stroke onset.This study indicates that 10-year stroke survivors in Sweden are mostly independent in daily activities and report good overall health and frequent physical activity, although half of them are ≥78 years.
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| 16. |
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| 17. |
- Jönsson, Ann-Cathrin
(författare)
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Life after stroke Outcome and views of patients and carers
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aims were to follow stroke patients over time with respect to general pain, shoulder pain, weight loss, and health related quality of life (HRQOL), the latter also in stroke survivors' informal caregivers. Methods During a 1 year period, 416 first-ever stroke patients were included in the population based Lund Stroke Register; 327 survivors were followed up after four months and 305 one year later. Baseline assessments included weight, height (to calculate Body Mass Index), functional status (NIH Stroke Scale), plasma/serum albumin, prealbumin, and glycosylated hemoglobin (HbA1c). After four months, assessments included functional status (Barthel Index), HRQOL (SF-36), pain (visual analogue scale [VAS]), shoulder pain (clinical examinations and questionnaires), weight, albumin, and prealbumin. One year later the same parameters were examined, with addition of geriatric depression scale (GDS-20), and HbA1c. Results Patients' physical function deteriorated over time, but they improved in socio-emotional and mental domains of HRQOL. Surprisingly, caregivers had lower scores than patients in emotional and mental domains, indicating strain. In patients, depression was the most important determinant of HRQOL. Although prevalence of pain decreased over time, after 16 months a fifth had moderate-severe pain; across the entire study period one third experienced moderate to severe pain. Almost one third of patients developed shoulder pain, which mostly was moderate to severe and restricted daily life activities. Impaired arm motor function and low general status were the major determinants for shoulder pain. Weight loss >3 kg was found in a quarter of the patients at both follow-ups and appeared to be a marker of malnutrition. Major risk factors of weight loss >3 kg were eating difficulties, haemorrhagic stroke, low social participation, and low prealbumin. Conclusions Stroke patients need enhanced attention in post acute care regarding nutritional status, pain, and depression. An intervention program towards patients and their informal caregivers would have a potential to improve their life after stroke.
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| 18. |
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| 19. |
- Jönsson, Ann-Cathrin
(författare)
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Mångfaldiga internationella perspektiv på strokevård
- 2016
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Ingår i: Neurologi i Sverige. - 2000-8538. ; 1:16, s. 60-67
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Tidskriftsartikel (refereegranskat)abstract
- Den 18:e nordiska kongressen arrangerad av Nordic Stroke Society ägde rum i Malmö den 26-28 augusti, 2015. Föreningen som i många år arrangerat nordiska strokekongresser bildades för över 30 år sedan. Denna rapport från årets kongress av Ann-Cathrin Jönsson, docent vid Institutionen för hälsovetenskaper, Lunds universitet, inleds med en beskrivning av bakgrunden till Nordic Stroke Society.
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| 20. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Neurologiska sjukdomar
- 2016. - 1
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Ingår i: Omvårdnad & medicin. - 9789144076645 ; , s. 155-190
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Bokkapitel (populärvet., debatt m.m.)
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| 21. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Omvårdnad vid stroke
- 2015
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Ingår i: Omvårdnad vid neurologiska sjukdomar. - 9789144055008 ; 1:1
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Bokkapitel (populärvet., debatt m.m.)
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| 22. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Outcome of men and women after atrial fibrillation and stroke.
- 2015
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 1600-0404 .- 0001-6314. ; 132:2, s. 125-131
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Tidskriftsartikel (refereegranskat)abstract
- Atrial fibrillation (AF) is a well-known risk factor for ischaemic stroke. The aim was to examine long-term outcome of men and women after stroke related to AF.
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| 23. |
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| 24. |
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| 25. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Prevalence and intensity of pain after stroke: a population based study focusing on patients' perspectives.
- 2005
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Ingår i: Journal of Neurology, Neurosurgery and Psychiatry. - 1468-330X. ; , s. 590-595
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine prevalence and intensity of pain after stroke, focusing on patients' perspectives. METHODS: During a one year period, 416 first-ever stroke patients were included in the population based Lund Stroke Register. After 4 and 16 months (median), 297 patients (98% of survivors) were followed up. Worst pain intensity during the previous 48 hours was assessed on a visual analogue scale (VAS), range 0 to 100: a score of 0 to 30 was defined as no or mild pain; 40 to 100 as moderate to severe pain. NIH stroke scale (NIHSS) score and HbA1c were assessed at baseline. At 16 months, screening for depression was done using the geriatric depression scale (GDS-20), and cognition with the mini-mental state examination (MMSE). Predictors of pain were determined by multivariate analyses. RESULTS: Moderate to severe pain was reported by 96 patients (32%) after four months (VAS median=60). Predictors of pain were younger age (p=0.01), female sex (p=0.006), higher NIHSS score (p<0.001), and raised HbA1c (p=0.001) at stroke onset. At 16 months, only 62 patients (21%) had moderate to severe pain, but pain intensity was more severe (median VAS score=70; p<0.016). Higher pain intensity correlated with female sex, worse GDS-20 score, better MMSE score, and raised HbA1c. Pain was persistent in 47%, disturbed sleep in 58%, and required rest for relief in 40% of patients. CONCLUSIONS: Although prevalence of pain after stroke decreased with time, after 16 months 21% had moderate to severe pain. Late pain after stroke was on average more severe, and profoundly affected the patients' wellbeing.
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| 26. |
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| 27. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Secondary Prevention and Health Promotion after Stroke: Can It Be Enhanced?
- 2014
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Ingår i: Journal of Stroke & Cerebrovascular Diseases. - : Elsevier BV. - 1532-8511 .- 1052-3057. ; 23:9, s. 2287-2295
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to study if health outcome and secondary prevention were satisfactory 1 year after stroke and if nurse-led interventions 3 months after stroke could have impact. Design was a randomized controlled open trial in a 1-year population. Primary outcome was health status 1 year after stroke. One month after stroke, survivors were randomized into intervention group (IG) with follow-up by a specialist nurse (SN) after 3 months (n = 232), and control group (CG) with standard care (n = 227), all to be followed up 1 year after stroke. At the first follow-up, patients graded their health, replied to the EuroQol-5 Dimensions (EQ-5D) health outcome questions, health problems were assessed, and supportive counseling was provided in the IG. Health problems requiring medical interventions were primarily referred to a general practitioner (GP). One year after stroke, 391 survivors were followed up. Systolic blood pressure (BP) had decreased in IG (n = 194) from median 140 to 135 (P = .05), but about half were above the limit 139 in both groups. A larger proportion (22%) had systolic BP >155 in the CG (n = 197) than in the IG (14%; P = .05). In the IG, 62% needed referrals compared with the 75% in the CG (P = .009). Forty percent in the IG and 52.5% in the CG (P = .04) reported anxiety/depression. In the IG, 75% and 67% in the CG rated their general health as fairly good or very good (P = .05). Although nurse-led interventions could have some effect, the results were not optimal. A more powerful strategy could be closer collaboration between the SN and a stroke clinician, before referring to primary care.
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| 28. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Stroke
- 2010
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Ingår i: Äldres hälsa och ohälsa. - 9789144053530 ; , s. 215-243
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Bokkapitel (refereegranskat)
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| 29. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Stroke
- 2016
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Ingår i: Omvårdnad & medicin. - 9789144076645 ; , s. 191-214
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Bokkapitel (populärvet., debatt m.m.)
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| 30. |
- Jönsson, Ann-Cathrin, et al.
(författare)
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Weight loss after stroke: a population-based study from the Lund Stroke Register.
- 2008
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 39:3, s. 918-923
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Data on the prevalence and indicators of weight loss in population-based groups of stroke survivors are scarce. We aimed to find the predictors and indicators of weight loss >3 kg as a possible marker of malnutrition after stroke. METHODS: We registered weight at baseline, after 4 months, and 1 year later in 305 survivors from a population-based cohort of first-ever stroke patients. Characteristics of the patients were registered at baseline and follow-ups, including glycosylated hemoglobin at baseline and follow-up II, eating difficulties at both follow-ups, and screening for depression at follow-up II. We used univariate and multivariate analyses to find baseline predictors and follow-up indicators related to weight loss >3 kg from baseline. RESULTS: Among the 305 patients, 60% were male, the mean age was 72.5 years, and mean body mass index was 25.8 kg/m(2). The main stroke types were cerebral infarction (89%), intracerebral hemorrhage (7%), and subarachnoid hemorrhage (4%). Weight loss >3 kg was found in 74 (24%) patients (mean, -6.6 kg) after 4 months and in 79 patients (26%; mean, -8.3 kg) 1 year later. Severe stroke and elevated glycosylated hemoglobin levels were baseline predictors of weight loss >3 kg. Indicators associated with short-term weight loss (at follow-up I) were eating difficulties, low prealbumin value, and dependence (Barthel Index), whereas indicators associated with long-term weight loss (follow-up II) were eating difficulties, hemorrhagic stroke, and low prealbumin value. CONCLUSIONS: Weight loss >3 kg after stroke indicates the need for closer observation regarding nutritional status. Monitoring of body weight may be useful, particularly among patients with severe stroke, eating difficulties, low prealbumin values, and impaired glucose metabolism
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| 31. |
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| 32. |
- Lindgren, Arne, et al.
(författare)
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Prevalence of Stroke and Vascular Risk Factors among First-Degree Relatives of Stroke Patients and Control Subjects.
- 2005
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Ingår i: Cerebrovascular Diseases. - : S. Karger AG. - 1421-9786 .- 1015-9770. ; 20:5, s. 381-387
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Tidskriftsartikel (refereegranskat)abstract
- <i>Background:</i> Genetic and environmental factors may be of importance for stroke risk. We assessed the prevalence of stroke and vascular risk factors among first-degree relatives and spouses of stroke patients and control subjects. <i>Methods:</i> As a part of the Lund Stroke Register study, we asked 925 consecutive patients with first-ever stroke and 286 control subjects to complete a questionnaire about all their first-degree relatives and spouses. The questionnaires addressed whether these relatives had been affected by stroke or TIA, hypertension, heart disease, diabetes mellitus, and if they were smokers. <i>Results:</i> A total of 606 patients and 261 control subjects returned the questionnaire, providing information on 4,972 first-degree relatives and 738 spouses. The prevalence of stroke or TIA was 12.3% among first-degree relatives of patients and 7.5% among first-degree relatives of control subjects (OR 1.74, 95% CI 1.36–2.22). Corresponding results for hypertension were 21.0 and 16.7% (OR 1.33, 95% CI 1.10–1.60). The prevalences of heart disease, diabetes mellitus and smoking did not differ significantly between first-degree relatives of patients and control subjects. Spouses of patients and control subjects had similar prevalences of stroke or TIA and vascular risk factors. <i>Conclusions:</i> The prevalences of stroke or TIA and hypertension are higher among first-degree relatives of stroke patients than among first-degree relatives of control subjects. This, and the lack of differences between spouses of patients and control subjects, indicates that an increased risk of stroke may in part be explained by heritability of hypertension.
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| 33. |
- Lindgren, Ingrid, et al.
(författare)
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Left-Sided Hemiparesis, Pain Frequency, and Decreased Passive Shoulder Range of Abduction Are Predictors of Long-Lasting Poststroke Shoulder Pain
- 2012
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Ingår i: PM&R. - : Wiley. - 1934-1482 .- 1934-1563. ; 4:8, s. 561-568
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine the proportion of persons with poststroke shoulder pain 4 months after onset of the stroke in whom long-lasting shoulder pain develops and to assess the extent to which age, side of paresis at stroke onset, pain frequency and pain intensity, passive shoulder range of motion, resistance to passive movements, motor function, and subluxation at 4 months after stroke predict shoulder pain 1 year later. Design: A prospective study. Setting: A university hospital outpatient clinical setting. Participants: Fifty-eight men and women with their first-ever stroke (mean age, 71 years) and affected sensory-motor function in the upper extremity at stroke onset who all reported shoulder pain in the affected side 4 months after onset of the stroke. Methods: At 4 and 16 months after having a stroke, the participants rated their selfperceived shoulder pain (frequency and intensity). Passive range of shoulder abduction and external rotation, resistance to passive movements in the elbow, and motor function in the shoulder were assessed by a physical therapist. Main Outcome Measurements: A question about pain frequency (constant, often, or occasional), the Visual Analogue Scale for Pain for self-perceived shoulder pain intensity, a goniometer for range of motion, the Modified Ashworth Scale for resistance to passive movements, and the Motor Assessment Scale for motor function. Results: Of the 58 participants who had shoulder pain 4 months after having a stroke, 42 (72%) still had pain at 16 months. The logistic regression indicated an association between shoulder pain at 16 months and left-sided hemiparesis at stroke onset (P= .01; odds ratio [OR] 10.47; 95% confidence interval [CI] 1.92-57.05), pain frequency (P = .02; OR 6.85; 95% CI 1.46-32.14), decreased passive abduction at 4 months (P = .05; OR 4.46; 95% CI 0.99-20.10), and age (P = .07; OR 1.05; 95% CI 1.0-1.12). Conclusions: A high proportion of persons with shoulder pain 4 months after having a stroke are at risk of having persistent shoulder pain 1 year later. Left-sided hemiparesis, pain reported frequently, and decreased passive shoulder range of abduction at 4 months are predictors of long-lasting poststroke shoulder pain and require increased attention in the rehabilitation setting.
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| 34. |
- Lindgren, Ingrid, et al.
(författare)
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Rörelseförmåga
- 2012. - 1
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Ingår i: Stroke - patienters, närståendes och vårdares perspektiv. - 9789144068121
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 35. |
- Lindgren, Ingrid, et al.
(författare)
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Shoulder Pain After Stroke. A Prospective Population-Based Study.
- 2007
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Ingår i: Stroke: a journal of cerebral circulation. - 1524-4628. ; 38, s. 343-348
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Shoulder pain is a well-known complication after stroke, but data on prevalence, predictors, and outcome in unselected stroke populations are limited.METHODS: During a 1-year period, 416 first-ever stroke patients were included in the population-based Lund Stroke Register. After 4 months, 327 patients were followed up and 1 year later, the surviving 305 patients were followed up again. General status (National Institutes of Health Stroke Scale score) was registered at stroke onset. Shoulder pain intensity (visual analog scale, score 0 to 30=no-mild and 40 to 100=moderate-severe pain); arm motor function; restricted dressing and/or ambulating; and functional status (Barthel Index) were registered at both follow ups.RESULTS: Shoulder pain onset within 4 months after stroke was reported by 71 patients (22%). Among the 61 patients able to score the visual analog scale, 79% had moderate-severe pain. One year later, 8 of these 71 patients had died, 17 had no remaining pain, and 28 additional patients had developed shoulder pain since the first follow up. Lost or impaired arm motor function and high National Institutes of Health Stroke Scale score were predictors of shoulder pain. Shoulder pain restricted daily life often or constantly when dressing for 51%/31% and when ambulating for 29%/13% of the patients at 4 and 16 months, respectively.CONCLUSIONS: Almost one third of the 327 patients developed shoulder pain after stroke onset, a majority with moderate- severe pain. Shoulder pain restricts patients' daily life after stroke. The increased risk of shoulder pain for patients with impaired arm motor function and/or low general status needs close attention in poststroke care.
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| 36. |
- Lövkvist, Håkan, et al.
(författare)
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Ischaemic stroke in hypertensive patients is associated with variations in the PDE4D genome region.
- 2008
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Ingår i: European Journal of Human Genetics. - : Springer Science and Business Media LLC. - 1476-5438 .- 1018-4813. ; 16, s. 1117-1125
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Tidskriftsartikel (refereegranskat)abstract
- Previous Icelandic studies reported that single nucleotide polymorphisms (SNPs) in the phosphodiesterase 4D (PDE4D) region and the 5-lipoxygenase activating protein ALOX5AP were associated with ischaemic stroke, whereas other studies reported ambiguous findings. We examined 932 ischaemic stroke patients from a Swedish population-based stroke register, and 396 control subjects. We assessed possible associations between ischaemic stroke and nine preselected SNPs in the chromosome regions of the PDE4D gene, including rs12188950 (SNP45) and rs3887175 (SNP39); the ALOX5AP gene, including rs17222814 (SG13S25) and the promoter region of the MHC class II transactivator, MHC2TA. The T allele of SNP45 showed negative association with ischaemic stroke (odds ratio, OR=0.72; 95% confidence interval (CI): 0.58-0.91; P=0.0055). Among hypertensive subjects, this influence of the T allele of SNP45, and the T allele of SNP39, were more pronounced (with OR=0.52; 95% CI: 0.37-0.73; P=0.0001 and OR=0.57; 95% CI: 0.41-0.79; P=0.0007, respectively). These SNPs also interacted with hypertension with a relative excess risk due to interaction of -1.66 (P=0.0002) for SNP45 and -1.65 (P=0.0005) for SNP39. The P-values remained significant after correction for multiple testing. Among nonhypertensives, the A allele of SG13S25 indicated increased stroke risk (OR=1.82; 95% CI: 1.21-2.74; P=0.0039; not significant after Bonferroni correction). SNP45 was associated with ischaemic stroke even when controlling for hypertension, diabetes, heart disease and smoking. Our meta-analysis of 13 studies (including ours) showed no overall influence of SNP45 on ischaemic stroke. However, the 13 studies may differ because of nonrandom causes, as suggested by the heterogeneity test (P=0.042). This might support previously undetected mechanisms causing fluctuating ischaemic stroke risk.European Journal of Human Genetics advance online publication, 9 April 2008; doi:10.1038/ejhg.2008.62.
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| 37. |
- Lövkvist, Håkan, et al.
(författare)
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Variations in apolipoprotein D and sigma non-opioid intracellular receptor 1 genes with relation to risk, severity and outcome of ischemic stroke
- 2014
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Ingår i: BMC Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: In experimental studies, the apolipoprotein D (APOD) and the sigma receptor type 1 (SIGMAR1) have been related to processes of brain damage, repair and plasticity. Methods: We examined blood samples from 3081 ischemic stroke (IS) patients and 1595 control subjects regarding 10 single nucleotide polymorphisms (SNPs) in the APOD (chromosomal location 3q29) and SIGMAR1 (chromosomal location 9p13) genes to find possible associations with IS risk, IS severity (NIHSS-score) and recovery after IS (modified Rankin Scale, mRS, at 90 days). Simple/multiple logistic regression and Spearman's rho were utilized for the analyses. Results: Among the SNPs analyzed, rs7659 within the APOD gene showed a possible association with stroke risk (OR = 1.12; 95% CI: 1.01-1.25; P = 0.029) and stroke severity (NIHSS >= 16) (OR = 0.70; 95% CI: 0.54-0.92; P = 0.009) when controlling for age, sex and vascular risk factors for stroke. No SNP showed an association with stroke recovery (mRS). Conclusions: We conclude that the SNP rs7659 within the APOD gene might be related to risk and severity of ischemic stroke in patients.
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| 38. |
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| 39. |
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| 40. |
- Norlander, Anna, et al.
(författare)
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Living and ageing with stroke : an exploration of conditions influencing participation in social and leisure activities over 15 years
- 2018
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Ingår i: Brain Injury. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 32:7, s. 858-866
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore conditions influencing long-term participation in social and leisure activities among people who have had a stroke. Methods: This study had a qualitative design, using a grounded theory methodology. Data collection was based on in-depth interviews performed 15 years after a first-ever stroke with 10 persons recruited from a population-based stroke cohort in Sweden. The study also included four family members. Findings: Over time, the stroke meant a changed but gradually normalised life situation. Participation in social and leisure activities was influenced by several transacting personal and contextual conditions changing with time and ageing. Central conditions that emerged from the analysis included personal characteristics, having social and supportive networks, being dependent on others, having access to valued activities and contexts, being motivated to participate, and perceiving sufficient capacity to participate. Conclusions: Long-term participation after stroke is possible despite impairments, but is influenced by a range of personal and environmental conditions. Stroke rehabilitation should be based on an awareness of this influence and address conditions that change with time and ageing during different phases after stroke.
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| 41. |
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| 42. |
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| 43. |
- Norlander, Anna, et al.
(författare)
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Long-Term Predictors of Social and Leisure Activity 10 Years after Stroke.
- 2016
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Restrictions in social and leisure activity can have negative consequences for the health and well-being of stroke survivors. To support the growing number of people who are ageing with stroke, knowledge is needed about factors that influence such activity in a long-term perspective. AIM: To identify long-term predictors of the frequency of social and leisure activities 10 years after stroke. METHOD: 145 stroke survivors in Sweden were followed-up at16 months and 10 years after a first-ever stroke. Data representing body functions, activities & participation, environmental factors and personal factors at 16 months after stroke, were used in multiple linear regression analyses to identify predictors of the activity frequency after 10 years, as assessed by the 'Community, social and civic life' sub-domain of the Frenchay Activities Index (FAI-CSC). RESULTS: At the 10-year follow-up the frequency of social and leisure activities varied considerably among the participants, with FAI-CSC scores spanning the entire score range 0-9 (mean/median 4.9/5.0). Several factors at 16 months post stroke were independently related to the long-term activity frequency. The final regression model included four significant explanatory variables. Driving a car (B = 0.999), ability to walk a few hundred meters (B = 1.698) and extent of social network (B = 1.235) had a positive effect on activity frequency, whereas an age ≥ 75 years had a negative effect (B = -1.657). This model explained 36.9% of the variance in the FAI-CSC (p<0.001). CONCLUSION: Stroke survivors who drive a car, have the ability to walk a few hundred meters and have a wide social network at 16 months after a first-ever stroke are more likely to have a high frequency of social and leisure activities after 10 years, indicating that supporting outdoor mobility and social anchorage of stroke survivors during rehabilitation is important to counteract long-term inactivity.
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| 44. |
- Norlander, Anna, et al.
(författare)
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Participation in social and leisure activities while re-constructing the self : understanding strategies used by stroke survivors from a long-term perspective
- 2022
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 44:16, s. 4284-4292
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To further understand social and leisure (SL) participation after stroke and how it can be supported in a long-term perspective, this study aims to deepen the understanding of strategies used by long-term stroke survivors in relation to SL activities. Materials and methods: The study has a qualitative design, using a grounded theory approach, and is based on in-depth interviews with 10 persons who had a stroke 15 years ago and four of their family members. Results: The findings comprise nine different strategies used by the participants. These had two overarching purposes; to protect and re-construct the post-stroke self and to enable participation in valued SL activities despite challenges. The findings are summarized in one overarching theme: “Employing different strategies to balance costs and rewards of engagement in social and leisure activities”. Conclusions: Strategies for SL participation involves balancing different priorities in life and can change over time as they are continuously influenced by various personal and environmental conditions. These findings contribute to an improved understanding of why and how people hold on to activities, give up activities and find new activities after a stroke. It also highlights the need for a long-term perspective on stroke rehabilitation and support.IMPLICATIONS FOR REHABILITATION Re-engagement in social and leisure activities after stroke is a long-term process and various types of support may be needed during different stages of recovery and adaptation. Successful rehabilitation interventions build on an understanding of each individual’s priorities, goals and strategies and how these may change or manifest over time. Special attention should be given to the individual’s perception of costs and benefits in relation to engagement in activities, and the role that it has for the person’s identity. By providing knowledge and supporting the use of adequate coping strategies, rehabilitation professionals can help patients find a new and accepted post-stroke identity.
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| 45. |
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| 46. |
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| 47. |
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| 48. |
- Tulek, Zeliha, et al.
(författare)
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Nursing care for stroke patients : A survey of current practice in eleven European countries
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 27:3-4, s. 684-693
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To conduct a survey of the clinical nursing practice in European countries in accordance with the European Stroke Strategies (ESS) 2006, and to examine to what extent the ESS have been implemented in stroke care nursing in Europe.BACKGROUND: Stroke is a leading cause of death and disability globally. Optimal organisation of interdisciplinary stroke care is expected to ameliorate outcome after stroke. Consequently, universal access to stroke care based on evidence-based guidelines is a priority.DESIGN: This study is a descriptive cross-sectional survey.METHODS: A questionnaire comprising 61 questions based on the ESS and scientific evidence in nursing practice was distributed to representatives of the European Association of Neuroscience Nurses, who sent the questionnaire to nurses active in stroke care. The questionnaire covered the following areas of stroke care: Organization of stroke services, Management of acute stroke and prevention including basic care and nursing, and Secondary prevention.RESULTS: Ninety-two nurses in stroke care in 11 European countries participated in the survey. Within the first 48 hours after stroke onset, 95% monitor patients regularly, 94% start mobilization after 24 hours when patients are stable and 89% assess patients' ability to swallow. Change of position for immobile patients is followed by 73%, and post-void residual urine volume is measured by 85%. Some aspects needed improvement, for example staff education (70%), education for patients/families/carers (55%), and individual care plans in secondary prevention (62%).CONCLUSIONS: The participating European countries comply well with the ESS guidelines, particularly in the acute stroke care, but not all stroke units have reached optimal development in all aspects of stroke care nursing.RELEVANCE TO CLINICAL PRACTICE: Our study may provide clinical administrators and nurses in stroke care with information that may contribute to improved compliance with the European Stroke Strategies and evidence-based guidelines. This article is protected by copyright. All rights reserved.
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| 49. |
- Vink, Peter, et al.
(författare)
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Consciousness assessment : A questionnaire of current neuroscience nursing practice in Europe
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067. ; 27:21-22, s. 3913-3919
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To study practice in consciousness assessment among neuroscience nurses in Europe. Background: Over the years, several instruments have been developed to assess the level of consciousness for patients with brain injury. It is unclear which instrument is being used by nurses in Europe and how they are trained to use these tools adequately. Design/methods: A cross-sectional questionnaire, created by the European Association of Neuroscience Nurses Research Committee, was sent to neuroscience nurses in 13 European countries. The countries participated in 2016 with a response period of 3 months for each country. Results: A total of 331 questionnaires were completed by nurses in 11 different countries. Assessment of consciousness was part of the daily routine for a majority of bedside nurses (95%), with an estimated median frequency of six times per shift. The majority uses a standardised instrument, and the Glasgow Coma Scale is the most common. Most participants assess consciousness primarily for clinical decision-making and report both total scores and subscores. The majority was formally trained or educated in use of the instrument, but methods of training were divers. Besides the estimated frequency of assessments and training, no significant difference was found between bedside nurses and other nurse positions, educational level or kind of institution. Conclusion: Our study shows that consciousness assessment is part of the daily routine for most nurses working in neurology/neurosurgery/neurorehabilitation wards in Europe. The greatest variation existed in training methods for the use of the instruments, and we recommend standardised practice in the use of assessment scales. Relevance to clinical practice: In clinical practice, both managers and staff nurses should focus on formalised training in the use of assessment tools, to ensure reliability and reproducibility. This may also increase the professionalism in the neuroscience nurses’ role and performance.
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| 50. |
- Westergren, Albert
(författare)
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Ätförmåga
- 2012
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Ingår i: Stroke. - Lund : Studentlitteratur. ; , s. 85-101
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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