| 1. |
- Arenhall, Eva, et al.
(författare)
-
Sexualitet och parrelation vid hjärtsjukdom
- 2012. - 2
-
Ingår i: Kardiologisk omvårdnad. - Lund : Studentlitteratur. - 9789144054995 ; , s. 403-416
-
Bokkapitel (övrigt vetenskapligt/konstnärligt)
|
|
| 2. |
|
|
| 3. |
- Arenhall, Eva, et al.
(författare)
-
The female partners' experiences of intimate relationship after a first myocardial infarction
- 2011
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:11-12, s. 1677-1684
-
Tidskriftsartikel (refereegranskat)abstract
- Aim.This study aimed to explore and describe women’s experience of intimate relationships in connection to and after their partner’s first myocardial infarction. Background.Support from partners is important for recovery, but little is known about partners’ experience of intimate relationships after myocardial infarction. Design. The study used an explorative, qualitative design. Methods. The first author interviewed 20 women having a partner who had suffered a first myocardial infarction during the preceding year. Qualitative content analysis was used to analyse the data. Findings. Three themes emerged: ‘limited life space’, ‘sense of life lost’ and ‘another dimension of life’. The women described how their self-assumed responsibility led to a more stifling and limited life. Their sense of life lost was described in terms of deficits and feeling the loss. The women also described experiencing another dimension of life characterised by three subthemes: ‘uncertainty of life’, ‘certain of relationship’ and ‘share life more’. Conclusions.The partners’ myocardial infarction had an impact on the interviewees’ intimate relationships; they suffered a major loss and missed their ‘former’ partner, both emotionally and sexually. They struggled with the new asymmetry in their intimate relationship and felt compelled to adapt to their partners’ lack of sexual desire or function. Also, their partner controlled them, which lead towards a stifling, more limited life space. Relevance to clinical practice. Caregivers in hospital and primary care settings could apply the findings in their efforts to help couples recover or maintain intimate relationships following myocardial infarction.
|
|
| 4. |
- Arenhall, Eva, 1974-, et al.
(författare)
-
The male partners' experiences of the intimate relationships after a first myocardial infarction
- 2011
-
Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 10:2, s. 108-114
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Stress in the intimate relationship is found to worsen the prognosis in women suffering from myocardial infarction (MI). Little is known about how male spouses experience the intimate relationship.Aim: This study aimed to explore and describe the experience of men's intimate relationships in connection to and after their female partner's first MI.Methods: An explorative and qualitative design was used. Interviews were conducted with 16 men having a partner who the year before had suffered a first MI. The data were analysed with qualitative content analysis. Results: Three themes emerged: masculine image challenged; life takes another direction; and life remains unchanged. The men were forced to deal with an altered image of themselves as men, and as sexual beings. They were hesitant to approach their spouse in the same way as before the MI because they viewed her to be more fragile. The event also caused them to consider their own lifestyle, changing towards healthier dietary and exercise habits.Conclusions: After their spouse's MI, men experienced a challenge to their masculine image. They viewed their spouse as being more fragile, which led the men to be gentler in sexual intimacy and more hesitant to invite sexual activity. This knowledge about how male spouses experience the intimate relationship could be helpful for health personnel in hospitals and primary care when they interact with couples where the woman suffers from cardiac disease or other chronic disorders. (C) 2010 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
|
|
| 5. |
- Brännström, Margareta, et al.
(författare)
-
Sexual knowledge in patients with a myocardial infarction and their partners
- 2014
-
Ingår i: Journal of Cardiovascular Nursing. - Philadelphia : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049. ; 29:4, s. 332-339
-
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.
|
|
| 6. |
- Eriksson, Elisabet, 1971-, et al.
(författare)
-
Living with a spouse with chronic illness – the challenge of balancing demands and resources
- 2019
-
Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 19:1
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe the partners’ experiences of living with a person with chronic illness and how they manage everyday life.Background. The number of partners providing informal care for their chronically ill spouse is rising, and they describe their daily life as demanding.Design. A descriptive design with a qualitative approach was used. Methods. A purposive sample of 16 partners with a chronically ill spouse were interviewed. The interviews were recorded, transcribed, and analyzed using qualitative content analysis.Results Four main themes were identified: ‘Living with challenges caused by the spouse's disease,’ ‘Seeking support for living with the spouse’s illness,’ ‘Appreciating the good parts of life’ and ‘Adapting to constant changes and an uncertain future.’ The participants rated their health as rather good and had great confidence in their own ability to cope with daily life. Their experiences of support from formal care providers varied; they expressed the need for more assistance from the health care sector.Conclusions. The partners experienced many challenges in everyday life when providing informal care for their chronically ill spouse. This affected both their physical and psychological health, as they had limited time for themselves. The partners seemed to receive more support from their informal network than from formal care providers. In handling daily life, the partners balanced demands and resources to identify possibilities to move forward and find meaning in life.Relevance to clinical practice. Formal care providers must acknowledge partners' needs, develop evidence-based assessment guidelines, and provide efficient support to partners with a chronically ill spouse.
|
|
| 7. |
|
|
| 8. |
- Hardy, Jenny, et al.
(författare)
-
The current status of nursing informatics in undergraduate nursing programs : comparative case studies between Sweden and Australia
- 1997
-
Ingår i: Studies in Health Technology and Informatics. - 0926-9630 .- 1879-8365. ; 46, s. 132-136
-
Tidskriftsartikel (refereegranskat)abstract
- During the last ten years, the inclusion of education in health information systems has assumed an important role in graduate programs for health professionals. More recently, attention has focused on undergraduate programs. Throughout the world schools of nursing, organisations and associations are addressing the issue of educational offerings in nursing informatics. This paper reports on the status of nursing informatics at undergraduate level. Nurse academics from Gavle and Lund in Sweden, and from Melbourne and Sydney in Australia, took part in a survey of the respective nursing courses. The purpose of the study was to identify and describe examples of types of nursing informatics courses in Australia and Sweden A convenient sample of academics were approached and interviewed The results of the survey illustrate, in the schools surveyed, the slow emergence of nursing informatics into nursing curricula.
|
|
| 9. |
|
|
| 10. |
- Hedlund, Åsa, et al.
(författare)
-
Are return to work beliefs, psychological well-being and perceived health related to return-to-work intentions among women on long-term sick leave for common mental disorders? A cross-sectional study based on the Theory of Planned Behaviour
- 2021
-
Ingår i: BMC Public Health. - : Springer. - 1471-2458. ; 21:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term sick leave due to common mental disorders (CMDs) is a great burden in several countries. Women are more likely to be affected by CMDs. A strong intention to return to work (RTW) as well as symptom relief may facilitate RTW in this group. However, there is a lack of knowledge regarding what constitutes a strong intention. The Theory of Planned Behaviour is well-suited to identifying underlying beliefs about intentions to perform a behaviour. By including psychological well-being and perceived health, a more comprehensive picture of determinants of RTW intention might be achieved. Thus, the aim of the present study was to identify associations between RTW beliefs, psychological well-being, perceived health and RTW intentions among women on long-term sick leave due to CMDs, and to do so based on the Theory of Planned Behaviour.Methods: The study was cross-sectional. Between October 2019 and January 2020, 282 women on long-term sick leave (>2 months) due to CMDs were included in the study. The questionnaires for data collection were: “RTW Beliefs Among Women-Questionnaire”, the “General Health Questionnaire -12” and the “EuroQol Visual Analogue Scale”. Standard multiple regression analysis was performed both with and without adjustment for potential confounders.Results: The results showed that more positive attitude towards RTW, stronger social pressure to RTW, higher perceived control over RTW and higher psychological well-being were associated with stronger RTW intention. The adjusted analysis eliminated the importance of psychological well-being for RTW intention, but showed that women who reported that their employer had taken actions to facilitate their RTW had stronger RTW intention. Conclusion: The RTW beliefs, derived from the Theory of Planned Behaviour, were all important for a strong RTW intention, while psychological well-being and perceived health showed weaker associations. Furthermore, having an employer that take actions for facilitating RTW was associated with stronger RTW intentions. Though some caution is warranted regarding the representativeness of the sample, the results do improve our understanding of some important determinants of RTW intention among women on long-term sick leave for CMDs.
|
|
| 11. |
- Hedlund, Åsa, et al.
(författare)
-
Beliefs about return to work among women during/after long-term sick leave for common mental disorders: a qualitative study based on the theory of planned behaviour
- 2021
-
Ingår i: Journal of occupational rehabilitation. - : Springer. - 1053-0487 .- 1573-3688. ; 31, s. 604-612
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: Long-term sick leave due to common mental disorders (CMDs) is an increasing problem, especially among women. To help these women return to work (RTW) sustainably, we need to know more about their own beliefs about RTW. One applicable theory is the theory of planned behaviour (TPB). Thus, the present study aimed to describe, based on the TPB, women's beliefs about RTW during or after long-term sick leave for a CMD.Methods: A qualitative approach was used. Twenty women were included during a long-term sick leave period due to a CMD. A deductive content analysis was conducted using predetermined factors from the TPB: behavioural beliefs (advantages – disadvantages of RTW), normative beliefs (supporters and non-supporters of RTW), and control beliefs (facilitators of – barriers to RTW).Results: The women believed that RTW would give them meaning and balance in life, but also that it would be challenging to maintain balance after RTW. They believed they had several supporters of RTW, but that the support was sometimes perceived as stressful rather than encouraging. Furthermore, individual adaptation and high demands were the most mentioned facilitator and barrier, respectively. Workplace conditions and personal strategies were thought to be important aspects.Conclusions: By using the TPB, the present study was able to offer new findings on women’s beliefs about RTW after long-term sick leave for a CMD. Based on the findings, we suggest that various RTW stakeholders should focus on striving to provide the tasks and work pace women need so they can maintain their professional competence and sense of meaning.
|
|
| 12. |
- Hedlund, Åsa, et al.
(författare)
-
Development and psychometric evaluation of a theory-based questionnaire measuring women’s return-to-work beliefs after long-term sick leave for common mental disorders
- 2023
-
Ingår i: Work. - : IOS Press. - 1051-9815 .- 1875-9270. ; 76:1, s. 109-124
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Common mental disorders (CMDs) are currently a major cause of long-term sick leave, with women being the most affected.Objective: Using the Theory of Planned Behaviour (TPB), we aimed to describe the development and psychometric evaluation of a new questionnaire to measure women's beliefs about return to work (RTW) after long-term sick leave for CMDs.Methods: Data were collected in central Sweden from women on long-term sick leave(2–24 months) for CMDs. The questionnaire was developed by conducting an elicitation study with 20 women and included direct and indirect measures. Subsequently, 282 women participated in a psychometric evaluation and 35 of them in a test-retest procedure. Psychometric properties were evaluated by determining reliability (internal consistency [Cronbach’s alpha] and test-retest stability [intraclasscorrelation coefficient]), construct validity (exploratory factor analysis) and content validity. Results: The development resulted in 60 questionnaire items. Content validity assessment showed that the women overall found it easy to complete the questionnaire. Reliability analyses showed satisfactory results for direct and indirect measures, with a few exceptions. Factor analyses of the indirect scales showed that items were generally in line with the TPB, but that items related to life as a whole/personal life and items related to work separated into two different factors. Conclusions: The questionnaire, called the RTW Beliefs Questionnaire, showed promising results and can among women with CMDs considered useful, especially scales for direct measures. This questionnaire gives the opportunity to identify new potential predictors for RTW.
|
|
| 13. |
- Hedlund, Åsa, et al.
(författare)
-
New insights and access to resources change the perspective on life among persons with long-term illness - An interview study
- 2019
-
Ingår i: Nursing Open. - : Wiley-Blackwell Publishing Inc.. - 2054-1058. ; 6:4, s. 580-588
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim was to describe individuals’ experiences of living with long-term illness.Methods: A qualitative approach with a descriptive design was used. Semi-structured interviews were conducted with 16 persons (50–80 years). They were also asked to self-rate their perceptions of their current health status and confidence in their ability to cope with everyday life.Results: One main theme was identified: new insights and access to resources change the perspective on life. Personal characteristics and support from others were advantageous in finding ways to deal with limitations related to the illness. Most of the persons experienced a changed approach to life, in that they now valued life more than they had before. However, some persons also experienced lost values and found it difficult to accept medications. The persons rated their current health status as slightly above average, but their confidence in their ability to cope with everyday life as high.
|
|
| 14. |
- Hedlund, Åsa, et al.
(författare)
-
Predictors of return to work and psychological well-being among women during/after long-term sick leave due to common mental disorders - a prospective cohort study based on the theory of planned behaviour
- 2022
-
Ingår i: Health & Social Care in the Community. - : Wiley. - 0966-0410 .- 1365-2524. ; 30:6, s. 5245-5258
-
Tidskriftsartikel (refereegranskat)abstract
- Common mental disorders are associated with long-term sick leave, especially among women. There is a lack of theory-based research regarding the impact of personal factors on return to work and psychological well-being. Therefore, the aim of this study was to examine whether return-to-work beliefs and perceived health were predictors of return to work and psychological well-being among women during or after long-term sick leave for common mental disorders, based on the Theory of Planned Behaviour. This was a prospective cohort study with a 1-year follow-up. At baseline, women (n = 282) had been on full- or part-time sick leave for common mental disorders for 2–24 months. Data were collected in October 2019–January 2020 and October 2020–January 2021 in Sweden. The Social Insurance Agency identified the women at baseline. The Return-To-Work Beliefs Questionnaire, EuroQol Visual Analogue Scale and General Health Questionnaire-12 were used. Multiple logistic and linear regression analyses were conducted. The women were divided into two groups: full-time sick leave or part-time sick leave at baseline. The results showed that stronger return-to-work intention significantly predicted return to work among women on full-time sick leave at baseline. No significant predictors of return to work were found among women on part-time sick leave at baseline. Psychological well-being was predicted by stronger social pressure to return to work (full-time group) and a more positive attitude toward returning to work and better perceived health (part-time group). We concluded that the Theory of Planned Behaviour can be useful for understanding return to work among women on full-time sick leave, and what underlies psychological well-being in both groups. However, return to work and psychological well-being were predicted by different factors, indicating that a multifactorial approach should be used in supporting women to return to work after long-term sick leave for common mental disorders.
|
|
| 15. |
|
|
| 16. |
|
|
| 17. |
- Hedman, Maria, et al.
(författare)
-
Life memories and the ability to act : the meaning of autonomy and participation for older people when living with chronic illness
- 2015
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:4, s. 824-833
-
Tidskriftsartikel (refereegranskat)abstract
- There is a lack of knowledge about how older people living with chronic illness describe the meaning of autonomy and participation, indicating a risk for reduced autonomy and participation in their everyday life. The purpose of this study was to describe the meaning of autonomy and participation among older people living with chronic illness in accordance with their lived experience. The design was descriptive with a phenomenological approach guided by Giorgi's descriptive phenomenological psychological method. Purposive sampling was used, and 16 older people living with chronic illness who lived in an ordinary home participated in individual interviews. The findings showed that the meaning of autonomy and participation among the older people emerged when it was challenged and evoked emotional considerations of the lived experience of having a chronic illness. It involved living a life apart, yet still being someone who is able, trustworthy and given responsibility – still being seen and acknowledged. The meaning of autonomy and participation was derived through life memories and used by the older people in everyday life for adjustment or adaption to the present life and the future. Our conclusion is that autonomy and participation were considered in relation to older people's life memories in the past, in their present situation and also their future wishes. Ability or disability is of less importance than the meaning of everyday life among older people. We suggest using fewer labels for limitations in everyday life when caring for older people and more use of the phrase ‘ability to act’ in different ways, based on older people's descriptions of the meaning of autonomy and participation.
|
|
| 18. |
- Hellström-Hyson, Eva, et al.
(författare)
-
To take responsibility or to be an onlooker : Nursing students' experiences of two models of supervision
- 2012
-
Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 32:1, s. 105-110
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: The present study aimed at describing how nursing students engaged in their clinical practice experienced two models of supervision: supervision on student wards and traditional supervision. BACKGROUND: Supervision for nursing students in clinical practice can be organized in different ways. In the present study, parts of nursing students' clinical practice were carried out on student wards in existing hospital departments. The purpose was to give students the opportunity to assume greater responsibility for their clinical education and to apply the nursing process more independently through peer learning. METHOD: A descriptive design with a qualitative approach was used. Interviews were carried out with eight nursing students in their final semester of a 3-year degree program in nursing. The data were analyzed using content analysis. FINDINGS: Two themes were revealed in the data analysis: When supervised on the student wards, nursing students experienced assuming responsibility and finding one's professional role, while during traditional supervision, they experienced being an onlooker and having difficulties assuming responsibility. CONCLUSIONS: Supervision on a student ward was found to give nursing students a feeling of acknowledgment and more opportunities to develop independence, continuity, cooperation and confidence.
|
|
| 19. |
- Israelsson, Johan, et al.
(författare)
-
Health status and psychological distress among in-hospital cardiac arrest survivors in relation to gender
- 2017
-
Ingår i: Resuscitation. - : Elsevier. - 0300-9572 .- 1873-1570. ; 114, s. 27-33
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe health status and psychological distress among in-hospital cardiac arrest (IHCA) survivors in relation to gender.METHODS: This national register study consists of data from follow-up registration of IHCA survivors 3-6 months post cardiac arrest (CA) in Sweden. A questionnaire was sent to the survivors, including measurements of health status (EQ-5D-5L) and psychological distress (HADS).RESULTS: Between 2013 and 2015, 594 IHCA survivors were included in the study. The median values for EQ-5D-5L index and EQ VAS among survivors were 0.78 (q1-q3=0.67-0.86) and 70 (q1-q3=50-80) respectively. The values were significantly lower (p<0.001) in women compared to men. In addition, women reported more problems than men in all dimensions of EQ-5D-5L, except self-care. A majority of the respondents reported no problems with anxiety (85.4%) and/or symptoms of depression (87.0%). Women reported significantly more problems with anxiety (p<0.001) and symptoms of depression (p<0.001) compared to men. Gender was significantly associated with poorer health status and more psychological distress. No interaction effects for gender and age were found.CONCLUSIONS: Although the majority of survivors reported acceptable health status and no psychological distress, a substantial proportion reported severe problems. Women reported worse health status and more psychological distress compared to men. Therefore, a higher proportion of women may be in need of support. Health care professionals should make efforts to identify health problems among survivors and offer individualised support when needed.
|
|
| 20. |
|
|
| 21. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
A study of two generic health-related quality of life questionnaires - Nottingham Health Profile and Short-Form 36 Health Survey - and of coping in patients with sensory hyperreactivity
- 2013
-
Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 11
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundSensory hyperreactivity (SHR) is one explanation for airway symptoms induced by chemicals and scents. Little is known about health-related quality of life (HRQOL) and coping, in this group of patients. A study was done in patients with SHR to (1) compare the Nottingham Health Profile (NHP) and the Short-Form 36 Health Survey (SF-36) in regard to their suitability, validity, reliability, and acceptability; (2) evaluate how the patients cope with the illness; (3) assess whether there are differences between women and men with respect to HRQOL and coping; and (4) assess whether there are differences between patients and normative data with respect to HRQOL and coping.MethodsA total of 115 patients (91 women) with SHR were asked to answer five questionnaires: a study-specific questionnaire, the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR), the NHP, the SF-36, and the Jalowiec Coping Scale-60.ResultsEighty-three patients (72%; 70 women) completed all questionnaires. The SF-36 scores were less skewed and more homogeneously distributed and showed fewer floor and ceiling effects than the NHP scores. The SF-36 was also discriminated better between patients with high and low CSS-SHR scores. The reliability standard for both questionnaires was satisfactory. There were no gender differences in HRQOL. Patients with SHR had significantly lower HRQOL scores than the normative data in comparable domains of the NHP and the SF-36: emotional reactions/mental health, energy/vitality, physical mobility/functioning, and pain/bodily pain. In social isolation/functioning, the results were different; the NHP scores were similar to the normative data and the SF-36 scores were lower. The most commonly used coping styles were optimistic, self-reliant, and confrontational. Women used optimistic coping more than men. Compared with the normative group, patients with SHR used confrontational and optimistic coping more and emotive coping less.ConclusionsThe current findings showed that both the NHP and the SF-36 were reliable instruments; but the results suggest that the SF-36 is a more sensitive instrument than the NHP for elucidating HRQOL in patients with SHR. Patients with SHR experienced a poor HRQOL and they followed the Western tradition of preferring problem-focused coping strategies to palliative and emotive strategies.
|
|
| 22. |
|
|
| 23. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Coping mediates the relationship between sense of coherence and mental quality of life in patients with chronic illness: a cross-sectional study
- 2018
-
Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 27:7, s. 1855-1863
-
Tidskriftsartikel (refereegranskat)abstract
- PurposeThe aim of the present study was to investigate relationships between sense of coherence, emotion-focused coping, problem-focused coping, coping efficiency, and mental quality of life (QoL) in patients with chronic illness. A model based on Lazarus’ and Folkman’s stress and coping theory tested the specific hypothesis: Sense of coherence has a direct and indirect effect on mental QoL mediated by emotion-focused coping, problem-focused coping, and coping efficiency in serial adjusted for age, gender, educational level, comorbidity, and economic status.MethodsThe study used a cross-sectional and correlational design. Patients (n = 292) with chronic diseases (chronic heart failure, end-stage renal disease, multiple sclerosis, stroke, and Parkinson) completed three questionnaires and provided background data. Data were collected in 2012, and a serial multiple mediator model was tested using PROCESS macro for SPSS.ResultsThe test of the conceptual model confirmed the hypothesis. There was a significant direct and indirect effect of sense of coherence on mental QoL through the three mediators. The model explained 39% of the variance in mental QoL.ConclusionsSelf-perceived effective coping strategies are the most important mediating factors between sense of coherence and QoL in patients with chronic illness, which supports Lazarus’ and Folkman’s stress and coping theory.
|
|
| 24. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Coping, social support and quality of life over time after myocardial infarction
- 2005
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 52:2, s. 113-124
-
Tidskriftsartikel (refereegranskat)abstract
- Aim. This paper describes gender differences in perceived coping, social support and quality of life 1, 4 and 12 months after myocardial infarction.Background. There is a shortage of studies with a longitudinal research design investigating coping, social support and quality of life in women and men after myocardial infarction.Methods. A longitudinal, descriptive and comparative design was used for the study, which included 74 women and 97 men. At 12 months, 60 women and 88 men remained. Data were collected using the Jalowiec Coping Scale, a social support questionnaire, the SF-36 Health Survey (health-related quality of life) and the Quality of Life Index-Cardiac version (quality of life). The data were collected during the period 1999–2001.Results. No statistically significant changes over time in coping assessments emerged in the study group, except for fatalistic coping, which diminished over time in men. Women used more evasive coping than men at 4 and 12 months. The perceived efficiency in coping with physical aspects of the heart disease increased. More women than men perceived available support from grandchildren and staff of the church. Health-related quality of life increased in women and men in physical functioning, role-physical, vitality, social functioning, and role-emotional scales.Moreover, an improvement in the mental health scale was evident in women and a reduction in pain in men. No statistically significant gender differences were found for quality of life at any point in time.Conclusions. The findings can be used to inform caregivers that optimistic, selfreliant and confrontational coping were the most frequently used by both women and men over the first year after myocardial infarction, and that confrontational coping has been shown to have positive outcomes in the longer term. Nurses should tell women about the importance of seeking prompt treatment and discuss health problems with caregivers and significant others. Care planning should include family members and significant others so that they can support and encourage patients to cope with problems in daily life.
|
|
| 25. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: A pilot study
- 2010
-
Ingår i: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1474-5151 .- 1873-1953. ; 9:3, s. 168-174
-
Tidskriftsartikel (refereegranskat)abstract
- Background: As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required. Aims:The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.Methods:A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions. Results:Two separate factor analyses each revealed a two-factor structure on both occasions: “Sexual appetite” and “Sexual expectations ”with gender-neutral questions and “Sexual sensitiveness” and “Sexual ability” with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test – retest values for all but one question exceeded 0.70.Conclusions:The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.
|
|
| 26. |
|
|
| 27. |
|
|
| 28. |
|
|
| 29. |
- Kristofferzon, Marja-Leena, 1950-
(författare)
-
Health-related quality of life over the first year after myocardial infarction
- 2006
-
Ingår i: New Frontiers in Cardiac Care. - : Oxford University Press (OUP). ; , s. s40-s41
-
Konferensbidrag (refereegranskat)abstract
- Purpose: The aim of the study was to compare healthrelated quality of life (HRQoL) in patients 1, 4 and 12 months after myocardial infarction with regard to (1) differences over time and (2) differences between younger (42–64 years old) and older (65–90 years old) patients. Methods: A longitudinal, descriptive and comparative design was used for the study, which included 69 younger (39% women) and 79 older (42% women) patients. Data were collected with the SF-36 Health Survey during the period 1999–2001. Results: Table 1 displays main effects of time and groups. No group-by-time interaction effects emerged. HRQoL increased in younger patients for physical functioning, bodily pain, vitality and social functioning scales between 1 and 4 months, which remained at 12 months. There was also an increase for role-physical and role-emotional scales between 1 and 4 months and a further increase between 4 and 12 months. In older patients the increase for rolephysical, vitality, social functioning and role-emotional scales was found between 1 and 4 months, which remained at 12 months. Moreover, an improvement in the physical functioning scale was found between 4 and 12 months and for the bodily pain scale between 1 and 4 months. An increase for mental health scale in the study group was evident between 4 and 12 months, but when the study group was divided into younger and older patients the change over time disappeared. The general health scale was stable over time. Compared with older patients, younger patients rated higher HRQoL for the physical functioning scale at 1, 4 and 12 months, for the social functioning scale at 1 and 12 months, for the roleemotional scale at 4 and 12 months and for the rolephysical scale at 12 months. Conclusion: There was an improvement in HRQoL in both younger and older patients, but the improvement was more obvious in younger patients. In addition, younger patients perceived higher HRQoL than older patients in several dimensions and at several points in time. This was most evident at 12 months.
|
|
| 30. |
- Kristofferzon, Marja-Leena, 1950-
(författare)
-
Life After Myocardial Infarction in Swedish Women and Men : Coping, Social Support and Quality of Life Over the First Year
- 2006
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims: The general aim of this thesis was to describe the life situation of women and men during their first year after myocardial infarction (MI) with regard to problems in daily life, how they coped with them, the social support available and the patients’ perceived quality of life (QoL). An additional aim was to examine differences over time and between women and men in coping, social support and QoL. Methods: A consecutive series of 74 women and 97 men were selected 1 month after MI and followed over the first year. A qualitative approach was used to describe experiences of everyday life of 20 women and 19 men from the study group, from the onset of MI through the first months after the event (retrospectively). Focus was on managing problems and support from the network (I). Also experiences at 4 to 6 months and expectations of the future were explored (II). Coping, social support and QoL were compared between women and men both with a cross-sectional (at 1 month; 74 women and 97 men; III) as well as with a longitudinal design (at 1, 4 and 12 months; 60 women and 88 men; IV). Findings: Physical symptoms and emotional distress were the most commonly described problems during the first months after MI. The patients managed the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviour and taking their own decisions. The network was generally supportive but also communication problems were described (I). Many of the patients had not established a stable health condition after 6 months. They managed the consequences of their disease, found a meaning in what had happened, and confidence in the future. The support from their social network encouraged them to move on (II). Women used more evasive and supportive coping than men 1 month after MI. More women perceived support being available from grandchildren and friends and more men from their partners. Compared with men, women rated lower health-related QoL and QoL (III). Coping and social support were stable over time, women used more evasive coping than men and health-related QoL increased for both women and men. (IV). Conclusions: The first month after MI seems to be a vulnerable period especially for women. They had difficulties interpreting their heart symptoms, did not want to bother others with their worries and rated lower QoL than men. Patients redefined normal life, found hopes for the future and women did not demonstrate a poorer QoL profile than men over time.
|
|
| 31. |
- Kristofferzon, Marja-Leena, 1950-
(författare)
-
Life after myocardial infarction in women and men : coping, social support and quality of life over the first year
- 2006
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aims : The general aim of this thesis was to describe the life situation of women and men during their first year after myocardial infarction (MI) with regard to problems in daily life, how they coped with them, the social support available and the patients’ perceived quality of life (QoL). An additional aim was to examine differences over time and between women and men in coping, social support and QoL.Methods : A consecutive series of 74 women and 97 men were selected 1 month after MI and followed over the first year. A qualitative approach was used to describe experiences of everyday life of 20 women and 19 men from the study group, from the onset of MI through the first months after the event (retrospectively). Focus was on managing problems and support from the network (I). Also experiences at 4 to 6 months and expectations of the future were explored (II). Coping, social support and QoL were compared between women and men both with a cross-sectional (at 1 month; 74 women and 97 men; III) as well as with a longitudinal design (at 1, 4 and 12 months; 60 women and 88 men; IV).Findings : Physical symptoms and emotional distress were the most commonly described problems during the first months after MI. The patients managed the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviour and taking their own decisions. The network was generally supportive but also communication problems were described (I). Many of the patients had not established a stable health condition after 6 months. They managed the consequences of their disease, found a meaning in what had happened, and confidence in the future. The support from their social network encouraged them to move on (II). Women used more evasive and supportive coping than men 1 month after MI. More women perceived support being available from grandchildren and friends and more men from their partners. Compared with men, women rated lower health-related QoL and QoL (III). Coping and social support were stable over time, women used more evasive coping than men and health-related QoL increased for both women and men. (IV).Conclusions : The first month after MI seems to be a vulnerable period especially for women. They had difficulties interpreting their heart symptoms, did not want to bother others with their worries and rated lower QoL than men. Patients redefined normal life, found hopes for the future and women did not demonstrate a poorer QoL profile than men over time.
|
|
| 32. |
- Kristofferzon, Marja-Leena, et al.
(författare)
-
Living with chronic illness
- 2009
-
Ingår i: The 2nd International Research Seminar on Salutogenesis.
-
Konferensbidrag (refereegranskat)abstract
- Aim: To study differences between two groups, end-stage renal disease (ESRD) and chronic heart failure (CHF), regarding sense of coherence (SOC), General Self-efficacy (GSE), and quality of life (QoL) as well as relationships between these variables. Design: Descriptive, comparative and correlative design. Sample: A Swedish sample of 100 patients (59 CHF and 41 ESRD) was included. The mean age was 68 years (46 – 80 years). Measures: Data were collected with the SOC, the GSE and the Life Satisfaction Questionnaire (LSQ). Age, sex, educational level and living area were also examined. Data analysis: Differences were tested with chi-square and Mann-Whitney U-test and correlations with Pearson’s correlation coefficient. Results: Both SOC (r=0.58, P<0.01) and GSE (r=0.46, P=<0.01) were positively correlated with LSQ. No significant differences between the two groups were found for the study variables. Older persons (>65 years) rated their personal relationships within QoL higher (P=0.045) and older ESRD patients their SOC stronger (P=0.049). Men with CHF rated their self-efficacy higher (P=0.034).Conclusions: Our preliminary results indicate that it seems more important how the individual tackle their present situation than what chronic illness they have.
|
|
| 33. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Managing consequences and finding hope : experiences of Swedish women and men 4-6 months after myocardial infarction
- 2008
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:3, s. 367-375
-
Tidskriftsartikel (refereegranskat)abstract
- Research has focused more on symptoms, risk factors and treatment, than on individuals’ experiences of illness and recovery after myocardial infarction (MI). Therefore, the aim of the study was to describe the experiences of present everyday life of women and men 4–6 months after MI and their expectations for the future. Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed with content analysis. Two themes, ‘Managing consequences of MI’ and ‘Finding a meaning in what had happened’, were generated. The first theme reveals that many of the patients had not established a stable health condition, even if symptoms and emotional distress had diminished over time. They had to manage health problems, lifestyle modifications, emotional reactions and changes in social life. The support from their social network encouraged them to move on. The second theme shows that patients also found positive consequences of what they had gone through, new life values and hopes in the future. The conclusions were that most of the patients moved on and began to regain a balance in everyday life, but some patients still struggled hard to find this balance. Those patients experienced large difficulties with managing their everyday life and felt a lack of support from their social network. Health professionals can be an important resource in helping patients in their adaptation to changes if they are more sensitive to patients’ needs of support both in a short- and long-term perspective.
|
|
| 34. |
- Kristofferzon, Marja-Leena, et al.
(författare)
-
Managing consequences and finding hope : experiences of Swedish women and men 4-6 months after myocardial infarction
- 2008
-
Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 22:3, s. 367-375
-
Tidskriftsartikel (refereegranskat)abstract
- Research has focused more on symptoms, risk factors and treatment, than on individuals' experiences of illness and recovery after myocardial infarction (MI). Therefore, the aim of the study was to describe the experiences of present everyday life of women and men 4-6 months after MI and their expectations for the future. Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed with content analysis. Two themes, 'Managing consequences of MI' and 'Finding a meaning in what had happened', were generated. The first theme reveals that many of the patients had not established a stable health condition, even if symptoms and emotional distress had diminished over time. They had to manage health problems, lifestyle modifications, emotional reactions and changes in social life. The support from their social network encouraged them to move on. The second theme shows that patients also found positive consequences of what they had gone through, new life values and hopes in the future. The conclusions were that most of the patients moved on and began to regain a balance in everyday life, but some patients still struggled hard to find this balance. Those patients experienced large difficulties with managing their everyday life and felt a lack of support from their social network. Health professionals can be an important resource in helping patients in their adaptation to changes if they are more sensitive to patients' needs of support both in a short- and long-term perspective.
|
|
| 35. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Myocardial infarction : gender differences in coping and social support
- 2003
-
Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 44:4, s. 360-374
-
Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this review is to summarize current knowledge about gender differences in perceptions of coping and social support among patients who have experienced myocardial infarction.Rationale. Women with coronary heart disease have physical, social and medical disadvantages compared with their male counterparts, which can influence their perception of recovery after cardiac events. No review has been found which focuseson gender differences in coping and social support in myocardial infarction patients.Method. A computerized search was conducted using the keywords ‘myocardial infarction’, ‘coping’, ‘gender differences’ and ‘social support’. Forty-one articles, published between 1990 and October 2002, were scrutinized.Findings. Two studies report that women used more coping strategies than men. Several qualitative studies found that women used a variety of coping strategies. Women minimized the impact of the disease, tended to delay in seeking treatmentand did not want to bother others with their health problems. Household activities were important to them and aided their recovery. Men were more likely to involve their spouses in their recovery, and resuming work and keeping physically fit wereimportant to them. Women tended to report that they had less social support up to 1 year after a myocardial infarction compared with men. They received less informationabout the disease and rehabilitation and experienced lack of belief in their heart problems from caregivers. Further, they received less assistance with household duties from informal caregivers. Men tended to report more support from theirspouses than did women.Conclusions. Traditional gender-role patterns may influence the recovery of patients who have experienced myocardial infarction. Caregivers may need to be more sensitive to gender-specific needs with regard to risk profiles, social roles, and the patient’s own role identity. For many women, especially older ones, household duties and family responsibilities may be an opportunity and a base for cardiac rehabilitation.
|
|
| 36. |
|
|
| 37. |
|
|
| 38. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Nursing students' perceptions of clinical supervision : The contributions of preceptors, head preceptors and clinical lecturers
- 2013
-
Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 33:10, s. 1252-1257
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aims of the study were 1) to investigate to what extent nursing students were satisfied with the supervision provided by facilitators (preceptor, head preceptor, and clinical lecturer), 2) to compare nursing students' ratings of facilitators' contribution to supervision as supportive and challenging, and 3) to examine relationships between facilitators' supportive and challenging behavior in supervision and nursing students' perception of fulfillment of expected learning outcomes in clinical education.Background: Although there are many studies on support of students in clinical education, few have addressed this from the students' point of view or made comparisons between different facilitators.Methods: A cross-sectional survey study was conducted during April to November 2010, where 107 nursing students, from a university in central Sweden, answered a questionnaire about supervision immediately after their period of clinical education.Result: Supportive behavior in supervision was rated higher by students for all facilitator groups as compared with challenging behavior. The students rated preceptors and clinical lecturers as more supportive than head preceptors and clinical lecturers as providing more challenges than the two other facilitator groups. Supportive and challenging behavior in supervision explained 39% of the variance in students' overall learning outcomes. However, the regression coefficient was only significant for students' ratings of supportive behavior for the preceptor.Conclusions: Nursing students were satisfied with facilitators' supervision and by their contribution to fulfillment of overall learning outcomes. Comparisons showed that preceptors in a higher degree were perceived as supportive while clinical lecturers were perceived as more important as challengers for critical thinking, reflection and exchange of experiences between students. The model of supervision seems to be promising, but the roles across facilitators need to be made clearer, especially the head preceptor's role, which seemed to be the most unclear role in this model.
|
|
| 39. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Perceived coping, social support, and quality of life 1 month after myocardial infarction : A comparison between Swedish women and men
- 2005
-
Ingår i: Heart & Lung. - : Elsevier BV. - 0147-9563 .- 1527-3288. ; 34:1, s. 39-50
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The study objective was to compare coping, social support, and quality of life in Swedish women and men 1 month after myocardial infarction.DESIGN: The study design was cross-sectional and descriptive-comparative.SETTING: The study took place in 1 hospital service area in the middle of Sweden.SUBJECTS: The sample consisted of 74 women and 97 men.INSTRUMENTS: The Jalowiec Coping Scale, the Social Network and Social Support Questionnaire, the Short Form-36 Health Survey, and the Quality of Life Index-Cardiac Version were used.RESULTS: Compared with men, women used more evasive and supportive coping and rated psychologic aspects of the heart disease as more problematic to manage. More women perceived available support from friends and grandchildren, and more men perceived available support from their partner. Women rated lower levels in physical and psychologic dimensions of quality of life.CONCLUSION: The first month after myocardial infarction is a susceptible period especially for women. They used more evasive and supportive coping and experienced a lower quality of life compared with men.
|
|
| 40. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Relationships between coping, coping resources and quality of life in patients with chronic illness : a pilot study
- 2011
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 25:3, s. 476-483
-
Tidskriftsartikel (refereegranskat)abstract
- In Sweden there are approximately about 3500 end-stage renal disease and 250 000 chronic heart failure patients. Objectives: The original purpose of the study was to determine differences between two groups of patients with chronic illness (end-stage renal disease and chronic heart failure) regarding the following study variables: coping, sense of coherence, self-efficacy and quality of life. Following this, the aim was to explore the relationships between demographic variables (sex, age, educational level and living area) and quality of life as well as between coping, sense of coherence, self-efficacy and quality of life for the combined sample of patients with end-stage renal disease and chronic heart failure.Methods: A comparative and correlative design was used with a sample of 100 patients (n=41 end-stage renal disease, n=59 chronic heart failure). The data were collected during 2004, using four standardized questionnaires and regression analyses were conducted.Results: No significant differences were found between the two groups. Positive correlations were identified between sense of coherence, general self-efficacy and quality of life, whereas negative correlations emerge between emotion-focused coping, sense of coherence, general self-efficacy and quality of life. Sense of coherence, general self-efficacy and emotion-focused coping explained 40% of the variance in quality of life. Those with low sense of coherence and general self-efficacy showed negative correlations between emotion-focused coping and quality of life, whereas no such correlations were shown for those with high values on sense of coherence and general self-efficacy. Conclusions: The present results on coping and quality of life correspond with previous research regarding how other groups with chronic illness handled their daily life. Preliminary results indicate that how individuals tackle their present situation is more important than which chronic illness they have. Women used more emotion-focused coping than men, which constitute an important finding for further research.
|
|
| 41. |
|
|
| 42. |
- Kristofferzon, Marja-Leena, 1950-, et al.
(författare)
-
Striving for balance in daily life: experiences of Swedish women and men shortly after myocardial infarction
- 2007
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 16:2, s. 391-401
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim is to describe experiences of daily life of women and men during the first four to six months after a myocardial infarction. The focus is on problems, managing problems and support from their network.Background: A cardiac event is traumatic and may influence well-being during a significant period of time. Few qualitative studies have investigated experiences of both women and men after a myocardial infarction and remarkably little research has been conducted on men’s experiences.Design: The study design was descriptive, retrospective and qualitative.Methods: Semi-structured interviews were conducted with 20 women and 19 men from January 2000 to November 2001. Data were analysed using qualitative content analysis.Results: Three themes were generated from the analysis; ‘Threatening ordinary life’, ‘Struggling for control’ and ‘The ambiguous network’. Physical symptoms and emotional distress were the most commonly described problems during the first months after a myocardial infarction. The informants manage the problems by negotiating with themselves, relying on their own capabilities, changing attitudes and behaviours and taking their own decisions and actions. The network was generally supportive but rather often the informants also experienced communication problems when they interacted with their network.Conclusions: Women and men strive for balance between problems and resources in daily life after a myocardial infarction. How well they succeeded depends on how secure they feel how well they communicate their needs to their network and how sensitive their network is to their spoken and unspoken needs.Relevance to clinical practice: The findings provide an insight into what kind of problems women and men may experience after myocardial infarction and how caregivers can aid them to increase security in their daily life. Some risk characteristics that may have increased their problems in daily life are suggested, for women and men respectively.
|
|
| 43. |
|
|
| 44. |
|
|
| 45. |
- Larsson, I. -M, et al.
(författare)
-
Health related quality of life improves during the first 6 month after cardiac arrest and hypothermia treatment
- 2013
-
Ingår i: Intensive Care Medicine. - 0342-4642 .- 1432-1238. ; 39:Suppl. 2, s. S221-S221
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTIONPatients’ quality of life (QoL) after having survived a cardiac arrest hasbeen reported negatively influenced or acceptable to good [1–3]. Feelings of anxiety anddepression are present in CA patients [3] and depressions have been shown to be related toQoL [4]. There is little known, however about changes over time in anxiety, depression and health-related quality of life (HRQoL) after surviving CA treated with therapeutic hypothermia (TH). Therefore, the aim of the study was to investigate if there were any changes and correlation in anxiety, depression and HRQoL from hospital discharge until one and 6 months after CA in patients treated with TH.OBJECTIVESDuring a 4-year period at three hospitals in Sweden, 26 patients were prospectively included after CA treated with TH.METHODSThe patients answered the questionnaires Hospital Anxiety and Depression Scale (HADS), Euroqol (EQ5D), Euroqol visual analogue scale (EQ-VAS) and Short Form12 (SF12) at three occasions; in connection with hospital discharge, and at one and 6 months after CA.RESULTSThere was improvement over time in HRQoL, in EQ5D index (p=0.002) and SF12 physical component score (PCS) (p=0.005). Changes over time in anxiety and depression were not found. Seventy-three percentages scored overall health status with EQ-VAS below 70 (scale 0–100) at discharge from hospital and at 6 months this was found in 41 %. Physical problems were most common cause of affected HRQoL. Correlation was found between depression and HRQoL and this was strongest at 6 months (rs=-0.44 to-0.71,pB0.001).CONCLUSIONSHRQoL are affected negatively in patients after CA treated with TH, but improvement over the first 6 months can be seen. The patients scored lower self-reported levels of HRQoL in physical than in mental components. The result indicates that time is an important factor and patients may require more support the first time after discharge from hospital.REFERENCE(S)1. Torgersen J, Strand K, Bjelland TW, et al. Cognitive dysfunction and health-related quality of life after a cardiac arrest and therapeutic hypothermia. Acta Anaesthesiol Scand. 2010;54:721–8. 2. Horsted TI, Rasmussen LS, Meyhoff CS and Nielsen SL. Long-term prognosis after out-of-hospital cardiac arrest. Resuscitation. 2007;72:214–8.3. Wachelder EM, Moulaert VR, van Heugten C, Verbunt JA, Bekkers SC and Wade DT. Life after survival: long-term daily functioning and quality of life after an out-of-hospitalcardiac arrest. Resuscitation. 2009;80:517–22. 4. Moulaert VR, Wachelder EM, Verbunt JA, Wade DT and van Heugten CM. Determinants of quality of life in survivors of cardiac arrest. J Rehabil Med. 2010;42:553–8.
|
|
| 46. |
- Larsson, Ing-Marie, et al.
(författare)
-
Health-related quality of life improves during the first six months after cardiac arrest and hypothermia treatment
- 2014
-
Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 85:2, s. 215-220
-
Tidskriftsartikel (refereegranskat)abstract
- Aim of the study:To investigate whether there were any changes in and correlations between anxiety, depression and health-related quality of life (HRQoL) over time, between hospital discharge and one and six months after cardiac arrest (CA), in patients treated with therapeutic hypothermia (TH). Method: During a 4-year period at three hospitals in Sweden, 26 patients were prospectively included after CA treated with TH. All patients completed the questionnaires Hospital Anxiety and Depression Scale (HADS), Euroqol (EQ5D), Euroqol visual analogue scale (EQ-VAS) and Short Form 12 (SF12) at three occasions, at hospital discharge, and at one and 6 months after CA. Result: There was improvement over time in HRQoL, the EQ5D index (p = 0.002) and the SF12 physical component score (PCS) (p = 0.005). Changes over time in anxiety and depression were not found. Seventy-three percent of patients had an EQ-VAS score below 70 (scale 0–100) on overall health status at discharge from hospital; at 6 months the corresponding figure was 41%. Physical problems were the most com-mon complaint affecting HRQoL. A correlation was found between depression and HRQoL, and this was strongest at six months (rs = −0.44 to −0.71, p ≤ 0.001). Conclusion: HRQoL improves over the first 6 months after a CA. Patients reported lower levels of HRQoL on the physical as compared to mental component. The results indicate that the less anxiety and depression patients perceive, the better HRQoL they have and that time can be an important factor in recovery after CA.
|
|
| 47. |
- Larsson, Ing-Marie, 1963-
(författare)
-
Post-Cardiac Arrest Care : Therapeutic Hypothermia, Patient Outcomes and Relatives’ Experiences
- 2014
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of the thesis was to study post-resuscitation care of cardiac arrest (CA) patients with a focus on therapeutic hypothermia treatment, outcomes up to six months post-CA and relatives’ experiences during the hospital stay.In Paper I, the aim was to asses effectiveness of hypothermia treatment with cold, 4°C, intravenous crystalloid infusion combined with ice packs. In conclusion, the described cooling method was found to be useful for inducing and maintaining hypothermia, allowed good temperature control during rewarming and to be feasible in clinical practice.The aim in Paper II was to investigate biomarkers and the association of serum glial fibrillary acidic protein (GFAP) levels with outcome, and to compare GFAP with neuron-specific enolas (NSE) and S100B. The result showed increased GFAP levels in the poor outcome group, but did not show sufficient sensitivity to predict neurological outcome. Both NSE and S100B were shown to be better predictors. A combination of the investigated biomarkers did not increase the ability to predict neurological outcome.In Paper III, the aim was to investigate whether there were any changes in and correlations between anxiety, depression and health-related quality of life (HRQoL) over time, between hospital discharge and one and six months post-CA. There was improvement over time in HRQoL, but changes over time in anxiety and depression were not found. Physical problems seemed to affect HRQoL more than psychological problems. The results also indicate that the less anxiety and depression patients perceive, the better their HRQoL.In the fourth paper, the aim was to describe relatives’ experiences during the next of kin’s hospital stay after surviving a CA. The analysis resulted in three themes: The first period of chaos, Feeling secure in a difficult situation, and Living in a changed existence.In conclusion, the results of the thesis have helped to improve knowledge within the areas studied and reveal aspects that should be taken into account in the overall treatment of this group of patients. The thesis have also shown the importance of developing an overall view and establishing a chain of care from an individual’s CA until follow-up for both the patient and his/her relatives.
|
|
| 48. |
- Larsson, Ing-Marie, et al.
(författare)
-
Post-cardiac arrest serum levels of glial fibrillary acidic protein for predicting neurological outcome
- 2014
-
Ingår i: Resuscitation. - : Elsevier BV. - 0300-9572 .- 1873-1570. ; 85:12, s. 1654-1661
-
Tidskriftsartikel (refereegranskat)abstract
- Aim of the study: To investigate serum levels of glial fibrillary acidic protein (GFAP) for evaluation of neurological outcome in cardiac arrest (CA) patients and compare GFAP sensitivity and specificity to that of more studied biomarkers neuron-specific enolas (NSE) and S100B. Method: A prospective observational study was performed in three hospitals in Sweden during 2008-2012. The participants were 125 CA patients treated with therapeutic hypothermia (TH) to 32-34. °C for 24. hours. Samples were collected from peripheral blood (n. =. 125) and the jugular bulb (n. =. 47) up to 108. hours post-CA. GFAP serum levels were quantified using a novel, fully automated immunochemical method. Other biomarkers investigated were NSE and S100B. Neurological outcome was assessed using the Cerebral Performance Categories scale (CPC) and dichotomized into good and poor outcome. Results: GFAP predicted poor neurological outcome with 100% specificity and 14-23% sensitivity at 24, 48 and 72. hours post-CA. The corresponding values for NSE were 27-50% sensitivity and for S100B 21-30% sensitivity when specificity was set to 100%. A logistic regression with stepwise combination of the investigated biomarkers, GFAP, did not increase the ability to predict neurological outcome. No differences were found in GFAP, NSE and S100B levels when peripheral and jugular bulb blood samples were compared. Conclusion: Serum GFAP increase in patients with poor outcome but did not show sufficient sensitivity to predict neurological outcome after CA. Both NSE and S100B were shown to be better predictors. The ability to predict neurological outcome did not increased when combining the three biomarkers.
|
|
| 49. |
- Larsson, Ing-Marie, et al.
(författare)
-
Relatives' experiences during the next of kin's hospital stay after surviving cardiac arrest and therapeutic hypothermia
- 2013
-
Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:4, s. 353-359
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: To describe relatives’ experiences during the next of kin’s hospital stay after surviving a cardiac arrest (CA) treated with hypothermia at an intensive care unit (ICU).Methods: Twenty relatives were interviewed when the person having suffered the CA was discharged from hospital, 1.5 to 6 weeks post-CA. Data were analysed using qualitative content analysis.Results: Three themes are described: The first period of chaos, Feeling secure in a difficult situation, and Living in a changed existence. Relatives found it difficult to assimilate the medical information and wanted it in written form. They wanted honest and clear information about their next of kin’s condition and prognosis. They lacked rehabilitation plans after discharge from the medical ward. Relatives felt a need to maintain telephone contact with family members and friends, which was time-consuming. They felt guilty and had a conscience about these feelings. Relatives felt uncertain about the future, but still hopeful.Conclusion: Relatives asked for more information and individual rehabilitation plans. Booklets describing CA, the ICU stay and continuing care and rehabilitation directed at both the patients and their relatives are needed. Follow-up visits to the ICU staff, for both patients and relatives, need to be arranged. Hospitals should consider having a rehabilitation plan for this group of patients, which is presented by a team of healthcare professionals and that focuses on the individual’s situation, including the consequences of their heart disease and brain damage.
|
|
| 50. |
- Larsson, I.-M., et al.
(författare)
-
Therapeutic hypothermia after cardiac arrest : Relatives experiences during the first six weeks after cardiac arrest
- 2011
-
Ingår i: Intensive Care Medicine. - 0342-4642 .- 1432-1238. ; 37:Suppl. 1, s. S74-S74
-
Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- INTRODUCTIONThe aim was to describe the relatives need for support and information during the acute phase when a next of kin has survived cardiac arrest treated with hypothermia at the intensive care unit (ICU). The aim was also to describe how everyday life is affected.OBJECTIVESTwenty relatives were interviewed at the time the person who had suffered acardiac arrest was discharged from hospital, 1.5–6 weeks after the cardiac arrest.METHODSThe interviews were recorded and transcribed verbatim and were analyzed with qualitative content analysis.RESULTSSupport and information.The relatives emphasized the importance of support from the family but they could also feel loneliness in difficult moments. The staff’s presence in the ICU was supportive but how much of support the relatives experienced varied among the groups of relatives. Several of them experienced that the contact with other relatives and friends was a requirement and that all telephone calls to other relatives and friends took a lot of time and also that they could not cope with it. The relatives described that the information received at the ICU was adequate and correct. They felt, however, difficulties to assimilate the information because of difficulties in concentration and language confusion affecting the interpretation of the information. They appreciated the opportunity to ask questions but felt that the answers they sought for was not available. In comparison with ICU, the relatives experienced less information and contact with the staff in the medical ward. The relatives wished more written information and were missing information about prevention. Impact on daily life. The relatives experienced that every day life was affected through increased responsibility for the home. They also experienced that they had to support other relatives and had difficulty to take care of other relatives’ worries. The injured person’s disease resulted in a lot of practical things to take care of, like certificate, absence from work and travels to the hospital. They felt worry for the injured person and how the disease had affected them, mostly they were concerned about personality changes. They felt responsible for the injured person and were also concerned about how to cope with daily life after the person being discharged from the hospital. The relatives felt uncertainty about the future but hopeful. The interviews also revealed that many of the relatives had not discussed with the person stricken by the disease what really had happened.CONCLUSIONSThe most important support when a next of kin had suffered a cardiac arrest was from other family members. The relatives wished repeated and more written information. Increased responsibility for the home and for the person stricken by the disease was the experience by the relatives on how everyday life was affected
|
|
