| 1. |
- Kettis, Åsa, et al.
(författare)
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The role of dermatologists, nurses and pharmacists in chronic dermatological treatment: patient and provider views and experiences.
- 2006
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 86:3, s. 202-8
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Tidskriftsartikel (refereegranskat)abstract
- Effectively co-ordinated treatment support from healthcare providers (doctors, nurses and pharmacists) may improve patients' adherence to treatment. The objective of this study was to identify patients' and providers' perceptions of the roles of different healthcare providers in dermatological treatment. Focus groups were used in two types of fora: patients with chronic dermatological diseases (n =2x6) and healthcare providers (n =2x6), including doctors, nurses and pharmacists working in dermatological care. Data were analysed according to the Consensual Qualitative Research approach. The respondents viewed the roles of the providers as complementary, but poorly co-ordinated. Treatment support is provided mainly by the nurse. During the doctor's appointment, diagnosis and treatment decisions are often prioritized, leaving limited time for treatment support. The pharmacist's provision of support is constrained by the lack of privacy and clinical history of individual patients. The most apparent "gap" in the chain of treatment support was between the pharmacist and the other providers. There was a wish for improved interprofessional collaboration to avoid giving conflicting advice. There is a need to improve interprofessional collaboration in dermatology, in order to optimize treatment support in clinical practice.
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| 2. |
- Kjellgren, Karin I, 1950, et al.
(författare)
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To follow dermatological treatment regimens--patients' and providers' views.
- 2004
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Ingår i: Acta dermato-venereologica. - : Medical Journals Sweden AB. - 0001-5555 .- 1651-2057. ; 84:6, s. 445-50
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Tidskriftsartikel (refereegranskat)abstract
- Adherence to long-term therapy for chronic illness is on average 50%. However, regarding adherence to dermatological treatment the existing literature is limited. The aim of the study was to acquire an understanding of issues associated with adherence to dermatological therapy. Focus group interviews were used in two types of fora: patients with chronic dermatological diseases and health care providers, including doctors, nurses and pharmacists working in dermatological care. Results reveal the providers' view of a suboptimal rate of adherence. According to both providers and patients, factors affecting adherence were patients' expectations and experiences of therapeutic effect, possibilities for the patient to take active part in treatment decisions, as well as mode of administration and type of medication. Suggested strategies for improvement are individualized patient education, continuous treatment support with assessment of medication-taking behaviour and enhanced communication skills among the providers.
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| 3. |
- Maroti, Marianne, et al.
(författare)
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A prospective population-based study, aiming to support decision-making in a follow-up programme for patients with cutaneous malignant melanoma, based on patterns of recurrence
- 2016
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Ingår i: EJD. European journal of dermatology. - : JOHN LIBBEY EUROTEXT LTD. - 1167-1122 .- 1952-4013. ; 26:6, s. 586-591
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Tidskriftsartikel (refereegranskat)abstract
- Background: The incidence of malignant melanoma (MM) is steadily rising, with only a minor increase in mortality. At present, there is no consensus regarding recommendations for follow-up programmes for MM, and health care programmes currently involve different schedules. With increasing opportunities to administer successful treatment for early disseminated disease, it may be of interest to engage MM patients and/or relatives in self-control. Objectives: The aim of the present study was to analyse both the time to, and the location of, the first metastatic lesion in order to provide help for the patient, relatives, and health professionals, and ensure better follow-up. Materials and methods: Data from the Swedish Melanoma Register, pathology registers, and the Cause of Death Register were used. Patients from the south-east region diagnosed with primary cutaneous MM between 1993 and 2007 were selected and data were correlated to characteristics of the primary tumour. Results: Metastases developed in 421 of the 2,910 patients with primary cutaneous MM in Stage I and II of the disease. Thirty-five percent of all recurrences were detected during the first year. Time to first metastasis to the skin and lymph nodes was almost identical. Conclusion: The vast majority of the recurrences were diagnosed at sites that were easily recognised by the patient and relatives; self-examination may therefore be a worthwhile approach. Our findings further indicate that the follow-up programme should focus on the first three years after diagnosis.
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| 4. |
- Maroti, Marianne, et al.
(författare)
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Quality of life before and 6 weeks after treatment in a dermatological outpatient treatment unit
- 2006
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Ingår i: Journal of the European Academy of Dermatology and Venereology. - : Wiley. - 0926-9959 .- 1468-3083. ; 20:9, s. 1081-1085
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dermatological disease affects quality of life to a great extent. Treatments are time-consuming and many patients have problems adhering to treatment. Attending an outpatient unit regularly during an intensive treatment period may enable patients to cope with their illness, adhere to treatment and thus improve their quality of life. Objective: To study the effect on quality of life of 6 weeks of regular treatment in the outpatient unit in the County Hospital of Jönköping, by means of a questionnaire and interviews. Methods: The Dermatology Life Quality Index (DLQI) was distributed to 50 consecutive patients with psoriasis, atopic dermatitis or pruritus attending our outpatient treatment unit. Nine of the patients were interviewed during treatment about factors that might influence their quality of life. Results: The DLQI scores before treatment indicated a low quality of life. Women were more affected than men. After 6 weeks of treatment there was a clear improvement, with a 57% reduction in the scores. The answers from the interviews indicated important areas of concern such as withdrawal from public places, adoption of special clothing habits and concern about personal relationships. Conclusion: Dermatological diseases have an important influence on patients' quality of life. Attending an outpatient treatment unit was in this series of cases associated with improved quality of life as measured with the DLQI. © 2006 European Academy of Dermatology and Venereology.
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| 5. |
- Ring, Lena, et al.
(författare)
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Living with skin diseases and topical treatment: patients' and providers' perspectives and priorities.
- 2007
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Ingår i: The Journal of dermatological treatment. - : Informa UK Limited. - 0954-6634 .- 1471-1753. ; 18:4, s. 209-18
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Relationship-centred care stresses the importance of taking both patients' and health-care providers' values, expectations and preferences into account to improve health outcomes. The aim of this qualitative study was to identify patients' and providers' views and experiences of skin disease and topical treatment. METHODS: Two types of focus group were used: (i) patients with chronic dermatological diseases and (ii) doctors, nurses and pharmacists working in dermatological care. RESULTS: Three major categories emerged: (i) problems related to the disease, (ii) problems related to the treatment and (iii) strategies for improving everyday life for patients. CONCLUSION: Patients and providers made several suggestions for improving everyday life. Future research needs to focus on how to achieve preference-matched shared decision-making, or concordance, between patients and health-care providers, taking different perspectives into account and how to evaluate the effect of the final, clinical, economical and humanistic outcomes of care and treatment. More seamless care and an increasingly shared understanding between patients and providers of their values, expectations and preferences for care and treatment may contribute to better health and better daily lives for patients.
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| 6. |
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| 7. |
- Serup, Jørgen, et al.
(författare)
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Manage your skin problems for the dermatology patient
- 2006
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Ingår i: The European Academy of Dermatology and Venereology. The Continuing Medical Education Committee. EADV Master Class in Dermatology Series, F1. 2006. DVD-film.
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Annan publikation (övrigt vetenskapligt/konstnärligt)
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| 8. |
- Serup, Jörgen, 1946-, et al.
(författare)
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To follow or not to follow dermatological treatment : A review of the literature
- 2006
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Ingår i: Acta Dermato-Venereologica. - : Taylor & Francis. - 0001-5555 .- 1651-2057. ; 86:3, s. 193-197
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Forskningsöversikt (refereegranskat)abstract
- Creams, ointments and solutions applied to the skin surface by patients as part of a daily routine might be expected to provide a more variable dosage than do standard tablets. However, adherence to treatment in dermatology has been little studied. This article reviews recent publications in the field. These are dominated by questionnaire-based studies, which tend to over-estimate adherence. Reduced adherence to dermatological treatment is noted in 34-45% of patients. It is likely that the percentage of patients who practice truly optimal treatment in their daily life is even lower considering the variable practice of self-treatment. Self-reported psychiatric morbidity contributes to poor adherence to dermatological treatment, while a well-functioning doctor-patient interaction is a major determinant of good adherence, as is patient satisfaction. In conclusion, adherence to dermatological treatment is unsatisfactory and there is a need for intervention and change in clinical routines. The therapeutic and economic benefits may be considerable. The immediate challenge is to stimulate a change in patient behaviour and improve self-treatment at home. © 2006 Acta Dermato-Venereologica.
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| 9. |
- Ulff, Eva, et al.
(författare)
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A potent steroid cream is superior to emollients in reducing acute radiation dermatitis in breast cancer patients treated with adjuvant radiotherapy. A randomised study of betamethasone versus two moisturizing creams
- 2013
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Ingår i: Radiotherapy and Oncology. - : Elsevier. - 0167-8140 .- 1879-0887. ; 108:2, s. 287-292
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose: The aim was to investigate whether treatment with potent local steroids can reduce signs and symptoms of acute radiation dermatitis in breast cancer patients undergoing adjuvant radiotherapy (RT) compared to emollient creams. less thanbrgreater than less thanbrgreater thanMaterial and methods: The study was randomised and double-blinded. Patients with breast cancer who had undergone mastectomy or breast-conserving surgery were included when they started adjuvant 3D planned RT. In all, 104 patients were randomised 2:1:1 to three treatment groups, i.e. betamethasone + Essex (R) cream, Essex (R) cream or Canoderm (R) cream. The patients themselves treated the irradiated area during the radiation period (5 weeks) and two weeks after cessation of RT. Signs of RT dermatitis were measured qualitatively with RTOG clinical scoring and quantitatively by colorimeter. In addition, the patients symptoms were recorded as well as the Fitzpatrick skin type. less thanbrgreater than less thanbrgreater thanResults: There was a statistically significant difference (p = 0.05) in skin reactions when assessed with RTOG in favour of the group treated with the potent steroid. Patient-related symptoms did not differ between the treatment groups. The effect of the steroid was prominent in three subgroups, i.e. (i) patients treated with ablation of the breast, (ii) patients receiving RT to the armpit and the supraclavicular fossa, and (iii) patients with Fitzpatrick skin type 1. less thanbrgreater than less thanbrgreater thanConclusions: Treatment with betamethasone cream is more efficient than moisturizers for the control of acute RT dermatitis in patients treated with adjuvant RT for breast cancer.
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| 10. |
- Ulff, Eva, et al.
(författare)
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Fluorescent cream used as an educational intervention to improve the effectiveness of self-application by patients with atopic dermatitis
- 2013
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Ingår i: Journal of dermatological treatment (Print). - : Informa Healthcare. - 0954-6634 .- 1471-1753. ; 24:4, s. 268-271
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of the study was to assess if a fluorescent cream, in a self-application educational session, could increase the effectiveness of cream application in practice and serve as a therapeutic intervention. Methods: 30 adults with atopic dermatitis were enrolled. They applied a fluorescent test cream on two occasions. Effectiveness of application was checked under ultraviolet illumination. At baseline, the patients greased their skin as they normally do. After 2 weeks, the patients were instructed to grease the whole body area. The results were commented on and visualised to the patients on both occasions. Results: At the baseline visit, 29% of the target skin was untreated, and at the follow-up visit after education, this improved to 13.6% (mean values, p andlt; 0.05). Women performed better than men at baseline; however, men performed similar to women at the follow-up visit. Conclusions: The Fluorescent-cream Educational Session (FES) is an educational instrument for therapeutic intervention based on interaction between patient and provider. It includes hard endpoints, that is, visualisation and measurement of treated area, time spend on treatment and amount of cream used.
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