| 1. |
- Gard, G, et al.
(författare)
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Stress and qualification of computer work
- 1989
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Ingår i: Work with display units 89: Selected papers from the second international conference of work with display units (Eds. L Berlinguet, D Berthelette.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 2. |
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| 3. |
- Karlsson, Jan, 1950, et al.
(författare)
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Psychometric properties and factor structure of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. Results from the Swedish Obese Subjects (SOS) study.
- 2000
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Ingår i: International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity. - 0307-0565. ; 24:12, s. 1715-25
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the construct validity of the Three-Factor Eating Questionnaire (TFEQ) in obese men and women. SUBJECTS: A total of 4377 middle-aged, obese subjects in the Swedish Obese Subjects (SOS) study. METHODS: The total sample was randomly split into two data subsets and psychometric testing was performed separately in each sample. Multitrait/multi-item analysis was conducted to test scaling assumptions and factor analysis was used to test the factor structure. Measures of mental well-being (MACL, HAD) were used for testing criterion-based validity. RESULTS: The Cognitive Restraint factor was consistently reproduced and scaling analysis demonstrated strong item-scale discriminant validity, while the item-scale convergent validity was unsatisfactory. The internal structure of the Disinhibition scale was weak. Most Disinhibition and Hunger items grouped in one global factor labeled Uncontrolled Eating. A third cluster containing items on Emotional Eating was also identified. The obtained three-factor structure was cross-validated and replicated across subgroups by gender, age and BMI. CONCLUSION: The original TFEQ factor structure was not replicated. A short, revised 18-item instrument was constructed, representing the derived factors of Cognitive Restraint, Uncontrolled Eating and Emotional Eating. The most efficient items were used to boost both the convergent and discriminant validity of the scales.
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| 4. |
- Nilsson, Madeleine, et al.
(författare)
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The perceived threat of the risk for graft rejection and health-related quality of life among organ transplant recipients
- 2011
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:1-2, s. 274-282
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Tidskriftsartikel (refereegranskat)abstract
- Aims. This study was primarily aimed for developing and testing a valid and reliable instrument that measures perceived threat of the risk for graft rejection after organ transplantation. A second aim was to report descriptive data regarding graft rejection and Health-Related Quality of Life. Background. The most serious risk connected with transplantations besides infection is graft rejection. Design. Non experimental, descriptive involving instrument development and psychometric assessment. Method. Questionnaires about perceived threat of the risk for graft rejection and Health-Related Quality of Life were mailed to 229 OTRs between 19-65 years old. The items were formed from a previous interview study. Patients were transplanted with a kidney, a liver or a heart and/or a lung. All patients with follow-up time of one year +/- three months and three years +/- three months were included. Results. With an 81% response rate, the study comprised of 185 OTRs, who had received either a kidney (n = 117), a liver (n = 39) or heart or lung (n = 29). Three homogenous factors of perceived threat for graft rejection were revealed, labelled 'intrusive anxiety', 'graft-related threat' and 'lack of control'. Tests of internal consistency showed good item-scale convergent and discriminatory validity. A majority of the OTRs scored low levels for 'intrusive anxiety'. The kidney transplant recipients experienced more 'graft-related threat' by acute graft rejection than those transplanted with a liver, heart or lung. Conclusion. In conclusion, this study suggests that it is possible to measure the perceived threat of the risk for graft rejection in three homogenous factors. Relevance to clinical practice. The instrument perceived threat of the risk for graft rejection, might be usable to measure the impact of fear of graft rejection, to predict needs of pedagogical intervention strategies to reduce fear and to improve Health-Related Quality of Life related to graft rejection.
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| 5. |
- Rydén, Anna, 1957, et al.
(författare)
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Obesity-related coping and distress and relationship to treatment preference.
- 2001
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Ingår i: The British journal of clinical psychology / the British Psychological Society. - 0144-6657. ; 40:2, s. 177-88
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The primary purpose was to define obesity-related strategies for coping with psychological problems connected with obesity. We also wanted to identify obesity-related distress and explore the effect of coping on distress. Thirdly, we wanted to investigate differences in coping and distress related to choice of surgery or conventional treatment. DESIGN: Cross-sectional data from patients in the Swedish Obese Subjects (SOS) intervention study. METHODS: An obesity-related questionnaire concerning coping and distress was created and evaluated in 2510 patients from the SOS study, using multitrait, exploratory and confirmatory factor analysis procedures. RESULTS: Three coping factors were defined. Social Trust and Fighting Spirit were problem-focused, whereas Wishful Thinking was emotion-focused. Surgical candidates displayed lower levels of problem-focused and higher levels of emotion-focused coping. We also identified two distress factors: Intrusion and Helplessness. Wishful Thinking was positively related to distress, and Social Trust and Fighting Spirit were inversely related, thus explaining the higher levels of distress reported by the surgical candidates. CONCLUSIONS: In our sample, emotion-focused coping proved maladaptive and was associated with increased distress. Problem-focused coping, however, was adaptive and associated with reduced distress. These findings partly explain psychological morbidity and should be taken into consideration in the treatment of obese people.
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| 6. |
- Ahlborg, Tone, 1950, et al.
(författare)
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Assessing the quality of the dyadic relationship in first-time parents: development of a new instrument.
- 2005
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Ingår i: Journal of family nursing. - Thousand Oaks, Calif. : SAGE Publications. - 1074-8407 .- 1552-549X. ; 11:1, s. 19-37
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this research was to psychometrically evaluate the Dyadic Adjustment Scale (DAS), modified for use with new, first-time parents by extending the items of communication, sensuality, and sexuality. A total of 820 Swedish respondents, 6 months after the birth of their first child, participated in the study. Psychometric evaluation was conducted with factor analysis. The obtained factor structure was tested with multitrait analysis program. Thirty-three items were found to fit into a five-factor solution, explaining 50% of the total variance. Descriptive data revealed that most new parents were satisfied with their intimate relationship in general, but dissatisfied with their sexual lives. The modified DAS, now called the Quality of Dyadic Relationship Instrument includes 33 items and seems to be a useful, updated measurement for assessing quality of the intimate relationship in new first-time parents.
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| 7. |
- Alsén, Pia, 1956-, et al.
(författare)
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Fatigue after myocardial infarction : Relationships with indices of emotional distress, and sociodemographic and clinical variables
- 2010
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Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 16:4, s. 326-334
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Tidskriftsartikel (refereegranskat)abstract
- Fatigue and depressive symptoms are relatively common among patients recovering from myocardial infarction (MI). The symptoms of depression and fatigue overlap. The present study aimed at identifying patient fatigue and at examining the incidence of fatigue, particularly without coexisting depression, after MI. The sample comprised 204 consecutive patients who had completed the questionnaires Hospital Anxiety and Depression Scale and the Multidimensional Fatigue Inventory–20 after MI (1 week and 4 months). The results showed that fatigue had decreased after 4 months compared with the time of MI onset. Compared with the general population, patients reported significantly higher levels of fatigue. Furthermore, fatigue was associated with depression, but 33% of the sample reported fatigue without coexisting depression after 4 months. In order to prevent or treat patients' symptoms of fatigue after MI, the concepts of fatigue and depression should be assessed separately so as to exclude overlapping effects.
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| 8. |
- Alsén, Pia, 1956, et al.
(författare)
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Illness perceptions after myocardial infarction: relations to fatigue, emotional distress, and health-related quality of life.
- 2010
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Ingår i: Journal of Cardiovascular Nursing. - 1550-5049. ; 25:2
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Tidskriftsartikel (refereegranskat)abstract
- Background and Research Objective: Health-related quality of life (HRQoL) is impaired in patients after a myocardial infarction (MI), and fatigue and depression are common health complaints among these patients. Patients' own beliefs about their illness (illness perceptions) influence health behavior and health outcomes. The aim of the present study was to examine illness perception and its association with self-reported HRQoL, fatigue, and emotional distress among patients with MI. Subjects and Methods: The sample consisted of 204 patients who had had MI and who completed the questionnaires during the first week in the hospital and 4 months after the MI. The questionnaires used were the Illness Perception Questionnaire, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and the Short Form Health Survey (SF-36). Results: Patient's illness perception changed over time from a more acute to a more chronic perception of illness, and beliefs in personal and treatment control of MI had decreased. Furthermore, these negative beliefs were associated with worse experiences of fatigue and lowered HRQoL. Conclusions: Patients' illness perceptions influence health outcomes after an MI. Supporting MI patients in increasing their perception of personal control could be a primary nursing strategy in rehabilitation programs aimed at facilitating health behavior, decreasing experiences of fatigue, and increasing HRQoL.
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| 9. |
- Alsén, Pia, 1956-, et al.
(författare)
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Living with incomprehensible fatigue after recent myocardial infarction.
- 2008
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Ingår i: Journal of advanced nursing. - : Wiley. - 1365-2648 .- 0309-2402. ; 64:5, s. 459-68
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This paper is a report of a study of what fatigue means to patients with recent myocardial infarction (MI) and how they manage to deal with the consequences of this symptom. BACKGROUND: After MI, fatigue is a frequent and distressing symptom. In nursing practice and in everyday conversations, the term 'tiredness' has a broad meaning that is often used synonymously with fatigue. Fatigue may be defined as a state along an adaptation continuum with tiredness and exhaustion as distinct states at the ends of the continuum. METHOD: In accordance with a constructivist grounded theory method, 19 patients were interviewed four months after having a MI. The informants were chosen from a larger sample of patients admitted to a coronary care unit during the period October 2005 to September 2006. FINDINGS: Living with incomprehensible fatigue was identified as the central theme, which described what fatigue meant to patients 4 months after their MI and how they handled it. The core category was labelled incomprehensible fatigue. Two of the categories refer to consequences: being restricted and feeling defeated and one category describes management: fumbling coping strategies. Finally, one category concerns the outcome: moderate relief of fatigue. CONCLUSION: Nursing interventions could focus on identifying and reducing stressors as well as on increasing patients' ability to cope with stressors. Further research should focus on identifying stressors and useful coping strategies after MI, knowledge that could be used to prevent aggravation of fatigue.
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| 10. |
- Alsén, Pia, 1956-, et al.
(författare)
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Patients' illness perception four months after a myocardial infarction.
- 2008
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 17:5A, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: The aim of this study was to explore patients' illness perception of myocardial infarction four months after a myocardial infarction. BACKGROUND: An important task for research on recovery from myocardial infarction is to understand the factors that influence an individual's adherence to secondary preventive strategies. Perceptual, cognitive and motivational factors have been found to influence adherence to a secondary preventive regimen. METHOD: Twenty-five patients were interviewed four months after a myocardial infarction. In accordance with grounded theory methodology, data collection and analysis were carried out simultaneously. RESULTS: The findings can be understood in light of two core categories: 'trust in oneself ' vs. 'trust in others'; belief in one's own efforts to control the illness; and 'illness reasoning', lines of thought about illness identity. In searching for relationships, six categories describing variation in illness perceptions of a myocardial infarction emerged: (i) 'sign of a chronic condition - feasible to influence'; (ii) 'sign of a chronic condition - uncontrollable'; (iii) 'acute event that can recur - feasible to influence'; (iv) 'acute event that can recur - uncontrollable'; (v) 'unthinkable acute event'; and (vi) 'non-recurring acute event'. CONCLUSION: The more reflective patients perceived the heart attack as a sign of a chronic condition; they also devoted time for reasoning about the possible causes of their illness. This is in contrast to patients who were less reflective and viewed their myocardial infarction as an acute event, which they avoided thinking about. The findings contribute to our understanding of variation in illness perceptions. RELEVANCE TO CLINICAL PRACTICE: The examination of how individuals perceive myocardial infarction may help health-care professionals individualize secondary preventive strategies, thereby improving adherence to health-care regimens. Nurse-patient discussions could begin with identification of the patient's variations of reflectiveness concerning his/her illness.
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| 11. |
- Andersson, Inger, 1964, et al.
(författare)
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Health-related quality of life in patients undergoing allogeneic stem cell
- 2009
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Ingår i: Cancer Nursing. - 0162-220X. ; 32:4
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this prospective study was to describe health-related quality of life (HRQOL) in patients during the first year after stem cell transplantation (SCT) who were undergoing reduced intensive conditioning (RIC) compared with patients undergoing myeloablative conditioning (MAC). Fifty-seven patients (25 for MAC and 32 for RIC) were enrolled in the study. HRQOL was assessed at 6 occasions during the first year after SCT using European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and the 19-item treatment-specific module High-Dose Chemotherapy. Both groups reported most symptoms and worst functioning 1 month after SCT, but there were substantial differences. The MAC group deteriorated considerably in 20 symptom scales compared with 8 in the RIC group (score differences <10; P values ranged from .001 to .05). Dry mouth, sore mouth, appetite loss, and change of taste were among the most frequent symptoms in both groups. Thereafter, the functioning improved and the symptom scores decreased and returned to baseline in both groups, except dry mouth, which remained a worse problem for the MAC group. Overall, the RIC group regained health and QOL faster than the MAC group did. However, there were no significant differences in global QOL between the groups 1 year after SCT.
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| 12. |
- Andersson, Inger, 1964, et al.
(författare)
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Health related quality of life in stem cell transplantation: clinical and psychometric validation of the questionnaire module, High Dose Chemotherapy (HDC-19).
- 2008
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 47:2, s. 275-85
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to assess the psychometric properties of the HDC-19, a module questionnaire for assessing symptoms and problems of patients undergoing stem cell transplantation (SCT) following high-dose chemotherapy (HDC). It consists of 19 questions and was developed for use in conjunction with EORTC QLQ-C30. Psychometric evaluations were performed according to guidelines recommended by the EORTC. The principal component analyses suggested that nine of the HDC-19 items could be reduced to four components (sexual functioning, future health perspectives, skin irritations and joint/muscle pain). Multitrait scaling analysis showed that most item-scale correlation coefficients met the standards of convergent (>0.40) and discriminant validity. Test-retest reliability coefficients between assessments at inclusion and admission were high, indicating that perceived health status remained virtually unchanged during this period. As expected, correlations between admission and one month after transplantation were considerably lower. The internal consistency of the multi-item scales was also satisfactory, (Cronbach's alpha 0.59-0.87). Overall, the known-groups comparisons showed smaller differences between designated groups than expected. As expected, changes in the HDC-19 mirrored changes in QLQ-C30 'global quality of life'. These results lend support to the validity of the HDC-19 as a supplementary questionnaire for assessing specific health-related quality of life (HRQOL) issues relevant for SCT patients.
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| 13. |
- Andersson, Inger, 1964, et al.
(författare)
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Patients' perception of health-related quality of life during the first year after autologous and allogeneic stem cell transplantation.
- 2011
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Ingår i: European journal of cancer care. - : Hindawi Limited. - 1365-2354 .- 0961-5423. ; 20:3, s. 368-379
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Tidskriftsartikel (refereegranskat)abstract
- Little attention has been paid to examine health-related quality of life (HRQoL) the first year post-transplant, despite that this period is crucial for returning to normal life and functioning and to prevent delayed psychosocial adjustment. The purpose of the present study was to describe HRQoL after autologous versus allogeneic stem cell transplantations during the first year post-transplant. The allogeneic group was further divided into two groups: allogeneic stem cell transplantation after reduced intensive conditioning and allogeneic stem cell transplantation after myeloablative conditioning. All together 202 patients were enrolled in the study. HRQoL was assessed by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the treatment-specific module High-Dose Chemotherapy (HDC-19). The questionnaires were filled out at six occasions (from inclusion to 12 months after transplantation). The reduced intensive conditioning group seemed to recover in the same way as the autologous group and these two groups were closer in their scoring compared with the myeloablative conditioning group. One month after the transplantation there were no significant differences in change scores between the autologous and reduced intensive conditioning group, and 1 year after the transplantation levels of symptoms and functioning were back to baseline or better. The myeloablative conditioning group, who perceived more symptoms and lower levels of functioning during the whole period, was still impaired in 10 out of 29 scales 1 year after the transplantation and no significant improvements compared with baseline were observed for this group.
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| 14. |
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| 15. |
- Bergh, Anne-Louise, et al.
(författare)
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Psychometric properties of the Swedish version of the Well-Being Questionnaire in a sample of patients with diabetes type 1.
- 2000
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Ingår i: Scandinavian journal of public health. - : Sage Publications Ltd.. - 1403-4948 .- 1651-1905. ; 28:2, s. 137-45
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the present investigation was to further test the psychometric properties of a Swedish version of the Well-Being Questionnaire (WBQ) in order to determine whether it could be suitable for measuring health-related quality of life among type 1 diabetic patients. METHODS: In total, 94 patients who fulfilled the inclusion criteria were selected for the study and of these 85% participated. Reliability was tested with Cronbach's alpha coefficient and the internal validity by means of principal component analysis and multitrait analysis. To test the external validity, comparisons were made with two other questionnaires, the Short form-36 and a Swedish Mood Adjective Check List. RESULTS: The results show that, above all, the Swedish version of the WBQ measures psychological well-being, and thus must also be complemented with scales that measure other consequences of the illness and/or treatment, i.e. physical symptoms. The questionnaire has low discriminatory validity between subscales, which casts doubt on the appropriateness of using the four subscales as separate measures. The two scales measuring anxiety and depression are not sensitive enough for use among type 1 diabetics without complications and high or normal levels of psychological well-being. CONCLUSIONS: The Well-Being Questionnaire alone does not give any more information about subjective health status among type 1 diabetic patients than, for example, the generic SF-36.
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| 16. |
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| 17. |
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| 18. |
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| 19. |
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| 20. |
- Brink, Eva, 1952-, et al.
(författare)
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Coping with myocardial infarction : Evaluation of a coping questionnaire
- 2009
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 23:4, s. 792-800
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Tidskriftsartikel (refereegranskat)abstract
- Coping with myocardial infarction: evaluation of a coping questionnaire The negative effects of emotional distress on the recovery following myocardial infarction make it important to study coping strategies in this situation. The present study aimed to evaluate the psychometric properties and the validity of a 10 dimensions questionnaire labelled The General Coping Questionnaire (GCQ). The structure of the questionnaire was based on a previous interview study with 26 persons with different diseases. The 10 dimensions are called self-trust, problem-reducing actions, change of values, social trust, minimization, fatalism, resignation, protest, isolation and intrusion. The present study comprised 114 first-time myocardial infarction patients (37 women, 77 men). Five months after myocardial infarction, they answered questions about health-related quality of life, health complaints, sense of coherence and the GCQ. A multi-trait/multi-item analysis showed good item-scale convergent and discriminatory validity when the GCQ was reduced from 47 to 40 items. In conclusion, the results showed that the 40-item GCQ is a well-structured and reliable questionnaire for measuring coping strategies in myocardial infarction patients.
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| 21. |
- Browall, Maria, et al.
(författare)
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Daily assessment of stressful events and coping among post-menopausal women with breast cancer treated with adjuvant chemotherapy : Original article
- 2009
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Ingår i: European Journal of Cancer Care. - : John Wiley & Sons. - 0961-5423 .- 1365-2354. ; 18:5, s. 507-516
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was twofold: to examine what type of daily stressful events post-menopausal woman with breast cancer experience during adjuvant chemotherapy and how bothersome these are and to identify coping strategies used by these women used to manage such stressful events. The patient group comprised 75 consecutively invited women (≥55 years of age) at two university hospitals and one county hospital in Sweden. The Daily Coping Assessment was used to collect data over time. Data were analysed both qualitatively and quantitatively. Six categories of stressful events were identified: 'nausea and vomiting', 'fatigue', 'other symptoms', 'isolation and alienation', 'fear of the unknown' and 'being controlled by the treatment'. The first three categories were subsumed under the domain physical problems and the latter three under psychosocial problems. Almost 30% of the diary entries recorded no stressful event. Physical problems were three times as frequent as psychosocial problems. 'Nausea/vomiting' was the most frequently observed stressful event (21.6%). 'Isolation and alienation' and 'fear of the unknown' were less frequent, but when they occurred they were rated as the most distressing. Several coping strategies were used to manage each stressful event. The most common strategies were acceptance, relaxation and distraction. Religion was rarely used as a coping strategy.
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| 22. |
- Browall, Maria, et al.
(författare)
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Health-related quality of life during adjuvant treatment for breast cancer among postmenopausal women
- 2008
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Ingår i: European Journal of Oncology Nursing. - : Elsevier. - 1462-3889 .- 1532-2122. ; 12:3, s. 180-189
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the present study was twofold: first, to describe changes of Health-Related Quality of Life (HRQoL) during the adjuvant treatment among postmenopausal women with breast cancer; second, in the same population to identify the best predictors of Overall Quality of Life (QoL) after treatment, from perceived functioning, symptoms, emotional distress and clinical/demographic variables measured at baseline. The study group was 150 women (>= 55 years of age) scheduled for adjuvant chemotherapy (CT, n=75) or radiotherapy (RT, n=75). They were examined before (baseline), during and after completing the treatment. Data about QoL, perceived functioning, symptoms and emotional distress were collected with the European Organisation for Research and Treatment of Cancer (EORTC)-QLQ-C30, BR23 and Hospital Anxiety and Depression Scale (HADS) questionnaires. The general finding was that the adjuvant treatments were associated with decrease in overall QoL, physical and role functioning, anxiety and body image, as well as with increase in fatigue, dyspnoea, pain, nausea/vomiting, constipation and systemic therapy side effects measured over time. For women receiving CT, better emotional functioning and less pain at baseline predicted better overall QoL at the end of the treatment. For women receiving RT, better physical and emotional functioning, less breast symptoms and lower tumour stage at baseline predicted better overall QoL at the end of the treatment.
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| 23. |
- Browall, Maria, et al.
(författare)
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Patient-reported stressful events and coping strategies in post-menopausal women with breast cancer
- 2016
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Ingår i: European Journal of Cancer Care. - : Hindawi Limited. - 0961-5423 .- 1365-2354. ; 25:2, s. 324-333
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this paper was to explore what stressful events post-menopausal women with primary or recurrent breast cancer experience, how bothersome these events were and which coping strategies these women used. Data were collected from 131 patients diagnosed with primary or recurrent breast cancer. The Daily Coping Assessment was used. Thematic analysis was applied to form themes of stressful events. Six types of stressful events were extracted. The most frequently experienced events for women with primary cancer and those with recurrent cancer were distressing bodily symptoms'. The most bothersome event among primary cancer was everyday concerns' and in the recurrent group, distressing psychological reactions'. The most commonly used strategies were acceptance', distraction' and relaxation'. This study shows that women in different parts of the cancer trajectory differ in what they perceive to be stressful events when reporting them in their own words in a diary. The differences have an impact on the subsequent coping strategies they used.
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| 24. |
- Browall, Maria, 1963, et al.
(författare)
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The impact of age on Health-Related Quality of Life (HRQoL) and symptoms among postmenopausal women with breast cancer receiving adjuvant chemotherapy.
- 2008
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Ingår i: Acta oncologica (Stockholm, Sweden). - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 47:2, s. 207-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Elderly women with breast cancer are often not given adjuvant chemotherapy (CT). One reason for this is that older women are believed to have more problems in tolerating side-effects of CT. The purpose of this study was to analyze the impact of age on health related quality of life (HRQoL) and symptoms in postmenopausal women with breast cancer undergoing adjuvant CT. PATIENTS AND METHODS: Eighty consecutive postmenopausal patients planned for CT were invited. Seventy-five agreed to participate (age 55-77 years). The patients completed two cancer-specific HRQoL questionnaires, The European Organisation for Research and Treatment of cancer (EORTC) EORTC-QLQ-C30, the EORTC-QLQ-BR23, and the Hospital Anxiety and Depression Scale (HADS) before, during, and 4 months after completion of treatment. The design was descriptional and longitudinal. Correlations were examined between age and change in HRQoL variables. RESULTS: No significant correlations were found between age and any of the assessed HRQoL domains or symptom scales, except for dyspnoea and sexual functioning. Age was inversely correlated to change in dyspnoea from baseline through follow-up, whereas older women perceived their sexual functioning significantly lower at baseline. CONCLUSION: The results indicate that among postmenopausal patients in the age range 55-77 years consecutively selected for adjuvant CT age was not a predictor of decreased HRQoL. This supports the argument that age should not be used in isolation in decisions about adjuvant CT for breast cancer in elderly women.
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| 25. |
- Elfström, Magnus L., et al.
(författare)
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General and condition-specific measures of coping strategies in persons with spinal cord lesion.
- 2005
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Ingår i: Psychology, Health & Medicine. - : Informa UK Limited. - 1354-8506 .- 1465-3966. ; 10:3, s. 231-242
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Tidskriftsartikel (refereegranskat)abstract
- We examined psychometric properties and validity of a general (Ways of Coping Questionnaire; WCQ) and a condition-specific (Spinal Cord Lesion-related Coping Strategies Questionnaire; SCL CSQ) measure of coping strategies. The sample included 181 community-residing traumatically spinal cord lesioned persons aged 16-85 years. Multi-trait/multi-item analysis, confirmatory factor analysis and multiple regression were used. Reliability and validity estimates were acceptable in most instances for the SCL CSQ, whereas the validity of the WCQ was inadequate. The SCL CSQ showed a significant relationship with the overall quality of life outcome measure, whereas the WCQ did not. We recommend condition-specific measures of coping strategies, and that the combination with coping style measures be tested in medical populations.
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| 26. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Functional status and well being in chronic obstructive pulmonary disease with regard to clinical parameters and smoking: a descriptive and comparative study.
- 1996
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Ingår i: Thorax. - 0040-6376. ; 51:8, s. 825-30
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Self-assessment questionnaires which measure the functional and affective consequences of chronic obstructive pulmonary disease (COPD) give valuable information about the effects of the disease and may serve as important tools with which to evaluate treatment. METHODS: A cross sectional comparative study was performed between patients with COPD (n = 68), stratified according to pulmonary function, and a healthy control group (n = 89). A battery of well established clinical and quality of life measures (the Sickness Impact Profile (SIP), Mood Adjective Check List (MACL), and Hospital Anxiety and Depression scale (HAD)) was used to examine in which functional and affective aspects the patient group differed from the control group and how these measures related to pulmonary function and smoking habits. RESULTS: Compared with the controls, COPD affected functional status in most areas, not just those requiring physical activity. Forty six patients with forced expiratory volume in one second (FEV1) below 50% predicted showed particularly high levels of dysfunction in ambulation, eating, home management, and recreation/ pastimes (SIP). Despite this, their level of psychosocial functioning and mood status was little different from that of the healthy controls. Among the patients, a subgroup reported substantial psychological distress, but mood status was only weakly, or not at all, related to pulmonary function. Smoking habits did not affect functional status or well being. CONCLUSIONS: Quality of life is not significantly affected in patients with mild to moderate loss of pulmonary function, possibly due to coping and/or pulmonary reserve capacity. This suggests that generic self-assessment questionnaires are of limited value for detecting the early consequences of COPD. However, in later stages of the disease they are sensitive enough to discriminate between patients with different levels of pulmonary dysfunction. The low correlations between the indices of pulmonary function and the indices of affective status suggest that well being depends, to a large extent, on factors outside the clinical domain.
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| 27. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Health-related quality of life in COPD: why both disease-specific and generic measures should be used.
- 2001
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Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - 0903-1936. ; 18:1, s. 69-76
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Tidskriftsartikel (refereegranskat)abstract
- Although research has consistently demonstrated that chronic obstructive pulmonary disease (COPD) impairs health-related quality of life (HRQL), little agreement has been evidenced regarding the factors identified as contributing to impaired HRQL. The aim was to study such factors using well established generic and specific HRQL instruments. The patients (n=68) were stratified by forced expiratory volume in one second (FEV1) to represent a wide range of disease severity. Pulmonary function, blood gases and 6-min walking distance test (6MWD) were assessed. HRQL instruments included: St George's Respiratory Questionnaire (SGRQ), Sickness Impact Profile (SIP), Hospital Anxiety and Depression Scale and Mood Adjective Check List. The strength of the impact of COPD on HRQL was represented along a continuum ranging from lung function, functional status (physical and psychosocial) to wellbeing. Although correlations between FEV1 versus SGRQ total and SIP overall scores (r=-0.42 and -0.32) were stronger than previously reported, multiple regression analyses showed that lung function contributed little to the variance when dyspnoea-related limitation, depression scores and 6MWD were included in the models. These three factors were important to varying degrees along the whole range of HRQL. Physiological, functional and psychosocial consequences of chronic obstructive pulmonary disease are only poorly to moderately related to each other. The present study concludes that a comprehensive assessment of the effects of chronic obstructive pulmonary disease requires a battery of instruments that not only tap the disease-specific effects, but also the overall burden of the disease on everyday functioning and emotional wellbeing.
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| 28. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Long-term effects of a pulmonary rehabilitation programme in outpatients with chronic obstructive pulmonary disease: a randomized controlled study.
- 1999
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Ingår i: Scandinavian journal of rehabilitation medicine. - 0036-5505. ; 31:4, s. 207-13
-
Tidskriftsartikel (refereegranskat)abstract
- Fifty patients with severe chronic obstructive pulmonary disease (FEV1 < 50% pred.) were randomized to a rehabilitation group and a control group. The rehabilitation group took part in an individualized multidisciplinary, outpatient 12-month rehabilitation programme. Exercise training was intensive during the first 6 weeks and was then gradually replaced by an individual home-training programme and booster sessions. Controls received the usual outpatient care. Positive effects were found in terms of maximum symptom-limited exercise tolerance and walking distance (13.5 and 12.1% increase, respectively) in the rehabilitation group compared with the controls. Quality of life measurements showed minor beneficial effects on the Sickness Impact Profile, indicating a higher level of activity. No effect was seen on the St George's Respiratory Questionnaire or the Mood Adjective Check List. Patients expressed their enthusiasm for the rehabilitation programme in a study-specific questionnaire.
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| 29. |
- Engström, Carl-Peter, 1945, et al.
(författare)
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Reliability and validity of a Swedish version of the St George's Respiratory Questionnaire.
- 1998
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Ingår i: The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology. - 0903-1936. ; 11:1, s. 61-6
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Tidskriftsartikel (refereegranskat)abstract
- The St George's Respiratory Questionnaire (SGRQ) was designed to measure quality of life (QoL) in obstructive pulmonary disease. Its reliability, validity and sensitivity have been demonstrated. The aim was to develop a Swedish version of the SGRQ and to confirm its scaling and clinical properties. The SGRQ was adapted for Swedish conditions following a translation-backtranslation procedure. The psychometric and clinical evaluation included 68 patients with chronic obstructive pulmonary disease (COPD). Supplementary QoL, clinical and physiological data were collected. A follow-up study was performed 1 yr later. Correlation analysis used a multitrait-multimethod model. Internal consistency reliability and discriminant validity were documented by performing a multitrait analysis. The results confirmed expected levels of associations. Correlation coefficients between the SGRQ total score and the Sickness Impact Profile Total score (a generic health measure), forced expiratory volume in one second (FEV1) and 6 min walking distance were 0.69, -0.42 and -0.61 respectively. The pattern of correlations in the Swedish data set was very similar to that of the original. The stability of the SGRQ scores was confirmed at follow-up after 1 yr. The reliability was satisfactory, with Cronbach's alpha coefficients >0.80 for the SGRQ and its subdimensions. In conclusion, the Swedish version of the St George's Respiratory Questionnaire is reliable, valid and compares well with the corresponding tests of the original version.
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| 30. |
- Falk, Hanna, 1977, et al.
(författare)
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A psychometric evaluation of a Swedish version of the Quality of Life in Late-Stage Dementia (QUALID) scale.
- 2007
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Ingår i: International psychogeriatrics / IPA. - 1041-6102 .- 1741-203X. ; 19:6, s. 1040-50
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of the present study was to evaluate the validity, reliability and responsiveness of a Swedish translation of the Quality of Life in Late-Stage Dementia (QUALID) Scale. METHOD: A total of 169 elderly residents at 19 dementia special care units in eight long-term care facilities in the Gothenburg city region participated in the study. Assessments were made by 107 proxy informants. RESULTS: Results showed satisfactory levels of internal consistency reliability (Cronbach's alpha coefficients 0.74), acceptable inter-rater reliability between informants (0.69), and high test-retest reliability (0.86). As hypothesized, QUALID scores were also associated with those from other quality-of-life (QoL) indices (criterion validity), as well as with use of psychoactive drugs, and with tests of cognitive impairment (clinical validity). The responsiveness of the questionnaire was also acceptable. CONCLUSIONS: As important clinical decisions may derive from perceived QoL effects, it is vital that the QoL data be reliable, valid and sensitive to change. Our evaluations of the psychometric properties of the Swedish QUALID indicate that it satisfactorily meets the need for an instrument to assess QoL in late-stage dementia in Sweden, in a wide range of settings and applications.
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| 31. |
- Falk, Hanna, 1977, et al.
(författare)
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A sense of home in residential care
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 27:4, s. 999-1009
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Tidskriftsartikel (refereegranskat)abstract
- Moving into a residential care facility requires a great deal of adjustment to an environment and lifestyle entirely different from that of one's previous life. Attachment to place is believed to help create a sense of home and maintain self-identity, supporting successful adjustment to contingencies of ageing. The purpose of this study was to deepen our understanding of processes and strategies by which older people create a sense of home in residential care. Our findings show that a sense of home in residential care involves strategies related to three dimensions of the environment – attachment to place, to space and attachment beyond the institution – and that the circumstances under which older people manage or fail in creating attachment, consist of psychosocial processes involving both individual and shared attitudes and beliefs. Assuming that attachment is important to human existence regardless of age, attention must be paid to optimize the circumstances under which attachment is created in residential care, and how nursing interventions can help speed up this process due to the frail and vulnerable state of most older residents.
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| 32. |
- Falk, Hanna, 1977, et al.
(författare)
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Frail Older Persons' Experiences of Interinstitutional Relocation
- 2011
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Ingår i: Geriatric Nursing. - : Elsevier BV. - 0197-4572 .- 1528-3984. ; 32:4, s. 245-256
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Tidskriftsartikel (refereegranskat)abstract
- This study examined the effects and experiences of an interinstitutional relocation on older persons' quality of life, wellbeing, and perceived person-centeredness. A pre-test/post-test mixed method design, with an equivalent reference group, was used to examine relationships between variables and to explore personal meaning. Results indicate a significantly larger deterioration in perceived person centeredness among those cognitively intact residents that moved compared to the non-movers. Interviews with moving residents revealed that the relocation was experienced as uncontrollable, un-affectable, and uncertain. However, no significant relocation effects were found from the proxy ratings of the cognitively impaired residents. Nursing interventions that involve, inform, and prepare older persons prior to interinstitutional relocation to enhance their sense of control of the move might minimize adverse relocation effects. Further research is needed on the effects of interinstitutional relocations, which procedures that should be used, as well as effects of preparatory interventions.
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| 33. |
- Falk, Hanna, 1977, et al.
(författare)
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The effects of refurbishment on residents’ quality of life and wellbeing in two Swedish nursing homes
- 2009
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Ingår i: Health & Place. - : Elsevier BV. - 1353-8292. ; 15:3, s. 717-724
-
Tidskriftsartikel (refereegranskat)abstract
- This study was conducted to follow a refurbishment aimed at enhancing the supportiveness of the physical environment in two Swedish nursing homes. Significant differences between intervention and equivalent reference groups were found for quality of life (p= 0.007) and wellbeing (p= 0.02, p= 0.01) indicating a deterioration for the intervention group. These results suggest that nursing home residents are more frail and sensitive to change than has been assumed. This needs to be considered when facilities accommodating the elderly need refurbishment. It also indicates that interior design features alone have little importance for the care climate in nursing homes. Key words; Supportive physical environment, nursing home, elderly, quality of life, wellbeing
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| 34. |
- Flodén, Anne, 1957, et al.
(författare)
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Attitudes to organ donation among Swedish ICU nurses.
- 2011
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Ingår i: Journal of clinical nursing. - : Wiley. - 1365-2702 .- 0962-1067. ; 20:21-22, s. 3183-95
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Tidskriftsartikel (refereegranskat)abstract
- To present data on Swedish ICU nurses' attitudes to brain death and organ donation and to test a questionnaire designed to explore these issues in terms of validity and reliability.
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| 35. |
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| 36. |
- Gething, Lindsay, et al.
(författare)
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Validation of the Reactions to Ageing Questionnaire: assessing similarities across several countries.
- 2004
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Ingår i: Journal of gerontological nursing. - 0098-9134. ; 30:9, s. 47-54
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Tidskriftsartikel (refereegranskat)abstract
- With the increasing numbers of older adults, factors impacting the effectiveness of provision of health care must be addressed. The literature suggests attitudes, particularly those of nurses, impact health service provision. This article reports the outcome of a multicountry validation study of the Reactions to Ageing Questionnaire (RAQ). The RAQ measures attitudes toward personal aging and has been used in Australia for 5 years. This study was designed to determine whether the psychometric characteristics and norms of the RAQ identified for Australian nurses also apply to nursing samples in Sweden and the United Kingdom. Findings indicate the internal structure of the RAQ extends outside Australia, with similar factors appearing across the three countries. Ranges and standard deviations indicate the instrument is able to discriminate between respondents within each country. Cronbach's alpha coefficients were consistent across countries and fell in the moderately high range. The findings indicate the RAQ has many potential applications in attitude assessment and in providing direction for training designed to address attitudinal factors that may impact the effectiveness of nursing practice for older adults.
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| 37. |
- Gustafsson, Margareta, 1952-, et al.
(författare)
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A qualitative study of coping in the early stage of acute traumatic hand injury.
- 2002
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Ingår i: Journal of clinical nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 11:5, s. 594-602
-
Tidskriftsartikel (refereegranskat)abstract
- Twenty patients with acute traumatic hand injury were interviewed 8-20 days after the day of the accident. The aim of the study was to identify coping strategies, defined as thoughts or actions used by the hand-injured patients to manage stress factors and resulting emotions in the early stage. Stress factors were reported in an earlier study. The analyses of the interviews followed the first steps in the analytical process described in a modified model of grounded theory. Eleven different coping strategies were identified in the interviews. By "comparing with something worse", "positive thinking", "relying on personal capacity", "distancing" and "distracting attention" the patients tried to play down the seriousness of the problem or situation. Other coping strategies used by the hand-injured were "accepting the situation", "seeking social support", "maintaining control", "solving practical problems by oneself", "pain-relieving actions" and "active processing of the trauma experience." The findings of the study show how important it is to identify the patient's own way of coping with a stressful illness situation in order to give adequate psychosocial support.
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| 38. |
- Gustafsson, Margareta, 1952-, et al.
(författare)
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A qualitative study of stress factors in the early stage of acute traumatic hand injury.
- 2000
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Ingår i: Journal of advanced nursing. - Oxford : Blackwell Science. - 0309-2402 .- 1365-2648. ; 32:6, s. 1333-40
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study reported in this paper was to identify stress factors in the early stage of acute traumatic hand injury. Stress factors were defined as circumstances which the hand-injured patients experienced as problems in the actual situation. A total of 20 patients, treated as inpatients at the Department of Hand Surgery in Orebro Medical Centre Hospital, Sweden, were interviewed 8-20 days after the day of the accident. The analyses of the interviews followed the first step in the analytical process described in a modified model of grounded theory. The trauma experience was one of the stress factors in the early stage. Single acute traumatic stress symptoms, mostly involuntary recollection and re-experience of the trauma, were found in a fourth of the hand-injured patients. All patients reported impaired functioning caused by their hand, irrespective of injury. Practical problems with daily activities and being dependent on help from others for solving practical problems were stress factors caused by functional impairment. Before the accident most of the hand-injured had been very active, also working a lot with their hands in their leisure-time. Involuntary inactivity was a big problem for some of them. Other stress factors in the early stage were uncertainty about function in the future and pain. The appearance of the hand was a minor problem before the first follow-up visit. Probably because the hand was hidden in a bandage. However, some hand-injured felt discomfort in seeing the hand when the dressing was changed at the first follow-up visit.
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| 39. |
- Hammerlid, Eva, 1957, et al.
(författare)
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Quality-of-life effects of psychosocial intervention in patients with head and neck cancer.
- 1999
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Ingår i: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery. - 0194-5998. ; 120:4, s. 507-16
-
Tidskriftsartikel (refereegranskat)abstract
- METHODS: Two studies of psychosocial interventions in head and neck cancer patients at different stages of their disease were performed. We explored the feasibility and effectiveness of different approaches, offered for the first time to this population. The first study concerned long-term group psychological therapy for patients with newly diagnosed head and neck cancer. Quality of life was measured longitudinally for 1 year and compared with that of a control group. The second study comprised a short-term psychoeducational program 1 year after treatment for head and neck cancer. Quality-of-life assessments were made repeatedly from diagnosis until 1 month after the intervention. RESULTS: Thirteen patients started the psychological group therapy, and 8 of them completed both the intervention and evaluation procedure. The quality of life of the therapy group improved more than that of a control group in most areas measured during the study year, in particular psychiatric morbidity, social functioning, emotional functioning, and global quality of life. The results indicate benefits from the therapy, although the therapy group scored worse than the control group at diagnosis. Most of the variables representing functioning and symptoms improved after the 1-week psychoeducational program, especially items reflecting "trouble eating" and "problems enjoying your meals." Patients' judgments of the intervention quality indicated satisfaction with all separate elements, mostly education, about cancer and the opportunity to socialize with the other guests. CONCLUSION: These pilot studies suggest that head and neck cancer patients can benefit from different psychosocial interventions. Quality-of-life questionnaires were well accepted and sensitive to changes during the studies. Thus our early findings seem promising and would justify confirmation in larger studies.
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| 40. |
- Jakobsson, Eva, 1960, et al.
(författare)
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End-of-life in a Swedish population: demographics, social conditions and characteristics of places of death.
- 2006
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Ingår i: Scandinavian journal of caring sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 20:1, s. 10-7
-
Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to identify and describe the demographics and social conditions as well as characteristics of the places of death in a randomly selected sample that died in a county in Sweden during 2001. The present study reports part of the findings from a larger study undertaken during 2003 using a survey design of retrospective reviews of death certificates, medical records, and nursing records. Among several noteworthy findings are: first, an examination of these individuals' living arrangements reveal not only a large and vulnerable group that lives alone at the end-of-life but also a group living separated from their partners near end-of-life; second, individuals differ with respect to residence prior to death, that is private homes versus residential care facilities, imparting highly different contexts of care at the end-of-life; and third, a high prevalence of institutionalized deaths demonstrates that places of death other than hospitals and residential care facilities are uncommon, if not rare. It is concluded that increased attention to the social circumstances of the time period surrounding individuals' at the end-of-life is essential. There is need to develop more integrated models of care for dying people. Contemporary services available are not designed to meet a wide range of peoples' needs at the end-of-life. Home-based care, residential care and hospital care must be adapted to the changing patterns of dying. The services available should be organized to the benefit of the users rather than around the providers. This is the first study of its kind of a Swedish sample and while the data are limited to one county in Sweden its findings may contribute to a deeper understanding of demographic and social patterns at the end-of-life in general.
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| 41. |
- Kenne Sarenmalm, Elisabeth, 1956, et al.
(författare)
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Relationship of sense of coherence to stressful events, coping strategies, health status, and quality of life in women with breast cancer
- 2013
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Ingår i: Psycho-Oncology. - : John Wiley & Sons. - 1057-9249 .- 1099-1611. ; 22:1, s. 20-27
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: To test the hypothesis that Antonovsky's concept of sense of coherence (SOC) predicts stressful events, coping strategies, health status, and quality of life (QoL) in a cohort of postmenopausal women (n = 131) with newly diagnosed primary or recurrent breast cancer.Methods: Regression analyses of longitudinal data at baseline through 6 months following breast cancer diagnosis examined the relationships between SOC (13-item version), daily assessment of coping with stressful events, health status, and QoL (EORTC QLQ-30).Results: The findings support Antonovsky's concept of SOC. Women with strong SOC reported fewer stressful events and more days without stressful events. They used more coping strategies and more frequently used distraction, situation redefinition, direct action, and relaxation, but seldom religion, to cope with stressful events, and reported better health status and QoL. Women with weak SOC experienced more distress and used fewer coping strategies, and they more frequently used coping strategies such as catharsis and seeking social and spiritual support, but seldom acceptance of the situation. They reported worse health status and QoL, regardless of disease stage or treatment. The relationships between SOC and health status and QoL were linear.Conclusions: Sense of coherence significantly predicts distress, number and type of coping strategies such as direct action and relaxation, health status, and QoL in women with breast cancer. Our data suggest that the SOC scale may be a useful screening tool to identify individuals particularly vulnerable to distress and unable to cope adequately. Assessing SOC strength may assist health care providers to provide individualized patient interventions.
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| 42. |
- Lindberg, Jeanette, 1987, et al.
(författare)
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Family Members’ Perspectives on Patient Participation in Spinal Cord Injury Rehabilitation
- 2014
-
Ingår i: International Journal of Physical Medicine & Rehabilitation. - 2329-9096. ; 2:5, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine the importance and experiences of patient participation in spinal cord injury (SCI) rehabilitation from the perspective of family members, and compared with patients’ views. Method: Family members (N=83) and discharged patients with SCI (N=141) completed the Patient Participation in Rehabilitation Questionnaire (PPRQ), assessing the importance and experiences of the domains Respect and integrity; Planning and decision-making; Information and knowledge; Motivation and encouragement; and Involvement of family. Importance ratings were compared between all family members and patients, and experience ratings were compared between patient-family dyads (N=74). Results: Both family members and patients rated all participation domains as very or extremely important (m ≥4.0 of max 5). Family members rated all domains as slightly more important than did patients; however, patients rated Planning and decision-making more important that the family members (Δ=0.20; p<0.01). No significant differences were found between patients and family members regarding experience ratings and agreement was substantial (ICC=0.63-0.80). Conclusions: Current guidelines recommend involvement of family members in SCI care and rehabilitation. This study shows that family members, and patients alike, also considered their involvement as very important and that they were often given opportunities to be involved. Moreover, patients and family members shared perceptions of conditions necessary for facilitating and promoting participation. Although considerable congruence was found between family members’ and patients’ assessments, agreement was not perfect. As incongruence between patients and family members regarding the quality and delivery of care may disturb the rehabilitation process and its outcomes, it is important that differences in perspectives be identified and successfully resolved. The PPRQ may be useful in assessing patients’ and family members’ views of patient participation and in detecting disparities between them.
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| 43. |
- Lindberg, Jeanette, 1987, et al.
(författare)
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Patient participation in care and rehabilitation from the perspective of patients with spinal cord injury
- 2013
-
Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 51:11, s. 834-7
-
Tidskriftsartikel (refereegranskat)abstract
- Study design:Qualitative method, semi-structured interviews.Objectives:The aim of the study was to explore the meaning of patient participation in care and rehabilitation from the perspective of patients with spinal cord injury (SCI).Setting:Post discharge community setting.Methods:Semi-structured interviews were performed with 10 persons with SCI representing different ages, gender and levels of injury. All interviews were conducted individually and lasted 40-120min. The interviews were verbally transcribed and the data were analyzed by means of content analysis.Results:All informants stressed the importance of patient participation as a necessary prerequisite for successful care and rehabilitation, but emphasized that participation must be tailored to each patient's own preferences, capacities and needs. They also underscored that the staff should be sensitive and responsive to the fact that desired levels and kinds of participation may vary from patient to patient, as well as for the same patient during the course of the rehabilitation. Five themes reflecting central aspects of participation emerged: respect and integrity, planning and decision-making, information and knowledge, motivation and encouragement, and involvement of family.Conclusions:Patient participation is a critical component of successful SCI rehabilitation and must be facilitated, promoted and tailored to each patient by the staff. Based on the finding from this study a questionnaire has been developed for assessing patient experiences of five domains of participation in rehabilitation to serve as a tool to help in evaluating provided care and in identifying patients' preferences for participation
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| 44. |
- Lindberg, Jeanette, 1987, et al.
(författare)
-
Patient Participation in Rehabilitation Questionnaire (PPRQ)-development and psychometric evaluation
- 2013
-
Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 51:11, s. 838-42
-
Tidskriftsartikel (refereegranskat)abstract
- Study design:A cross-sectional postal questionnaire study.Objectives:The aim of the study was to evaluate selected psychometric properties of a draft version of the Patient Participation in Rehabilitation Questionnaire (PPRQ) measuring patients' experiences of participation in care and rehabilitation.Setting:Sweden.Methods:On the basis of previous qualitative analyses of patient interview data, a 32-item questionnaire covering five domains of participation was developed and sent to 268 persons with spinal cord injury, aged 18-80 years and injured 1-12 years previously. In total, 141 (51%) evaluable questionnaires were returned. Multi-trait analysis was used to assess scaling assumptions by testing item convergent and discriminant validity and internal consistency reliability (Cronbach's α) associated with the hypothesized item-scale structure of the questionnaire.Result:Nine items failed to meet scaling assumptions and were omitted. Scaling assumptions were thereafter substantiated for the scales: 'respect and integrity' (6 items); 'planning and decision-making' (4 items); 'information and knowledge' (4 items); 'motivation and encouragement' (5 items); and 'involvement of family' (4 items). Item-scale correlations ranged from 0.67 to 0.85 and most items correlated higher or significantly higher with their hypothesized scale than with other scales. Cronbach's α was 0.89 for all scales.Conclusion:The PPRQ appears to adequately assess central aspects of participation in care and rehabilitation from the perspective of patients with spinal cord injury. Further studies using larger samples will be undertaken to confirm the scale structure as well as the sensitivity and responsiveness of the questionnaire.
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| 45. |
- Lundén, Maud, 1959, et al.
(författare)
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Patients´experiences and feelings before undergoing peripheral transluminal angioplasty
- 2013
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Ingår i: Journal of Vascular Nursing. - : Elsevier BV. - 1062-0303. ; 31:4, s. 158-164
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Tidskriftsartikel (refereegranskat)abstract
- The use of interventional radiology as treatment has increased dramatically and peripheral arterial disease (PAD) is now a common indication for vascular interventions such as percutaneous transluminal angioplasty (PTA).1 PAD seriously impairs quality of life, and patients experience a lack of control over the disease. The aim of this study was to identify patients who are predominantly anxious or calm before PTA treatment and to explore reasons for these feelings. The study includes both individual interviews, a shortened version of a Swedish Mood Adjective Check List (MACL), and an overall assessment of the perceived degree of calmness–anxiety. Forty-two patients were included in the study. The ‘anxious’ group showed a significantly lower mood in all scales of the MACL compared with the ‘calm’ group. Reasons for feeling calm were a sense of being safe and high expectations. Reasons for feeling anxious were represented by a sense of despair and apprehension about the PTA. The main reason for feeling calm was related to trust in their caregivers and an ability to foresee upcoming events. The main reason for feeling anxious before the PTA was fear of a negative outcome and being unsure of treatment options. Greater knowledge and a better understanding of their disease and treatment options would support patients’ ability to accept reasons for waiting before using invasive treatment. Moreover, this could decrease their anxiety and increase their feeling of being in control of their situation.
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| 46. |
- Lundén, Maud, 1959, et al.
(författare)
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Patients' feelings and experiences during and after peripheral percutaneous transluminal angioplasty
- 2015
-
Ingår i: Radiography. - : Elsevier BV. - 1078-8174 .- 1532-2831. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- © 2014 The College of Radiographers. Background: Peripheral Arterial Disease (PAD) often caused by atherosclerosis is a major health care issue worldwide. Percutaneous Transluminal Angioplasty (PTA) on the lower limb is a common procedure used to enhance peripheral circulation. With an increasing number of individuals acquiring peripheral PTA treatment and with an increased focus on patient centred care, there is a need to find out more about patients' feelings and thoughts of undergoing PTA. Aim: The aim was to identify patients who are predominantly anxious or calm during and after peripheral PTA and to explore reasons for these feelings. Method: The study includes 51 patients who received PTA treatment in western Sweden. Findings: Seventy-eight percent of the patients rated themselves as calm after the PTA. The analysed interviews resulted in two themes: reasons for feelings of calmness and reasons for feelings of anxiety. Conclusion: In order to feel calm during and after the PTA, information given prior to the PTA needs to be comprehensive and consistent with the actual situation at the angiography suite. The dialogue with the physician and the radiographers was considered valuable, as was the ability to follow the procedure on the image screen. It is concluded that a thorough dialogue with the physician in a calm setting after the PTA is important for the patients' ability to foresee and plan for the future. Moreover, there is a need to find ways to improve analgesic routines regarding assessment and evaluation in connection with PTA treatment as pain is shown to increase anxiety.
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| 47. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Effects of coping on psychological outcome when controlling for background variables: a study of traumatically spinal cord lesioned persons.
- 2002
-
Ingår i: Spinal cord : the official journal of the International Medical Society of Paraplegia. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 40:8, s. 408-15
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional. OBJECTIVES: In a previous study we found spinal cord lesion (SCL)-related coping factors to be distinctly related to levels of SCL-related psychological outcome. However, we did not control for other potentially confounding variables. In this study we investigated effects of coping strategies on psychological outcome reactions in traumatically spinal cord lesioned persons controlling for sociodemographic, disability-related and social support variables. SETTING: The Gothenburg Spinal Injuries Unit in Sweden. METHODS: The study sample comprised 255 persons and a subsample of 157 persons. A series of stepwise multiple regression analyses were performed. RESULTS: SCL-related coping factors clearly predicted psychological outcome even when background variables were controlled. Higher levels of acceptance coping predicted decreased psychological distress and increased positive morale. Elevated social reliance coping predicted heightened distress. Higher levels of social support predicted lower feelings of helplessness. Sociodemographic and disability-related variables were weak predictors of psychological outcome with one exception: higher education predicted less bitterness and brooding. CONCLUSION: SCL-related coping remained the most important predictor of psychological outcome even when a wide range of variables was controlled. Thus we conclude that psychosocial interventions aimed at helping individuals develop their coping strategies might be of substantial value in their adjustment to SCL.
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| 48. |
- Lundgren Elfström, Magnus, 1971, et al.
(författare)
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Linkages between coping and psychological outcome in the spinal cord lesioned: development of SCL-related measures.
- 2002
-
Ingår i: Spinal cord : the official journal of the International Medical Society of Paraplegia. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 40:1, s. 23-9
-
Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional. OBJECTIVES: To investigate relationships between coping and mental well-being with clinical relevance to spinal cord lesion (SCL). SETTING: The Gothenburg Spinal Injuries Unit in Sweden. METHODS: The study sample comprised 274 persons. From in-depth interviews, literature reviews, and the transactional theory of stress and coping, items reflecting coping and psychological outcome, respectively were generated. Principal components factor analysis, multi-trait analysis, and structural equation modelling were used. RESULTS: The coping scale comprised three factors: Acceptance (i.e. revaluation of life values); Fighting spirit (i.e. efforts to behave independently); Social reliance (i.e. a tendency towards dependent behaviour). The outcome scale included the factors: Helplessness (i.e. feeling perplexed, out of control and low self-esteem); Intrusion (i.e. bitterness and brooding); Personal growth (i.e. positive outcomes of life crisis). Acceptance showed a positive relation to Personal growth and was inversely related to both Helplessness and Intrusion. Fighting spirit had a weak negative association to Helplessness and a weak positive association to Personal growth. Social reliance was positively related to Helplessness and Intrusion. Only Social reliance showed any association to neurological status. Those lesioned 1-4 years reported more Helplessness, Intrusion, Social reliance, and less Acceptance than those lesioned >or=5 years. CONCLUSION: Coping is related to psychological outcome in SCL. Our situational coping measure may be a candidate to assess intervention effects.
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| 49. |
- Melin, Jeanette, et al.
(författare)
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Patient participation from the perspective of staff members working in spinal cord injury rehabilitation
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56:6, s. 614-620
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Tidskriftsartikel (refereegranskat)abstract
- Study design Qualitative method, semi-structured interviews. Objectives The aims of this study were to explore the meaning of patient participation from the perspective of staff members working with spinal cord injury (SCI) rehabilitation, and what they saw as requisites for and constraints to patient participation. Methods Interviews with 13 staff members at a spinal unit were conducted individually and analyzed by means of content analysis. Results One category describing patient participation emerged from the interviews: Patient - a team member. Four categories were extracted as requisites: Communication; information and knowledge; routines; respecting the patient as a unique person; and an open climate. Three categories of constraints were identified: Understaffing and new staff members; patients' inability to grasp information; and structures and fragmented responsibilities. Conclusions The informants were unanimous in stating that the patient is an integral and natural member of the rehabilitation team. Recognizing the person with SCI as a team member acknowledges and endorses the patient as a person with capabilities to participate in his or her rehabilitation. The patient as a person also means that he or she has unique needs and preferences, which the staff members must accommodate. This is also fundamental in a person-centered approach. Therefore, the viewpoints of the informants may be useful for other settings to enhance person centeredness and patient participation.
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- Montgomery, Henry, 1943, et al.
(författare)
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Importance and attainment of life values among disabled and non-disabled people.
- 1996
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Ingår i: Scandinavian journal of rehabilitation medicine. - 0036-5505. ; 28:4, s. 233-40
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Tidskriftsartikel (refereegranskat)abstract
- How do disabled persons evaluate their life situation? To address this issue, importance and attainment ratings of 82 different life values as well as mood ratings were collected from 325 chronically ill and/or disabled persons and 504 non-disabled persons. Both groups largely agreed on what is important in life. The disabled persons, however, gave lower importance ratings on functions related to health and mobility. The attainment and mood ratings were in general slightly lower for the disabled persons. The attainment ratings for health and mobility were markedly lower. The concordance between rated importance and attainment across different life values was positive in both groups. This measure was also positively related to mood in both samples. It was suggested that disabled persons adjust to their life situation by de-emphasizing the importance of the physical functions affected by the disability and through habituation.
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