| 1. |
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| 2. |
- Gellerstedt, Linda, et al.
(författare)
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Nurses' experiences of hospitalised patients' sleep in Sweden : a qualitative study
- 2015
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:23/24, s. 3664-3673
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES:The aim was to describe nurses' experiences of patients' sleep at an emergency hospital and their perceptions of sleep-promoting interventions.BACKGROUND:Promotion of patients' sleep during hospital care is an important intervention for the nursing profession. To promote sleep and to initiate sleep-promoting interventions, nurses need basic knowledge about sleep and its physiology. Therefore, it is of importance to explore and expand knowledge about how nurses experience patients' sleep and how they perceive working with it while providing care.DESIGN:A qualitative descriptive design was used.METHODS:Data were collected from four focus groups and seven individual interviews. A total of twenty-two registered nurses participated. Data were analysed using a qualitative content analysis.RESULTS:Nurses expressed a desire and an ambition to work in ways that promote patients' sleep during hospitalisation. Nurses reported that health care services and emergency hospitals were not organised according to patients' perspective and needs. Furthermore, they did not have opportunities to work effectively to promote sleep according to the patients' wishes. Several nurses stated that they did not have sufficient knowledge about sleep and that they did the best they could under prevailing circumstances. Nurses emphasised the importance of sleep for patients and that it was an area that should be given far greater priority.CONCLUSIONS:The results indicate that nurses currently have insufficient knowledge about sleep and sleep-promoting interventions. These aspects of nursing is based on personal experience and common sense rather than being evidence based. Furthermore, sleep as a nursing topic needs to be developed and given more focus in order for nurses to be able to deliver high quality care at emergency hospitals.RELEVANCE TO CLINICAL PRACTICE:Nurses require more knowledge and education to gain deeper understanding of sleep and to deliver evidence-based, high quality care.
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| 3. |
- Gellerstedt, Linda, et al.
(författare)
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Nursing care and management of patients' sleep during hospitalisation : a cross-sectional study
- 2019
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 28:19-20, s. 3400-3407
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore and describe how patients' sleep is addressed at acute-care hospitals in Sweden with regard to nursing care, management, and the development of knowledge in this area.BACKGROUND: Sleep is a basic human need and thus important for health and health maintenance. Patients describe sleeping in hospital as a stressor, and research shows that nurses tend to underestimate patients' perceived problems with sleep during hospitalization. How do nursing staff at acute hospitals address patients' sleep and the development of knowledge in this area?.DESIGN/METHOD: A cross-sectional descriptive study was conducted based on data collected through a web survey. Head nurses, registered nurses, nursing care developers, and local training supervisors at 36 randomized acute-care hospitals in Sweden were invited to participate. This study was executed and reported in accordance with SQUIRE 2.0.RESULTS: The results of the survey (53 responses from 19 wards at 15 acute-care hospitals) showed that no policy documents exist and no current training addresses sleep during hospital stay. All participants agreed that sleep should be considered a nursing topic and that it is important for hospitalized patients.CONCLUSION: Patients' sleep during hospitalization is undermanaged at acute-care hospitals. Nurses, health care managers, and organizations face challenges if they are to achieve better outcomes.RELEVANCE TO CLINICAL PRACTICE: This study shows that nurses do consider patients' sleep important and addressing sleep as part of nursing care. Future studies in the area should focus on what kinds of support and education are needed in the clinical context. This article is protected by copyright. All rights reserved.
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| 4. |
- Gellerstedt, Linda
(författare)
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Nursing perspectives on patients' sleep during hospital care
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Sleep is crucial for all humans in terms of health, daily functioning and well-being. Previous research has shown that sleep is considered a stressor for patients during hospital care. The general aim of this thesis was to explore and describe, from a nursing perspective, patients’ sleep and how sleep is addressed, promoted and assessed during hospital care.Methods: To cover the general aim of this thesis, various designs were chosen, and diverse methods of data collection were employed. In Study I, data were collected through qualitative interviews of ten consecutively recruited patients at an acute hospital. In Study II, data were collected through qualitative individual interviews and four focus groups, with a total of twenty-two registered nurses at four acute hospitals in an urban region. Study III was designed as a mixed method study and data were collected through twenty-one qualitative individual interviews as well as from program and course syllabuses and intended learning outcomes at three universities. Data from Studies I-II were analysed by qualitative content analysis with an inductive, latent approach. Data in Study III were analysed by qualitative content analysis with an inductive, manifest approach and collected documents were read word-for-word and scanned for the pre-set word, sleep. Study IV was a cross-sectional study and data were collected through a web-based survey. Acute hospitals in Sweden were subjected to stratified randomized sampling. Registered nurses, head nurses, nursing care developers and local training staff were included in the study. Data were analysed using descriptive statistics, and free-text answers were analysed by a thematic text analysis. Study V was performed as a non-experimental prospective study. Data from a group of twenty-five patients at two hospitals were collected by using the Richards-Campbell Sleep Questionnaire and actigraphy by Vivago® and were analysed with correlation and regression analysis.Findings: Patients’ sleep during hospital care is affected by several different factors and patients’ sleep is described as an important but undermanaged area. Limited knowledge and education within the area and insufficient support from the organization can be seen as barriers. Study III reveals that several student nurses lack evidence-based knowledge about sleep and sleep-promotion and consider themselves only to be prepared to address and promote sleep to a limited extent. Furthermore, the word, sleep, occurred explicitly only three times in two different learning outcomes at one of three included universities. Study IV shows that the area of sleep is not highlighted in a clinical context; for example, there is an absence of training days and education about sleep, only a few departments actively address patients’ sleep, and the use of sleep-assessment is non-existent. Study V shows a relationship between individual Vivago® graphs and patients’ self-assessed sleep, but a significant correlation for all patients between mean values for the two assessments was only obtained for one of the two included nights.Conclusions: This thesis indicates that sleep deprivation is common among patients during hospital care. Furthermore, education about patients’ sleep in the investigated nursing programs and in clinical practice seems to be deficient. Assessments with the Richards-Campbell Sleep Questionnaire and measurement with Vivago® capture different dimensions of sleep. In its present form, the RCSQ could have the potential to facilitate nursing actions to promote sleep amongst hospitalized patients in line with person-centred care. Furthermore, it is concluded that patients’ sleep during hospital care is an undermanaged and non-highlighted area. This thesis shows that there are several challenges for nurses, nursing managers and organizations at acute hospitals if better outcomes are to be achieved.
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| 5. |
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| 6. |
- Gellerstedt, Linda, et al.
(författare)
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Patient's experiences of sleep in hospital : a qualitative interview study
- 2014
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Ingår i: Journal of Research in Nursing. - : SAGE Publications. - 1744-9871 .- 1744-988X. ; 19:3, s. 176-188
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Tidskriftsartikel (refereegranskat)abstract
- Many patients experience sleep disturbances and a reduced quality of sleep while hospitalised. Studies have shown that a person with a disease and/or a bodily injury has an increased need for sleep. Patients' experiences of sleep should govern how sleep disturbances should be managed. It is thus necessary to focus upon and describe patients’ needs and experiences. The aim of this study was to explore and describe patients’ experiences of sleeping in hospital. This study is based on qualitative semi-structured interviews with 10 consecutively included patients. The interviews were conducted between October 2010 and March 2011 and were audio recorded and transcribed verbatim. Collected data were analysed by qualitative content analysis. The participants reported physical and psychological experiences that had affected their sleep. Their experiences were categorised using four themes: bedside manner, physical factors, being involved and integrity. Patients considered that experiencing some degree of control, feeling involved and preserving one’s integrity affect sleep during hospitalisation. Several factors have an impact on patients’ sleep. It is not only physical factors but also psychological factors such as bedside manner and having the opportunity to influence and be involved. The patients’ accounts provide a new perspective and open the door to changes in nursing care regarding patients’ sleep.
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| 7. |
- Gellerstedt, Linda, et al.
(författare)
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Patients’ self-assessed sleep as a nursing tool during hospital care : A pilot study
- 2020
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 40:3, s. 123-129
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Tidskriftsartikel (refereegranskat)abstract
- Sleep in hospital is considered a challenge from both a patient and a nursing perspective. To enable nurses to promote patients? sleep during hospital care it is essential to have valid, reliable and useful sleep assessment tools at hand. The aim of the present study was to evaluate and compare the outcomes of objectively estimated sleep and self-reported sleep quality. Data were collected through continuous wrist-worn actigraphy and completion of the Richards?Campbell Sleep Questionnaire (RCSQ) in a pilot study on 25 patients during hospital care. A correlation between mean values for the two assessments was shown for the second night but not for the third night of assessment, and it was concluded that the two assessments might capture different dimensions of sleep. Furthermore, based on a high response rate and an evident feasibility in a nursing context the RCSQ may facilitate person-centered care.
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| 8. |
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| 9. |
- Gellerstedt, Linda, et al.
(författare)
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Sleep as a topic in nursing education programs? A mixed method study of syllabuses and nursing students' perceptions
- 2019
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Ingår i: Nurse Education Today. - : Elsevier BV. - 0260-6917 .- 1532-2793. ; 79, s. 168-174
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Sleep is a basic human need and is considered important for maintaining health. It is even more important during illness due to its impact for example on our immune system. Nurses have an important role in identifying sleep deprivation. They are also in a unique position to promote and address sleep among patients. However, it is essential that they are provided with the appropriate knowledge during training.AIM: To explore and describe nursing students' perceptions of preparedness to adress and support patients' sleep during hospitalization and to apply sleep-promoting interventions in a clinical context. Furthermore, the aim was to investigate if, and how, the topic of sleep is explicitly incorporated in nursing education programs.DESIGN: A descriptive study based on a mixed method approach.METHODS: Quantitative and qualitative data were collected from program and course syllabuses and intended learning outcomes from three universities. Twenty-one nursing students from the same universities were interviewed during their final year of education.RESULTS: The results of both quantitative and qualitative data consistently show that education regarding sleep and patients' sleep is limited and, in some respects, absent in the Bachelor of Science Nursing programs investigated.CONCLUSION: This study indicates that education about sleep and patients' sleep in the nursing programs studied is insufficient and limited. This gap in knowledge may lead to prospective registered nurses using their own experiences instead of evidence-based knowledge when assessing, supporting and applying sleep-promoting interventions.
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| 10. |
- Lidin, Matthias, et al.
(författare)
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Effects of Structured Lifestyle Education Program for Individuals With Increased Cardiovascular Risk Associated With Educational Level and Socioeconomic Area
- 2021
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Ingår i: American Journal of Lifestyle Medicine. - : Sage Publications. - 1559-8276 .- 1559-8284. ; 15:1, s. 28-38
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Tidskriftsartikel (refereegranskat)abstract
- Background.Differences in socioeconomic status contribute to inequalities in lifestyle habits and burden of noncommunicable diseases. We aimed to examine how the effects of a 1-year structured lifestyle education program associate with the participant's educational level and socioeconomic area (SEA) of residence.Methods.One hundred individuals (64% women) with high cardiovascular risk were included. Education level (nonuniversity vs university degree) was self-reported and SEA (low vs high) defined by living in different SEAs. Lifestyle habits and quality of life were self-reported, cardiovascular risk factors and Framingham 10-year cardiovascular disease risk were measured at baseline and after 1 year.Results.Sedentary behavior decreased in both nonuniversity degree and low SEA group over 1 year, with a significantly greater improvement in daily activity behavior in low- compared with high-SEA group. Abdominal obesity decreased significantly more in the nonuniversity compared with the university degree group. Cardiovascular risk and quality of life improved in all groups, however, with greater discrimination when using educational level as the dichotomization variable.Conclusion.The results are clinically and significantly relevant, suggesting that low socioeconomic status measured both as educational level and SEA are no barriers for changing unhealthy lifestyle habits and decreasing cardiovascular risk after participation in a lifestyle program.
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| 11. |
- Lidin, Matthias, et al.
(författare)
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Experiences from individuals with increased cardiovascular risk participating in a one-year lifestyle program.
- 2019
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 18:7, s. 554-561
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The purpose of the current study was to describe the participants' experiences of a structured lifestyle program for persons with high cardiovascular risk.METHOD: Sixteen participants with high cardiovascular risk participating in a one-year structured lifestyle intervention program were interviewed regarding their experiences of the program. The interviews were analyzed using content analyses.RESULTS: The participants' (mean age 58 ± 9) experiences were categorized into three categories: "How to know," based on the participants' experience from both individual counselling and group sessions with tools to strengthen self-care; "Staff who know how," based on experience from the meeting with, and the importance of, competent health professionals; "Why feedback is essential," based on the participants' experience and effects of person-centered feedback. Several factors were deemed important in the structure of the program: an individual visit with shared goal setting, a group education session with interactive discussion, a competent, educated, and respectful health professional who gives continuous feedback, and the right tools to support self-care at home between visits.CONCLUSION: Individuals participating in a structured lifestyle program experienced several factors as important: an individual visit with shared goal setting, a group education session with interactive discussion, a competent, educated, and respectful healthcare professional who gives continuous feedback, and the right tools to support self-care at home between visits.
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| 12. |
- Lidin, Matthias, et al.
(författare)
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Long-term effects of a Swedish lifestyle intervention programme on lifestyle habits and quality of life in people with increased cardiovascular risk.
- 2018
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Ingår i: Scandinavian Journal of Public Health. - : Sage Publications. - 1403-4948 .- 1651-1905. ; 46:6, s. 613-622
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: The aim of this study was to evaluate the effects of a structured intervention programme on lifestyle habits and quality of life after six months and one year in participants with increased cardiovascular risk.METHODS: Participants aged ≥18 years with increased cardiovascular risk were referred from primary health care and hospitals. The programme was launched at an outpatient clinic in a department of cardiology at a university hospital. It consisted of individual visits to a nurse for a health check-up and lifestyle counselling at baseline, after six months and at one year. In addition, five group sessions - focusing on nicotine, alcohol, physical activity, eating habits, stress, sleep and behavioural change - were offered to the participants and their relatives or friends. Lifestyle habits and quality of life were assessed with questionnaires at baseline, after six months and at one year.RESULTS: One hundred participants (64 women, 36 men, age 58±11 years) were included in the programme. Compared with the baseline, significant and favourable changes in reported lifestyle habits were noted. Exercise levels were higher after one year and sedentary time decreased from 7.4 to 6.3 h/day. Dietary habits improved and the number of participants with a high consumption of alcohol decreased. Quality of life improved after one year.CONCLUSIONS: Participating in a structured lifestyle programme resulted in improved lifestyle habits and quality of life over one year in people with increased cardiovascular risk. Components such as an inter-professional teamwork, a focus on lifestyle rather than the disease, and combining individual visits and group sessions, might be central to the positive outcome of the programme.
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| 13. |
- Lidin, Matthias, et al.
(författare)
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Long-term effects on cardiovascular risk of a structured multidisciplinary lifestyle program in clinical practice.
- 2018
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Ingår i: BMC Cardiovascular Disorders. - : Springer Science and Business Media LLC. - 1471-2261 .- 1471-2261. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Cardiovascular disease is still the leading cause of premature death world-wide with factors like abdominal obesity, hypertension and dyslipidemia being central risk factors in the etiology. The aim of the present study was to investigate the effects on cardiovascular risk factors and cardiovascular risk after 6 months and 1 year, in individuals with increased cardiovascular risk enrolled in a lifestyle multidisciplinary program in a clinical setting.METHOD: Individuals with increased cardiovascular risk were referred from primary health care and hospitals to a program at an outpatient clinic at a department of cardiology. The program consisted of three individual visits including a health check-up with a physical examination and blood sampling, and a person-centered dialogue for support in behavioural change of unhealthy lifestyle habits (at baseline, 6 months and 1 year). Furthermore, five educational group sessions were given at baseline. Cardiovascular risk was assessed according to Framingham cardiovascular risk predicting model.RESULTS: One hundred individuals (mean age 59 years, 64% women) enrolled between 2008 and 2014 were included in the study. Waist circumference, systolic and diastolic blood pressure and total cholesterol decreased significantly over 1 year. In parallel, cardiovascular risk according to the cardiovascular risk profile based on Framingham 10-year risk prediction model, decreased with 15%. The risk reduction was seen in both men and women, and in participants with or without previous cardiovascular disease.CONCLUSION: Participating in a structured lifestyle program over a year was associated with significant improvement in multiple cardiovascular risk factors and decreased overall cardiovascular risk.TRIAL REGISTRATION: The study is registered at www.clinicaltrials.gov (ClinicalTrial.gov ID: NCT02744157 ).
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| 14. |
- Löfvenmark, Caroline, et al.
(författare)
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A group-based multi-professional education programme for family members of patients with chronic heart failure : effects on knowledge and patients' health care utilization
- 2011
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 85:2, s. e162-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim was to investigate if family members of patients with chronic heart failure (CHF) increased knowledge about CHF through a group-based multi-professional educational programme and whether there was an effect on patients' health care utilization. METHODS: Family members (n=128) were randomly assigned to intervention-group (IG) who received CHF education programme or control-group (CG) who received information according to hospital routines. Programme effects were evaluated with CHF knowledge questionnaire, patient readmissions and number of days hospitalised during 18 months. RESULTS: Knowledge about CHF increased in both groups, significantly higher in IG at second assessment (IG 16±1.9 vs. CG 14.9±2.1, p=0.006), and knowledge maintained at third assessment. In IG 17 patients were re-admitted at least once and 28 patients in CG due to CHF (p=0.085). There were no differences in frequency of readmissions or number of days hospitalised. CONCLUSION: A group-based multi-professional education programme increased family members' knowledge about CHF. Despite this, effect on patient's health care utilization could not be seen during follow-up period. PRACTICAL IMPLICATIONS: We suggest that CHF education programmes for family members should be provided at clinics, with information preferably repeated 2-3 times during a period of six months to maintain knowledge level.
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| 15. |
- Plüss, Catrine Edström, et al.
(författare)
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Effects of an expanded cardiac rehabilitation programme in patients treated for an acute myocardial infarction or a coronary artery by-pass graft operation
- 2008
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Ingår i: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 22:4, s. 306-318
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the effects of expanded cardiac rehabilitation with multifactorial interventions on metabolic and inflammatory markers, exercise performance and on established cardiovascular risk factors. Design: Single-centre prospective randomized controlled trial. Setting: A university hospital. Subjects: Two hundred and twenty-four patients with an acute myocardial infarction or patients undergoing coronary artery by-pass grafting. Intervention: Patients were randomized to expanded cardiac rehabilitation including stress management, increased physical training, staying at a 'patient hotel' and cooking sessions, or to usual cardiac rehabilitation Main measures: Biochemical risk markers and exercise performance; follow-up was one year. Results: There were no significant differences between the two treatment groups in the changes of biochemical risk markers or in exercise performance. Thus, low-density lipoprotein (LDL)-cholesterol levels decreased from 3.00 (0.97) to 2.54 (0.66) mmol/L in the intervention group and from 3.20 (0.85) to 2.54 (0,63) mmol/L in the control group, fibrinogen levels decreased from 5.30 (2.00) to 4.25 (1.01) g/L in the intervention group and from 5.29 (1.89) to 4.33 (0.83) g/L in the control group and C-reactive protein (CRP) levels decreased from 3.04 (2.79) to 2.09 (2.13) mg/L in the intervention group and from 4.01 (3.49) to 2.39 (2.49) mg/L in the control group. Total workload (W) improved from 118 (35) to 136 (34) in the intervention group and from 117 (36) to 133 (39) in the control group. Conclusion: There was no further significant benefit in biochemical risk markers or in exercise performance among patients undergoing the expanded rehabilitation as compared to the control group which received usual cardiac rehabilitation.
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| 16. |
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| 17. |
- Rydell Karlsson, Monica, et al.
(författare)
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A nurse-based management program in heart failure patients affects females and persons with cognitive dysfunction most
- 2005
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 58:2, s. 146-53
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Tidskriftsartikel (refereegranskat)abstract
- It is important that congestive heart failure (CHF) patients know how to monitor and manage disease-associated signs and symptoms. CHF patients were randomised to follow-up at a nurse-based outpatient clinic (intervention group (IG); n = 103), or to follow-up in primary healthcare (control group (CG); n = 105). Patient knowledge of CHF and self-care were assessed by a questionnaire and cognitive function by a Mini Mental State Examination (MMSE) at baseline and at six months. Men knew more about CHF as compared to females at baseline (p < 0.01). However, females in the IG increased their knowledge of self-care between baseline and six months as compared to CG females (p < 0.05). Patients with cognitive dysfunction (MMSE < 24) presented lower scores on knowledge as compared to those with a MMSE of >24 at baseline (p < 0.01). These differences disappeared after the intervention. Thus, females seemed to gain more than men from a nurse-based management program and patients with in-hospital signs of cognitive dysfunction should be encouraged to participate.
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| 18. |
- Rydell Karlsson, Monica, et al.
(författare)
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Effects of Expanded Cardiac Rehabilitation on Psychosocial Status in Coronary Artery Disease with Focus on Type D Characteristics
- 2007
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Ingår i: Journal of behavioral medicine. - : Springer Science and Business Media LLC. - 0160-7715 .- 1573-3521. ; 30:3, s. 253-261
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Tidskriftsartikel (refereegranskat)abstract
- Type D personality has been shown to increase the risk for cardiovascular events in patients with coronary artery disease (CAD). We investigated the effects of expanded cardiac rehabilitation on type D score and psychosocial characteristics in 224 CAD patients randomised to either expanded cardiac rehabilitation (stress management, increased physical training, stay at a “Patient Hotel” after discharge and cooking sessions), or routine rehabilitation. Follow-up was 1 year. At baseline patients with a high type D score [patients in the upper quartile of type D score (Q4) i.e., type D patients] had a lower sense of coherence (p < 0.001), a lower quality of life (p < 0.001), more depressive symptoms (p < 0.001) and increased anxiety (p < 0.001) as compared to patients with a low type D score (Q1). During follow-up, type D patients (Q4) randomised to intervention had significant decrements in type D-score (p < 0.01), depression and anxiety (p < 0.05) and an increment in quality of life scores (p < 0.001). Quality of life was also improved in control type D patients (Q4; p < 0.01) but no significant changes were seen in type D score, depression or anxiety. Expanded cardiac rehabilitation reduces type D score, anxiety and depressive symptoms, and improves the quality of life in type D patients.
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| 19. |
- Rydell-Karlsson, Monica
(författare)
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Knowledge Acquisition in Patients with Heart Disease
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The general aim was to evaluate different aspects of the knowledge acquisition process in patients with heart disease. Three different education programs were evaluated.In Paper I 208 patients with systolic heart failure (HF) aged >60 years, were included. They were randomized to the nurse-based outpatient clinic or to the patients´ general practitioners (GP). The aim was to assess effects of a nurse-based management program – intended to increase the knowledge of the HF disease and its self-care – and relate the results to gender and cognitive function. The results showed that the nurse-based outpatient clinic has an important role in patient education, and increases patients´ knowledge about self-care and the disease. The results indicate that females have more to gain than men from such management programs. Patients demonstrating signs of cognitive dysfunction when in hospital did also benefit.In Paper II 224 patients, aged <75 years suffering from an acute AMI or who had underwent coronary artery by-pass grafting, were randomized to intervention (an expanded cardiac rehabilitation program) or to control (usual care). The aim was to investigate the effect of an expanded cardiac rehabilitation program on psychosocial characteristics including depression, anxiety, and quality of life (QoL) in type D and non-type D coronary artery disease (CAD) patients. The results show that an expanded rehabilitation program significantly reduces type D score, improves QoL, and decreases self-estimated depression and anxiety in CAD patients in the highest quartile of type D score.In Paper III and IV 182 patients with chronic heart failure (CHF) were included and referred to the nurse-based outpatient clinic. They were randomized to intervention (patients decided on how they should be informed and by which information technique) or to control (the nurse decided according to usual routine).The aim in Paper III was to compare patient-based selection of information with nurse-based selection of information in patients with HF and to evaluate the effects on knowledge acquisition, QoL, visits to the outpatient clinic, drug therapy and readmissions. Patients had fewer visits to the nurse-based outpatient clinic and a trend to a more flexible diuretic regimen, if patients were involved in the decision on how to be informed. Both groups increased QoL, knowledge their doses of relevant medication, and readmissions did not differ between the two groups.The aim in Paper IV was to compare patient-based and nurse-based New York Heart Association (NYHA) classification and its relation to grade of depression and knowledge acquisition in patients with HF. The results show a mismatch between the NYHA classifications performed by patients respectively by the nurse. Furthermore, patients in a depressed mood at baseline had more clinical events during the first year after hospitalization due to CHF. However, there was no difference in knowledge acquisition between patients in a depressed mood as compared to patients in a normal mood.The conclusion is that information given at a nurse-based outpatient clinic has an important role in patient education. Females and patients with in-hospital cognitive dysfunction had the greatest gains Patients who are involved in the decision on how to be informed had fewer visits to the nurse-based outpatient clinic. The fewer visits did not affect knowledge, QoL, readmissions, or medical treatment in a negative way. Patients assessed a higher NYHA class than a nurse. Patients who were depressed had an increased incidence of clinical events during the first year after hospitalisation due to HF. There was no difference in knowledge acquisition between patients in a depressed mood as compared to patients in a normal mood. An expanded rehabilitation program significantly reduces type D score, improves quality of life, and decreases self-estimated depression and anxiety in patients with CAD in the upper quartile of type D score.
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| 20. |
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| 21. |
- Rydell Karlsson, Monica, et al.
(författare)
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Patients with chronic heart failure who plan their own self- care education decrease their outpatient visits
- 2011
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 1:4, s. 705-718
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Tidskriftsartikel (refereegranskat)abstract
- Background, aims and objectives: Patient education programs delivering a defined package of information aimed to optimise the care of chronic heart failure have been evaluated. However, there is a lack of knowledge about the effects of programs designed to support the patients’ learning by allowing them to self-direct their learning activities. We aimed to contribute to the associated knowledge base.Method: We compared an intervention group of patients choosing among different learning activities with a control group, where the nurse practitioner scheduled a package of learning activities. One hundred and eighty two patients with chronic heart failure in NYHA class I-IV who were referred to the nurse practitioner outpatient clinic randomised to either a structured control education program (92 patients) or to a self-directed intervention program (90 patients). Additionally, both groups received the same nurse-practitioner based self-care advice and treatment. Outcome measures were quality of life, knowledge acquisition, visits to the outpatient clinic, readmissions and medication during one year.Results: All patients significantly increased their knowledge and quality of life, with no difference between the groups. However, the intervention group patients had fewer visits to the outpatient clinic as compared to controls (p=0.007). This was accomplished without a concomitant increase in re-admission rate. Both groups increased, as intended, their use of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and beta-blockers.Conclusion: In conclusion, our findings show that it is safe and results in fewer outpatient visits if patients with chronic heart failure actively plan their own education program. To encouraging patients taking own decisions lead to an increased self-control of their healthcare behaviour.
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| 22. |
- Söderberg, AnneCharlotte, et al.
(författare)
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Upplevelse av trygghet och otrygghet bland patienter med hjärtsvikt som får avancerad vård i hemmet : Experience of security and insecurity among patients with heart failure in advanced home care
- 2015
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Ingår i: Nordic journal of nursing research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 35:4, s. 203-209
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Tidskriftsartikel (refereegranskat)abstract
- Aim The aim of this study was to describe the experience of security and insecurity in patients with chronic heart failure who were treated by Advanced Home Care (AHC) in a city in Sweden.Background It is common for patients with heart failure to have frequent readmissions to hospital due to deterioration. The patients have various symptoms such as breathing problems, oedema and fatigue. Being cared for by AHC has become more common for patients with heart failure to reduce deterioration of heart failure and prevent hospitalization.Method A qualitative method with semi-structured interviews was used. Eight patients with heart failure participated in the study. The interviews were analysed by content analysis.Findings Three categories were identified: ‘home care’, ‘the social network’ and ‘internal and external resources’.Conclusion The experience was complex and depended on several factors both within and outside the health care situation. The need for access to a multidisciplinary team was great and it was important that the nursing staff had time to listen. It was important that the care had focus on the patient’s perspective to create security and avoid insecurity.
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| 23. |
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| 24. |
- Wahlström, Maria
(författare)
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Effects of MediYoga among patients with paroxysmal atrial fibrillation
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- IntroductionPatients with paroxysmal atrial fibrillation often experience impaired health-related quality of life. Standard treatment is not always sufficient and changes in life-style habits are suggested as a complement. Also, studies have suggested differences in gender where women have extended side effects of rhythm medications, more symptoms and estimate lower health-related quality of life than men. Yoga has been shown to increase health-related quality of life and decrease blood pressure, heart rate and cardiac biomarkers. The overall aim of this thesis was to study the effects of MediYoga among patients with paroxysmal atrial fibrillation. In addition, to evaluate perceptions and experiences of MediYoga as well as gender differences.Methods and resultsPaper I: This is a randomized, controlled pilot study in which 80 patients were randomized to MediYoga, n=40, or a control group, n=40 at an University Hospital, in Stockholm, Sweden. The yoga groups had been performing MediYoga for one hour/week over a 12 weeks period. Assessments as health-related quality of life questionnaires (i.e. SF-36, EQ-5D Visual Analogue Scale), blood pressure and heart rate were collected at baseline and at the end of study. The results showed an improvement of health-related quality of life in the yoga group. Blood pressure and heart rate also decreased in the yoga group.Paper II: In this prospective randomized study at an University Hospital, Stockholm, Sweden, with stratification in gender, 132 patients, with symptomatic PAF, were randomized to yoga (n=44), relaxation (n=44) and a control group (n=44). The yoga groups had been performing MediYoga for one hour/week over a 12 weeks period. Assessments as health-related quality of life questionnaires (i.e. SF-36, ASTA), blood pressure, heart rate as well as NT-proBNP were collected at baseline and at the end of the study. The results showed no differences in the ASTA and SF-36 between the groups. However, improvements were seen in health-related quality of life, SF-36, with-in the MediYoga group. Both systolic and diastolic blood pressure decreased in the MediYoga group compared to the control group but there was no difference compared to the relaxation group. There were no differences in heart rate and NT-proBNP between or with-in the groups after 12 weeks.Paper III: A study with a qualitative design was conducted using individual semistructured interviews. The study included 12 participants (7 men and 5 women) who had participated in the yoga group in Paper II. The data were analysed using qualitative content analysis with an inductive method and a manifest approach. Three categories were found in the analysis; “A time for a sense of existence and presence”, “A way of gaining well-being and increased consciousness” and “Access to a tool to gain willpower and relieve symptoms”.Paper IV: A comparative design examining gender differences among those who had performed MediYoga (women n=37, men n=34). The yoga groups had been performing MediYoga for one hour/week over a 12 weeks period. Data (i.e healthrelated quality of life [SF-36], blood pressure and heart rate) were collected at baseline and the end of the study. There were no differences between the women or men group in SF-36 at end of study, however, there was improvement with-in the women group in the subscales vitality, social function, mental health and the domain mental component summary score. In the male group, there were improvement within the subscales role-physical, bodily pain, general health, vitality, social function, role-emotion and the domain mental component summary score (SF-36). There were no differences between the groups in systolic and diastolic blood pressure as well as heart rate at the end of the study. With-in the women group differences were observed in systolic and diastolic blood pressure, however, no difference was seen in heart rate. With-in the men group improvement were seen in diastolic blood pressure but no differences were seen in systolic blood pressure or heart rate.ConclusionsMediYoga improves health-related quality of life as well as blood pressure among patients with PAF. Also, both genders report benefits, and patients describe MediYoga as an accessible tool with which to handle emotions and symptoms. MediYoga may be a part of a self-management program, as a complementary treatment, among patients with PAF.
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| 25. |
- Wahlström, Maria, et al.
(författare)
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Effects of yoga in patients with paroxysmal atrial fibrillation - a randomized controlled study.
- 2016
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 16:1, s. 57-63
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Patients with atrial fibrillation often have an impaired quality of life (QoL). Practising yoga may decrease stress and have positive effects on mental and physical health. The aim of this study was to investigate whether yoga can improve QoL and decrease blood pressure and heart rate in patients with paroxysmal atrial fibrillation (PAF).METHODS: In this pilot study, 80 patients diagnosed with PAF were randomized to standard treatment (control group, n=40) or standard treatment in combination with yoga (yoga group, n=40) during a 12-week period. QoL, blood pressure and heart rate were evaluated at baseline and at the end of the study (12 (+2) weeks). EuroQoL-5D (EQ-5D) Visual Analogue Scale (VAS) and the two dimensions in Short-Form Health Survey (SF-36) were used to evaluate QoL.RESULTS: At baseline there was a significant difference in QoL between the groups in EQ-5D VAS- scale (p=0.02) and SF-36 mental health score (p<0.001) in which the control group had higher scores. At the end of the study, the yoga group averaged higher SF-36 mental health scores. There was a significant difference between the two groups (p=0.016), but no differences in EQ-5D VAS- scale and physiological health score was seen between the two groups. At the end of the study, the yoga group had significantly lower heart rate (p=0.024) and systolic (p=0.033) and diastolic blood pressure (p<0.001) compared to the control group.CONCLUSIONS: Yoga with light movements and deep breathing may lead to improved QoL, lower blood pressure and lower heart rate in patients with PAF compared to a control group. Yoga could be a complementary treatment method to standard therapy.
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| 26. |
- Wahlström, Maria, et al.
(författare)
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Gender differences in health-related quality of life, blood pressure and heart rate among patients with paroxysmal atrial fibrillation after performing MediYoga
- 2023
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Ingår i: International Journal of Cardiology. Heart & Vasculature. - : Elsevier BV. - 2352-9067. ; 49
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Patients with paroxysmal atrial fibrillation experience low health-related quality of life which can be improved by performing yoga. The aim of this study was to evaluate gender differences in health-related quality of life, blood pressure and heart rate among patients with paroxysmal atrial fibrillation after performing MediYoga.METHODS: This is a secondary analysis of subgroups, investigating the yoga groups, from two randomized controlled trials (RCT 1: yoga group versus control group, RCT 2: a three-armed randomized study with yoga, control and relaxation groups). The yoga groups performed MediYoga for one hour/week over a 12-week period in both studies. Quality of life (SF-36), blood pressure and heart rate were collected at baseline and end of study.RESULTS: No differences were found between the women and men. Within the women's group, there were improvements in vitality (p = 0.011), social function (p = 0.022), mental health (p = 0.007) and Mental Components Summary (p = 0.022). There were differences within the men's group in bodily pain (p = 0.005), general health (p = 0.003), vitality (p = 0.026), social function (p = 0.005), role-emotion (p = 0.011) and Mental Components Summary (p = 0.018). Within the women's group, differences were observed in systolic blood pressure (p = 0.010) and diastolic blood pressure (p = <0.001). The men's group also showed improvement in diastolic blood pressure (p = 0.021).CONCLUSION: MediYoga improved mental health as well as diastolic blood pressure in both men and women with PAF. This study suggests that both men and women, with PAF, may benefit from complementary treatment such as yoga.Clinical Trial Gov Id: NCT01789372.
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| 27. |
- Wahlström, Maria, et al.
(författare)
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MediYoga as a part of a self-management programme among patients with paroxysmal atrial fibrillation - a randomised study
- 2020
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 19:1, s. 74-82
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Paroxysmal atrial fibrillation is associated with impaired health-related quality of life. Yoga has been suggested to improve health-related quality of life among patients with heart failure and hypertension.AIM: The aim of the study was to evaluate the effects of MediYoga, in respect of health-related quality of life, blood pressure, heart rate, as well as N-terminal pro b-type natriuretic peptide, among patients with symptomatic paroxysmal atrial fibrillation, compared with standard therapy or relaxation.METHODS: Patients with symptomatic paroxysmal atrial fibrillation, n=132, were stratified for gender and randomised to MediYoga, a relaxation group or a control group, 44 patients per group with a 12-week follow-up. Health-related quality of life, blood pressure, heart rate and N-terminal pro b-type natriuretic peptide were assessed.RESULTS: After 12 weeks, there were no differences in health-related quality of life between the groups. There were improvements in Short-Form Health Survey bodily pain, general health, social function, mental health and mental component summary scores within the MediYoga group (p=0.014, p=0.037, p=0.029, p=0.030, p=0.019, respectively). No change was seen in the relaxation and control groups. Systolic blood pressure decreased in the MediYoga group (134±18 to 127±13) compared with the control group (126±17 to 127±15, p=0.041); no difference compared with the relaxation group (131±17 to 125±12). Diastolic blood pressure decreased in the MediYoga group (79±9 to 74 ±9) compared with the control group (76±9 to 79±8, p=0.005); no difference compared with the relaxation group (76±9 to 77±8). There were no differences in heart rate and N-terminal pro b-type natriuretic peptide between the groups after 12 weeks.CONCLUSIONS: MediYoga improves health-related quality of life and decreases blood pressure in patients with paroxysmal atrial fibrillation. MediYoga may be used as a part of a self-management programme among patients with paroxysmal atrial fibrillation.
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| 28. |
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| 29. |
- Wahlström, Maria, et al.
(författare)
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Perceptions and experiences of MediYoga among patients with paroxysmal atrial fibrillation : An interview study
- 2018
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Ingår i: Complementary Therapies in Medicine. - : Elsevier BV. - 0965-2299 .- 1873-6963. ; 41, s. 29-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: We investigated the perceptions and experiences of a therapeutic yoga form, MediYoga, which is evolved from Kundaliniyoga among patients with symptomatic paroxysmal atrial fibrillation (PAF).DESIGN AND SETTING: an inductive exploratory design was chosen with individual semi-structured interviews. The study was conducted with 12 participants (7 men and 5 women, average age 63.5) at a university hospital, Sweden. Informed consent was obtained from all participants. The data were analyzed using a qualitative content analysis with an inductive method and a manifest approach.RESULTS: Three categories were found in the analysis. In the category "A time for a sense of existence and presence", the patients described an increased thoughtfulness and experiences of gaining access to an inner self. The category "A way of gaining well-being and increased consciousness" describes patients` feelings of relaxation and feeling of comfort, with components of mental and physical well-being. Furthermore, "Access to a tool to gain willpower and relieve symptoms" describes the perceptions from patients to obtained access to a tool for handling the emotions, such as fear and anxiety, as well as symptoms that they could struggling with between, and during, their episodes of atrial fibrillation. No adverse events were reported by the yoga group, during the study.CONCLUSIONS: Patients with PAF described MediYoga as an accessible tool to manage emotions and symptoms related to episodes of AF. MediYoga may also assist in enhancing body awareness, whereby physical, mental and spiritual components are integrated. MediYoga may strengthen self-management among patients with PAF.
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