| 11. |
- Ahldén, Maria KC, et al.
(author)
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Facing the unexpected - A content analysis of how dyads face the challenges of postoperative heart failure
- 2014
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In: Clinical Nursing Studies. - : Sciedu Press. - 2324-7940 .- 2324-7959. ; 2:2, s. 74-83
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to identify the challenges, strategies and needs of dyads who are dealing with postoperative heart failure.Background: An increasing number of patients with postoperative heart failure are living with their partner as primary caregiver. Heart failure is known to reduce quality of life but little is known about the strategies dyads use to cope with postoperative heart failure or what kind of support they need.Methods: Data were collected through semi-structured dialogue guides. Content analysis was performed to derive the main themes and categories of the data.Results: Three main themes were derived from the data; Everyday challenges, Strategies to deal with everyday challenges and Factors facilitating everyday life.Conclusions: Dyads living with postoperative heart failure find the change in everyday life challenging, but have strategies to handle the situation and know what kind of help they need. With the right help from health care, quality of life and self-care can be improved.
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| 12. |
- Ahlgren, Jennie, et al.
(author)
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Consumers on the Internet : ethical and legal aspects of commercialization of personalized nutrition
- 2013
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In: Genes & Nutrition. - : Springer. - 1555-8932 .- 1865-3499. ; 8:4, s. 349-355
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Research review (peer-reviewed)abstract
- Consumers often have a positive attitude to the option of receiving personalized nutrition advice based upon genetic testing, since the prospect of enhancing or maintaining one’s health can be perceived as empowering. Current direct-to-consumer services over the Internet, however, suffer from a questionable level of truthfulness and consumer protection, in addition to an imbalance between far-reaching promises and contrasting disclaimers. Psychological and behavioral studies indicate that consumer acceptance of a new technology is primarily explained by the end user’s rational and emotional interpretation as well as moral beliefs. Results from such studies indicate that personalized nutrition must create true value for the consumer. Also, the freedom to choose is crucial for consumer acceptance. From an ethical point of view, consumer protection is crucial, and caution must be exercised when putting nutrigenomic-based tests and advice services on the market. Current Internet offerings appear to reveal a need to further guaranty legal certainty by ensuring privacy, consumer protection and safety. Personalized nutrition services are on the borderline between nutrition and medicine. Current regulation of this area is incomplete and undergoing development. This situation entails the necessity for carefully assessing and developing existing rules that safeguard fundamental rights and data protection while taking into account the sensitivity of data, the risks posed by each step in their processing, and sufficient guarantees for consumers against potential misuse.
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| 13. |
- Ahlstrand, Inger, et al.
(author)
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Less pain and activity limitations in today's early RA patients compared with patients diagnosed 10 years earlier (the swedish TIRA-project)
- 2014
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In: EULAR 2014: Scientific Abstracts. - : BMJ. ; , s. 141-142
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Conference paper (peer-reviewed)abstract
- Background: Over the last decades the RA-treatment strategies have changed considerably. Routines for early RA diagnosis and instituted disease modifying anti rheumatic drugs (DMARDs) have been established. In the early 2000s biologic agents also became available for treatment purposes. Despite these altered and improved strategies RA patients continue to report pain and activity limitations; women more so than men.Objectives: To study differences regarding pain and activity limitations during the first three years after diagnosis of RA in today's patients compared with patients diagnosed 10 years earlier from a gender perspective.Methods: This study was based on patients recruited to the project “early interventions in RA” (TIRA). In the first cohort (TIRA-1) 320 patients were included during 1996-1998. In the second cohort (TIRA-2) 463 patients were included during 2006-2008. Disease activity score 28 joint count (DAS-28) and medication were registered. Pain intensity (VAS), bodily pain (BP) in Short Form36 (SF-36) and activity limitation (Health Assessment Questionnaire, HAQ) were reported at inclusion and at follow-ups after one, two and three years.Results: Disease activity did not differ between cohorts at inclusion, but was significant lower at the follow ups in the TIRA-2 cohort compared with the TIRA-1 cohort. Patients in TIRA2 were prescribed traditional DMARD:s and biologic agents more frequent than in TIRA-1. The TIRA-2 patients reported significantly higher pain intensity and activity limitations at inclusion but lower pain intensity and activity limitations at all follow-ups than TIRA-1 patients. There were no significant differences between cohorts regarding bodily pain at inclusion, but thereafter the TIRA-2 patients showed significant lower bodily pain than the TIRA-1 patients. Men reported lower activity limitation than women in TIRA-1; otherwise there were no gender differences in TIRA-1. In TIRA-2, there were no significant gender differences regarding pain at inclusion. However, men reported lower pain than women at all follow-ups. Women, in turn, reported significantly higher activity limitations at all time points in TIRA-2. Pain and activity limitations were significantly reduced from inclusion to the one year follow-up but remained stable thereafter.Conclusions: Both women and men in today's early RA patient cohort report lower pain and less activity limitations at the follow ups after diagnosis of RA compared to 10 years earlier. However, both activity limitations and bodily pain are still pronounced.
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| 14. |
- Ahlstrand, Inger, et al.
(author)
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Pain and activity limitations in women and men with contemporary treated early RA compared to 10 years ago: the Swedish TIRA project
- 2015
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In: Scandinavian Journal of Rheumatology. - : Informa Healthcare. - 0300-9742 .- 1502-7732. ; 44:4, s. 259-264
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Journal article (peer-reviewed)abstract
- Objectives: To study differences regarding pain and activity limitations during the 3 years following diagnosis in women and men with contemporary treated early RA compared with their counterparts who were diagnosed 10 years earlier. Method: This study was based on patients recruited to the Early Intervention in RA (TIRA) project. In the first cohort (TIRA-1) 320 patients were included in time for diagnosis during 1996-1998 and 463 patients were included in the second cohort (TIRA-2) during 2006-2009. Disease activity, pain intensity (Visual Analogue Scale, VAS), bodily pain (BP) in the 36-item Short Form Health Survey (SF-36), activity limitations (Health Assessment Questionnaire, HAQ), and medication were reported at inclusion and at follow-up after 1, 2, and 3 years. Results: Disease activity, pain, and activity limitations were pronounced at inclusion across both genders and in both cohorts, with some improvement observed during the first year after diagnosis. Disease activity did not differ between cohorts at inclusion but was significantly lower at the follow-ups in the TIRA-2 cohort, in which the patients were prescribed traditional disease-modifying anti-rheumatic drugs (DMARDs) and biological agents more frequently. In TIRA-2, patients reported significantly lower pain and activity limitations at all follow-ups, with men reporting lower pain than women. Women reported significantly higher activity limitations at all time points in TIRA-2. Conclusions: Pain and activity limitations were still pronounced in the contemporary treated early RA cohort compared with their counterparts diagnosed 10 years earlier and both of these factors need to be addressed in clinical settings.
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| 15. |
- Ahlstrand, Inger, et al.
(author)
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Pain and Daily Activities in Rheumatoid Arthritis
- 2012
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In: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 34:15, s. 1245-1253
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Journal article (peer-reviewed)abstract
- The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). Method. Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. Results. Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it.Conclusion. The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.
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| 16. |
- Ahlstrand, Inger, et al.
(author)
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Pain and difficulties performing valued life activities in women and men with rheumatoid arthritis
- 2015
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In: Clinical Rheumatology. - : Springer Verlag (Germany). - 0770-3198 .- 1434-9949. ; 34:8, s. 1353-1362
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Journal article (peer-reviewed)abstract
- This study aimed to examine the difficulties with performing valued life activities in relation to pain intensity in women and men with rheumatoid arthritis (RA). In total, 737 persons with RA (73 % women) from three rheumatology units in Sweden responded to a questionnaire measuring performance of 33 valued life activities and self-rated pain. The relationships between performance of valued life activities (VLAs) and pain (measured by visual analogue scale (VAS)) were analysed based on gender. Multiple linear regression analyses were conducted with the total VLA score as dependent variable. Women reported more pain and difficulties in performing valued life activities than men. Across genders, 85 % reported at least one valued life activity affected by RA. Significantly more women than men encountered difficulties in performing some activities such as cooking, gardening and meeting new people. Women reported higher pain intensity (35 mm) than men (31 mm). Almost all 33 difficulty ratings for valued life activities were higher among persons with high pain (greater than 40 mm) than persons with lower pain. Difficulty ratings for valued life activities correlated positively with pain in persons with lower pain, but not among those with high pain. The results highlight the importance of addressing pain, especially among women with RA, as they reported pain to impact on their valued life activities. Interestingly, this was evident also in women with lower levels of pain.
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| 17. |
- Ahlstrand, Inger, et al.
(author)
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Self-efficacy and pain acceptance as mediators of the relationship between pain and performance of valued life activities in women and men with rheumatoid arthritis
- 2017
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In: Clinical Rehabilitation. - : Sage Publications. - 0269-2155 .- 1477-0873. ; 31:6, s. 824-834
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.
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| 18. |
- Ahlstrand, Inger, et al.
(author)
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Smärta och dagliga aktiviteter vid Reumatoid artrit ur ett patientperspektiv
- 2011
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Conference paper (other academic/artistic)abstract
- Bakgrund: Smärta vid Reumatoid artrit (RA) ärett välkänt symtom som orsakar lidande ochaktivitetsbegränsning. Traditionellt mäts smärtainom reumatologin som smärtintensitet på enVisuell Analog Skala (VAS). Kunskapen kring hurpatienter med RA upplever smärta och dess konsekvenser är begränsad. Patientens egenbeskrivning behövs som underlag för behandlingsplanering och för att utveckla nya metoderför att beskriva problematiken.Syfte: Syftet med studien är att beskriva smärtavid RA ur ett patientperspektiv med fokus på hursmärtan påverkar dagliga aktiviteter.Metod: Patienter med diagnostiserad RA i syd-östra Sverige identifierades via Svenska Reumatologiregistret. Urvalet baserades på minst 5 årssjukdomsduration och minst 40 mm smärtintensitet på VAS vid de två senaste besöken på reumatologklinik. Sammanlagt 33 patienter, 7 män och26 kvinnor, deltog i sju fokusgrupper. Gruppernaformades utifrån kön och ålder. Intervjuguideninnehöll frågor som: Hur beskriver patienter medRA sin smärta? Vad påverkar smärtan? Vilkakonsekvenser har smärtan för aktivitetsutförande,aktivitetsbalans och undvikande av aktivitet? Enkvalitativ innehållsanalys görs.Resultat/förväntat resultat: Analyser hittills visar patienternas frustration över att inteklara det man vill eller behöver göra, beroendeav andra, minskade möjligheter till delaktigheti sociala sammanhang. Och närståendes betydelse. Analyserna visar att smärtan är relaterad till Göteborg6-8 april 201134trötthet, stress och sinnesstämning och att arbeteeller andra aktiviteter medverkar till att glömmabort smärtan och uppehålla förmåga. Analysenslutförs under hösten.Konklusion: Denna studie förväntas genererany angelägen kunskap om och förståelse försmärta.
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| 19. |
- Ahlström, Gerd, et al.
(author)
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A comprehensive rehabilitation programme tailored to the needs of adults with muscular dystrophy.
- 2006
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In: Clinical Rehabilitation. - : SAGE Publications. - 0269-2155 .- 1477-0873. ; 20:2, s. 132-141
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess if activities of daily living (ADL), coping and quality of life could be improved in adults with muscular dystrophy through a comprehensive rehabilitation programme. DESIGN: Quasi-experimental, controlled clinical study comparing patients with similar age and disease aspects. SETTING: Two different counties in Sweden, being either study or control setting. SUBJECTS: The study group comprised 37 adults (21 women, 16 men; mean age 50 years), while the control group comprised 39 people (25 women, 14 men; mean age 46 years). INTERVENTIONS: Four rehabilitation sessions tailored to different medical, physical and psychosocial needs of the patients, comprising a total of 10 days over a period of 18 months. MAIN MEASURES: ADL, the Mental Adjustment to Cancer Scale measuring coping strategies, the Sickness Impact Profile measuring health-related quality of life, the Hospital Anxiety and Depression Scale, and the Psychosocial Well-being Questionnaire. RESULTS: No significant differences were found between groups with regard to the outcome measures. There was increased dependence on others in ADL after 18 months in both groups, but it was more pronounced in the control group. Furthermore, a clear trend was observed in the data with regard to coping patterns, the control group using more coping strategies such as 'Helplessness/hopelessness' (P= 0.057), 'Anxious preoccupation' (P = 0.085) and 'Fatalistic' (P= 0.073) when being compared to the study group. CONCLUSIONS: No apparent effects on ADL were found from the rehabilitation programme, although there was a tendency of reduction of maladaptive coping patterns in the study group. This initial study may provide the rationale and basis for a randomized controlled trial.
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| 20. |
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