| 1. |
- Rozental, Alexander, et al.
(författare)
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The Negative Effects Questionnaire : Psychometric Properties of an Instrument for Assessing Negative Effects in Psychological Treatments
- 2019
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Ingår i: Proceedings of the 9th World Congress of Behavioural & Cognitive Therapies. - Tübingen : dgvt-Verlag. - 9783871598517 ; 47:5, s. 559-572
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: Psychological treatments provide many benefits for patients with psychiatric disorders, but research also suggest that negative effects might occur from the interventions involved. The Negative Effects Questionnaire (NEQ) has previously been developed as a way of determining the occurrence and characteristics of such incidents, consisting of 32 items and six factors. However, the NEQ has yet to be examined using modern test theory, which could help to improve the understanding of how well the instrument works psychometrically. Aims: The current study investigated the reliability and validity of the NEQ from both a person and item perspective, establishing goodness-of-fit, item bias, and scale precision. Method: The NEQ was distributed to 564 patients in five clinical trials at post-treatment. Data was analyzed using Rasch analysis, i.e., a modern test theory application. Results: 1) the NEQ exhibits fairness in testing across sociodemographics, 2) shows comparable validity for a final and condensed scale of 20 instead of 32 items, 3) uses a rating scale that advances monotonically in steps of 0-4, and 4) is suitable for monitoring negative effects on an item-level. Conclusion: The NEQ is proposed as a useful instrument for investigating negative effects in psychological treatments, and its newer shorter format could facilitate its use in clinical and research settings. However, further research is needed to explore the relationship between negative effects and treatment outcome, as well as to test it in more diverse patient populations
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| 2. |
- Astvaldsdottir, A., et al.
(författare)
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Oral health and dental care of older persons-A systematic map of systematic reviews
- 2018
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Ingår i: Gerodontology. - : Wiley. - 0734-0664 .- 1741-2358. ; 35:4, s. 290-304
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Forskningsöversikt (refereegranskat)abstract
- Objectives: To examine the current knowledge on oral health status and dental care of older persons through a systematic mapping of systematic reviews of low or moderate risk of bias. Background: Geriatric dentistry covers all aspects of oral health and oral care of older persons. Oral health is part of general health and contributes to a person's physical, psychological and social wellbeing. Methods: A literature search was performed in three different databases (PubMed, The Cochrane Library and Cinahl) within 12 domains: Dental caries, periodontitis, Orofacial pain and temporomandibular joint (TMJ) pain, mucosal lesions, oral motor function, dry mouth, halitosis, interaction between oral status and other medical conditions, ability to interrelate and communicate, quality of life, ethics and organisation of dental care for older persons. Systematic reviews were identified and scrutinised, highlighting scientific knowledge and knowledge gaps. Results: We included 32 systematic reviews of which 14 were judged to be of low/moderate risk of bias. Most of the domains lack systematic reviews with low or moderate risk of bias. In two of the domains evidence was identified; in institutionalised people aged 65 or older, effective oral hygiene can prevent pneumonia. Furthermore, there is an evidence of a relationship between malnutrition (protein energy-related malnutrition, PEM) and poor appetite and edentulousness. Conclusions: There is an urgent need for further research and evidence-based knowledge within most domains in geriatric dentistry and in other fields related to oral health and dental care for older persons striving for multi-disciplinary research programmes.
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| 3. |
- Sturup, Joakim, et al.
(författare)
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Increased Gun Violence Among Young Males in Sweden : a Descriptive National Survey and International Comparison
- 2019
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Ingår i: European Journal on Criminal Policy and Research. - : Springer Science and Business Media LLC. - 0928-1371 .- 1572-9869. ; 25:4, s. 365-378
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Tidskriftsartikel (refereegranskat)abstract
- This population-based time-trend study examines gun violence rates among males in Sweden during the years 1996 to 2015 and compares the rate in Sweden to other Western European countries. Data were collected from six registries and are presented descriptively per 100,000 inhabitants. The risks among males in Sweden increased considerably in both lethal and non-lethal gun victimization and perpetration. Among males aged 15 to 29 there was a five-fold increase in risk for victimization in lethal and non-lethal gun violence during the 20-year observation period. In a comparative perspective the rate of gun homicide victimization among males 15 to 29 years was higher in Sweden compared to other Western European countries, while the risk for males over age 30 was at an average level. Based on the results of this study we conclude that gun violence among young males in Sweden has been on the rise and is at a high level compared to other Western European countries. The development of gun violence in Sweden can be characterized as endemic, prevalent in both population and socially vulnerable areas.
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| 4. |
- Samuelsson, Eva, et al.
(författare)
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Effect of pharmacological treatment for urinary incontinence in the elderly and frail elderly: A systematic review
- 2015
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Ingår i: Geriatrics & Gerontology International. - : Wiley. - 1444-1586 .- 1447-0594. ; 15:5, s. 521-534
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The prevalence and severity of urinary incontinence (UI) increase with age and comorbidity. The benefits of pharmacotherapy for UI in the elderly are questionable. The aim of the present study was to systematically review the efficacy of pharmacological treatment for UI in the elderly and frail elderly. Methods: We searched PubMed, EMBASE, Cochrane library and Cinahl databases through October 2013 to identify prospective controlled trials that evaluated pharmacological treatment for UI in persons aged >= 65 years. Elderly persons living in nursing homes were regarded as frail elderly. Outcomes were urinary leakage, quality of life and adverse events. Results: We screened 1038 abstracts and assessed 309 full-text articles. We identified 13 trials of high or moderate quality; 11 evaluated anticholinergic drugs and two evaluated duloxetine. Oxybutynin, the only drug studied in the frail elderly population, had no effect on urinary leakage or quality of life in elderly with urgency UI (UUI). Seven trials evaluated the effects of darifenacin, fesoterodine, solifenacin, tolterodine or trospium. Urinary leakage decreased (standard mean difference: -0.24, 95% confidence interval -0.32-0.15), corresponding to a reduction of half a leakage per 24 h. Common side-effects of treatment were dry mouth and constipation. Data were insufficient for evaluation of the effect on quality of life or cognition. The evidence was insufficient to evaluate the effects of duloxetine. No eligible studies on mirabegron and estrogen were found. Conclusions: Anticholinergics have a small, but significant, effect on urinary leakage in older adults with UUI. Treatment with drugs for UUI in the frail elderly is not evidence based.
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| 5. |
- Anderberg, Peter, et al.
(författare)
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Analyzing nursing students’ relation to electronic health and technology as individuals and students and in their future career (the ENURSED study) : Protocol for a longitudinal study
- 2019
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Ingår i: Journal of Medical Internet Research. - : Journal of Medical Internet Research. - 1438-8871. ; 21:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: The nursing profession has undergone several changes in the past decades, and new challenges are to come in the future; patients are now cared for in their home, hospitals are more specialized, and primary care will have a key role. Health informatics is essential in all core competencies in nursing. From an educational perspective, it is of great importance that students are prepared for the new demands and needs of the patients. From a societal point of view, the society, health care included, is facing several challenges related to technological developments and digitization. Preparation for the next decade of nursing education and practice must be done, without the advantage of certainty. A training for not-yet-existing technologies where educators should not be limited by present practice paradigms is desirable. This study presents the design, method, and protocol for a study that investigates undergraduate nursing students’ internet use, knowledge about electronic health (eHealth), and attitudes to technology and how experiences of eHealth are handled during the education in a multicenter study. Objective: The primary aim of this research project is to describe the design of a longitudinal study and a qualitative substudy consisting of the following aspects that explore students’ knowledge about and relation to technology and eHealth: (1) what pre-existing knowledge and interest of this area the nursing students have and (2) how (and if) is it present in their education, (3) how do the students perceive this knowledge in their future career role, and (4) to what extent is the education capable of managing this knowledge? Methods: The study consists of two parts: a longitudinal study and a qualitative substudy. Students from the BSc in Nursing program from the Blekinge Institute of Technology, Karlskrona, Sweden, and from the Swedish Red Cross University College, Stockholm/Huddinge, Sweden, were included in this study. Results: The study is ongoing. Data analysis is currently underway, and the first results are expected to be published in 2019. Conclusions: This study presents the design of a longitudinal study and a qualitative substudy. The eHealth in Nursing Education eNursEd study will answer several important questions about nursing students’ attitudes toward and use of information and communications technology in their private life, their education, and their emerging profession. Knowledge from this study will be used to compare different nursing programs and students’ knowledge about and relation to technology and eHealth. Results will also be communicated back to nursing educators to improve the teaching of eHealth, health informatics, and technology. ©Peter Anderberg, Gunilla Björling, Louise Stjernberg, Doris Bohman.
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| 6. |
- Hälleberg Nyman, Maria, 1968-, et al.
(författare)
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Promoting evidence-based urinary incontinence management in acute nursing and rehabilitation care : A process evaluation of an implementation intervention in the orthopaedic context
- 2019
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell Publishing Inc.. - 1356-1294 .- 1365-2753. ; 25:2, s. 282-289
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Tidskriftsartikel (refereegranskat)abstract
- RATIONALE, AIMS, AND OBJECTIVES: The risk of developing urinary incontinence (UI) is associated with older age and hip surgery. There has been limited focus on factors that promote evidence-based UI practice in the orthopaedic context. The aim of this study was to evaluate an implementation intervention to support evidence-based practice for UI in patients aged 65 or older undergoing hip surgery.METHODS: A 3-month intervention was delivered in 2014 to facilitate the implementation of UI knowledge in orthopaedic units in 2 hospitals in Sweden. Each unit appointed a multidisciplinary team of nurses and physiotherapists or occupational therapists to facilitate the implementation. The teams were supported by external facilitators who shared knowledge about UI and implementation science. Interviews, nonparticipant observations, and audits of patient records were performed.RESULTS: Prior to the intervention, there was no use of guidelines regarding UI. The intervention raised the internal facilitators' awareness of UI risks associated with hip surgery. As internal facilitators shared this information with their peers, staff awareness of UI increased. The teams of internal facilitators described needing additional time and support from managers to implement evidence-based UI care. A management initiative triggered by the intervention increased the documentation of UI and urinary problems in 1 unit.CONCLUSION: To promote evidence-based practice related to safe procedures for older people in hospital care, there is a need to better understand strategies that successfully facilitate knowledge implementation. This study suggests that a multiprofessional team approach is promising for instigating a process towards evidence-based management of UI.
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| 7. |
- Hälleberg Nyman, Maria, 1968-, et al.
(författare)
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Urinary incontinence and its management in patients aged 65 and older in orthopaedic care : what nursing and rehabilitation staff know and do
- 2017
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Ingår i: Journal of Clinical Nursing. - West Sussex, United Kingdom : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 26:21-22, s. 3345-3353
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To describe what nursing and rehabilitation staff know and do with regards to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery.Background: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent UI, there are indications that these guidelines are not applied in hospital care.Design: A qualitative study with descriptive design was conducted in two orthopaedic units.Methods: 46 interviews and 36 observations of care were conducted from January to October 2014 and analysed with qualitative content analysis.Results: Enrolled nurses performed most of the care related to bladder function, with focus on urinary catheterisation and preventing urinary tract infection and urinary retention. Registered nurses' role in urinary matters mainly comprised documentation, while the rehabilitation staff focused on making it possible for the patient to be independent in toileting. The nursing staff considered urinary incontinence a common condition for older people and that it was convenient for the patients to have an indwelling catheter or incontinence pad/pant, although they acknowledged some of the risks associated with these procedures.Conclusions: Urinary incontinence is not a priority in orthopaedic care, and urinary incontinence guidelines are not applied. Further, attitudes and actions are mainly characterised by a lack of urinary incontinence knowledge and the nursing and rehabilitation staff do not take a team approach to preventing and managing UI.Relevance and clinical practive: An increased focus on knowledge on urinary incontinence and evidence-based guidelines is needed. To secure evidence-based practice, the team of nursing and rehabilitation staff and managers must be aligned and work actively together, also including the patient in the team.
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| 8. |
- Tistad, Malin, et al.
(författare)
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Resource use of healthcare services 1 year after stroke : a secondary analysis of a cluster-randomised controlled trial of a client-centred activities of daily living intervention
- 2018
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 8:8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of the study was to compare the total use of healthcare services in the course of the first year after a stroke between participants who, after the acute care, had received occupational therapy as a client-centred activities of daily living (ADL) intervention (CADL) and participants who had received usual ADL intervention (UADL).DESIGN: A secondary analysis of a multicentre cluster-randomised controlled trial (RCT).SETTING: Primary and secondary care in Sweden.PARTICIPANTS: Participants were included if they: (1) had received CADL or UADL in the RCT, either as inpatients in geriatric rehabilitation units or in their own homes, and (2) data could be retrieved about their use of healthcare services provided by the county council from computerised registers.INTERVENTIONS: CADL or UADL.OUTCOME MEASURES: Inpatient and outpatient healthcare in the course of the first year after stroke.RESULTS: Participants from 7 of the 16 units included in the RCT met the criteria. Participants in the CADL group (n=26) who received geriatric inpatient rehabilitation had a shorter length of hospital stay (p=0.03) than participants in the UADL group (n=46), and the CADL group with home rehabilitation (n=13) had fewer outpatient contacts (p=0.01) compared with the UADL group (n=25). Multiple regression analyses showed that in four of the models, a higher age was associated with a lower use of healthcare services. The use of healthcare services was also associated (some of the models) with dependence in ADL, stroke severity and type of rehabilitation received, CADL or UADL.CONCLUSIONS: The provision of client-centred occupational therapy after stroke did not appear to increase the use of healthcare services during the first year after stroke.rrrrr TRIAL REGISTRATION NUMBER: NCT01417585.
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| 9. |
- Gaber, Sophie N., et al.
(författare)
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Everyday technologies and public space participation among people with and without dementia
- 2019
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Ingår i: Canadian Journal of Occupational Therapy / Revue Canadienne d`Ergotèrapie. - Stockholm : Sage Publications. - 0008-4174 .- 1911-9828. ; 86:5, s. 400-411
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Tidskriftsartikel (refereegranskat)abstract
- Background.: Occupational therapists support everyday technology use; however, it is necessary to consider the challenges that people with dementia encounter with everyday technologies when participating in various places within public space.Purpose.: The purpose of the study was to explore stability and change in participation in places visited within public space in relation to the relevance of everyday technologies used within public space.Method.: People with dementia (n = 35) and people with no known cognitive impairment (n = 34) were interviewed using the Participation in Activities and Places Outside Home Questionnaire and the Everyday Technology Use Questionnaire. Data analysis used modern and classical test theory.Findings.: Both samples participated in places within public space; however, participation and relevance of everyday technologies were significantly lower for the dementia group.Implications.: To enable participation, occupational therapists need to be aware of challenges that technologies and places within public space present to people with dementia.
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| 10. |
- Magnéli, Martin, et al.
(författare)
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Validation of adverse events after hip arthroplasty : a Swedish multi-centre cohort study.
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:3
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Preventing adverse events (AEs) after orthopaedic surgery is a field with great room for improvement. A Swedish instrument for measuring AEs after hip arthroplasty based on administrative data from the national patient register is used by both the Swedish Hip Arthroplasty Register and the Swedish Association of Local Authorities and Regions. It has never been validated and its accuracy is unknown. The aim of this study was to validate the instrument's ability to detect AEs, and to calculate the incidence of AEs following primary hip arthroplasties.DESIGN: Retrospective cohort study using retrospective record review with Global Trigger Tool methodology in combination with register data.SETTING: 24 different hospitals in four major regions of Sweden.PARTICIPANTS: 2000 patients with either total or hemi-hip arthroplasty were recruited from the SHAR. We included both acute and elective patients.PRIMARY AND SECONDARY OUTCOME MEASURES: The sensitivity and specificity of the instrument. Adjusted cumulative incidence and incidence rate.RESULTS: The sensitivity for all identified AEs was 5.7% (95% CI: 4.9% to 6.7%) for 30 days and 14.8% (95% CI: 8.2 to 24.3) for 90 days, and the specificity was 95.2% (95% CI: 93.5% to 96.6%) for 30 days and 92.1% (95% CI: 89.9% to 93.8%) for 90 days. The adjusted cumulative incidence for all AEs was 28.4% (95% CI: 25.0% to 32.3%) for 30 days and 29.5% (95% CI: 26.0% to 33.8%) for 90 days. The incidence rate was 0.43 AEs per person-month (95% CI: 0.39 to 0.47).CONCLUSIONS: The AE incidence was high, and most AEs occurred within the first 30 days. The instrument sensitivity for AEs was very low for both 30 and 90 days, but the specificity was high for both 30 and 90 days. The studied instrument is insufficient for valid measurements of AEs after hip arthroplasty.
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