| 1. |
- Hommel, Ami, et al.
(författare)
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Influence of optimised treatment of people with hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year
- 2008
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Ingår i: Injury. - : Elsevier. - 0020-1383 .- 1879-0267. ; 39:10, s. 1164-1174
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Tidskriftsartikel (refereegranskat)abstract
- Hip fractures are a major cause of hospital stay among the elderly, and result in increased disability and mortality. In this study from 1 April 2003 to 31 March 2004, the influence of optimised treatment of hip fracture on time to operation, length of hospital stay, reoperations and mortality within 1 year were investigated. Comparisons were made between the first 210 patients in the period and the last 210 patients, who followed the new clinical pathway introduced at the University Hospital in Lund, Sweden. Early surgery, within 24h, was not associated with reduced mortality, but was significantly associated with reduced length of stay (p<0.001). Significantly more cases of osteosynthesis for femoral neck fracture were reoperated compared with all other types of surgery (p<0.001) when reoperations with extraction of the hook pins in healed fractures were excluded. Mortality was significantly higher among men than women at 4 (p=0.025) and 12 (p=0.001) months after fracture and among medically fit patients with administrative delay to surgery compared with patients with no delay (p<0.001).
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| 2. |
- Franzén, Kristofer, et al.
(författare)
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Impact of chronic heart failure on elderly persons' daily life : a validation study
- 2006
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 5:2, s. 137-145
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Knowledge about how elderly persons perceive the impact of chronic heart failure (CHF) on daily life is important when planning nursing care. For this purpose, disease specific instruments are needed. However, few instruments have been developed or tested specifically on elderly persons. AIM: To validate a Swedish version of the Minnesota Living with Heart Failure Questionnaire (LHFQ) on elderly persons with CHF, and use it to describe the impact of CHF on daily life in the same population. METHODS: The sample comprised of 357 persons, aged between 65 and 99, diagnosed with CHF. A questionnaire including background data, the LHFQ and the SF-12 was used. RESULTS: A factor analysis resulted in four dimensions: physical, emotional, treatment and pleasure. LHFQ showed convergent validity and ability to discriminate between known groups. Cronbach's alpha for the total scale was 0.94. Impairments in the physical dimension were most common, especially fatigue (88%) and shortness of breath (87%). CONCLUSIONS: The LHFQ showed satisfying psychometric properties in an elderly Swedish population with CHF and can, with minor alterations, be recommended for research and clinical use. The impact of chronic heart failure on daily life was mostly physical, but other impairments were also common.
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| 3. |
- Franzén, Kristofer, et al.
(författare)
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Predictors for health related quality of life in persons 65 years or older with chronic heart failure
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 6:2, s. 112-120
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA main goal in nursing care of persons with chronic heart failure (HF) is to strengthen their health related quality of life (HRQoL). This presupposes knowledge about the relation between heart failure and HRQoL. Existing studies have shown incongruent results about whether HRQoL is affected differently depending on age or sex of elderly persons with chronic HF.AimThis study aimed to investigate if age, sex, disease severity, comorbidity and living conditions predict health related quality of life among persons 65 years or older with chronic HF.MethodsThe study included a sample of 357 persons. HRQoL was measured by the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. Multiple regression analyses were performed to analyse the relation between the predictors and HRQoL.ResultsThe main finding was that self-rated disease severity was strongly associated with HRQoL, but also age, sex, diabetes and respiratory diseases was associated with some of the dimensions of HRQoL.ConclusionsInterventions aimed at delaying the progress of the disease, assist persons' to cope with the disease and maintain the domains of HRQoL that are still feasible could be important to improve HRQoL in elderly persons with chronic HF.
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| 4. |
- Karlsson, Staffan, et al.
(författare)
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Older people receiving public long-term care in relation to consumption of medical health care and informal care
- 2008
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Ingår i: The Open Geriatric Medicine Journal. - Bussum : Bentham Open. - 1874-8279. ; 1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate medical health care and informal care consumption among older people receiving public long-term care, and factors associated with medical health care consumption. 1958 persons aged 65 years and over were included. Data were collected from two registers, including demography, functional ability and received long-term, informal and medical health care. 35% of those at home were admitted to hospital and 76% had contact with outpatient care by physician compared to 26% and 87% respectively of those in special accommodation. Living in special accommodation was associated with more contacts with primary health care and fewer contacts with specialist care other than psychiatric care. Informal care was associated with more contacts with primary health care, specialist care, admissions to and days in hospital. More elderly people being cared for at home may mean more hospital and outpatient care consumption.
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| 5. |
- Johansson, Gunvi, et al.
(författare)
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Measuring oral health from a public health perspective
- 2008
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Ingår i: Swedish Dental Journal. - Stockholm : Swedish Dental Journal. - 0347-9994. ; 32:3, s. 125-137
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Tidskriftsartikel (refereegranskat)abstract
- The paper aims to analyse measures of oral health-related quality of life (OHQOL) from a Public Health perspective. Twenty-two measures were analysed conceptually as to their mirroring of the Public Health principles: empowerment, participation, holism and equity. Elements of empowerment were found in connection with application of the measures. Participation was found in using lay opinions during development in 12 measures. All measures analysed had elements of a holistic approach so far that they were not wholly biological. Two measures captured positive health effects. Measures were available for all ages, various languages and populations, an element of equity. No measure was wholly compatible with Public Health. They were based on a utilitarian theory not in full accordance with modern health promotion. There is a need to develop measures that more obviously capture the positive aspects of health and health as a process, as well as the personal perspective of oral health.
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| 6. |
- Rothenberg, Elisabet, et al.
(författare)
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Texture-modified meat and carrot products for elderly people with dysphagia : preference in relation to health and oral status
- 2007
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Ingår i: Scandinavian Journal of Food and Nutrition. - : Taylor & Francis. - 1748-2976 .- 1748-2984. ; 51:4, s. 141-147
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Tidskriftsartikel (refereegranskat)abstract
- Background: Reduced taste and smell, chewing problems and swallowing dysfunction are common among elderly people and affect perception, food choice and the ability to eat. Objective: To study the preference for texture-modified carrot and meat products in elderly people aiming to meet the needs of people with impaired chewing and/or swallowing. Design: Data were collected using questionnaires focusing on health, oral status and preference for the products. Altogether, 108 elderly people in ordinary housing (OH) and 50 living in special housing (SH) in Malmö (SH-M) and Göteborg (SH-G) participated. Results: 19% had a body mass index 522, predominantly in SH (24%). Stroke was reported by 20% of the subjects in SH. Among those with subjectively experienced difficulties in swallowing (12%), 58% reported coughing, 21% a gurgly voice in association with food intake and 50% obstruction during swallowing. Only 20% with subjective swallowing difficulties had been specifically examined regarding this problem. All the tested products were easy to masticate and swallow. Compared with OH, people in SH-M found the meatproducts easier to masticate and swallow. Compared with OH, subjects in SH found the carrot products easier to masticate. Conclusions: There is a need to develop tasty texture-modified nutritious food products for people with mastication and/or swallowing problems. Possible factors for differences in preference between groups, in this study OH and SH, may be related to health status in general and specifically mastication and swallowing functions.
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| 7. |
- Borglin, Gunilla, et al.
(författare)
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Older people in Sweden with various degrees of present quality of life : their health, social support, everyday activities and sense of coherence.
- 2006
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Ingår i: Health & Social Care in the Community. - : Blackwell Publishing. - 0966-0410 .- 1365-2524. ; 14:2, s. 136-146
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Tidskriftsartikel (refereegranskat)abstract
- Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly 'healthy' older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with 'present QoL' as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with 'poor or bad' self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more 'excellent or good' self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of 'poor or bad' self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.
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| 8. |
- Hagell, Peter, et al.
(författare)
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Measuring fatigue in Parkinson's disease : a psychometric study of two brief generic fatigue questionnaires.
- 2006
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Ingår i: Journal of Pain and Symptom Management. - : Elsevier. - 0885-3924 .- 1873-6513. ; 32:5, s. 420-32
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated and compared the measurement properties of the 13-item Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F) and the 9-item Fatigue Severity Scale (FSS) in 118 consecutive Parkinson's disease (PD) patients, using traditional and Rasch measurement methodologies. Both questionnaires exhibited excellent data quality and reliability (coefficient alpha>or=0.9), and acceptable rating scale functionality, and both discriminated between fatigued and nonfatigued patients. Factor and Rasch analyses provided general support for unidimensionality of both FACIT-F and FSS, although they do not appear to measure identical aspects of fatigue. No signs of differential item functioning (DIF) were found for the FACIT-F, whereas potential age DIF was detected for two FSS items. These results support the measurement validity of both questionnaires in PD, although the FACIT-F displayed better measurement precision and modest psychometric advantages over the FSS. Availability of psychometrically sound fatigue measures that are applicable across disorders provides a sound basis for advancing the understanding of this common and distressing complaint.
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| 9. |
- Bengtsson Tops, Anita, et al.
(författare)
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The structure of Antonovsky's sense of coherence in patients with schizophrenia and its relationship to psychopathology
- 2005
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 19:3, s. 280-287
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Tidskriftsartikel (refereegranskat)abstract
- The main aim of the study was to investigate whether the three hypothesized subscales of Antonovsky's sense of coherence (SOC) scale: comprehensibility, meaningfulness and manageability, can be found when measuring SOC in a sample of patients with schizophrenia living in the community. A further aim was to study the relationship between SOC and psychopathology. The concept of SOC has been proposed to explain successful coping with life stressors. A total of 120 patients completed the SOC scale and the Brief Psychiatric Rating Scale (BPRS) was used to assess the psychopathology of the patients. The SOC scale was analysed by means of a factor analysis with a varimax rotation and the Spearman rank correlation test was used to test for associations between subscales, factors and psychiatric symptoms. A four-factor model presented the best solution and explained 48% of the total variation in SOC. The first factor, which included 12-items of the SOC scale, turned out to be the most salient factor explaining 29% of the total variation. All factors displayed some overlapping between items. Affective symptoms were negatively related to all the three subscales and the four factors of SOC, while positive symptoms were similarly related to two of the subscales and two of the factors while negative symptoms were not associated with any of the factors or subscales. The findings in this study corroborate those in studies with other patient groups and indicate that the theoretical framework of SOC should not be adopted uncritically. Furthermore, the use of the three subscales in the SOC scale in studies of patients with a severe mental illness is questioned and a further investigation of the relationship between SOC and psychopathology is proposed.
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| 10. |
- Sandman, Lars, et al.
(författare)
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Ethical considerations of refusing nutrition after stroke
- 2008
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Ingår i: Nursing Ethics. - : Sage Publications Ltd.. - 0969-7330 .- 1477-0989. ; 15:2, s. 147-59
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to analyse and discuss the ethically problematic conflict raised by patients with stroke who refuse nutritional treatment. In analysing this conflict, the focus is on four different aspects: (1) Is nutritional treatment biologically necessary? (2) If necessary, is the reason for refusal a functional disability, lack of appetite or motivation, misunderstanding of the situation or a genuine conflict of values? (3) If the latter, what values are involved in the conflict? (4) How should we deal with the different kinds of refusal of nutritional treatment? We argue that patients' autonomy should be respected as far as possible, while also considering that those who have suffered a stroke might re-evaluate their life as a result of a beneficial prognosis. However, if patients persist with their refusal, health care professionals should force nutritional treatment only when it is clear that the patients will re-evaluate their future life.
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