| 1. |
- Ulin, Kerstin, 1963, et al.
(författare)
-
Flip focus and emphasise patient resources in person-centred care over the telephone-A retrospective descriptive study
- 2023
-
Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 37:3, s. 797-804
-
Tidskriftsartikel (refereegranskat)abstract
- Aim: The study aim was to describe the content of person-centred health plans, formulated via telephone conversations between registered nurses and patients with chronic obstructive pulmonary disease and/or chronic heart failure. Method: Patients who had been hospitalised due to worsening chronic obstructive pulmonary disease and/or chronic heart failure were enrolled. After hospital discharge, the patients received a person-centred telephone support where a health plan was co-created with registered nurses who had received training in the theory and practice of person-centred care. A retrospective descriptive review of 95 health plans using content analysis was conducted. Results: The health plan content revealed personal resources such as optimism and motivation in patients with chronic obstructive pulmonary disease and/or chronic heart failure. Although patients reported severe dyspnoea symptoms, the most common goals were to engage in physical activity and to be able to manage social life and leisure activities. Additionally, the health plans illustrated that patients were capable of using their own interventions to reach their goals rather than accessing municipal and health care support. Conclusion: The focus on listening, that person-centred telephone care affords, promotes the patient's own goals, interventions, and resources, which can be used to tailor support and engage the patient as an active partner in their care. The flipped focus from patient to person highlights the person's own resources, which in turn may contribute to a reduced need for hospital care.
|
|
| 2. |
- Ali, Lilas, 1981, et al.
(författare)
-
Effects of person-centred care via telephone on self-efficacy in patients with chronic obstructive pulmonary disease: Subgroup analysis of a randomized controlled trial
- 2021
-
Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 8:2, s. 927-935
-
Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To evaluate the effects of PCC in the form of structured telephone support on self-reported cardiac self-efficacy in patients with COPD. Methods: We enrolled 105 patients, aged ≥50years, admitted to hospital and diagnosed with COPD from January 2015 to November 2016. The patients received usual care or PCC via telephone added to usual care. The Swedish Cardiac Self-Efficacy Scale comprising three dimensions (control symptoms, control illness and maintain functioning) was used as outcome measure. Data was collected at baseline, and at 3- and 6-month follow-ups. Results: At both the 3- and 6-month follow-ups, the intervention group improved significantly more than the control group in the control illness dimension (p=.012 and p=.032, respectively). No differences were found in the other two dimensions. Conclusions: PCC in the form of structured telephone support increases patients’ confidence in managing their illness and may be a feasible strategy to support patients in their homes.
|
|
| 3. |
- Ali, Lilas, 1981, et al.
(författare)
-
Person-centred care by a combined digital platform and structured telephone support for people with chronic obstructive pulmonary disease and/or chronic heart failure: study protocol for the PROTECT randomised controlled trial
- 2020
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:7
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A core feature of chronic obstructive pulmonary disorder (COPD) and chronic heart failure (CHF) is that symptoms may change rapidly because of illness progression. Thus, these chronic conditions are associated with high rehospitalisation rates. Person-centred care (PCC) has been shown to have several benefits for patients with COPD or CHF (or both disorders) but it has not yet been investigated through e-health services. AIM: The project aims to evaluate the effects of PCC by a combined digital platform and structured telephone support for people with COPD and/or CHF. METHODS AND ANALYSIS: A randomised controlled trial with open, parallel groups which employs a participatory design process will be used. This project will also include process and health economic evaluation of the intervention. ETHICS AND DISSEMINATION: Ethical approval has been secured from the Regional Ethical Review Board in Gothenburg, Sweden (Dnr 063-17 and T063-18). Results will be presented at conferences and to healthcare professionals, participants and patient organisations. Findings will also be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03183817.
|
|
| 4. |
- Alsén, Sara, et al.
(författare)
-
Facing a blind alley - Experiences of stress-related exhaustion: a qualitative study
- 2020
-
Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10:9
-
Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Mental illness is a major concern in many countries. In Sweden, stress-related mental illness is currently the most frequent reason for sick leave. OBJECTIVE: This study aimed to explore patients' experiences of stress-related exhaustion. DESIGN: A qualitative study with interview data analysed using a phenomenological hermeneutic method. SETTING: Participants were selected from public primary healthcare centres in a larger city in western Sweden. PARTICIPANTS: Seven women and five men on sick leave from work due to stress-related exhaustion were included in the study. FINDINGS: Stress-related exhaustion was experienced as a loss of access to oneself and one's context and feelings of being trapped and lost in life. The condition had a significant impact on personal identity, raised existential issues and was interpreted as facing a blind alley. Participants described a mistaken direction in life, being forced to stop, change direction and act differently. CONCLUSION: Stress-related exhaustion is a challenging, life-changing existential experience that involves a crisis with an opportunity for new insights. Careful consideration of patients' narratives together with the expertise of healthcare professionals can be combined to improve health and optimise recovery based on individual's situation.
|
|
| 5. |
- Alsén, Sara, et al.
(författare)
-
Having allies—Experiences of support in people with stress-related exhaustion: A qualitative study
- 2022
-
Ingår i: Plos One. - : Public Library of Science (PLoS). - 1932-6203. ; 17
-
Tidskriftsartikel (refereegranskat)abstract
- Background The number of people seeking care for symptoms of exhaustion and stress is a major concern in several countries. The condition is a challenging and life-changing experience, and a deeper understanding of support to help people on sick leave due to stress-related exhaustion in their early stages is needed to facilitate recovery. Objective The aim was to explore experiences of support in people with stress-related exhaustion being on sick-leave less than six months. Method A qualitative interview study was conducted with 12 participants (7 women and 5 men; aged 25–46 years) who were on sick leave that had not exceeded six months due to stress-related exhaustion. The participants were recruited from public healthcare centres in the western part of Sweden, and the intention was to reach them early in their ongoing sick leave period. The interviews were performed face-to-face and analysed using a phenomenological hermeneutical approach. Results The findings show that people affected by stress-related exhaustion struggle to maintain their dignity and define support in terms of allies who acknowledge their personhood and provide them helpful guidance. Participants expressed their needs to be taken seriously by professionals, family, and friends willing to engage in their situation. Lack of empathy and professional knowledge in the clinical encounter induced additional stress. Conclusions This study indicates that people affected by stress-related exhaustion need allies from their surrounding networks in their struggle to maintain their dignity. Our findings highlight that it is essential to acknowledge them as persons and establish an alliance to provide appropriate support based on each person’s specific situation, needs and resources. This approach can be facilitated in a partnership, as emphasized in person-centred care (PCC). PCC emphasizes the co-creation of care in partnership between the patient (often with relatives) and health care professionals which may imply a more collaborative view of health care in which patients are engaged as active partners in planning their care.
|
|
| 6. |
- Barenfeld, Emmelie, 1981, et al.
(författare)
-
Becoming more of an insider: A grounded theory study on patients' experience of a person-centred e-health intervention.
- 2020
-
Ingår i: PloS one. - : Public Library of Science (PLoS). - 1932-6203. ; 15:11
-
Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore the experiences of a person-centred e-health intervention, in patients diagnosed with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF).Grounded theory was applied to gather and analyse data.The study is part of a research project evaluating the effects of person-centred care (PCC) using a digital platform and structured telephone support for people with COPD or CHF recruited from nine primary care units in Sweden.Twelve patients from the intervention group were purposefully selected in accordance with the initial sampling criteria.The intervention was delivered through a digital platform and telephone support system for 6 months. The intervention relied on person-centred ethics operationalised through three core PCC components: patient narratives, partnership and shared documentation.A core category was formulated: Being welcomed through the side door when lacking the front door keys. The core category reflects how a PCC intervention delivered remotely provides access to mutual and informal meetings at times when professional contacts were desired to support patient self-management goals. According to patients' wishes, family and friends were seldom invited as care partners in the e-health context.A PCC intervention delivered remotely as a complement to standard care in a primary care setting for patients diagnosed with COPD or CHF is a viable approach to increase patients' access and involvement in preventive care. The e-health intervention seemed to facilitate PCC, strengthen patients' position in the health service system and support their self-management.
|
|
| 7. |
|
|
| 8. |
- Barenfeld, Emmelie, 1981, et al.
(författare)
-
Meaningful use of a digital platform and structured telephone support to facilitate remote person-centred care - a mixed-method study on patient perspectives
- 2022
-
Ingår i: Bmc Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background Process evaluations are useful in clarifying results obtained from randomised controlled trials (RCTs). Traditionally, the degree of intervention usage in process evaluations is monitored by measuring dose or evaluating implementation fidelity. From a person-centred perspective, such evaluations should be supplemented with patients' experiences of meaningful use, given that intervention use should be agreed upon between interested parties and tailored to each patient. This study aimed to elucidate patients' experiences of a remote person-centred care (PCC) intervention by deepening the understanding of, if, how and for whom the intervention contributed to meaningful use. Methods Patients (n = 86) were recruited from the RCT PROTECT intervention group. A convergent mixed-method approach was implemented. Data were collected in parallel with the ongoing RCT via a survey, including ratings and written comments on meaningful or non-meaningful use. Also, interviews were performed with twelve purposefully selected participants. Descriptive statistics, logistic regression and content analysis were employed. Data sources were integrated in the results. Results Most participants rated the overall intervention as meaningful to use, with the telephone support rated as most meaningful. Interviews and written comments showed that patient ratings on meaningful use were explained by four categories: Not in need, Communication deficiency, Benefits in everyday life and A personal boost. Meaningful use of rating symptoms on the digital platform was predicted by living alone (adjusted odds ratio [aOR] = 2.8 P = .044). A diagnosis of chronic obstructive pulmonary disease (COPD) predicted meaningful use of digital platform direct messaging (aOR = 3.5, P = .045). Moreover, having access to direct-dial telephone contact explained meaningful use among participants with low ratings of technical competence (aOR = 3.6, P = .014). Conclusions The combined digital platform and structured telephone support could be helpful in identifying preventive actions to maintain health for people diagnosed with COPD and chronic heart failure but tends to be more meaningful for those diagnosed with COPD. Overall, lower adoption of the digital platform was seen compared to telephone support. Shortcomings were noted in the digital platform's implementation that negatively influences experiences of meaningful use. When used, the intervention proved to be an easily applicable and valued tool to support preventive actions in a person-centred manner.
|
|
| 9. |
- Blanck, Elin, et al.
(författare)
-
Informal carers in Sweden - striving for partnership
- 2021
-
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 16:1
-
Tidskriftsartikel (refereegranskat)abstract
- Informal carers have an important role in society through their care and support of their long-term ill relatives. Providing informal care is challenging and can lead to caregiver burden
|
|
| 10. |
- Blanck, Elin, et al.
(författare)
-
Self‐efficacy and healthcare costs in patients with chronic heart failure or chronic obstructive pulmonary disease
- 2023
-
Ingår i: ESC Heart Failure. - 2055-5822.
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract Aims This study aims to explore possible associations between self‐efficacy and healthcare and drug expenditures (i.e. direct costs) in patients with chronic heart failure (CHF) or chronic obstructive pulmonary disease (COPD) in a study investigating the effects of person‐centred care delivered by telephone. Methods and results This exploratory analysis uses data from an open randomized controlled trial conducted between January 2015 and November 2016, providing remote person‐centred care by phone to patients with CHF, COPD, or both. Patients hospitalized due to worsening of CHF or COPD were eligible for the study. Randomization was based on a computer‐generated list, stratified for age ≥ 75 and diagnosis. At a 6 month follow‐up, 118 persons remained in a control group and 103 in an intervention group. The intervention group received person‐centred care by phone as an addition to usual care. Trial data were linked to register data on healthcare and drug use. Group‐based trajectory modelling was applied to identify trajectories for general self‐efficacy and direct costs. Next, associations between self‐efficacy trajectories and costs were assessed using regression analysis. Five trajectories were identified for general self‐efficacy, of which three indicated different levels of increasing or stable self‐efficacy, while two showed a decrease over time in self‐efficacy. Three trajectories were identified for costs, indicating a gradient from lower to higher accumulated costs. Increasing or stable self‐efficacy was associated with lower direct costs ( P = 0.0013). Conclusions The findings show that an increased or sustained self‐efficacy is associated with lower direct costs in patients with CHF or COPD. Person‐centred phone contacts used as an add‐on to usual care could result in lower direct costs for those with stable or increasing self‐efficacy.
|
|
