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- Edell-Gustafsson, Ulla, 1947-, et al.
(författare)
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Measurement of sleep and quality of life before and after coronary artery bypass grafting : A pilot study
- 1997
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Ingår i: International Journal of Nursing Practice. - : Wiley. - 1322-7114 .- 1440-172X. ; 3:4, s. 239-246
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to: (i) test different instruments that focused on sleep, quality of life and personal adjustment in order to evaluate the usefulness of these instruments in a larger study; and (ii) to describe self perceptions of sleep and life situation by patients who had undergone coronary artery bypass grafting (CABG). A one-group pre-test repeated post-test design was used. Six men aged between 51 and 70 years were interviewed, and 24 h polysomnographic recordings were performed before and after the operation. The interviews indicated disturbed sleep and changes in behaviour and mental state immediately postoperatively. Postoperatively the polysomnographic recordings revealed a significant decrease in mean duration of sleep, mean percentage of stage 3-4 sleep and mean rapid eye movement (REM) sleep. One month after surgery the quality of life was improved, while moderate anxiety and sensation of incisional pain persisted. The measurements used in this pilot study provide valuable information into the understanding of altered sleep, quality of life and personal adjustment following CABG.
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- Edell-Gustafsson, Ulla, 1947-
(författare)
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Sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting
- 1999
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- In this thesis sleep, psychological symptoms and quality of life (Qol) in patients undergoing coronary artery bypass grafting (CABG) at the University Hospital in Linköping were evaluated. Interviews and 24-hour polysomnography were performed prior to surgery, immediately after surgery and again at one month, with a six-month-follow-up mailed questionnaire. Habitual sleep was evaluated using the Uppsala Sleep Inventory questionnaire and a diary the recorded mornings. The Spielberger State of Anxiety Scale and the Zung's Self-rating Depression Scale were used to measure anxiety and depression, respectively. Physical functional capacity was assessed according to the New York Heart Association's (NYHA) classes and Qol, with the Nottingham Health Profile instrument (NHP).A retrospective evaluation of nurse's documentation about sleep was also performed. In addition, the quality and quantity of sleep were assessed before surgery and in the immediate postoperative period in a pilot study, with a one-month follow-up interview. The results indicated disturbed sleep, and changes in behaviour and mental state after surgery due to fragmented sleep, pain and anxiety.Forty-four patients were examined prior to surgery. The results showed that almost two-fifths experienced too little sleep habitually and 50 % had a combination of at least two sleep problems. Poorer health, higher level of anxiety and increased difficulties maintaining sleep (DMS) were consistent with significantly longer sleep latency, increased fragmented sleep, and reduced stages 3 and 4 and RIM sleep measured by polysomnography. The level of Qol on the NBP was significantly associated with objectively measured sleep.In the immediate period following CABG there is a changed distribution of sleep, with a reduction of nocturnal sleep duration and an increase in daytime sleep, which had almost returned to preoperative values one month after surgery. Qol was significantly improved six months after surgery compared to before surgery.It was noted that patients with a more anxiety prone reactivity during six months following CABG had significantly more sleep disturbances, reduced energy and functional physical capacity, and lower quality of life, compared to those without such reactivity. Significantly more sleep disturbances, reduced energy and lower quality of life were more prominent among those with sadness/depression or cognitive/behavioural fatigue as reactions to sleep loss. A higher degree of cognitive/behavioural fatigue and dysphoria reactions were associated with a higher NYHA class.In conclusion, patients with coronary artery disease have poor quantity and quality of sleep. Increased psychological symptoms in patients with CAD prior to surgery were associated with greater symptoms six months after surgery. Physical functional capacity and quality of life were significantly improved six months after surgery.
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- Götherström, Christine, et al.
(författare)
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Development of a tool for measuring the concept of good care among patients and staff in relation to Swedish legislation
- 1995
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Ingår i: International Journal of Nursing Studies. - 0020-7489 .- 1873-491X. ; 32:3, s. 277-87
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Tidskriftsartikel (refereegranskat)abstract
- An instrument for measuring the concept of good care, in relation to the Swedish Health and Medical Services Act, has been developed and tested in short-term care. The instrument comprises 14 statements on good care. The construct validity was estimated by factor analysis based on the results from 240 patients. Five factors explained 62% of the variance of the 14 variables and covered the following areas: information, security, accessibility, continuity, and influence and respect. Patients (n = 240) and registered nurses (n = 57) showed differences in estimations of the concept of good care on all factors. There were only minor differences, however, within the patient group and the nursing group, respectively, on comparing the two samples. The instrument needs further testing in different care conditions.
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- Idvall, Ewa, et al.
(författare)
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A tentative model for developing strategic and clinical nursing quality indicators : postoperative pain management
- 1999
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Ingår i: International journal of nursing practice. - 1322-7114. ; 5:4, s. 216-226
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to evaluate the usefulness of a tentative model, based on important aspects of surgical nursing care, for designing strategic and clinical quality indicators. Objective postoperative pain management was chosen for the model because it is a priority area in surgical nursing care. Items within a questionnaire were designed by using the tentative model as a base and by means of a literature review. The questionnaire, directed to clinical nurses (n = 233), was compiled to establish the validity and the usefulness of the indicators. Fourteen items were assessed as essential for achieving high quality outcomes in postoperative pain management (11 as realistic to carry out, and 13 as possible for nurses to influence) with mean scores > or = 4 (on a 5-point scale). The conclusion reached was that the tentative model combined with a literature search was found to be effective for designing items that might be useful as strategic and clinical indicators of quality in postoperative pain management.
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- Räty, Lena, et al.
(författare)
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Quality of life in newly-debuted epilepsy : an empirical study
- 1999
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Ingår i: Acta Neurologica Scandinavica. - : Hindawi Limited. - 0001-6314 .- 1600-0404. ; 100:4, s. 221-226
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Tidskriftsartikel (refereegranskat)abstract
- Objectives - This study aimed to illuminate adult's experienced quality of life in newly-debuted epilepsy and to test the American instrument Quality of Life Index (QLI) for the first time on an epilepsy population. A second aim was to find appropriate questions to measure patient perceptions in epilepsy.Material and methods - All persons 18–65 fulfilling criteria (n=41) and diagnosed during a 15-month period at 2 Swedish hospitals, answered questionnaires (n= 37/41) on quality of life and perceptions of epilepsy.Results - Patients experienced the highest quality in the “Family” domain and the lowest in the “Psychological/ spiritual”. Significant correlations were found between quality of life and experienced change of life situation, own perceptions of epilepsy, seizure frequency after diagnosis, gender and side effects from antiepileptic drugs. The QLI was well applicable on people with epilepsy.Conclusions - Data indicates that debut of epilepsy has an evident impact on quality of life and a more extensive study is required.
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