| 1. |
- Dozet, Alexander, et al.
(författare)
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Radiography on wheels arrives to nursing homes - an economic assessment of a new health care technology in southern Sweden
- 2016
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley-Blackwell. - 1356-1294 .- 1365-2753. ; 22:6, s. 994-1001
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectives: The process of transferring older, vulnerable adults from an elder care facility to the hospital for medical care can be an emotionally and physically stressful experience. The recent development of modern mobile radiography may help to ease this anxiety by allowing for evaluation in the nursing home itself. Up until this point, no health economic evaluation of the technology has been attempted in a Swedish setting. The objective of this study was to determine whether examinations of patients in elder care facilities with mobile radiography were cost-effective from a societal perspective compared with hospital-based radiological examinations.Methods: This prospective study included two groups of nursing home residents in two different areas in southern Sweden. All residents in the nursing homes were targeted for the study. Seventy-one patients were examined with hospital-based radiography at two hospitals, and 312 patients were examined using mobile radiography in nursing homes. Given that the diagnostic effects are regarded as equivalent, a cost minimization method was applied. Direct costs were estimated using prices from the county council, Region Skane, Sweden.Results: From a societal perspective, mobile radiography was shown to have significantly lower costs per examination compared with hospital-based radiography. The difference in health care-related costs was also significant in favour of mobile radiography.Conclusion: Mobile radiography can be used to examine patients in nursing homes at a lower cost than hospital-based radiography. Patients benefit from not having to transfer to a hospital for radiography, resulting in reduced anxiety for patients.
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| 2. |
- Ivarsson, Bodil, et al.
(författare)
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Adherence and medication belief in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension : A nationwide population-based cohort survey
- 2018
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Ingår i: Clinical Respiratory Journal. - : Wiley. - 1752-6981 .- 1752-699X. ; 12:6, s. 2029-2035
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare diseases with a gradual decline in physical health. Adherence to treatment is crucial in these very symptomatic and life threatening diseases. Objective: To describe PAH and CTEPH patients experience of their self-reported medication adherence, beliefs about medicines and information about treatment. Methods: A quantitative, descriptive, national cohort survey that included adult patients from all PAH-centres in Sweden. All patients received questionnaires by mail: The Morisky Medication Adherence Scale (MMAS-8) assesses treatment-related attitudes and behaviour problems, the Beliefs about Medicines Questionnaire-Specific scale (BMQ-S) assesses the patient's perception of drug intake and the QLQ-INFO25 multi-item scale about medical treatment information. Results: The response rate was 74% (n = 325), mean age 66 ± 14 years, 58% were female and 69% were diagnosed with PAH and 31% with CTEPH. Time from diagnosis was 4.7 ± 4.2 years. More than half of the patients (57%) reported a high level of adherence. There was no difference in the patients' beliefs of the necessity of the medications to control their illness when comparing those with high, medium or low adherence. Despite high satisfaction with the information, concerns about potential adverse effects of taking the medication were significantly related to adherence. Conclusions: Treatment adherence is relatively high but still needs improvement. The multi-disciplinary PAH team should, together with the patient, seek strategies to improve adherence and prevent concern.
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| 3. |
- Ivarsson, Bodil, et al.
(författare)
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Coping, social support and information in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension : A 2-year retrospective cohort study
- 2018
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Ingår i: SAGE Open Medicine. - : SAGE Publications. - 2050-3121. ; 6, s. 1-6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension are severe diseases with complicated treatment that need care at specialist clinics. The aim was to investigate changes in the patients' perceptions on coping, social support and received information when attending a newly started nurse-coordinated pulmonary arterial hypertension-outpatient clinic.Methods: The present study was a descriptive, questionnaire-based cohort study including 42 adult patients. To evaluate coping, the Pearlin Mastery Scale was used. Social support, information and health-related quality of life were measured using Social Network and Support Scale, QLQ-INFO25 and the EQ-5D.Results: Attending the pulmonary arterial hypertension-outpatient clinic increased coping ability (Mastery Scale) significantly (baseline 16.0 ± 3.3 points vs 2-year follow-up 19.6 ± 5.2 points, p < 0.001) while there was no difference in social network and support or in perception of received information after. Patients who improved their coping ability (67%) were younger, had better exercise capacity, experienced better health-related quality of life and were more satisfied with received information about treatment and medical tests than those who reduced the coping ability. There was no difference in gender, diagnosis, time since diagnose, pulmonary arterial hypertension-specific treatment, education level or civil status between the two groups.Conclusion: This study suggests that the pulmonary arterial hypertension-team, in partnership with the patient, can support patients to take control of their disease and increase their health-related quality of life.
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| 4. |
- Ivarsson, Bodil, et al.
(författare)
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Everyday life experiences of spouses of patients who suffer from pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension
- 2019
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Ingår i: ERJ Open Research. - : European Respiratory Society (ERS). - 2312-0541. ; 5:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Spouses play a crucial role, both physically and psychologically, for patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Our aim was to investigate the spouse's experiences when living with a partner diagnosed with PAH or CTEPH.Methods: We used a qualitative interview study design based on open-ended questions analysed using qualitative content analysis.Results: 14 spouses were interviewed. Two categories that describe spouses' experiences of dealing with everyday life were identified: "Living in an insecure life situation" and "Providing and receiving information and support". The experiences reported by the spouses were that their life situation was insecure, and that they had challenges in providing and receiving information and support. Most spouses also wanted and felt a need to be more involved in the care.Conclusion: The spouses were only partly satisfied with their life situation. To support the spouse's participation, the PAH/CTEPH team should encourage the patient to bring their spouse along, and offer them the opportunity to participate in the contacts with healthcare and provide information on an individual family perspective.
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| 5. |
- Ivarsson, Bodil, et al.
(författare)
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Experiences of supportive care when waiting for a lung re-transplantation
- 2017
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Ingår i: SAGE Open. - : SAGE Publications. - 2158-2440 .- 2050-3121. ; 5, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Lung transplant patients and their next of kin share the experiences of illness but little is known in the face of a lung re-transplantation. To describe patients' and next of kin's experiences of supportive care while awaiting lung re-transplantation and the objective was to highlight a small group with special circumstances and needs.METHODS: Using qualitative content analysis, seven adult patients and seven next of kin were consecutively selected from a regional lung transplantation centre and individually interviewed shortly after decision about lung re-transplantation.RESULTS: The experiences of supportive care were captured in one main category: 'once again haunted by death' and three sub-categories: 'when life turns and death once again snorts down your neck', 'the importance of information', and 'perceptions of support'. A complex interaction between the experience of waiting, and communication patterns, emotional states, and social support was shown.CONCLUSION: This study provides insights into the complex interaction between the experience of waiting for a second lung transplant and communication patterns, emotional states, social support and social roles between patients, next of kin, healthcare professionals, and the health and social welfare system. There is a need for developing supportive care programme to achieve the best possible care.
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| 6. |
- Ivarsson, Bodil, et al.
(författare)
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Health-related quality of life, treatment adherence and psychosocial support in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension
- 2019
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Ingår i: Chronic Respiratory Disease. - : SAGE Publications. - 1479-9723 .- 1479-9731. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) share similar quality of life impairment. The aim of the present study was to investigate health-related quality of life (HRQoL) and its relation to the perception of treatment and psychosocial support among PAH and CTEPH patients. All adult PAH or CTEPH patients in the Swedish Pulmonary Arterial Hypertension Register were invited to participate in a national cohort survey. The survey included the EuroQol 5-dimensions (EQ-5D) instrument that measures an individual's HRQoL; the Beliefs about Medicines Questionnaire-Specific Scale that assesses the perception of PAH-specific treatment; the Mastery scale that evaluates the feeling of control and ability to cope with the disease; and the Social Network and Support Scale that maps the social support network. Of the 440 invited patients, 74% responded. Mean age was 66 ± 14 years, 58% were female and 69% diagnosed with PAH. Patients with PAH were younger, more often female and had a lower EQ-5D index (0.67 ± 0.29 vs. 0.73 ± 0.25, p = 0.050) than patients with CTEPH. Patients with a low EQ-5D index had more concerns about treatment ( p = 0.004), lower coping ability ( p < 0.001), less emotional support ( p = 0.003) and less accessible social network ( p = 0.002). In conclusion, patients with an impaired HRQoL also reported negative effects on their social support network, ability to handle stressors and concerns about treatment.
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| 7. |
- Ivarsson, Bodil, et al.
(författare)
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Information and/or medical technology staff experience with regulations for medical information systems and medical devices
- 2016
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Ingår i: Health Policy and Technology. - : Elsevier BV. - 2211-8837. ; 5:4, s. 383-388
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Regulations heavily control medical technology (MT), which often includes information technology (IT), but staff experiences related to these regulations are unknown. The study aim was to assess Swedish IT/MT staff experiences regarding regulations for medical devices and medical information systems. Methods An anonymous, ten-item, self-report questionnaire was administered to IT and MT staff (N=228) who attended a 3-h training course on IT and information security and MT regulations in 2014. Results Most of the 228 (86%) IT and MT staff who completed the survey strongly agreed that IT security and MT security are relevant to patient safety. One third of the IT staff reported feeling that their knowledge about regulations within MT was sufficient. Less than half of the respondents experienced that healthcare professionals generally had sufficient knowledge of IT or MT regulations (41% versus 46%, IT and MT regulations, respectively). Conclusions Although IT/MT staff felt that they had knowledge of regulations for medical devices and medical information systems, they reported that maintaining and increasing this knowledge is important and that there is a need for recurring training programs in IT and MT regulations. Improved knowledge in IT and MT regulation, and a better understanding of clinical healthcare, could lead to an increased quality in the daily operations and support to the healthcare professionals. Healthcare professionals may need education to develop their knowledge of IT or MT regulations, which in turn will ensure higher patient safety.
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| 8. |
- Ivarsson, Bodil, et al.
(författare)
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Information, social support and coping in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension-A nationwide population-based study
- 2017
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 100:5, s. 936-942
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) decrease life expectancy for affected patients. The aim was to describe the perceptions of received information regarding diagnosis, treatment and management, as well as social support and coping perceived by patients with PAH or CTEPH. Methods: A descriptive, national cohort survey that included patients from all PAH-centres in Sweden. A quantitative methodology was employed where all patients received three questionnaires, QLQ-INFO25, Mastery Scale and Social Network & Support Scale. Results: The response rate was 74% (n. =325), mean age 66. ±. 14. years, 71% were female and 69% were diagnosed with PAH and 31% with CTEPH. Sixty percent of respondents were satisfied with the received information and felt it was helpful. Best experiences were of information in the areas of medical tests (70%) and the disease (61%). Forty-five percent wanted more information. Men described their social network as more accessible than women (p. =0.004). Those living alone had a lower coping ability. Conclusion: Despite a high level of satisfaction with the received information, almost half of the patients wanted more information. Practice implications: Regular repeating or giving new information should be an ongoing process in the care of patients at the PAH-centres.
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| 9. |
- Ivarsson, Bodil, et al.
(författare)
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Patientens perspektiv på att leva med PAH eller CTEPH i Sverige : Enkätstudie visar på betydelsen av adekvat och upprepad information
- 2019
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Ingår i: Läkartidningen. - 0023-7205. ; 116:18, s. 803-803
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Tidskriftsartikel (refereegranskat)abstract
- For patients living with chronic conditions, the daily life will change due to symptoms, drug treatment, and psychosocial factors caused by the disease. Our studies show that Swedish patients with PAH or CTEPH are satisfied with the information they have received, but still have a wish for more. Therefore, it is important to repeat the information on a regular basis and to make sure that patients have understood and remember the messages. In order to increase the knowledge about their disease, improve compliance with treatment and quality of life, patients and next of kin should continuously be informed by the multidisciplinary team at the PAH/CTEPHspecialist care centers.
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| 10. |
- Ivarsson, Bodil, et al.
(författare)
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Support Experienced by Patients Living with Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension
- 2016
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Ingår i: Heart, Lung and Circulation. - : Elsevier BV. - 1443-9506 .- 1444-2892. ; 25:1, s. 35-40
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Tidskriftsartikel (refereegranskat)abstract
- Background As pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are debilitating and fatal diseases it is essential to increase the understanding of patients' experience of support. The aim was to describe patients' experiences of support while living with PAH or CTEPH. Methods Seventeen patients (13 women and four men) aged 28-73 years were strategically selected from a regional PAH centre and individually interviewed. The answers were analysed using qualitative content analysis. Results Three categories that describe patients' experiences of support emerged: Support linked to the healthcare; support linked to the private sphere; and support linked to persons outside the private sphere. Conclusion Healthcare practitioners must work more in collaboration to detect patients' need for support and to develop the patient's own skills to manage daily life. The PAH teams should tailor interventions to provide emotional, informational and instrumental support and guidance to patients and their families.
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