| 1. |
- Söderström, Lisa, 1982-, et al.
(författare)
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Associations between dietary advice on modified fibre and lactose intakes and nutrient intakes in men with prostate cancer undergoing radiotherapy
- 2022
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Ingår i: Upsala Journal of Medical Sciences. - : Upsala Medical Society. - 0300-9734 .- 2000-1967. ; 127:1
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: A variety of non-evidence-based dietary advice on modified fibre and lactose intakes are provided to patients undergoing pelvic radiotherapy to counteract treatment-related bowel symptoms. More knowledge on the nutritional consequences of such advice is needed. This study aimed to explore how advice on modified fibre and lactose intakes during pelvic radiotherapy was associated with nutrient intakes amongst patients with prostate cancer.Methods: A total of 77 Swedish men who underwent radiotherapy (50/2 Gy + boost 20–30 Gy) in 2009–2014 due to prostate cancer were given dietary advice at radiotherapy onset (baseline) and at 4 and 8 weeks after radiotherapy onset, to modify their fibre and lactose intakes. At baseline, the participants completed a food frequency questionnaire (FFQ) and a 24-h dietary recall. At 4 and 8 weeks, the participants completed the FFQ and a 4-day estimated food record.Fibre and lactose intakes were measured by intake scores calculated from the FFQs. Multiple linear regression models were used to analyse associations between intake scores and fibre- and lactose-related nutrients.Results: In adjusted analyses, there were few significant associations between dietary advice on modified fibre and lactose intakes and observed intakes of fibre- and lactose-related nutrients. A more modified lactose intake was thus associated with a lower intake of calcium (P = 0.041), whilst a more modified fibre intake was associated with a higher value for the change in intake of vitamin C (P = 0.016).Conclusions: Dietary advice on modified fibre and lactose intake was in most cases not significantly associated with altered nutrient intakes, rather the energy and nutrient intakes were mostly stable during the pelvic radiotherapy. More research is needed on the nutritional consequences of dietary advice on modified fibre and lactose intakes to reach consensus on if they should continue to be provided in the clinic.
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| 2. |
- Fattahi, Nina, et al.
(författare)
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Risk factors in 50-year-old men predicting development of abdominal aortic aneurysm
- 2020
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 0741-5214 .- 1097-6809. ; 72:4, s. 1337-1346
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abdominal aortic aneurysm (AAA) is a potentially lethal condition associated with several well-known risk factors including age, smoking, and male sex. The aim of this study was to identify risk factors predicting future development of AAA, which could influence future prevention strategies.Methods: This study collected the data sets of the Westmannia Cardiovascular Risk Factors Study (WICTORY) from 1990 to 1999 and combined them with cases of individuals who have undergone ultrasound examination of the infrarenal aortic diameter as part of the Vastmanland County's ongoing AAA screening program that commenced in 2007 or for other purposes. The study analyzed 5817 men aged 50 years at the time they participated in WICTORY and who underwent an ultrasound examination of the infrarenal aorta on average 15 years later.Results: The prevalence of AAA in our study was 2.6%. Age, smoking status, angina pectoris treatment, prior myocardial infarction, blood pressure treatment, body mass index, waist circumference, systolic blood pressure, heart rate, and total cholesterol level were found to be associated with the development of AAA later in life in the univariate analysis. In the multivariate analysis, current smokers at age 50 years had 11 times higher risk for later development of AAA (hazard ratio [HR], 11.178; confidence interval [CI], 6.277-19.908; P < .001). Former smokers did not suffer a similar risk of AAA development. Elevated total cholesterol concentration at baseline was associated with later AAA development (HR, 1.275; CI, 1.119-1.451; P < .001), as were increasing age (HR, 1.702; CI, 1.153-2.512; P = .007) and waist circumference (HR, 1.019; CI, 1.002-1.037; P = .031).Conclusions: Both the well-known and the somewhat less established possible predictors for future development of AAA identified in this study can support improvement of strategic preventive measures toward specific risk groups and thereby possibly reduce the risk for development of AAA later in life or at least increase the possibility of an early diagnosis in patients with intact AAA.
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| 3. |
- Gerhardsson, Emma, et al.
(författare)
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Mothers' Adaptation to a Late Preterm Infant When Breastfeeding
- 2020
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Ingår i: Journal of Perinatal & Neonatal Nursing. - : Wolters Kluwer. - 0893-2190 .- 1550-5073. ; 34:1, s. 88-95
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to psychometrically test the Adaptation to the Late Preterm Infant when Breastfeeding Scale (ALPIBS) and also to test how a mother's self-efficacy predicts adaptation to a late preterm infant when breastfeeding. This study had a longitudinal and prospective design, and data collection was consecutive. Mothers (n = 105) with infants born between and weeks were recruited from a neonatal intensive care unit or a maternity unit. The ALPIBS was developed using exploratory factor analysis, and the association between breastfeeding self-efficacy and ALPIBS score was examined using linear regression analysis. The Breastfeeding Self-Efficacy Scale-Short Form instrument was used to measure self-efficacy in breastfeeding. A higher degree of self-efficacy was significantly associated with a higher degree of adaptation to the late preterm infant's breastfeeding behavior (P < .001). We identified 4 separate underlying factors measured by 11 items in the ALPIBS: (A) breastfeeding is a stressful event; (B) the infant should breastfeed as often as he or she wants; (C) a mother has to breastfeed to be a good mother; and (D) it is important to ensure control over the infant's feeding behavior. There is a link between self-efficacy and ALPIBS score, and self-efficacy is a modifiable factor that influences breastfeeding.
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| 4. |
- Karlsson Rosenblad, Andreas, Fil. dr, 1973-, et al.
(författare)
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A psychometric evaluation of the Functional assessment of cancer therapy-kidney symptom index (FKSI-19) among renal cell carcinoma patients suggesting an alternative two-factor structure
- 2021
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Ingår i: Quality of Life Research. - : Springer. - 0962-9343 .- 1573-2649. ; 30:9, s. 2663-2670
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To psychometrically evaluate the hypothesized four-factor structure of the 19-item Functional Assessment of Cancer Therapy-Kidney Symptom Index (FKSI-19) health-related quality of life (HRQoL) instrument in a sample of surgically treated renal cell carcinoma (RCC) patients and examine if an alternative factor structure with good psychometric properties may be derived from the available items.METHODS: The model fit of the hypothesized four-factor structure was examined using confirmatory factor analysis on cohort data from 1731 individuals included in the National Swedish Kidney Cancer Register who had undergone surgery for RCC during the three years 2016-2018 and answered the FKSI-19 instrument within 6-12 months after surgery. Exploratory factor analysis was applied to the same dataset to derive a possible alternative factor solution.RESULTS: -value or the Comparative Fit Index, although the Standardized Root Mean Square Residual and Root Mean Square Error of Approximation measures indicated good and acceptable model fits, respectively. An alternative 14-item trimmed FKSI version (FKSI-14) with a two-factor structure derived from the available FKSI-19 items was found to measure the same aspects of HRQoL as the full FKSI-19 instrument.CONCLUSION: The present study is the first to use psychometric methods for examining the factor structure of the FKSI-19 instrument. The hypothesized four-factor structure of FKSI-19 provided a barely acceptable model fit. The two-factor FKSI-14 structure may be used as an alternative or complement to the four-factor structure when interpreting the FKSI-19 instrument.
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| 5. |
- Klarare, Anna, et al.
(författare)
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Translation, Cross-Cultural Adaptation, and Psychometric Analysis of the Attitudes Towards Homelessness Inventory for Use in Sweden
- 2021
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 18:1, s. 42-49
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Homelessness is an increasing problem worldwide, and the origins of homelessness in high-income countries are multifaceted. Due to stigma and discrimination, persons in homelessness delay seeking health care, resulting in avoidable illness and death. The Attitudes Towards Homelessness Inventory (ATHI) was developed to cover multiple dimensions of attitudes toward persons in homelessness and to detect changes in multiple segments of populations. It has, however, not previously been translated to Swedish.AIMS: The aim of the present study was to translate, cross-culturally adapt, and psychometrically test the ATHI for use in a Swedish healthcare context.METHODS: The project used a traditional forward- and back-translation process in six stages: (1) two simultaneous translations by bilingual experts; (2) expert review committee synthesis; (3) blind back-translation; (4) expert review committee deliberations; (5) pre-testing with cognitive interviews including registered nurses (n = 5), nursing students (n = 5), and women in homelessness (n = 5); and (6) psychometric evaluations. The final ATHI questionnaire was answered by 228 registered nurses and nursing students in the year 2019.RESULTS: The translation process was systematically conducted and entailed discussions regarding semantic, idiomatic, experiential, and conceptual equivalence. Confirmatory factor analysis was used to examine if the collected data fitted the hypothesized four-factor structure of the ATHI. Overall, it was found that the model had an acceptable fit and that the Swedish version of ATHI may be used in a Swedish healthcare context.LINKING EVIDENCE TO ACTION: The ATHI has been shown to be a psychometrically acceptable research instrument for use in a Swedish healthcare context. The systematic and rigorous process applied in this study, including experts with diverse competencies in translation proceedings and testing, improved the reliability and validity of the final Swedish version of the ATHI. The instrument may be used to investigate attitudes toward women in homelessness among nursing students and RNs in Sweden.
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| 6. |
- Söderström, Lisa, 1982-, et al.
(författare)
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Dietary advice and oral nutritional supplements do not increase survival in older malnourished adults : a multicentre randomised controlled trial
- 2020
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Ingår i: Upsala Journal of Medical Sciences. - : Uppsala Medical Society. - 0300-9734 .- 2000-1967. ; 125:3, s. 240-249
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Forskningsöversikt (refereegranskat)abstract
- Objectives: The study aimed to investigate the effect on survival after 6 months of treatment involving individual dietary advice and oral nutritional supplements in older malnourished adults after discharge from hospital. Methods: This multicentre randomised controlled trial included 671 patients aged 65 years who were malnourished or at risk of malnutrition when admitted to hospital between 2010 and 2014, and followed up after 8.2 years (median 4.1 years). Patients were randomised to receive dietary advice or oral nutritional supplements, separate or in combination, or routine care. The intervention started at discharge from the hospital and continued for 6 months, with survival being the main outcome measure. Results: During the follow-up period 398 (59.3%) participants died. At follow-up, the survival rates were 36.9% for dietary advice, 42.4% for oral nutritional supplements, 40.2% for dietary advice combined with oral nutritional supplements, and 43.3% for the control group (log-rank test p = 0.762). After stratifying the participants according to nutritional status, survival still did not differ significantly between the treatment arms (log-rank test p = 0.480 and p = 0.298 for the 506 participants at risk of malnutrition and the 165 malnourished participants, respectively). Conclusions: Oral nutritional supplements with or without dietary advice, or dietary advice alone, do not improve the survival of malnourished older adults. These results do not support the routine use of supplements in older malnourished adults, provided that survival is the aim of the treatment.
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| 7. |
- Blixt, Ingrid, 1968-, et al.
(författare)
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Breastfeeding training improved healthcare professional's self-efficacy to provide evidence-based breastfeeding support : A pre-post intervention study
- 2023
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Ingår i: Midwifery. - : Elsevier. - 0266-6138 .- 1532-3099. ; 125
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe healthcare professional's (HCP's) perceived self-efficacy in their ability to provide breastfeeding support before and after a breastfeeding training program.DESIGN: Pre-post intervention study.SETTING: Antenatal care and child healthcare (CHC) centres in Sweden during 2020.PARTICIPANTS: An intervention group consisting of 39 HCPs (midwives 51.3%, child healthcare nurses 46.2%) completing a questionnaire at baseline and after intervention, and a control group of 34 HCPs (midwives 61.8%, child healthcare nurses 38.2%) completing a questionnaire at baseline.INTERVENTION: A breastfeeding training program in line with the Ten Steps to Successful Breastfeeding and WHO recommendations about breastfeeding.MEASUREMENTS AND FINDINGS: The 11-item Breastfeeding Support Confidence Scale (BSCS) measures HCP's self-efficacy regarding providing breastfeeding support in line with Ten Steps to Successful Breastfeeding and WHO recommendations. The intervention group experienced a significantly increased self-efficacy from pre-intervention to post-intervention for 8 of the 11 BSCS items, with the overall BSCS index score increasing from 36.87 to 39.56 points (p = 0.001). The index score in the intervention group at follow-up was significantly higher than the corresponding score in the control group at baseline (p = 0.025). The intervention group had significantly higher scores at follow-up than the control group at baseline on the questions: "I'm sure that I can help mothers continue to breastfeed even if the infant doesn't follow the growth curve" (p = 0.026) and "I'm sure that I can help mothers continue to breastfeed when the breastfeeding is painful" (p = 0.048).KEY CONCLUSIONS: The breastfeeding training program improved HCP' self-efficacy to provide evidence-based support to breastfeeding mothers.IMPLICATIONS FOR PRACTICE: This training program is well suited to implement in clinical practice and follows the Ten Steps to Successful Breastfeeding.TRIAL REGISTRATION: ACTRN12623000648628.
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| 8. |
- Gaber, Sophie, et al.
(författare)
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The relationship between attitudes to homelessness and perceptions of caring behaviours : a cross-sectional study among women experiencing homelessness, nurses and nursing students
- 2022
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Ingår i: BMC Women's Health. - : Springer Nature. - 1472-6874. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students. Methods A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman's rank correlation rho. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher's z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results. Results Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively. Conclusions To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours.
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| 9. |
- Gaber, Sophie, et al.
(författare)
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The relationship between attitudes to homelessness and perceptions of caring behaviours : a cross-sectional study among women experiencing homelessness, nurses and nursing students
- 2022
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Ingår i: BMC Women's Health. - : BioMed Central (BMC). - 1472-6874. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women experiencing homelessness have complex and multifaceted healthcare needs and yet they are an underserved population across healthcare services. Nurses are trained to perform an integral role in the provision of equitable healthcare and their attitudes towards homelessness may therefore influence the care that women experiencing homelessness receive. This study aimed to examine correlations between attitudes towards homelessness and caring behaviours, and to test if these correlations differed between the groups of women experiencing homelessness, registered nurses, and nursing students.Methods: A cross-sectional design using convenience sampling was used to recruit women experiencing homelessness (n = 37), registered nurses (n = 90), and nursing students (n = 138) in Stockholm, Sweden between August 2019 and December 2020. The participants answered two questionnaires: the Attitudes Toward Homelessness Inventory and the Caring Behaviours Inventory-24. Correlations between ordinal variables were calculated using Spearman’s rank correlation ρ. Tests of equality between two independent correlations were performed using a Z-test applied to Fisher’s z-transformed correlations. An advisory board of women with lived experience of homelessness supported the interpretation of the results.Results: Weak, negative correlations were identified between the Attitudes Toward Homelessness Inventory and Caring Behaviours Inventory-24. The Attitudes Toward Homelessness Inventory mean total scores (SD) were 4.1 (0.6), 4.2 (0.6), 4.1 (0.5) points for the women experiencing homelessness, registered nurse, and nursing student groups, respectively, with the corresponding scores for the Caring Behaviours Inventory-24 being 4.1 (1.1), 5.2 (0.5), 4.8 (0.7) points, respectively.Conclusions: To promote equitable health for women experiencing homelessness, healthcare providers and nurse educators should consider the role of stigmatising attitudes in relation to caring behaviours. © 2022, The Author(s).
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| 10. |
- Granstam, Elisabet, 1963-, et al.
(författare)
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Long‐term follow‐up of antivascular endothelial growth factor treatment for diabetic macular oedema : a four‐year real‐world study
- 2020
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Ingår i: Acta Ophthalmologica. - : Wiley. - 1755-375X .- 1755-3768. ; 98:4, s. 360-367
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo evaluate visual acuity (VA) and central retinal thickness (CRT) on optical coherence tomography during a 4‐year period in patients treated for sight‐threatening diabetic macular oedema (DMO) at two Swedish county hospitals. Additionally, to compare health‐related quality of life and subjective visual functioning before and after 4 years of treatment.MethodsFifty‐eight patients with DMO were evaluated after 4 years of antivascular endothelial growth factor (VEGF) treatment. VA, CRT and clinical data were retrospectively reviewed. Health‐related quality of life and subjective visual functioning were evaluated with Short Form Health Survey (SF‐36) and National Eye Institute Vision Functioning Questionnaire 25 (VFQ‐25). Comparisons between independent groups were performed using Pearson's χ2 test, Fisher's exact test or Mann–Whitney U test. Spearman's ρ was used for correlation analyses. Wilcoxon signed‐rank test was used for comparison between dependent groups. Logistic regression analysis was applied for analysis of VA and CRT over 4 years.ResultsFollow‐up data were obtained from 37 of 58 (63.8%) patients. Baseline characteristics were similar, regardless of follow‐up. VA improvement at 1 year (mean + 4.4, SD 7.5; ETDRS letter score) was maintained over 3 years, then declined. CRT was reduced throughout the study. In the first treatment year, eyes received 5.1 (1.4) anti‐VEGF injections, followed by approximately two injections yearly. Additional treatment included laser and dexamethasone implants. SF‐36 showed no change at 4 years, compared with baseline. VFQ‐25 demonstrated improvement in near vision activities (p = 0.036).ConclusionSignificant long‐term improvement in visual function was present in patients with anti‐VEGF‐treated DMO.
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