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- Fällman, Katarina, 1984-, et al.
(författare)
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Normative data for the oldest old: Trail Making Test A, Symbol Digit Modalities Test, Victoria Stroop Test and Parallel Serial Mental Operations
- 2020
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Ingår i: Aging, Neuropsychology and Cognition. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 1382-5585 .- 1744-4128. ; 27:4, s. 567-550
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Tidskriftsartikel (refereegranskat)abstract
- Normative data for evaluating cognitive function in the oldest old, aged 85 years and above, are currently sparse. The normative values used in clinical practice are often derived from younger old persons, from small sample sizes or from broad age spans (e.g. amp;gt;75 years) resulting in a risk of misjudgment in assessments of cognitive decline. This longitudinal study presents normative values for the Trail Making Test A (TMT-A), the Symbol Digit Modalities Test (SDMT), the Victoria Stroop Test (VST) and the Parallel Serial Mental Operations (PaSMO) from cognitively intact Swedes aged 85 years and above. 207 participants, born in 1922, were tested at 85, 90 (n = 68) and 93 (n = 35) years of age with a cognitive screening test battery. The participants were originally recruited for participation in the Elderly in Linkoping Screening Assessment. Normative values are presented as mean values and standard deviations, with and without adjustment for education. There were no clinically important differences between genders, but education had a significant effect on test results for the 85-year-olds. Age effects emerged in analyses of those participants who completed the entire study and were evident for TMT-A, SDMT, VST1 and PaSMO. When comparisons can be made, our results are in accordance with previous data for TMT-A, SDMT and VST, and we present new normative values for PaSMO.
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| 2. |
- Hult, Anna, et al.
(författare)
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Patient complaints about communication in cancer care settings : Hidden between the lines
- 2023
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 114
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate patient complaints in cancer care settings reported to patient advisory committees (PACs) and describe the frequency and content of communication failures across all reports.Methods: Content analysis, with a summative approach, was applied to cancer care complaints (2016–2020) by 692 patients to PACs in one Swedish healthcare region.Results: More than half the patients reported communication failures. Patients reported not receiving proper information, not being listened to, and being treated disrespectfully or impersonally. Communication failures occurred in different stages of the patients’ cancer care, from diagnostic workup to end-of-life. Compared with the results of the PACs, communication failures were underreported, and were often combined with complaints in other categories.Conclusions: Communication failures are hidden “between the lines” and do not appear clearly in existing reporting systems. Healthcare must utilize the knowledge conveyed by patient complaints and create conditions and environments that support healthcare providers in delivering person-centered care.Practice Implication: A summary picture of patients’ complaints in Swedish cancer care is provided. These results could be used to further improve the patient complaint system. Above all, the results could serve as a “wake-up call” about the importance of communication and a valuable resource in improving cancer care.
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| 3. |
- Hult, Anna, et al.
(författare)
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Patient representatives : Crucial members of health-care working groups facing an uncertain role and conflicting expectations. A qualitative study
- 2021
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Ingår i: Health Expectations. - : John Wiley & Sons. - 1369-6513 .- 1369-7625. ; 24:4, s. 1197-1206
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Tidskriftsartikel (refereegranskat)abstract
- Background Patient representatives (PRs) have been involved for decades in health-care development, and their participation is increasingly sought in health-care working groups (HCWGs) on every level. However, information on how the role could be further developed and teamwork improved remains sparse. Objective To explore the role of patient representatives in clinical practice guideline (CPG) monitoring groups, to describe their contributions and identify possibilities of improvement. Design Qualitative design using semi-structured interviews analysed by content analysis. Setting and participants Interviews were conducted with 11 PRs, 13 registered nurses, and 9 physicians, all members of national committees monitoring CPGs for cancer in Sweden. Results Most participants considered the PR role important but mentioned several problems. PRs' contributions were hampered by uncertainties about their role, the low expectations of other group members and their sense that their contributions were often disregarded. Some professionals questioned whether PRs were truly representative and said some topics could not be discussed with PRs present. Conclusion This study highlights the fundamental problems that remain to be solved despite the long involvement of PRs in HCWGs. Even though the PR role and teamwork differed between the groups, most PRs need to be empowered to be actively involved in the teamwork and have their engagement and knowledge fully utilized. Enhancing teamwork through clarifying roles and expectations could lead to more inclusive and equal teams able to work more effectively towards the goal of improving health care. Patient or public contribution PRs were information givers in data collection.
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| 4. |
- Larsson, Charlotta, 1981-
(författare)
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Surgical complications after vaginal and caesarean delivery
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Obstetric anal sphincter injuries (OASIS) after vaginal delivery are the most common cause of anal incontinence in women. Symptoms range from faecal urgency and soiling to inability to control flatus and passive faecal incontinence. OASIS are also associated with urinary incontinence, perineal pain, and sexual dysfunction. Apart from being a challenge to diagnose and treat, these conditions often result in social stigma and embarrassment, and in many cases have a great impact on emotional and physical health.Caesarean section has developed over several hundred years, from a procedure with 100 % mortality for both mother and child, to routine surgery that is rapidly increasing in many countries. However, both caesarean section and vaginal delivery are associated with complications that can affect the woman for the rest of her life. The aim of this thesis was primarily to investigate surgical complications after delivery.Methods: Papers I-III were population-based cohort-studies utilising national registries to examine the risk for anal incontinence, cardiovascular complications, and other surgical complications such as bowel obstruction, incisional hernia, and abdominal pain. Paper IV was a diagnostic cohort study comparing the traditional clinical method using inspection and palpation, to a new method with three-dimensional endoanal ultrasound (3D-EAUS) to diagnose anal sphincter injuries after delivery.Results: The risk for being diagnosed with anal incontinence after vaginal delivery was almost twice that after caesarean section. On the other hand, caesarean section was associated with a greater risk for serious cardiovascular complications, bowel obstruction, and incisional hernia. High maternal age, overweight and smoking were all risk factors for complications. Instrumental delivery, in particular, increased the risk for anal incontinence. In Study IV, more sphincter injuries were diagnosed using the 3D-EAUS than by clinical examination. However, some injuries diagnosed clinically could not be identified with 3D-EAUS.Conclusions: Both vaginal and caesarean delivery are associated with certain risks. Although the increased risk for cardiovascular complications, bowel obstruction, and incisional hernia must be taken into consideration, there seem to be a gain in reducing the risk for anal incontinence, when performing a caesarean section on the right indication. 3D-EAUS assessment of the anal sphincters after delivery is a new technique that with further improvement could be an important tool in the prevention of anal incontinence.
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