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- Eilertsen, G., et al.
(författare)
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Similarities and differences in the experience of fatigue among people living with fibromyalgia, multiple sclerosis, ankylosing spondylitis and stroke
- 2015
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 24:13-14, s. 2023-2034
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To elucidate the experience of fatigue across several long-term illnesses, focusing on the similarities and differences. Background: Fatigue is common to many long-term illnesses, but it has been studied mainly within the context of a single illness; qualitative studies comparing the experience and its impact on daily life across different long-term illnesses are lacking. Design: Qualitative design. Methods: A secondary analysis was conducted of five original interview studies involving 95 persons with ankylosing spondylitis, fibromyalgia, multiple sclerosis or stroke. Results: Similarities and differences concerning experiences of fatigue were found across the studied long-term illnesses. All patients expressed the perception of having an unfamiliar body. Fatigue was also commonly expressed as unpredictable, uncontrollable and invisible to others. Differences were related to a constant versus a varying condition, a sudden and an uncontrollable sleepiness, a mutual reinforcement with pain and increased stress sensitivity. A lack of energy and a need for sleep and rest were common experiences, as was the impact on social relationships. There were also similarities regarding how the patients managed their daily life. The search for practical solutions and attitude adjustment differed with the fatigue characteristics. All patients felt a lack of understanding and disbelief from others. Conclusion and relevance to clinical practice: Fatigue is commonly expressed by patients with long-term illnesses. Variations in experience are related to the type of diagnosis. The disparity between experiences influences how patients managed and adjusted to the conditions of everyday life. The illness-specific characteristics of fatigue warrant increased clinical awareness and may allow professionals to offer adequate information and establish effective methods of managing the condition. The feeling of invisibility and difficulty describing the experience of fatigue in particular highlights this need. © 2015 John Wiley & Sons Ltd.
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- Fritzell, Peter, et al.
(författare)
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Bacteria : back pain, leg pain and Modic sign—a surgical multicentre comparative study
- 2019
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Ingår i: European spine journal. - : Springer. - 0940-6719 .- 1432-0932. ; 28:12, s. 2981-2989
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To compare bacterial findings in pain-generating degenerated discs in adults operated on for lumbar disc herniation (LDH), and mostly also suffering from low back pain (LBP), with findings in adolescent patients with non-degenerated non-pain-generating discs operated on for scoliosis, and to evaluate associations with Modic signs on magnetic resonance imaging (MRI). Cutibacterium acnes (Propionibacterium acnes) has been found in painful degenerated discs, why it has been suggested treating patients with LDH/LBP with antibiotics. As multidrug-resistant bacteria are a worldwide concern, new indications for using antibiotics should be based on solid scientific evidence.Methods: Between 2015 and 2017, 40 adults with LDH/LBP (median age 43, IQR 33–49) and 20 control patients with scoliosis (median age 17, IQR 15–20) underwent surgery at seven Swedish hospitals. Samples were cultured from skin, surgical wound, discs and vertebrae. Genetic relatedness of C. acnes isolates was investigated using single-nucleotide polymorphism analysis. DNA samples collected from discs/vertebrae were analysed using 16S rRNA-based PCR sequencing. MRI findings were assessed for Modic changes.Results: No bacterial growth was found in 6/40 (15%) LDH patients, compared with 3/20 (15%) scoliosis patients. Most positive samples in both groups were isolated from the skin and then from subcutis or deep within the wound. Of the four disc and vertebral samples from each of the 60 patients, 235/240 (98%) were DNA negative by bacterial PCR. A single species, C. acnes, was found exclusively in the disc/vertebra from one patient in each group. In the LDH group, 29/40 (72%) patients had at least one sample with growth of C. acnes, compared to 14/20 (70%) in the scoliosis group. Bacterial findings and Modic changes were not associated.Conclusions: Cutibacterium acnes found in discs and vertebrae during surgery for disc herniation in adults with degenerated discs may be caused by contamination, as findings in this group were similar to findings in a control group of young patients with scoliosis and non-degenerated discs. Furthermore, such findings were almost always combined with bacterial findings on the skin and/or in the wound. There was no association between preoperative Modic changes and bacterial findings. Antibiotic treatment of lumbar disc herniation with sciatica and/or low back pain, without signs of clinical discitis/spondylitis, should be seriously questioned.
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| 4. |
- Nilsson, Åsa, et al.
(författare)
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Meanings of participation in hospital care : as narrated by patients
- 2018
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Ingår i: European Journal for Person Centered Healthcare. - : The University of Buckingham Press Ltd. - 2052-5648 .- 2052-5656. ; 6:3, s. 431-437
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Patient participation is said to be an important factor for patients to experience satisfaction and quality with hospital care. Still, little is known about what participation actually means for patients in the specific context of hospital settings. Therefore, the aim of this study was to elucidate meanings of participation as narrated by patients.Method: Narrative interviews were conducted during the Autumn of 2013 until the Spring of 2014 and then phenomenological hermeneutically interpreted. In this study, we suggest that the phenomenon of participation in hospital care is experienced by the patient when being a co-creator and seen as an important person in a trustful context.Results: The results illustrate that an experience of an open, cooperative and coherent environment invites and contributes to participate despite being in a vulnerable situation. The study highlights the importance of responding to each patient as a person, who sometimes has a need to participate actively and sometimes wants to hand over and assume the role of patient in the hospital care setting.Discussion: Meanings of participation among patients in hospital care can be understood as a phenomenon experienced when being an involved co-creator and seen as an important person in a trustful context. In this study, as well as in previous research it is obvious that participation in hospital care concerns more than being involved in decision-making and receiving information.
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| 5. |
- Uhlig, Elisabeth, et al.
(författare)
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Effects of household washing on bacterial load and removal of Escherichia coli from lettuce and "ready-to-eat" salads
- 2017
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Ingår i: Food Science and Nutrition. - : Wiley. - 2048-7177. ; 5:6, s. 1215-1220
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Tidskriftsartikel (refereegranskat)abstract
- Customer demands for fresh salads are increasing, but leafy green vegetables have also been linked to food-borne illness due to pathogens such as Escherichia coli O157:H7. As a safety measure, consumers often wash leafy vegetables in water before consumption. In this study, we analyzed the efficiency of household washing to reduce the bacterial content. Romaine lettuce and ready-to-eat mixed salad were washed several times in flowing water at different rates and by immersing the leaves in water. Lettuce was also inoculated with E. coli before washing. Only washing in a high flow rate (8 L/min) resulted in statistically significant reductions (p < .05), "Total aerobic count" was reduced by 80%, and Enterobacteriaceae count was reduced by 68% after the first rinse. The number of contaminating E. coli was not significantly reduced. The dominating part of the culturable microbiota of the washed lettuce was identified by rRNA 16S sequencing of randomly picked colonies. The majority belonged to Pseudomonadaceae, but isolates from Enterobacteriaceae and Staphylococcaceaceae were also frequently found. This study shows the inefficiency of tap water washing methods available for the consumer when it comes to removal of bacteria from lettuce. Even after washing, the lettuce contained high levels of bacteria that in a high dose and under certain circumstances may constitute a health risk.
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| 6. |
- Xu, Jie, et al.
(författare)
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Oral and faecal microbiota in volunteers with hypertension in a double blind, randomised placebo controlled trial with probiotics and fermented bilberries
- 2015
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Ingår i: Journal of Functional Foods. - : Elsevier BV. - 1756-4646. ; 18, s. 275-288
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Tidskriftsartikel (refereegranskat)abstract
- Two probiotic products containing either live Lactobacillus plantarum strain DSM 15313 or bilberries fermented by the same bacterial strain were tested for their antihypertensive potentials and their impact on the oral and the faecal microbiota in hypertensive adults. The results showed that consumption of the tested products for three months did not reduce the blood pressure in adults with hypertension. Neither the diversity nor the composition of the oral and faecal microbiota was significantly affected by the tested probiotic products. Moreover, the oral and the faecal microbiota remained generally stable over the intervention period of 3 months. (C) 2015 Elsevier Ltd. All rights reserved.
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| 7. |
- Zotterman, Anna Nygren, et al.
(författare)
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Being in togetherness : Meanings of encounters within primary healtcare setting for patients living with long-term illness
- 2016
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 25:19-20, s. 2854-2862
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: The aim of this study was to elucidate meanings of encounters for patients with long-term illness within the primary healthcare setting. Background: Good encounters can be crucial for patients in terms of how they view their quality of care. Therefore, it is important to understand meanings of interactions between patients and healthcare personnel. Design: A phenomenological hermeneutic method was used to analyse the interviews. Methods: Narrative interviews with ten patients with long-term illness were performed, with a focus on their encounters with healthcare personnel within the primary healthcare setting. A phenomenological hermeneutical approach was used to interpret the interview texts. Results: The results demonstrated that patients felt well when they were seen as an important person and felt welcomed by healthcare personnel. Information and follow-ups regarding the need for care were essential. Continuity with the healthcare personnel was one way to establish a relationship, which contributed to patients' feelings of being seen and understood. Good encounters were important for patients' feelings of health and well-being. Being met with mistrust, ignorance and nonchalance had negative effects on patients' perceived health and well-being and led to feelings of lower confidence regarding the care received. Conclusions: Patients described a great need to be confirmed and met with respect by healthcare personnel, which contributed to their sense of togetherness. Having a sense of togetherness strengthened patient well-being. Relevance to clinical practice: By listening and responding to patients' needs and engaging in meetings with patients in a respectful manner, healthcare personnel can empower patients' feelings of health and well-being. Healthcare personnel need to be aware of the significance of these actions because they can make patients experience feelings of togetherness, even if patients meet with different care personnel at each visit.
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| 8. |
- Zotterman, Anna Nygren, et al.
(författare)
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District nurses' views on quality of primary healthcare encounters
- 2015
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 29:3, s. 418-425
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Tidskriftsartikel (refereegranskat)abstract
- Good encounters are fundamental for good and professional nursing care, and can be described as treating patients with respect and protecting their integrity and autonomy. This study describes district nurses' views on quality of healthcare encounters in primary healthcare. A purposive sample of 27 district nurses participated in five focus group interviews. The focus groups interviews were digitally recorded and transcribed verbatim. The interview texts were analysed using a thematic content analysis. The analysis resulted in four themes, including being aware of the importance and difficulties during encounters, being the patient's advocate, being attentive to the unique person and being informed when a meeting turned out poorly. The results show that district nurses believed that encounters formed the basis of their work and it was vital for them to be aware of any difficulties. District nurses found that acting in a professional manner during encounters is the most significant factor, but this type of interaction was sometimes difficult because of stress and lack of time. The district nurses considered themselves to be the patients' advocate in the healthcare system; in addition, the acts of seeing, listening, believing and treating the patient seriously were important for providing good quality care. If a poor encounter occurred between the district nurse and the patient, the district nurses found that it was necessary to arrange a meeting to properly communicate what problems arose during the interaction. The district nurses highlighted that providing an apology and explanation could improve future encounters and establish a better nurse-patient relationship. In conclusion, this study shows the importance of confirming and respecting patients' dignity as the fundamental basis for a good quality encounter in primary healthcare. Copyright © 2015 Nordic College of Caring Science.
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