| 1. |
- Strömberg, Anna, 1967-, et al.
(författare)
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Computer-based education for patients with chronic heart failure : A randomised, controlled, multicentre trial of the effects on knowledge, compliance and quality of life
- 2006
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Ingår i: Patient Education and Counseling. - Shannon, Ireland : Elsevier. - 0738-3991 .- 1873-5134. ; 7, s. 128-35
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the effects of a single-session, interactive computer-based educational program on knowledge, compliance and quality of life in heart failure patients with special emphasis on gender differences.METHODS: One hundred and fifty-four patients, mean age 70 years, from five heart failure clinics were randomised to either receiving only standard education (n = 72) or standard education and additional computer-based education (n = 82).RESULTS: Knowledge was increased in both groups after 1 month with a trend towards higher knowledge (P = 0.07) in the computer-based group. The increase in knowledge was significantly higher in the computer-based group after 6 months (P = 0.03). No differences were found between the groups with regard to compliance with treatment and self-care or quality of life. The women had significantly lower quality of life and did not improve after 6 months as the men did (P = 0.0001).CONCLUSION: Computer-based education gave increased knowledge about heart failure. PRACTICE IMPLICATIONS: Computers can be a useful tool in heart failure education, but to improve compliance a single-session educational intervention is not sufficient. Gender differences in learning and quality of life should be further evaluated.
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| 2. |
- Amsberg, Susanne, et al.
(författare)
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A cognitive behavior therapy-based intervention among poorly controlled adult type 1 diabetes patients : a randomized controlled trial
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 77:1, s. 72-80
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To examine the impact of a Cognitive Behavior Therapy (CBT)-based intervention on HbA(1c), self-care behaviors and psychosocial factors among poorly controlled adult type 1 diabetes patients. METHODS: Ninety-four type 1 diabetes patients were randomly assigned to either an intervention group or a control group. The intervention was based on CBT and was mainly delivered in group format, but individual sessions were also included. All subjects were provided with a continuous glucose monitoring system (CGMS) during two 3-day periods. HbA(1c), self-care behaviors and psychosocial factors were measured up to 48 weeks. RESULTS: Significant differences were observed with respect to HbA(1c) (P<0.05), well-being (P<0.05), diabetes-related distress (P<0.01), frequency of blood glucose testing (P<0.05), avoidance of hypoglycemia (P<0.01), perceived stress (P<0.05), anxiety (P<0.05) and depression (P<0.05), all of which showed greater improvement in the intervention group compared with the control group. A significant difference (P<0.05) was registered with respect to non-severe hypoglycemia, which yielded a higher score in the intervention group. CONCLUSION: This CBT-based intervention appears to be a promising approach to diabetes self-management. PRACTICE IMPLICATIONS: Diabetes care may benefit from applying tools commonly used in CBT. For further scientific evaluation in clinical practice, there is a need for specially educated diabetes care teams, trained in the current approach, as well as cooperation between diabetes care teams and psychologists trained in CBT.
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| 3. |
- Anderbro, Therese, et al.
(författare)
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Psychometric evaluation of the Swedish version of the Hypoglycaemia Fear Survey
- 2008
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 73:1, s. 127-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of this study was to evaluate the psychometric properties of the Swedish version of the Hypoglycaemia Fear Survey (Swe-HFS) for use among Swedish-speaking patients with type 1 diabetes. METHODS: The HFS was translated using the forward-backward translation method and was thereafter answered by 325 type 1 patients. The psychometric properties were investigated using exploratory factor analysis, Cronbach's alpha, content and convergent validity. RESULTS: The factor analysis showed that a three-factor solution was reasonable with the subscales Behaviour/Avoidance (10 items), Worry (6 items) and Aloneness (4 items). Cronbach's alpha coefficient for the total score was 0.85. The result also supports the instrument's content validity and convergent validity. CONCLUSION: The Swedish version of the HFS appears to be a reliable and valid instrument for measuring fear of hypoglycaemia (FoH) in type 1 patients. PRACTICE IMPLICATIONS: The results from this study suggest that the Swe-HFS, an instrument that is brief and easy to administer, may be valuable in clinically assessing FoH among patients with type 1 diabetes.
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| 4. |
- Arving, Cecilia, et al.
(författare)
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Satisfaction, utilisation and perceived benefit of individual psychosocial support for breast cancer patients : A randomised study of nurse versus psychologist interventions
- 2006
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 62:2, s. 235-243
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Tidskriftsartikel (refereegranskat)abstract
- Objective: In a prospective, randomised study, individual psychosocial support performed by: (1) specially trained oncology nurses (INS) or (2) psychologists (IPS) were compared with respect to utilisation, satisfaction and perceived benefit. Methods: Between December 1997 and December 1999, consecutive breast cancer patients (n = 120) were included at start of adjuvant therapy (chemo-, endocrine and/or loco-regional radiotherapy). Data were collected by an extended version of the 'IPS-patient satisfaction questionnaire' within I week after termination of the support intervention. Questionnaires were also mailed to all patients 6, 12 and 18-24 months after inclusion. Levels of distress were collected with the Hospital Anxiety and Depression Scale (HADS) and Impact of Event Scale (IES) questionnaires. Results: The patients were highly satisfied with the individual psychosocial support intervention they received, irrespective of which profession provided the support. However, the patients in the INS group reported higher levels of benefit regarding disease-related problems, regardless if the patients at baseline reported low or high levels of distress. Conclusions: Patients were highly satisfied with an individual psychosocial support intervention. In areas dealing with somatic aspects, the group intervened by nurses were more satisfied than the one by psychologists. Practice implications: Individual psychosocial support by specially trained nurses is a realistic alternative in routine cancer care.
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| 5. |
- Broström, Anders, et al.
(författare)
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Perceived informational needs, side-effects and their consequences on adherence-A comparison between CPAP treated patients with OSAS and healthcare personnel
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 74:2, s. 228-235
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare perceptions among continuous positive airway pressure (CPAP) treated patients with obstructive sleep apnoea syndrome (OSAS) and healthcare personnel with regard to informational needs, side-effects and their consequences on adherence. Methods: A cross-sectional descriptive design was used including 350 CPAP treated OSAS patients from three Swedish hospitals and 105 healthcare personnel from 26 Swedish hospitals. Data collection was performed using two questionnaires covering informational needs, side-effects and adherence to CPAP. Results: Both groups perceived all surveyed informational areas as very important. Patients perceived the possibilities to learn as significantly greater in all areas (p < 0.001) compared to healthcare personnel, and scored significantly higher regarding positive effects on adherence of information about pathophysiology (p < 0.05), self-care (p < 0.001) and troubleshooting (p < 0.01). A total of I I out of 15 surveyed side-effects were perceived to be more frequent by healthcare personnel (p < 0.01 - p < 0.001). They also scored all side-effects to cause greater problems and decrease the CPAP use to a greater extent (p < 0.001). Conclusion: Knowledge about these differences between patients and healthcare personnel regarding educational needs, side-effects and their effects on adherence can be important when designing educational programmes to increase CPAP adherence. Practice implications: Measurement of these parameters before, during and after educational programs are suggested.
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| 6. |
- Carlsson, Christina, et al.
(författare)
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Patients' involvement in improving cancer care: experiences in three years of collaboration between members of patient associations and health care professionals.
- 2006
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Ingår i: Patient education and counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 61:1, s. 65-71
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to explore how members of patient associations (PACPs) and health care professionals (HCPs) experience collaboration in a network initiated by the health care system and aimed at improving cancer care. METHODS: The participants were asked to describe, after 1 and 3 years, their experiences of collaboration. Data collected were in the form of a written answer to a single, open-ended question, and the answers were analysed using inductive content analysis. RESULTS: The analysis revealed four themes: the impact of processes that occur within the network, the impact of learning, the impact of innovation and development in cancer care, and the impact of PACP members' personal cancer experience. Statements about the impact of the processes that occur within the network dominated at both occasions. CONCLUSION: This study of experiences of collaboration provides new data on the importance ascribed to such efforts between patients in an organised association and HCPs. PRACTICE IMPLICATIONS: We suggest that differences in perceptions and expectations should be taken into account in future collaborations between representatives of patient associations and of health care systems in order to reach out and to influence developments in cancer care.
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| 7. |
- Jangland, Eva, et al.
(författare)
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Patients' and relatives' complaints about encounters and communication in health care : evidence for quality improvement
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 75:2, s. 199-204
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to describe patients' and relatives' complaints to the local Patients' Advisory Committee about their encounters and communication in health care. METHODS: Complaints (n=105) regarding patients' and relatives' dissatisfaction with communication and encounters in health care, registered at a local Patients' Advisory Committee between 2002 and 2004, were included. The texts were analysed using content analysis. RESULTS: Three categories were identified: "Not receiving information or being given the option to participate", "Not being met in a professional manner" and "Not receiving nursing or practical support". Insufficient information, insufficient respect and insufficient empathy were described as the most common reasons for a negative professional encounter. CONCLUSION: Patients and relatives experienced unnecessary anxiety and reduced confidence in health care after negative professional encounters. PRACTICE IMPLICATIONS: The complaints reported to the Patients' Advisory Committee could be used more effectively in health care and be regarded as important evidence when working with quality improvement. To systematically use patient stories, such as those obtained in this report, as a reflective tool in education and supervision could be one way to improve communication and bring new understanding about the patient's perspective in health care.
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| 8. |
- Kaati, Gunnar, et al.
(författare)
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Outcomes of comprehensive lifestyle modification in inpatient setting
- 2006
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Ingår i: Patient Education and Counseling. - Clare : Elsevier. - 0738-3991 .- 1873-5134. ; 62:1, s. 95-103
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the effectiveness of a 4-week inpatient non-pharmacological risk factor modification programme for individuals with the metabolic syndrome. The aim of the program was to reduce patients' over risks for stroke and myocardial infarction.Methods: A prospective clinical study including 2468 patients - 1096 men and 1372 women - with and average age of 50 +/- 10 years. The patients were referred to the programme from primary care units and hospitals where treatment options were exhausted.Results: All risk factor levels for stroke and myocardial infarction decreased. The reduction of weight among men was 4.7 +/- 2.6 kg and 3.8 +/- 1.8 kg among women from an initial weight of 96 17 kg and 85 +/- 16 kg. respectively. The patients systolic and diastolic blood pressure decreased by 15/10 mm Hg for men and 14/9 min Hg among women from initial average for the whole population of 148/90 +/- 19/11 mm Hg and 146/87 +/- 19/12 min Hg, respectively. The greatest decrease in weight and blood pressure occurred in men and women with an initial body mass index of >= 30 and with a diastolic blood pressure of >= 90; in this group, the average reductions in weight were 5.8 +/- 2.4 kg for men and 4.4 +/- 1.7 kg for women; the reductions in systolisk/diastolisk blood pressure were 22/15 +/- 16/9 mm Hg (p < 0.001) for both men and women. A reduction of medication (DDD) although not a goal was also achieved.Conclusion: The results prove the value of a comprehensive and highly structured inpatient approach to lifestyle modification. Practice implications: The results should give cause to trials with half-way strategies integrating features from the inpatient programme into the design of risk factor interventions.
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| 9. |
- Kjeldmand, Dorte, et al.
(författare)
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How patient-centred am I? : A new method to measure physicians' patient-centredness
- 2006
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 62:1, s. 31-37
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo describe a new method to determine physicians’ self-perceived degree of patient-centredness. A pilot study combining qualitative and quantitative methods.MethodsForty-one general practitioners (GPs) answered a questionnaire consisting of three open-ended questions about their view of the consultation and by choosing among 28 roles of the physician in the physician–patient relationship. Twenty of the GPs had participated in Balint groups while 21 had had no access to Balint group. Patient-centredness is central to Balint groups and consequently Balint group participants would be expected to be patient-centred.ResultsThe answers to the two parts were divided into three groups each, patient-centred, non-patient-centred and intermediary, and analysed statistically. Significantly more Balint participants were patient-centred than the reference group.ConclusionThe instrument describes physicians’ self-perceptions of their patient-centredness and can distinguish a group of patient-centred physicians from a group of non-patient-centred physicians.Practice implicationsThe instrument can be useful to evaluate educational programmes and detect decline in patient-centredness as early sign of burnout.
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| 10. |
- Lytsy, Per, et al.
(författare)
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Patient expectations on lipid-lowering drugs
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 67:1-2, s. 143-150
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Tidskriftsartikel (refereegranskat)abstract
- Objective The objective of this study was to assess expectations of effect when using statins in a treatment population. Further the aim was to examine factors, including history and concurrent risk of coronary heart disease, associated with a higher and lower treatment belief. Methods Eight hundred and twenty-nine (829) Swedish patients using statins completed postal questionnaires about their health, life style, cardiovascular risk factors and expectation of the treatment. Expected treatment benefit was used as outcome measurement. Results A medical history of coronary heart disease did not affect treatment expectations. Patients with a high risk of cardiovascular disease reported a slightly lower expectation of the treatment effect at a 10-year perspective (p<0.01) but not at shorter time perspectives. Low satisfaction with the explanation of the purpose of the treatment and a poor perceived control of own health was associated with a more negative view on treatment benefit. Conclusion The rationale applied by physicians prescribing statins does not seem to relate to the patients’ expectations, whereas factors relating to the patient–physician relationship, the social situation and the perceived control of health seem to affect patient belief. Practice implications The association between patients’ poor satisfaction of treatment explanation and a low belief in treatment benefits emphasizes the importance of the patient–physician communication. It is suggested that clinical tools are developed in order to identify patients with poor belief in treatment benefit since tailored education for this group might reduce the risk of non-compliance and subsequently reduce the risk of coronary heart disease.
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| 11. |
- Moen, Janne, 1980-, et al.
(författare)
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"I don't know how many of these [medicines] are necessary.." - a focus group study among elderly users of multiple medicines
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 74:2, s. 135-141
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The growing prevalence of multiple medicine use among elderly challenges health care. The aim was to conduct an exploratory study describing multiple medicine use from the elderly patient's perspective. METHODS: Twelve focus groups of 29 men and 30 women 65 years of age or older, using five or more medicines were analysed qualitatively. RESULTS: Initially the participants reported no problems with using multiple medicines; they felt fortunate that medicines existed and kept them alive. However, negative attitudes were also revealed, both similar to those presented in studies on lay experience of medicine-taking and some that appear more specific to users of multiple medicines. The foremost of these was that acceptance of medicines depends on not experiencing adverse effects and worrying whether multiple medicine use is 'good' for the body. Furthermore, participants' perception of their medicines depended on interaction with doctors, i.e. trusting 'good' doctors. CONCLUSION: The participants revealed co-existing accounts of both immediate gratitude and problems with using multiple medicines. Furthermore, the patient-doctor relationship coloured their attitudes towards their medicines. PRACTICE IMPLICATIONS: Importance of the patient-doctor relationship for treatment success is highlighted. Moreover, to be able to capture both accounts of the elderly in this study an appropriate consultation length is needed.
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| 12. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Different development of general beliefs about medicines during undergraduate studies in medicine, nursing and pharmacy
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 75:2, s. 283-289
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyze differences in general beliefs about medicines between healthcare students and to see if health education was of importance to general beliefs about medicines.Method: The participants were students of medicine, pharmacy, pharmaceutical bioscience, dispensing pharmacy, nursing and economics (comparison group) at the University of Gothenburg. Data were collected twice in 2003 and 2005. A questionnaire was used comprising background questions and the general part of Beliefs about Medicines Questionnaire.Results: The questionnaire was completed by 460 of 642 (71.7%) first-year and 293 of 398 (73.6%) thirdyear students. Over 70% were women and two-thirds were under 25 years of age. Medical and pharmacy students saw medicines as less harmful than nursing students did. Stage of education was also important: third-yearmedical and pharmacy students saw medicines as more beneficial and less harmful than firstyear students did. Experience of medicine use was relevant to general beliefs about medicines.Conclusion: Different beliefs exist between healthcare professions owing to different types and stages of education, which could result in different messages being given to the patient.Practice implications: It is important to educate future healthcare professionals about the potential effect of beliefs on communication.
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| 13. |
- Nordqvist, Ola, et al.
(författare)
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Assessing and achieving readiness to initiate HIV medication
- 2006
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 62:1, s. 21-30
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo summarise published HIV-specific research on readiness theories, factors influencing readiness, instruments to measure readiness and interventions to increase readiness for treatment.MethodsMedline and PsychInfo were searched until August 2004.ResultsTwo HIV-specific readiness theories were identified. Fear of side effects, emotions emerging from the diagnosis and lack of trust in the physician were some barriers to overcome in order to reach readiness. Of the three measurement instruments found, the index of readiness showed the most promise. Multi-step intervention programs to increase readiness for HIV treatment had been investigated.ConclusionReadiness instruments may be useful tools in clinical practice but the predictive validity of the instruments needs to be further established in the HIV-infected population.Practice implicationsReadiness instruments and practice placebo trials may serve as complements to routine care, since health care providers currently have no better than chance probability in identifying those patients who are ready to adhere.
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| 14. |
- Rydell Karlsson, Monica, et al.
(författare)
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A nurse-based management program in heart failure patients affects females and persons with cognitive dysfunction most
- 2005
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 58:2, s. 146-53
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Tidskriftsartikel (refereegranskat)abstract
- It is important that congestive heart failure (CHF) patients know how to monitor and manage disease-associated signs and symptoms. CHF patients were randomised to follow-up at a nurse-based outpatient clinic (intervention group (IG); n = 103), or to follow-up in primary healthcare (control group (CG); n = 105). Patient knowledge of CHF and self-care were assessed by a questionnaire and cognitive function by a Mini Mental State Examination (MMSE) at baseline and at six months. Men knew more about CHF as compared to females at baseline (p < 0.01). However, females in the IG increased their knowledge of self-care between baseline and six months as compared to CG females (p < 0.05). Patients with cognitive dysfunction (MMSE < 24) presented lower scores on knowledge as compared to those with a MMSE of >24 at baseline (p < 0.01). These differences disappeared after the intervention. Thus, females seemed to gain more than men from a nurse-based management program and patients with in-hospital signs of cognitive dysfunction should be encouraged to participate.
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| 15. |
- Röing, Marta, et al.
(författare)
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The uncanny mouth - a phenomenological approach to oral cancer
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 67:3, s. 301-306
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this retrospective qualitative study was to describe how patients with oral cancer experience their sickness and treatment. Methods: A purposeful sample of seven patients with oral cancer was interviewed. Data were analysed using a phenomenological approach outlined by van Manen. Results: The essence of the patients' experiences can be described as embodiment in a mouth that has become unreal, or 'uncanny'. At treatment start the body is invaded by cancer, during treatment there is no escape from a wounded mouth, at treatment end the mouth is disabled. Conclusions: The findings indicate that oral cancer patients' need for support may increase as treatment progresses and may be greatest at end of radiotherapy, as they return home with mouths that have not recovered after treatment and do not function normally. Practice implications: This suggests the importance of understanding the patients' situation during treatment and their desire for a return to normal living and normal mouth functions at treatment end. If possible, plans for oral rehabilitation should be considered in initial treatment planning. As the treatment of oral cancer is multiprofessional, this knowledge may be useful in guiding the organization of oral cancer care and multiprofessional collaboration.
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| 16. |
- Sarkadi, Anna, et al.
(författare)
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The influence of participant's self-perceived role on metabolic outcomes in a diabetes group education program
- 2005
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 58:2, s. 137-145
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Tidskriftsartikel (refereegranskat)abstract
- We investigated the demographic, biomedical, and perceptional factors influencing HbA(1c) 2 years after baseline in an educational program for persons with type 2 diabetes. Patients (N = 259) participated in a year-long group educational program led by specially trained pharmacists. There was a significant reduction of HbA(1c) (-0.15% unit; p < 0.05) on the group level after 24 months. Answers to open-ended questions on self-perceived role in diabetes management and occasions for testing blood glucose were analyzed qualitatively and used in a regression equation. Belonging to the "active" category of self-perceived role in diabetes management was associated with better outcomes compared to having a "passive" role. In addition, testing blood glucose levels for different purposes identified by the respondents was better than not to test blood glucose levels at all. The influence of these variables was striking; of the range of demographic and biomedical factors tested, only initial HbA(1c) and treatment entered the model.
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| 17. |
- Siwe, Karin, et al.
(författare)
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Medical students learning the pelvic examination : Comparison of outcome in terms of skills between a professional patient and a clinical patient model
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 68:3, s. 211-217
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare two models of learning the pelvic examination (PE) for medical students, with professional patients (PP) or with clinical patients (CP), by measuring perceived distress and learning outcome in terms of skills. Methods: Prospective longitudinal study. Assessments of self-perceived distress on four occasions at the prospect of performing a PE. Evaluation of the learning session (LS) and clinical clerkship concerning outcome of palpation skills. Results: During the LS, students in the PP model (PP students) received enough guidance from their coaches, were certain they had palpated the uterus and at least one ovary, and were less distressed afterwards compared with students who were instructed using the CP model (CP students). During the clinical clerkship, the PP students performed twice as many PEs as CP students did and had more often confirmed palpating the uterus and an ovary. Conclusion: PP students were more skilful in palpating the uterus and ovaries and performed more PEs during the clinical clerkship than did CP students. Practice implications: Engaging healthy and voluntary women as PPs takes time and effort. It is, however, worthwhile as it increases the confidence of students who perform PEs, makes them more competent, and ultimately improves their skills in performing the examination during their clinical clerkship.
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| 18. |
- Siwe, Karin, et al.
(författare)
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Performing the First Pelvic Examination : Female Medical Students’ Transition to Examiners
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 69:1-3, s. 55-62
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To gain a deeper understanding of how female medical students perceive and experience performing their first pelvic examination (PE). Methods: A qualitative study. In-depth interviews after the students’ involvement in a learning session about the PE, with professional patients (PPs) as instructors and a gynaecologist as supervisor. The interviews were analysed according to the constant comparative method to acquire a deeper understanding of the students’ experiences and the ongoing social processes. Results: “Transcending unspoken boundaries and taboos, a prerequisite for learning” was the essence of the entire material and was identified from two categories: “A didactic design facilitates the transition to examiner” and “Interactive support enables creative learning of interpersonal and palpation skills”. Conclusion: Through interactive guidance from the PPs, the students overcame affective obstacles and achieved the aim of becoming an examiner. The favourable learning experience heightened their awareness of their own bodies and promoted a deeper interest in PEs, both as examiners and as patients. Practice implications: Engaging voluntary, healthy and knowledgeable women as instructors in the PE situation creates a safe learning environment and promotes interaction with students. Immediate feedback teaches students to integrate communicative and behavioural skills in a professional manner and to palpate the uterus.
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| 19. |
- Södergård, Björn, et al.
(författare)
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A structural equation modeling approach to the concepts of adherence and readiness in antiretroviral treatment
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 67:1-2, s. 108-116
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The objective of this secondary analysis of data from a cross-sectional, nation-wide survey, was to test a hypothesized model with two latent concepts (readiness and adherence), based on the theory of trigger events. A secondary objective was to compare this model with two simpler models, without the concept of readiness. METHODS: Data consisted of a consecutive sample of 828 HIV patients > or = 18 years on antiretroviral treatment at 30 out of 32 HIV Clinics in Sweden (response rate 97.5%). Structural equation modeling (SEM) was used to test the models against the empirical data. Chi2 test was used to compare fit between models. RESULTS: The hypothesized model, with two latent concepts (readiness and adherence), fitted the data best (chi(2)=223.508, d.f.=129, p-value<0.0001, GFI=0.970, CFI=0.913, RMSEA=0.030), and significantly better than the models with adherence as the only latent concept. CONCLUSION: Although the SEM technique could not rule out that other models might also fit the data equally well, the hypothesized model, where readiness and adherence were two separate latent concepts, fitted data the best. This supports readiness as a distinct factor that influences adherence and hence treatment outcome. Increased attention should therefore be attached to interventions that focus on the individual' readiness for behavioural change, i.e. factors amendable to change and that can be addressed by the patients themselves. PRACTICE IMPLICATIONS: Based on these results it seems necessary to shift focus from adherence to readiness, especially in conditions where treatment can be postponed such as antiretroviral treatment.
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| 20. |
- Woolhead, G., et al.
(författare)
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"Tu" or "Vous?". A European qualitative study of dignity and communication with older people in health and social care settings
- 2006
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 61:3, s. 363-371
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the experiences of communication between older people and health and social care providers in six European countries. Methods: Focus groups were carried out with groups of older people (91 focus groups, 391 participants), and health and social care professionals (85 focus groups, 424 participants), in order to gain insights into concepts of good communications. Data collection and analysis continued concurrently according to the method of constant comparison. Results: Different styles of communication between professionals and older people were found to be capable of enhancing or jeopardising dignity. The use of appropriate forms of address, listening, giving people choice, including them, respecting their need for privacy and politeness, and making them feel valued emerged as significant ways to maintain older peoples' sense of self-worth and dignity. Despite being aware of good communication practices, health and social care professionals often failed to implement them. Lack of time, staff, resource scarcity, regulation and bureaucracy were cited as barriers, as was a lack of awareness and effort. Conclusions and practice implications: The findings have important implications for health and social care professionals when they engage with older people. © 2005 Elsevier Ireland Ltd. All rights reserved.
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| 21. |
- Österlund Efraimsson, Eva, et al.
(författare)
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Communication and self-management education at nurse-led COPD clinics in primary health care
- 2009
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 77:2, s. 209-217
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to explore the structure, content in communication and self-management education in patients' first consultations at nurse-led chronic obstructive pulmonary disease (COPD) clinics in primary healthcare. Method: Thirty consultations performed by seven registered nurses were videotaped; structure and content in the consultation was analyzed using Pendleton's Consultation Map. Nurses' self-management education was assessed from the content of the conversation: whether important and relevant information and self-management education was given, and how investigations were performed. Results: Each consultation lasted for a mean time of 37.53 min. Communication about reasons for consultations concerned mainly medical and physical problems and to a certain extent patients' perceptions. Teaching about self-management and smoking cessation was of an informative nature. Two consultations ended with shared understanding, and none of the patients received an individual treatment-plan. Conclusion: Nurses rarely planned the consultations on an individual basis and rarely used motivational dialogue in self-management education and in smoking cessation. Practice implications: The findings could be used to help nurses to reflect on how to improve the structure of the visit, self-management education, smoking cessation and patient communication.
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| 22. |
- Adolfsson, B, et al.
(författare)
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Locus of control and weight reduction
- 2005
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Ingår i: Patient education and counseling. - : Elsevier BV. - 0738-3991. ; 56:1, s. 55-61
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Tidskriftsartikel (refereegranskat)
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| 23. |
- Beckman, AGK, et al.
(författare)
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Can elderly people take their medicine?
- 2005
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Ingår i: Patient education and counseling. - : Elsevier BV. - 0738-3991. ; 59:2, s. 186-191
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Tidskriftsartikel (refereegranskat)
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| 24. |
- Bengtsson, Mariette, et al.
(författare)
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A course of instruction for women with irritable bowel syndrome.
- 2006
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 62:Aug 9, s. 118-125
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to determine the effects a course of instruction about irritable bowel syndrome (IBS) might have on symptoms, psychological well-being, and medical care requirements in these patients. Methods: Twenty-nine women with IBS participated in a programme of instruction on medical care, physical activity, stress-management, diet and health insurance. The women completed the Gastrointestinal Symptom Rating Scale and the Psychological General Well-Being Index and provided information about their requirements of medical care before and after the course. Results: Twenty-three of the women included, completed the questionnaires at 12 months after the course. When comparing these values to those at baseline, there were improvements in abdominal pain (p < 0.037) and vitality (p < 0.045) as well as a reduction in the number of visits to physicians (p < 0.037) and dieticians (p < 0.042). Conclusion: Information related to the disease, might help women with IBS to perceive less pain and more vitality and thereby experience a higher quality of life. Practice implications: A course of instruction for patients with IBS maybe of benefit for the patients, and could be apart of a multicomponent approach in the treatment of this patient group. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
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| 25. |
- Carlfjord, Siw, et al.
(författare)
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Computerized lifestyle intervention in routine primary health care : Evaluation of usage on provider and responder levels
- 2009
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Ingår i: PATIENT EDUCATION AND COUNSELING. - : Elsevier BV. - 0738-3991. ; 75:2, s. 238-243
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to evaluate the use of a computerized concept for lifestyle intervention in routine primary health care (PHC). Methods: Nine PHC units were equipped with computers providing a lifestyle test and tailored printed advice regarding alcohol consumption and physical activity. Patients were referred by staff, and performed the test anonymously. Data were collected over a period of I year. Results: During the study period 3065 tests were completed, representing 5.7% of the individuals visiting the PHC units during the period. there were great differences between the units in the number of tests performed and in the proportion of patients referred. One-fifth of the respondents scored for hazardous alcohol consumption, and one-fourth reported low levels of physical activity. The majority of respondents found the test easy to perform, and a majority of those referred to the test found referral positive. Conclusion: The computerized test can be used for screening and intervention regarding lifestyle behaviours in PHC. Responders are positive to the test and to referral. Practice implications: A more widespread implementation of computerized lifestyle tests could be a beneficial complement to face-to-face interventions in PHC.
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Ivarsson, Bodil, et al.
(författare)
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Patients perceptions of information about risks at cardiac surgery
- 2007
-
Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 67:1-2, s. 32-38
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim was to describe the patients' own experiences of risk information in connection with cardiac surgery and it's outcome. Methods: Questionnaires were answered prior to and 8 weeks after cardiac surgery. Data were analysed using qualitative content analysis. Patients in the intervention group (n = 55) received standard information and a newly written extended information brochure about risks in connection with cardiac surgery. Patients in the control group (n = 44) only received standard information. Results: Three categories emerged: attitude towards information, deficiencies and advantages of the information and concerns related to cardiac surgery. Patients in both groups pointed out the importance of information when they were put on the waiting list. Patients in the control group missed information about complications and some patients thought that their complications were caused by maltreatment. Patients having complications in the intervention group were more understanding about their situation. Conclusion: Much can be done for the patients on their path from diagnosis and being accepted for cardiac surgery and throughout the treatment period regarding the provision of information. Practice implications: If patients become carefully and thoroughly informed by the health care professionals, they are more satisfied and better prepared if complications occur. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
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| 30. |
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| 31. |
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| 32. |
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| 33. |
- Mårdby, Ann-Charlotte, 1976, et al.
(författare)
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Beliefs about medicines and self-reported adherence among pharmacy clients
- 2007
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 69, s. 158-164
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables. Methods: The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the selfreporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse). Results: Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines. Conclusions: General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines. Practice implications: Increased awareness of the patient’s beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.
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| 34. |
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| 35. |
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| 36. |
- Ågård, Anders, et al.
(författare)
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Familial hypercholesterolemia: ethical, practical and psychological problems from the perspective of patients.
- 2005
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991. ; 57:2, s. 162-167
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Tidskriftsartikel (refereegranskat)abstract
- The main aim of the study was to explore the extent to which familial hypercholesterolemia (FH) influences the life of the patients affected. The study employed a qualitative analysis of semi-structured interviews with 23 outpatients who were being treated following a diagnosis of heterozygous FH at a tertiary hospital in Göteborg, Sweden. Some interviewees reported concerns related to their medication and feelings of guilt when not complying with treatment recommendations. However, none of the respondents expressed sustained emotional distress or would have preferred to be ignorant of their diagnosis. Apart from being more observant about food intake, their awareness of FH did not appear to have had a substantial impact on their way of life. In fact, those who did not suffer from any other diseases generally regarded themselves as healthy. Discussing the genetic constitution with family members with whom they had close contact was natural, but informing distant family members was not.
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