| 1. |
- Allvin, Renée, 1956-, et al.
(författare)
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Patient Reported Outcome Measures (PROMs) after total hip- and knee replacement surgery evaluated by the Postoperative Recovery Profile questionnaire (PRP) : improving clinical quality and person-centeredness
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - Buckingham, United Kingdom : University of Buckingham Press. - 2043-7730 .- 2043-7749. ; 2:3, s. 368-376
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Tidskriftsartikel (refereegranskat)abstract
- Rationale and aims: The importance of evaluating postoperative recovery with consideration to the patient’s perspectivehas been emphasized. The aim of this study was to demonstrate how the recovery-specific Postoperative Recovery Profile(PRP) questionnaire can be used to evaluate patient-reported outcome measures (PROMs) after hip- and knee replacementin the enhancement of clinical quality and the person-centeredness of clinical services.Method: Patients undergoing primary total knee- and hip replacement were eligible for this longitudinal follow-up study. The participants completed the PRP questionnaire on repeated occasions. In this paper, data from Day 3 and Month 1 afterdischarge were used. The change in recovery, between the two measurement occasions, on item-, dimensional- and globallevels, both for each patient and for the group, were evaluated.Results: A total number of 75 patients were included. One month after discharge the median PRP score was 13 (partly recovered) out of 19. Recovery changes towards lower levels of problems/difficulties were shown in both item-, dimensional- and global levels of recovery month 1 after discharge, as compared with Day 3. The group of patients washomogenous in change.Conclusions: We demonstrated that the PRP questionnaire can be used to evaluate postoperative recovery after hip- andknee replacement surgery on item-, dimensional- and global levels. Data from each recovery level can be useful for quality development and in informing increases in the person-centeredness of clinical services. The global population scores can beused to evaluate treatment effect on a group of patients. It can also be used to define endpoints in follow-up studies.
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| 2. |
- Bäck, Annika, et al.
(författare)
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The Medication Adherence Report Scale (MARS-5) in a Swedish sample with bipolar disorder - a pilot study
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 2:2, s. 263-270
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To test the acceptability and reliability of the Swedish translation of the Medication Adherence Report Scale-5 (MARS-5) in a sample of patients who use mood stabilising medicines for bipolar disorder. A further aim was to compare the Swedish translation of the MARS-5 with the Swedish translation of the four-item scale Morisky Medication Adherence Scale (MMAS-4). Method: The study population (n=47, 70% women) was recruited through patient education sessions, at a Patient Association meeting, in Gothenburg, Sweden, as well as through advertisements on the home pages and newsletters of the Swedish patient associations. Participants received the Swedish translations of the MARS-5 and the MMAS-4, and questions on age, education, and country of birth. Reliability was examined for internal consistency (Cronbach’s α) and test-retest (intraclass correlation (ICC), MARS-5: Pearson’s correlation coefficient (r), MMAS-4: Spearman’s rho (ρ)). The acceptability of the MARS-5 was examined with a correlation analysis between the MARS-5 and the MMAS-4 and for face validity. Results: In the study population 53.3% were categorised as adherent with the MARS-5 and 82.6% using the MMAS-4. The value of Cronbach’s α was 0.66 for the MARS-5 and 0.37 for the MMAS-4. The test-retest of the MARS-5 resulted in r=0.90 and ICC=0.91. Corresponding values for the MMAS-4 were ρ=0.84 and ICC=0.85. The correlation between the MARS-5 and the MMAS-4 was 0.55. The face validity resulted in four comments regarding difficulties in answering the MARS-5. Conclusion: The Swedish translation of the MARS-5 ought to be used instead of the MMAS-4 to measure self-reported adherence in a Swedish sample with bipolar disorder. The MARS-5 showed good psychometric properties.
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| 3. |
- Eklund, Anna Josse, 1968-, et al.
(författare)
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Cross-cultural validation and psychometric testing of the Swedish version of the microsocial section of the Attitudes toward Patient Advocacy Scale
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - : Open Journal Systems. - 2043-7730 .- 2043-7749. ; 2:3, s. 473-481
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectives: Patient advocacy can be defined as a process for maintaining and monitoring patients’ rights, values and best interests. To measure attitudes toward patient advocacy, Bu and Wu (2008) developed the Attitudes toward Patient Advocacy Scale (APAS), which required further testing and refining in different contexts. This two-phased study aimed to: (1) translate and cross-culturally validate the APAS section for microsocial patient advocacy (AMIA) in accordance with the Swedish context and (2) test the instrument’s psychometric properties in the community care of older patients.Methods and results: The first phase consisted of back-translation and cultural validation of the APAS-AMIA in accordance with the Swedish context and resulted in a 39-item Swedish version of the APAS-AMIA. In the second phase, data were collected using the 39-item APAS-AMIA in 2009 from a sample of 230 registered nurses and nurse managers covering 16 communities. Subsequently, psychometric testing was conducted with exploratory factor analysis and reliability analysis in a final sample of 201 RNs. The exploratory factor analysis revealed a 4-factor structure, explaining 52.1% of the total scale variance in a 33-item instrument called the APAS-AMIA/SE. The Cronbach’s alpha for the APAS-AMIA/SE was 0.92 and varied between 0.82 and 0.88 for the factors.Conclusion: When the APAS-AMIA/SE semantic and conceptual equivalence to the APAS-AMIA, its distinct factor structure, internal consistency values and theoretical attachment are all added together, the conclusion is that the APAS-AMIA/SE is an acceptably reliable and valid instrument.
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| 4. |
- Larsson, Gerry, et al.
(författare)
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Changes over time in the importance patients ascribe to different aspects of care : On the need to improve person-centeredness
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - United Kingdom : The University of Buckingham Press. - 2043-7730 .- 2043-7749. ; 2:3, s. 482-490
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Tidskriftsartikel (refereegranskat)abstract
- Rational and aim: Knowledge of which aspects of care are more important to patients is crucial for health providers. The aim of the work presented here was to explore changes over time in patients’ preferences in hospital and in out-patient settings.Method: Cross-sectional data were collected among patients at a number of Swedish hospital wards and out-patient clinics in 2003, 2004, 2005 and 2008 (N = 46,525). Data for men and women were analysed separately. The main outcome measure consisted of replies to the questionnaire “Quality from the Patient’s Perspective” (QPP) (numerous references).Results: (1) Subjective importance (preference) ratings increased throughout the time period studied, (2) in-patients gave higher ratings than out-patients and (3) women gave higher ratings than men, particularly in out-patient settings.Conclusion: The increase over time in ratings of the importance ascribed to different aspects of care may reflect a general trend towards strengthened consciousness among citizens as consumers of care and is an important index for improving the person-centeredness of clinical services.
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| 5. |
- Nord, Lennart
(författare)
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Effects of slow breathing exercises and music in patients with hypertension ─ 15 months follow-up
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - : University of Buckingham Press. - 2043-7730 .- 2043-7749. ; 2:3, s. 377-383
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Tidskriftsartikel (refereegranskat)abstract
- Background: Active patient participation in care is a prerequisite for effective self-management. Aim: To evaluate if a person centred directed intervention such as device-guided slow breathing exercises (DGBE) and listening to music can reduce blood pressure over a period of 15 months in patients with hypertension. Methods: A randomized, controlled study was conducted for 15 months, 48 patients using DGBE- exercises and 42 patients in a CD group listening to music from a CD-player, for 15 minutes three times a week in both groups. Results: Systolic blood pressure (SBP) reduction was -9.8 mmHg (p<0.001) in the DGBE group and -7.7 mmHg (p<0.01) in the CD group, diastolic blood pressure (DBP) reduction was -4.1 mmHg (p<0.05) in the DGBE group and -2.5 mmHg (ns) in the CD group. No significant differences were found in median blood pressure between the groups neither at inclusion nor after 15 months. Conclusion: Person centred care with breathing exercises and listening to music 15 minutes three times a week can reduce blood-pressure in patients with hypertension over a period of 15 months.
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| 6. |
- Siouta, Eleni, et al.
(författare)
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Interactional resistance between patients with atrial fibrillation and cardiologists in consultation on treatment with warfarin: the value of shared decision-making
- 2012
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Ingår i: The International Journal of Person Centered Medicine. - 2043-7730 .- 2043-7749. ; 2:3, s. 427-436
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Rationale: Atrial fibrillation (AF) increases the risk of stroke and it can be reduced by treatment with warfarin. Some patients consider that warfarin is a stressful treatment with undesired effects and the perceived barriers include unwillingness to take it. Knowledge of patients resisting warfarin treatment may be useful for the potential threat to maintaining shared decision-making in the consultation as a central tenet of person-centered medicine. Aims and objectives: To identify how patients resist treatment with warfarin and how cardiologists respond to patients’ resistance. The co-constructive perspective of this work analyses the consultations by emphasizing the clinical communication strategies of both patients and cardiologists. Method: Eleven videotaped consultations, in 4 different hospitals, were selected for analysis. Treatment interactions regarding warfarin between patients with AF and cardiologists were analysed, according to the methodology of conversation analysis. Results: There were 4 types of resistance from patients for accepting treatment with warfarin. These included “Giving reasons for their resistance”, “Suggestion of another treatment option by the patient”, “Stating a treatment preference” and “Questioning or challenging the cardiologist’s treatment recommendation”. The cardiologists’ responses to the patients’ resistance included “Repeating the treatment recommendation”, “Negotiation with the patient”, “Providing additional information on the recommended treatment” and “Extending the explanation for the purpose of taking the treatment”. Conclusions: By showing resistance, patients are thought to want to participate in their treatment decisions and an awareness of patients’ resistance to treatment enables cardiologists to address the patients’ experience-based views on their treatment and individual concerns as part of clinical strategies to increase the person-centeredness of medical intervention.
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| 7. |
- Hommel, Ami, et al.
(författare)
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When nurses need nursing : expectations and experiences
- 2012
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Ingår i: International Journal of Person Centered Medicine. - : University of Buckingham Press. - 2043-7730. ; 2:3, s. 344-351
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Tidskriftsartikel (refereegranskat)abstract
- Rational and aim of the study: This paper explores the expectations and experiences of the care given when 5 registered nurses working as nurse teachers are affected by life-threatening illness or injury. This is important as little is known about patient`s preferences for care and as far as we know none have described when the patients are nurses.Method: Data were collected through interviews and analyzed by means of content analysis.Results: Five nurses have after life-threatening illness or injury made their entrance to the patients’ world. When we analyzed the text information, confirmation, participation, empowerment and responsibility emerged as main categories. The informants are struggling for information and confirmation. They want to be involved and take responsibility in the care. Conclusion: When a professional practitioner becomes ill, it is reasonable that the demands of care are very high. The requirements that emerge in the interviews; however, were surprisingly reasonable and were more related to basic needs than to receive care of extraordinary quality. That itself says a lot of what is happening within us humans when we become patients and it also gives us a unique opportunity for knowledge and understanding. Today’s trend to provide person-centered care is even more important to express how important it is to confirm humans’ individual needs.
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| 8. |
- Jangland, Eva, et al.
(författare)
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Patients’ experiences of interactions with health professionals in a surgical setting : implications for the advancement of person-centered medicine
- 2012
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Ingår i: International Journal of Person Centered Medicine. - 2043-7730. ; 1:4, s. 756-765
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the experiences of patients who complain about negative interactions with health professionals in a surgical setting. The study was based on interviews with patients (n = 15) who had contacted their local Patients’ Advisory Committee to report their negative interaction with health professionals in a large university hospital in Sweden. Exploring the experiences of patients who report negative interactions may be a starting point for learning about the patients’ views of the health care organisation, and this information may contribute to quality improvement. The interviews were analysed using qualitative content analysis. Patients’ experiences of negative interactions are described under three main themes: ‘having lost confidence’, ‘feeling like a nuisance’ and ‘feeling abandoned and lonely’. Negative interactions with health professionals caused long-term consequences for patients, including suffering, insecurity, and worry. It also reduced their confidence in upcoming consultations. From the patients’ perspective a caring relationship with health professionals and reliable, appropriate, and timely information are vital to high quality care. Patient access to information and positive interactions with health professionals should be routine quality indicators in the surgical care unit. In the process of quality improvement, all health professionals need to be involved in setting goals, making small tests of changes, and evaluating outcomes. Patients’ stories of negative interactions could provide the impetus for professional reflection sessions in the surgical care unit and for education for all health professionals to develop new competence in patient relations
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