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- Svensson, Hilda, Filosofie doktor, 1979-, et al.
(författare)
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The effects of person-centered or other supportive interventions in older women with osteoporotic vertebral compression fractures–a systematic review of the literature
- 2017
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Ingår i: Osteoporosis International. - London : Springer London. - 0937-941X .- 1433-2965. ; 28:9, s. 2521-2540
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Tidskriftsartikel (refereegranskat)abstract
- Vertebral compression fracture (VCF) is a common fragility fracture and the starting point of a lasting, painful, disabling condition. The aim was to summarize the evidence of person-centered/non-medical interventions supporting women with VCF. Results show small numbers of studies with only probable effect onfunction, pain, QoL, fear of falling, and psychological symptoms. The vertebralcompression fracture (VCF) caused by osteoporosis is the third most common fragility fracture worldwide. Previously, it was believed that the pain caused by VCF was self-subsiding within weeks or a few months post-fracture. However, this positive prognosis has been refuted by studies showing that, for the great majority of patients, the VCF was the starting point of a long-lasting, severely painful, and disabling condition. The low number of studies focusing on the experience of the natural course of VCF, and what support is available and how itis perceived by those affected, calls for further investigation. Strengthening older patients' sense of security and increasing confidence in their ownabilities are of great importance for successful rehabilitation following VCF. More research is needed to identify resources, possibilities, and strategies that can assist older patients to reach their goals to improve well-being. The purposeof this systematic review was to identify and summarize the current evidence ofperson-centered or other structured non-medical/non-surgical interventions supporting older women after experiencing an osteoporotic VCF. A systematic literature search was conducted on the MeSH terms encompassing osteoporosis andvertebral compression fractures in the PubMed-MEDLINE and Cumulative Index forNursing and Allied Health Literature (CINAHL) databases during March through June 2015. The initial search identified 8789 articles, but only seven articles (sixrandomized controlled trials and one observational study with a control group)met the inclusion criteria. It became evident from the current study that theavailability of evidence on the effects of non-medical interventions aiming tosupport older women with VCF is limited, to say the least. The trials included inthis review have few limitations and were mainly considered to be of moderatequality. This systematic literature review suggests that non-medical interventions aiming to support older women with VCF might decrease levels ofpain and use of analgesic as well as promote improved physical mobility andfunction. These interventions would probably result in an improved difference in experiences of fear of falling and perceived psychological symptoms, but would only slightly improve quality of life. However, given the nature of the seven studies, potential biases in patient selection, issues around precision with small cohorts, and failure to control for confounders, makes it difficult to drawa definitive conclusion about the significant effects of non-medical interventions. Incurring a VCF is a complex and diverse event, necessitating equally complex interventions to identify new ways forward. However, to date,interventions struggle with a risk of selection bias in that only the needs of the healthiest of the population are addressed and the voices of the remaining majority of the people affected by VCF are unheard. © 2017, The Author(s).
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| 2. |
- Carlström, Eric, 1957, et al.
(författare)
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The unannounced patient in the corridor - trust, friction and person centered care.
- 2017
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Ingår i: International Journal of Health Planning and Management. - : Wiley. - 0749-6753 .- 1099-1751. ; 32:1
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Tidskriftsartikel (refereegranskat)abstract
- In this study, a Swedish cancer clinic was studied where three to four unscheduled patients sought support from the hospital on a daily basis for pain and nutrition problems. The clinic was neither staffed nor had a budget to handle such return visits. In order to offer the patients a better service and decrease the workload of the staff in addition to their everyday activities, a multidisciplinary team was established to address the unscheduled return visits. The team was supposed to involve the patient, build trust, decrease the friction, and contribute to a successful rehabilitation process. Data were collected from the patients and the staff. Patients who encountered the team (intervention) and patients who encountered the regular ad hoc type of organization (control) answered a questionnaire measuring trust and friction. Nurses in the control group spent 35% of their full‐time employment, and the intervention group staffed with nurses spent 30% of their full‐time employment in addressing the needs of these return patients. The patients perceived that trust between them and the staff was high. In summary, it was measured as being 4.48 [standard deviation (SD) = 0.82] in the intervention group and 4.41 (SD = 0.79) in the control group using the 5‐point Likert scale. The data indicate that using a multidisciplinary team is a promising way to handle the problems of unannounced visits from patients. Having a team made it cost effective for the clinic and provided a better service than the traditional ad hoc organization.
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| 3. |
- Pirhonen, Laura, et al.
(författare)
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Effects of person-centred care on health outcomes—A randomized controlled trial in patients with acute coronary syndrome
- 2017
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 121:2, s. 169-179
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Tidskriftsartikel (refereegranskat)abstract
- © 2016 Elsevier Ireland LtdObjectives To study the effects of person-centred care provided to patients with acute coronary syndrome, using four different health-related outcome measures. Also, to examine the performance of these outcomes when measuring person-centred care. Data and method The data used in this study consists of primary data from a multicentre randomized parallel group, controlled intervention study for patients with acute coronary syndrome at Sahlgrenska University Hospital in Gothenburg, Sweden. The intervention and control group consisted of 94 and 105 patients, respectively. The effect of the intervention on health-related outcomes was estimated, controlling for socio-economic and disease-related variables. Results Patients in the intervention group reported significantly higher general self-efficacy than those in the control group six months after intervention start-up. Moreover, the intervention group returned to work in a greater extent than controls; their physical activity level had increased more and they had a higher EQ-5D score, meaning higher health-related quality of life. These latter effects are not significant but are all pointing towards the beneficial effects of person-centred care. All the effects were estimated while controlling for important socio-economic and disease-related variables. Conclusion The effectiveness of person-centred care varies between different outcomes considered. A statistically significant beneficial effect was found for one of the four outcome measures (self-efficacy). The other measures all captured beneficial, but not significant, effects.
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