| 1. |
- Ahmadi, Nasser, 1958, et al.
(författare)
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Breathlessness in everyday life from a patient perspective: A qualitative study using diaries
- 2014
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Ingår i: Palliative & supportive care. - Cambridge, United Kingdom : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 12:3, s. 189-194
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Breathlessness is a subjective symptom, which makes it difficult to define and understand. The aim of the present study was to illuminate how patients suffering from breathlessness experience their everyday life. Method: The study was a qualitative study, and the focus of the analysis was the patients’ descriptions of their experiences of breathlessness using a diary with two unstructured questions for a period of 7 consecutive days. Sixteen participants: 7men, mean age 65+7 (range 55–73 years old), and 9 women, mean age 65+9 (range 50–72 years old) participated in the study. Results: Two themes emerged from the analysis: 1) Impaired quality of life and 2) symptom tolerance and adaptation. The theme “impaired quality of life” included the categories limited physical ability, psychological burdens, and social life barriers. The theme “symptom tolerance and adaptation” included importance of health care, social support, hobbies and leisure activities, and coping strategies. Significance of results: The findings in our study showed that patients, in spite of considerable difficulties with shortness of breath, found relief in several types of activities, in addition to drug therapy. The result indicates that the “biopsychosocial model” is an appealing approach that should be discussed further to gain a better understanding of breathlessness.
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| 2. |
- Jonasson, Inger, et al.
(författare)
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A new primary care model for the rehabilitation of strokepatients with impaired arm and hand function - a pilot study.
- 2012
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Ingår i: Vård i Norden. - 0107-4083. ; 32:2, s. 15-20
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT Background: A new treatment method, Constraint-Induced Movement Therapy (CIMT), has been tested by stroke patients in hospital but not in primary care. Reduced time in hospital increases primary care’s responsibility for rehabilitation and necessitates the development of new methods. Aim: To investigate the effect of CIMT on stroke patients in primary care. Method: Sixteen patients with stroke were offered a ten-day intensive group-training course, six hours per day. They were included in median value 17 months (range:7-120) after stroke. They were prevented from using their non-affected hand by wearing a glove for 90% of their waking hours. Measurements with 14 standardized instruments were performed up to three months after intervention. Findings: The results revealed a significant improvement in the patients’motor and everyday life functions. There was a marked recovery of lost capacity in ADL, which combined with the increase in the performance of meaningful tasks led to improved possibilities of living an independent life. The improvements in motor function and recovery of lost ADL functions were maintained at the three month follow-up. The training intervention was perceived as highly satisfactory. Conclusion: CIMT in a group setting in primary health care seems to be a successful rehabilitation model after stroke. KEY WORDS: ADL, constraint-induced movement therapy, occupational therapy, primary care, rehabilitation outcome
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| 3. |
- Lydell, Marie C, 1961, et al.
(författare)
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Return or no return - psychosocial factors related to sick leave in persons with musculoskeletal disorders: a prospective cohort study.
- 2011
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Ingår i: Disability and rehabilitation. - Abingdon : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 33:8, s. 661-666
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The aim of this study was to compare psychosocial factors between healthy persons and sick-listed persons with musculoskeletal disorders (MSD); both groups with MSD 10 years ago. Methods. This cohort study was prospective and 385 persons participated in a rehabilitation program 10 years ago, and 354 persons took part in the follow-up. Of these, 243 persons completed a questionnaire. Two groups were included in the study: a healthy group (not sick-listed) (n = 112) and a sick-listed group (n = 74). Psychosocial factors related to sick leave were compared between the groups. Results. In the 10-year follow-up, the healthy group showed a significantly higher quality of life, more control over the working situation, better sense of coherence and unexpectedly more life events. There was no significant difference in social integration and emotional support between the groups. Conclusions. Using the knowledge about the characteristics of the healthy group, adequate rehabilitation for every sick-listed person with a musculoskeletal disorder can be given and therefore facilitate the returning to work process. A multidimensional approach taking into account a person's physical condition and workplace related problems, as well as psychosocial factors, is of great importance for the person and for society.
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| 4. |
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| 5. |
- Lydell, Marie, 1961-, et al.
(författare)
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Thoughts and feelings of future working life as a predictor of return to work : a combined qualitative and quantitative study of sick-listed persons with musculoskeletal disorders
- 2011
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Ingår i: Disability and Rehabilitation. - London : Taylor & Francis Group. - 0963-8288 .- 1464-5165. ; 33:13-14, s. 1262-1271
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. The main aim of this study was to describe the thoughts and feelings of future working life related to return to work (RTW) in sick-listed persons due to musculoskeletal disorders (MSD). Further aim was to compare these descriptions with the person’s actual working situation 1, 5 and 10 years after a rehabilitation period.Methods. This study consisted of two parts. The first part had an explorative design, and qualitative content analysis was chosen in order to analyse the response to an open question regarding future working life answered before, persons sick-listed due to MSD (n = 320), took part in a rehabilitation programme 10 years ago. The second part had a prospective design and quantitative analysis was used to compare the results of the qualitative analysis with RTW and the working situation 1, 5 and 10 years after baseline.Results. Three categories emerged from the data with a total of nine subcategories. In the categories Motivation and optimism and Limitations to overcome, there were significantly more persons who had RTW 1 year after baseline when compared with the category Hindrance and hesitation. There were also some significant differences between the subcategories.Conclusions. The question, regarding thoughts and feelings of future working life, may be a simple screening method to predict RTW in persons sick-listed with MSD. This will guide the rehabilitation team to adjust the rehabilitation to each person’s needs and facilitating RTW.
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| 6. |
- Månsson, Jörgen, 1958, et al.
(författare)
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Reasons for encounters, investigations, referrals, diagnoses and treatments in general practice in Sweden - a multicentre pilot study using electronic patient records
- 2011
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Ingår i: European Journal of General Practice. - : Informa UK Limited. - 1381-4788 .- 1751-1402. ; 17:2, s. 87-94
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate reasons for encounters, investigations, referrals, diagnoses and treatments in everyday general practice, using electronic patient records (EPR), and possible related differences concerning gender, socio-economic status (SES) and practice location. Method: Four Swedish primary care centres using EPR participated. Distributions of symptoms, investigations, diagnoses and prescribed drugs were registered. Results: In 1055 encounters, the mean patient age was 53; 59% were women. The most common reasons for the encounter were musculoskeletal (21.5%) and respiratory (15.2%) symptoms. A total of 1534 diagnoses were coded, on average 1.5 per encounter. The predominant diagnostic groups, i.e. ICD-10 chapters, were musculoskeletal (17.2%) and respiratory (12.4%). The most common specific diagnoses were essential hypertension (8.1%) and acute upper respiratory infections (3.7%). A total of 1687 prescriptions were issued, on average 1.6 per encounter. The most frequent pharmaceutical groups were nervous (17.7%), respiratory system (16.2%), and cardiovascular (15.7%). The most frequent drugs were phenoxymethyl penicillin (3.7%), diclofenac (2.9%) and acetylsalicylic acid (2.5%). An average of 1.3 laboratory tests was performed per encounter. In 7.5% of encounters, radiology referrals were made; in 12.3% referrals were made to other specialists/therapists, while sick-list certificates were written in 11.7%. There were significant differences concerning symptoms, diagnoses and investigations between female and male patients, urban and rural practices and SES. Conclusion: The musculoskeletal, respiratory and circulatory systems predominated, both as reasons for the encounter and in the diagnoses, but with significant differences concerning gender, SES and practice location.
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| 7. |
- Nilsson, Pia, 1959, et al.
(författare)
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Lateral epicondylalgia. A quantitative and qualitative analysis of interdisciplinary cooperation and treatment choice in the Swedish health care system
- 2012
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Ingår i: Scandinavian Journal of Caring Sciences. - London : Taylor & Francis. - 0283-9318 .- 1471-6712. ; 26:1, s. 28-37
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Tidskriftsartikel (refereegranskat)abstract
- Objective and aim: Interdisciplinary cooperation is essential to develop a broad range of knowledge and skills. The aim of this study was to describe health care professionals' treatment choices, their cooperation with other professionals and their perceptions of potential risks regarding treatments of acute lateral epicondylalgia (LE).Design: A quantitative descriptive study design with a summative approach to qualitative analysis.Ethical issues: The ethical committee was asked verbally for approval but, as this study was performed to develop an organised way to treat LE, it did not require approval. The four ethical aspects information, consent, confidentiality and the use of the study materials were all addressed.Subjects: All orthopaedic surgeons, general practitioners, physiotherapists and occupational therapists in a county.Methods: Questionnaire with 18 dichotomous, multiple-response, multiple-choice questions and three open-ended questions were analysed using quantitative cross-tab and qualitative content analysis with summative approach.Results: The most common treatment choices were Non Steroidal Anti Inflammatory Drugs (NSAID), corticosteroid injections, training programmes, braces and ergonomics. Advantages from interdisciplinary cooperation were higher rated than disadvantages. The qualitative findings dealt with perceptions of interdisciplinary cooperation and resulted in three categories; right level of care, increased quality of care and decreased quality of care. Almost half of the physicians felt potential risks associated with their treatment methods. The qualitative findings dealt with perceptions of the potential risks and resulted in two categories: side effects and inadequate treatment.Study limitations: The number of responses varied because some of the respondents did not answered all of the questions.Conclusion: Interdisciplinary cooperation in the treatment of patients with acute LE benefits the patients by shortening the rehabilitation period and provides health care professionals the opportunity for an improved learning and exchanging experiences. These basic conditions must be met to improve health care quality.
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| 8. |
- Nilsson, Pia, 1959, et al.
(författare)
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Lateral epicondylalgia: a structured programme better than corticosteroids and NSAID.
- 2012
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Ingår i: Scandinavian journal of occupational therapy. - Oxon, United Kingdom : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 19:5, s. 404-410
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim: To evaluate whether patients with lateral epicondylalgia had less pain or function loss two years following treatment by a structured programme and if the number of recurrent episodes and sick leave days differed compared with a control group. Subjects: All of the patients were diagnosed by a physician with the diagnosis code M77.1 (lateral epicondylitis). The intervention group (n = 103) was treated by a physiotherapist and an occupational therapist with a home training programme that included ergonomic advice. Wrist supports and/or night bandages were also available. Controls (n = 194) were diversely treated by different professionals. Major findings: In the total study group (n = 297), 54% of the patients experienced pain and 55% experienced function loss after two years. The intervention group had less pain than patients treated with corticosteroid injections (p < 0.0001) or NSAIDs (p = 0.048) and experienced better function than those treated with corticosteroid injections (p = 0.002). The intervention group had a lower recurrence (p < 0.0001) and fewer sick leave days at the time of the visit to the health care centre (p = 0.005). Principal conclusions: A structured treatment programme was more effective than corticosteroid injections and NSAIDs. Patients did not require additional treatment or sick leave and had learned self-treatment of the disorder.
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