| 1. |
- Bala, Sidona-Valentina, et al.
(författare)
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The experience of care at nurse-led rheumatology clinics
- 2012
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Ingår i: Musculoskeletal Care. - : Wiley. - 1478-2189 .- 1557-0681. ; 10:4, s. 202-211
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe how people with rheumatoid arthritis (RA) experience the care provided by Swedish nurse-led rheumatology outpatient clinics. Methods Eighteen adult people with a diagnosis of RA who had had at least three documented contact sessions with a nurse-led clinic were interviewed. The interviews were analysed with qualitative content analysis. Results Care was expressed in three categories: social environment, professional approach and value-adding measures. A social environment including a warm encounter, a familial atmosphere and pleasant premises was desired and contributed to a positive experience of care. The nurses' professional approach was experienced as empathy, knowledge and skill, as well as support. The care was described as person centred and competent, as it was based on the individual's unique experience of his/her disease and needs. The nurses' specialist knowledge of rheumatology and rheumatology care was highly valued. The offered care represented added value for the participants, instilling security, trust, hope and confidence. It was perceived as facilitating daily life and creating positive emotions. The nurse-led clinics were reported to be easily accessible and provided continuity of the care. These features were presented as fundamental guarantees for health care safety. Conclusion The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.
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| 2. |
- Bala, Sidona-Valentina, et al.
(författare)
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The experience of care at nurse-led rheumatology clinics
- 2012
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Ingår i: Musculoskeletal Care. - : Wiley. - 1478-2189 .- 1557-0681. ; 10:4, s. 202-211
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To describe how people with rheumatoid arthritis (RA) experience the care provided by Swedish nurse-led rheumatology outpatient clinics.METHODS: Eighteen adult people with a diagnosis of RA who had had at least three documented contact sessions with a nurse-led clinic were interviewed. The interviews were analysed with qualitative content analysis.RESULTS: Care was expressed in three categories: social environment, professional approach and value-adding measures. A social environment including a warm encounter, a familial atmosphere and pleasant premises was desired and contributed to a positive experience of care. The nurses' professional approach was experienced as empathy, knowledge and skill, as well as support. The care was described as person centred and competent, as it was based on the individual's unique experience of his/her disease and needs. The nurses' specialist knowledge of rheumatology and rheumatology care was highly valued. The offered care represented added value for the participants, instilling security, trust, hope and confidence. It was perceived as facilitating daily life and creating positive emotions. The nurse-led clinics were reported to be easily accessible and provided continuity of the care. These features were presented as fundamental guarantees for health care safety.CONCLUSION: The experiences emphasized the need for a holistic approach to care. In this process, the organization of care and the role and skills of the nurse should be focused on the individual's needs and perspectives. The social environment, professional approach and value-adding measures are particularly relevant for optimal care at nurse-led rheumatology outpatient clinics.
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| 3. |
- Knutsson, I., et al.
(författare)
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Stability of rating scale response category interpretations in neurological disorders
- 2013
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Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell. - 0001-6314 .- 1600-0404. ; 128:4, s. 265-272
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Unambiguous use and interpretation of rating scale data assume that response categories are interpreted and work as intended. This study investigated the stability of interpretations of commonly used patient-reported rating scale response categories among people with neurological disorders. Materials and methods Forty-six people with neurological disorders (26 men; mean age, 57; Parkinson's disease, 50%; multiple sclerosis, 41%) indicated their interpretation of 21 response categories (representing frequencies, intensities and levels of agreement) on 100-mm visual analog scales (VAS) at two occasions, ≥2 weeks apart. Data were analyzed using intraclass correlation and weighted Kappa (ICC/Κw; should be >0.4), mean/median differences, percentages agreement (PA), and the standard error of measurement (SEM). Results Most response categories had ICC/Κw values <0.4. The overall average ICC/Κw was 0.279/0.294 (frequencies, 0.224/0.255; intensities, 0.265/0.251; levels of agreement, 0.362/0.376). The mean/median difference between time points across all 21 categories was 0.43/0.5 mm (mean/median absolute difference, 3.36/9 mm). The overall average PA and SEM were 6.5% and 16.1 mm, respectively. Conclusions Stabilities in interpretations of patient-reported rating scale response categories among people with neurological disorders were generally low. Categories expressing levels of agreement showed best results, suggesting that these may be preferable when appropriate with respect to the scale and its items. Future studies should consider response category interpretations in relation to various contexts. These observations suggest caution when interpreting raw rating scale data and argue for the use of modern rating scale methodologies such as the Rasch measurement model.
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| 4. |
- Almgren, M, et al.
(författare)
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The Richmond Agitation-Sedation Scale: translation and reliability testing in a Swedish intensive care unit.
- 2010
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 54, s. 729-735
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Tidskriftsartikel (refereegranskat)abstract
- Background: Awareness about adequate sedation in mechanically ventilated patients has increased in recent years. The use of a sedation scale to continually evaluate the patient's response to sedation may promote earlier extubation and may subsequently have a positive effect on the length of stay in the intensive care unit (ICU). The Richmond Agitation-Sedation Scale (RASS) provides 10 well-defined levels divided into two different segments, including criteria for levels of sedation and agitation. Previous studies of the RASS have shown it to have strong reliability and validity. The aim of this study was to translate the RASS into Swedish and to test the inter-rater reliability of the scale in a Swedish ICU. Methods: A translation of the RASS from English into Swedish was carried out, including back-translation, critical review and pilot testing. The inter-rater reliability testing was conducted in a general ICU at a university hospital in the south of Sweden, including 15 patients mechanically ventilated and sedated. Forty in-pair assessments using the Swedish version of the RASS were performed and the inter-rater reliability was tested using weighted kappa statistics (linear weighting). Result: The translation of the RASS was successful and the Swedish version was found to be satisfactory and applicable in the ICU. When tested for inter-rater reliability, the weighed kappa value was 0.86. Conclusion: This study indicates that the Swedish version of the RASS is applicable with good inter-rater reliability, suggesting that the RASS can be useful for sedation assessment of patients mechanically ventilated in Swedish general ICUs.
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| 5. |
- Bunkenborg, Gitte, et al.
(författare)
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Impact of professionalism in nursing on in-hospital bedside monitoring practice.
- 2013
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402. ; 69:7, s. 1466-1477
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Tidskriftsartikel (refereegranskat)abstract
- AIM: This article reports a study exploring nursing practice of monitoring in-hospital patients including intra- and interprofessional communication and collaboration. BACKGROUND: Sub-optimal care in general in-hospital wards may lead to admission for intensive care, cardiac arrest, or sudden death. Reasons may include infrequent measurements of vital parameters, insufficient knowledge of their predictive values, and/or sub-optimal use of Medical Emergency Teams. This study was designed to improve understanding of nursing practice and to identify changes required to support nursing staff in improving standards of clinical monitoring practice and patient safety in general in-hospital wards. DESIGN: The study was designed as a qualitative descriptive clinical study, based on method triangulation including structured individual observations and semi-structured individual interviews. METHODS: In the spring of 2009, structured observations and semi-structured interviews of 13 nurses were carried out at a university hospital in Copenhagen, Denmark. The observational notes and interview transcriptions were analysed using content analysis. RESULTS: One theme (Professionalism influences nursing monitoring practice) and two sub-themes (Knowledge and skills and Involvement in clinical practice through reflections) were identified. Three categories (Decision-making, Sharing of knowledge, and Intra- and interprofessional interaction) were found to be associated with the theme, the sub-themes, and with each other. CONCLUSION: Clinical monitoring practice varies considerably between nurses with different individual levels of professionalism. Future initiatives to improve patient safety by further developing professionalism among nurses need to embrace individual and organizational attributes to strengthen their practice of in-hospital patient monitoring and management.
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| 6. |
- Bunkenborg, Gitte, et al.
(författare)
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Lower incidence of unexpected in-hospital death after interprofessional implementation of a bedside track-and-trigger system.
- 2014
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Ingår i: Resuscitation. - : Elsevier BV. - 1873-1570 .- 0300-9572. ; 85:3, s. 424-430
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Tidskriftsartikel (refereegranskat)abstract
- In-hospital patients may suffer unexpected death because of suboptimal monitoring. Early recognition of deviating physiological parameters may enable staff to prevent unexpected in-hospital death. The aim of this study was to evaluate short- and long-term effects of systematic interprofessional use of early warning scoring, structured observation charts, and clinical algorithms for bedside action.
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| 7. |
- Egerod, Ingrid, et al.
(författare)
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ICU-recovery in Scandinavia : a comparative study of intensive care follow-up in Denmark, Norway and Sweden
- 2013
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 1532-4036 .- 0964-3397. ; 29:2, s. 11-103
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of our study was to describe and compare models of intensive care follow-up in Denmark, Norway and Sweden to help inform clinicians regarding the establishment and continuation of ICU aftercare programmes.METHODS: Our study had a multi-centre comparative qualitative design with triangulation of sources, methods and investigators. We combined prospective data from semi-structured key-informant telephone interviews and unreported data from a precursory investigation.RESULTS: Four basic models of follow-up were identified representing nurse-led or multidisciplinary programmes with or without the provision of patient diaries. A conceptual model was constructed including a catalogue of interventions related to the illness trajectory. We identified three temporal areas for follow-up directed towards the past, present or future.CONCLUSIONS: ICU follow-up programmes in the Scandinavian countries have evolved as bottom-up initiatives conducted on a semi-voluntary basis. We suggest reframing follow-up as an integral part of patient therapy. The Scandinavian programmes focus on the human experience of critical illness, with more attention to understanding the past than looking towards the future. We recommend harmonization of programmes with clear goals enabling programme assessment, while moving towards a paradigm of empowerment, enabling patient and family to take an active role in their recovery and wellbeing.
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| 8. |
- Fridlund, Bengt, et al.
(författare)
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Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care : A Systematic Review
- 2014
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Ingår i: Open Journal of Nursing. - Irvine : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 4:3, s. 181-197
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Forskningsöversikt (refereegranskat)abstract
- Background: Nursing practice has to contribute to evidence pointing out why there is a need for more nurse-designed randomized control trials (RCTs) focusing on evidence-based practice (EBP). How far this EBP has progressed in different health aspects is usually established by systematic reviews of RCTs. Nurse-led RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on the stated context, goals, content, strategies as well as the nurse’s role related to effectiveness. Methods: A systematic review was realized according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the RCTs in somatic care, 71% showed a positive effectiveness of nurse-led interventions, of which the nurse had a significant role with regard to being the main responsible in 67% of the studies. Also, 47% of the RCTs presented a theoretical standpoint related to the nurse-led interventions and most prominent were international evidence-based guidelines. Goals were found to have either a patient-centered or a professional-centered ambition. Strategies were based on patient-directed initiatives, nurse-patient-directed initiatives or nurse-directed initiatives, while contents were built upon either a patient-nurse interaction or a nursing management plan. Conclusions: This review underlines the necessity of a holistic view of a person, as nurse-led RCTs comprising a patient-centered ambition, patient-directed initiative and patient-nurse interaction plan showed beneficial nursing care effectiveness, particularly if theory-based. In a nurse-led RCT, a basic theoretical perspective is advantageous as well as to elucidate the role of the nurse in relation to the estimated effects.
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| 9. |
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| 10. |
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| 11. |
- Knutsson, I., et al.
(författare)
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Stability of rating scale response category interpretations in neurological disorders
- 2013
-
Ingår i: Acta Neurologica Scandinavica. - : Wiley-Blackwell Publishing Ltd. - 0001-6314 .- 1600-0404. ; 128:4, s. 265-272
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives Unambiguous use and interpretation of rating scale data assume that response categories are interpreted and work as intended. This study investigated the stability of interpretations of commonly used patient-reported rating scale response categories among people with neurological disorders. Materials and methods Forty-six people with neurological disorders (26 men; mean age, 57; Parkinson's disease, 50%; multiple sclerosis, 41%) indicated their interpretation of 21 response categories (representing frequencies, intensities and levels of agreement) on 100-mm visual analog scales (VAS) at two occasions, ≥2 weeks apart. Data were analyzed using intraclass correlation and weighted Kappa (ICC/Κw; should be >0.4), mean/median differences, percentages agreement (PA), and the standard error of measurement (SEM). Results Most response categories had ICC/Κw values <0.4. The overall average ICC/Κw was 0.279/0.294 (frequencies, 0.224/0.255; intensities, 0.265/0.251; levels of agreement, 0.362/0.376). The mean/median difference between time points across all 21 categories was 0.43/0.5 mm (mean/median absolute difference, 3.36/9 mm). The overall average PA and SEM were 6.5% and 16.1 mm, respectively. Conclusions Stabilities in interpretations of patient-reported rating scale response categories among people with neurological disorders were generally low. Categories expressing levels of agreement showed best results, suggesting that these may be preferable when appropriate with respect to the scale and its items. Future studies should consider response category interpretations in relation to various contexts. These observations suggest caution when interpreting raw rating scale data and argue for the use of modern rating scale methodologies such as the Rasch measurement model.
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| 12. |
- Neziraj, M, et al.
(författare)
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The Intensive Care Delirium Screening Checklist: translation and reliability testing in a Swedish ICU.
- 2011
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 55, s. 819-826
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Tidskriftsartikel (refereegranskat)abstract
- Background: The view of delirium has changed considerably over the last decade, and delirium is now a very topical issue within the intensive care unit (ICU) setting. Delirium has proved to be common in critically ill patients and is manifested as acute changes in mental status with reduced cognitive ability, incoherent thought patterns, impaired consciousness, agitation and acute confusion. In order to be able to prevent, identify and alleviate problems related to delirium it is important that validated instruments for delirium screening are implemented and evaluated. The aim of this study was to translate the Intensive Care Delirium Screening Checklist (ICDSC) into Swedish and test the inter-rater reliability in a Swedish general ICU setting. Methods: The study was carried out during 2009 in a general Swedish ICU. A translation of the scale from English into Swedish was made, including back-translation, critical review and pilot testing. A total of 49 paired ratings were carried out using the Swedish version of the ICDSC scale. The inter-rater reliability was tested using weighted kappa (κ) statistics (linear weighting). Results: The ICDSC scale was successfully translated into Swedish and the inter-rater reliability testing of the Swedish version resulted in a weighted k value of 0.92. Conclusion: The result of this study indicates that the Swedish version of the ICDSC scale has a very good inter-rater reliability. The high inter-rater reliability and the ease of administration make the ICDSC scale applicable for delirium screening in a Swedish ICU setting.
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| 13. |
- Petersson, Ulrika, et al.
(författare)
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Intensivvård ur ett genusperspektiv : en registerstudie
- 2012
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Ingår i: Vård i Norden. - 0107-4083 .- 1890-4238. ; 32:2, s. 51-55
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to describe in a gender specific perspective, demographic data from adult patients that have been treated in an intensive care unit.Background: Many studies show that there are differences between men and women when it comes to different aspects of health care. The knowledge of these differences is limited when relating to intensive care in Sweden.Method: Demographic data registered in the Swedish intensive care register including all intensive care cases during the year of 2009 (n=695) in an intensive care unit in a hospital in southern Sweden was analyzed. A group comparison between the sexes was made with the following variables: number of patients admitted, length of stay in the ICU, SAPS 3 (Simplified Acute Physiology Score) points, the five most common diagnosis, mortality and mortality per diagnosis.Results: The study showed an over-representation of men (62,2 %, p<0.001) in number of intensive care patients. The mortality was 9,9 % overall and significantly higher amongst men (11,8 %), compared with women (6,8 %, p=0.034). There were no differences between the sexes in length of stay, diagnosis, SAPS 3 points and mortality per diagnosis.Conclusions: This study has shown that more men than women are treated in the intensive care unit and that more men die during their time in the intensive care unit.
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| 14. |
- Petersson, Ulrika, et al.
(författare)
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Intensivvård ur ett genusperspektiv : en registerstudie
- 2012
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Ingår i: Vård i Norden. - : Sykepleiernes Samarbeid i Norden. - 0107-4083. ; 32:2, s. 51-55
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to describe in a gender specific perspective, demographic data from adult patients that have been treated in an intensive care unit. Background: Many studies show that there are differences between men and women when it comes to different aspects of health care. The knowledge of these differences is limited when relating to intensive care in Sweden. Method: Demographic data registered in the Swedish intensive care register including all intensive care cases during the year of 2009 (n=695) in an intensive care unit in a hospital in southern Sweden was analyzed. A group comparison between the sexes was made with the following variables: number of patients admitted, length of stay in the ICU, SAPS 3 (Simplified Acute Physiology Score) points, the five most common diagnosis, mortality and mortality per diagnosis. Results: The study showed an over-representation of men (62,2 %, p<0.001) in number of intensive care patients. The mortality was 9,9 % overall and significantly higher amongst men (11,8 %), compared with women (6,8 %, p=0.034). There were no differences between the sexes in length of stay, diagnosis, SAPS 3 points and mortality per diagnosis. Conclusions: This study has shown that more men than women are treated in the intensive care unit and that more men die during their time in the intensive care unit.
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| 15. |
- Samuelson, Karin
(författare)
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Adult intensive care patients' perception of endotracheal tube-related discomforts: A prospective evaluation.
- 2011
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Ingår i: Heart & Lung. - : Elsevier BV. - 1527-3288 .- 0147-9563. ; Jul 1, s. 49-55
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study was designed to investigate adult patients' perceptions of endotracheal tube (ETT)-related discomfort at 5 days and 2 months after discharge from the intensive care unit (ICU). METHODS: This prospective cohort study in 2 general ICUs included 250 intubated, mechanically ventilated adults admitted for more than 24 hours. Patients were interviewed 5 days and 2 months after discharge from the ICU about their ETT-related discomfort, using a modified Swedish ETT version of the ICU Stressful Experience Questionnaire that comprises 14 items. RESULTS: Of 116 patients describing their ETT experience during their ICU stay, 88% rated their discomfort as moderately to extremely stressful. At 2 months after discharge from the ICU, 23% (51/226) reported bothersome discomfort, vs. 46% (104/226) 5 days after discharge from the ICU, and 10 patients suffered from severe, persistent hoarseness. CONCLUSION: The incidence of bothersome subjective complaints after tracheal intubation in the intensive-care setting is high, and severe ETT-related problems may persist several months after extubation.
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| 16. |
- Samuelson, Karin
(författare)
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Unpleasant and pleasant memories of intensive care in adult mechanically ventilated patients-Findings from 250 interviews.
- 2011
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Ingår i: Intensive and Critical Care Nursing. - : Elsevier BV. - 1532-4036 .- 0964-3397.
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Tidskriftsartikel (refereegranskat)abstract
- AIM: In order to improve the patients' comfort and well-being during and after a stay in the intensive care unit (ICU), the patients' perspective on the intensive care experience in terms of memories is essential. The aim of this study was to describe unpleasant and pleasant memories of the ICU stay in adult mechanically ventilated patients. METHOD: Mechanically ventilated adults admitted for more than 24hours from two Swedish general ICUs were included and interviewed 5 days after ICU discharge using two open-ended questions. The data were analysed exploring the manifest content. FINDINGS: Of the 250 patients interviewed, 81% remembered the ICU stay, 71% described unpleasant memories and 59% pleasant. Ten categories emerged from the content analyses (five from unpleasant and five from pleasant memories), contrasting with each other: physical distress and relief of physical distress, emotional distress and emotional well-being, perceptual distress and perceptual well-being, environmental distress and environmental comfort, and stress-inducing care and caring service. CONCLUSION: Most critical care patients have both unpleasant and pleasant memories of their ICU stay. Pleasant memories such as support and caring service are important to relief the stress and may balance the impact of the distressing memories of the ICU stay.
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| 17. |
- Åkerman, Eva, 1961-
(författare)
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Assessment and tools for follow-up of patients' recovery after Intensive Care
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to describe and explore the use and content of ICU-diaries and to develop and psychometrically test a questionnaire to detect physical and psychosocial problems for ICU patients in their recovery process. Methods: This thesis is based on four studies. Study I had an explorative descriptive design with a quantitative and qualitative approach. Data were collected by telephone interviews with staff at Swedish ICUs (n = 65) which kept ICU-diaries. One question “what was the purpose of keeping ICU-diaries” was analysed with latent content analysis, and the other data were analysed with descriptive and comparative statistics. Study II had an explorative descriptive cohort design with a concurrent mixed method approach. The sample in study II was a part of the sample in study IV in which 421 former ICU patients responded to a new developed questionnaire 3-set 4P two months after discharge from ICU. Patients from this sample who have had an ICU-diary (n = 115) responded to a questionnaire six months after discharge from ICU. Fifteen patients were interviewed about the content and usefulness of the ICU-diary. Data were analysed with descriptive statistics, descriptively by content and interviews with manifest content analysis and then combined at the interpretive level to seek convergence, as enable by the mixed method approach. Study III had a methodological design. In this study, the questionnaire 3-set 4P was developed and psychometrically tested in a pilot setting. In study IV, the questionnaire was further developed and tested based on psychometric evaluation of the 3-set 4P. In study III the questionnaire was responded by 39 patients and in study IV by 421 patients. Data in study III and IV were analysed with descriptive statistics and psychometrical tests. Results: The main purpose for keeping ICU-diaries was to provide a tool in the recovery by helping the patient remember and give time back. Keeping ICU-diaries was common although there was a difference in practice and patient recruitment among different hospitals (study I). An ICU-diary with content and photos in a chronological order describing the whole picture of critical illness and ICU stay could be a tool for the patient to construct a coherent individual story. The ICU-diary could be one piece to give a deeper understanding and meaning in the personal story and to give a realistic expectation of the recovery process. Absence of guidelines for keeping ICU-diaries could affect the possibility for the ICU-diary to be a helpful tool during the recovery process (study II). In study III, the 3-set 4P was developed to be used for identifying and evaluating former ICU patients’ physical, psychosocial problems and outcome during follow-up. The psychometrical tests showed acceptable validity and internal consistency reliability. The stability reliability was acceptable in two of three sets. The psychometrical tests of the further modified version of 3-set 4P in study IV showed good construct validity and internal consistency but it needs some modification before it can be used in clinical practice (study IV). Conclusion: Recovery can be a difficult process where different tools can be useful. Today there is no evidence about tools to use during follow-up. To promote high quality of the follow-up there is a need for evidence-based guidelines. The ICU-diary is one tool but this thesis shows that guidelines for keeping ICU-diaries have to be developed to meet the patients’ wishes in order for the ICU-diary to become a useful tool during the process to recovery. The 3-set 4P can after some modification be used at the follow-up clinic to identify the individual patient’s problems and create an individual program for recovery.
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| 18. |
- Åkerman, Eva, 1961-, et al.
(författare)
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Preferred content and usefulness of a photodiary as described by ICU-patients-A mixed method analysis
- 2013
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Ingår i: Australian Critical Care. - : Elsevier. - 1036-7314 .- 1878-1721. ; 26:1, s. 29-35
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Tidskriftsartikel (refereegranskat)abstract
- Many ICU-patients have memory-gaps which may affect their recovery. A tool in the recovery can be an ICU-diary to explain and clarify thoughts and events from the ICU-period. There are different standards for the content in the ICU-diary. The aim of this study was to identify the preferred content and usefulness of an ICU-diary as described by ICU-patients.Method: a descriptive, exploratory cohort design with a mixed method approach. The patients answered a questionnaire (n=115) and participated in an interview (n=15) six months after the ICU-stay. Data analysis was carried out in three stages; the questionnaire was analysed by descriptive statistics and categorized by content (four open-ended questions) and the interviews were analysed by manifest content analysis.Results: The patients explained that detailed information about daily activities and medical facts had to be included to understand and give a sense of coherence of what had happened. The content in the ICU-diary had to be chronological in order to follow the process in which photos were an important part. The patients re-read the ICU-diary during the recovery which helped them to fill in the memory gaps and used it as a tool for communication.Conclusion; To construct a coherent story, it was essential that the ICU-diary was complete and were amplified by photos, all appearing in a chronological order. The results of this study could form a basis for further developments of standards and guidelines for ICU-diaries
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| 19. |
- Åkerman, Eva, 1961-, et al.
(författare)
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Psychometric evaluation of 3-set 4P questionnaire
- 2013
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Ingår i: Intensive & Critical Care Nursing. - : Elsevier. - 0964-3397 .- 1532-4036. ; 29:1, s. 40-47
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Tidskriftsartikel (refereegranskat)abstract
- This is a further development of a specific questionnaire, the 3-set 4P, to be used for measuring former ICU patients’ physical and psychosocial problems after ICU and the need for follow-up. The aim was to psychometrically test and evaluate the 3-set 4P questionnaire in a larger population. The questionnaire consists of three sets: “physical”, “psychosocial” and “follow-up”. The questionnaires were sent by mail to all patients with >24 hour length of stay at four ICUs in Sweden. Construct validity was measured with exploratory factor analysis with varimax rotation resulting in “physical set” three factors, “psychosocial set” five factors and “follow-up set” four factors with strong factor loadings and a total explained variance of 62 - 77.5%. Thirteen questions in the SF-36 were used for concurrent validity showing Spearman’s rs 0.3-0.6 in eight and <0.2 in five questions. Test-retest was used for stability reliability. In set follow-up the correlation was strong to moderate and in physical and psychosocial sets the correlations were moderate to fair. This could be due to that the physical and psychosocial status changed rapidly during the test period. All three sets had good homogeneity. In conclusion, the 3-set 4P showed overall acceptable results, but it has to be further modified in different cultures before being an instrument which may be fully operational in clinical practice.
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