1.
Larsson, Ingrid, et al.
(författare)
Patients' independence of a nurse for the administration of subcutaneous anti-TNF therapy : a phenomenographic study
2010
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - London : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 5:2, s. 5146-1-5146-10
Tidskriftsartikel (refereegranskat) abstract
Rheumatology nursing supports patients to manage their lives and live as independently as possible without pain, stiffness and functional restrictions. When conventional drugs fail to delay the development of the rheumatic disease, the patient may require biological treatment such as self-administered subcutaneous anti-tumour necrosis factor (TNF) therapy. It is therefore important that the patient perspective focuses on the life-changing situation caused by the administration of regular subcutaneous injections. The aim of this study was to describe variations in how patients with rheumatic diseases experience their independence of a nurse for administration of subcutaneous anti-TNF therapy. The study had a descriptive, qualitative design with a phenomenographic approach and was carried out by means of 20 interviews. Four ways of understanding the patients' experience of their subcutaneous anti-TNF therapy and independence of a nurse emerged: the struggling patient; the learning patient; the participating patient; the independent patient. Achieving independence of a nurse for subcutaneous anti-TNF injections can be understood by the patients in different ways. In their strive for independence, patients progress by learning about and participating in drug treatment, after which they experience that the injections make them independent.
2.
Bergsten, Ulrika, et al.
(författare)
Patterns of background factors related to early RA patients' conceptions of the causes of their disease
2011
Ingår i: Clinical Rheumatology. - London : Springer Science and Business Media LLC. - 0770-3198 .- 1434-9949. ; 30:3, s. 347-352
Tidskriftsartikel (refereegranskat) abstract
The aim of the present study was to identify patterns of background factors related to the early RA patients' conceptions of the cause of the disease. Conceptions from a qualitative study formed the basis for the stratification of 785 patients from the Swedish EIRA study answering a question about their own thoughts about the cause to RA. Logistic regression analyses were used to explore the associations between patients' conceptions and relevant background factors: sex, age, civil status, educational level, anti-cyclic citrullinated peptide antibody (anti-CCP) and smoking habits. The results were presented as odds ratios (OR) with 95% confidence intervals (CI). A conception of family-related strain was strongly associated with being young (OR 0.50; 95% CI 0.33-0.78 for age 58-70 vs. 17-46), female (OR 0.38; 95% CI 0.25-0.60 for male vs. female) and having a high level of education (OR 2.15; 95% CI 1.54-3.01 for university degree vs. no degree). A conception of being exposed to climate changes was associated with being male (OR 1.99; 95% CI 1.24-3.22 for male vs. female), having a low level of education (OR 0.33; 95% CI 0.18-0.58 for university degree vs. no degree) and positive Anti-CCP (OR 1.72; 95% CI 1.03-2.87 for positive vs. negative Anti-CCP). Linking patients' conceptions of the cause of their RA to background factors potentially could create new opportunities for understanding the complexity of the aetiology in RA. Furthermore, this information is important and relevant in the care of patients with early RA.
3.
Larsson, Ingrid, 1968-, et al.
(författare)
Patients’ Perceptions of Drug Information Given by a Rheumatology Nurse : A Phenomenographic Study
2010
Ingår i: Musculoskeletal Care. - New Jersey : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 8:1, s. 36-45
Tidskriftsartikel (refereegranskat) abstract
Background: Pain, stiffness and functional restriction of the joints are the main problems experienced by patients with inflammatory rheumatic conditions. The majority of patients with rheumatic diseases require several drugs every day. Adherence is highest among patients who have repeatedly been given drug information by a nurse from the start of the treatment. When developing patient information, it is essential to utilise patients' experiences.Objectives: The purpose of this study was to describe variations in how patients with rheumatic diseases conceive drug information given by a rheumatology nurse.Methods: The study had a descriptive qualitative design with a phenomenographic approach. Fifteen in-patients with rheumatic diseases who had received a new drug agreed to take part in the study and were interviewed.Results: Three descriptive categories emerged: Autonomy, Power and Security. Autonomy was based on the patients' experiences of taking responsibility and participating. Power meant gaining knowledge and being motivated to take the drug. Security involved trust, experiencing care and access to a rheumatology nurse.Conclusions: Patients with a rheumatic disease experienced that drug information from a rheumatology nurse gave them autonomy, power and security. These factors could explain why information from a nurse increases drug treatment adherence.
4.
Larsson, Ingrid, 1968-, et al.
(författare)
Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy
2014
Ingår i: Journal of Advanced Nursing. - West Sussex : Wiley. - 0309-2402 .- 1365-2648. ; 70:1, s. 164-175
Tidskriftsartikel (refereegranskat) abstract
AimTo compare and evaluate the treatment outcomes of a nurse-led rheumatology clinic and a rheumatologist-led clinic in patients with low disease activity or in remission who are undergoing biological therapy.BackgroundPatients with chronic inflammatory arthritis treated with biological therapy are usually monitored by rheumatologists. Nurse-led rheumatology clinics have been proposed in patients with low disease activity or in remission.DesignRandomized controlled trial.MethodsA 12-month follow-up trial was conducted between October 2009 and August 2011, where 107 patients were randomized into two groups with a 6-month follow-up to a nurse-led rheumatology clinic based on person-centred care (intervention group; n = 53) or to a rheumatologist-led clinic (control group; n = 54). The hypothesis was that the nurse-led clinic outcomes would not be inferior to those obtained from a rheumatologist-led clinic at the 12-month follow-up. The primary outcome was disease activity measured by Disease Activity Score 28.ResultsA total of 47 patients in the intervention group and 50 in the control group completed the 12-month trial. The trial revealed no statistically significant differences between groups in mean change of Disease Activity Score 28, Visual Analogue Scales for pain, the Health Assessment Questionnaire, satisfaction with or confidence in obtaining rheumatology care.ConclusionPatients with stable chronic inflammatory arthritis undergoing biological therapy could be monitored by a nurse-led rheumatology clinic without difference in outcome as measured by the Disease Activity Score 28.
