| 1. |
- Johansson, Ingela, et al.
(författare)
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Ambulance use in patients with acute myocardial infarction
- 2004
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Ingår i: Journal of Cardiovascular Nursing. - 0889-4655. ; 19:1, s. 5-12
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore the choice of transportation mode to hospital in patients experiencing acute myocardial infarction. Method: A descriptive survey study at the Coronary Care Unit of one Swedish University Hospital. The study was carried out between July 2000 and March 2001. Results: The study population consisted of 114 consecutive patients with acute myocardial infarction. Thirty-two percent stated that they did not know the importance of a short delay when experiencing an acute myocardial infarction. Only 60% called the emergency service number, 112. Patients calling for an ambulance differed from those who did not in several aspects. Medical characteristics associated with ambulance use in a univariate analysis were ST-elevation myocardial infarction and prior history of myocardial infarction. There were no differences regarding gender or age. When looking at the patients' symptom-experience, patients with vertigo or nausea and severe pain chose an ambulance for transport to the hospital. The only significant reasons for not choosing an ambulance were cramping pain and the patient perceiving the symptoms not to be serious. In a multivariate analysis, ST-elevation (OR = 0.30, P = .04), unbearable symptoms (OR = 0.20, P = .03), and nausea (OR = .33, P = .04) appeared as independent predictors of ambulance use and cramping pain (OR = 5.17, P = .01) for not using an ambulance. Conclusions: Patients with acute myocardial infarction view the ambulance as an option for transportation to hospital only if they feel really sick. For that reason, it needs to be made well known to the public that ambulances are not only a mode of transport, but also provide diagnostics and treatment.
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| 2. |
- Johansson, Ingela, et al.
(författare)
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Factors related to delay times in patients with suspected acute myocardial infarction
- 2004
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Ingår i: Heart & Lung: The Journal of Acute and Critical Care. - : Elsevier BV. - 0147-9563. ; 33:5, s. 291-300
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Tidskriftsartikel (refereegranskat)abstract
- Objective The study’s objective was to describe symptoms, symptom management, and patient delay times in patients seeking treatment for suspected acute myocardial infarction (AMI), and to find explanatory factors influencing the decision time. Method This is a descriptive survey study including 403 Swedish patients with a median age of 64 years with suspected AMI. Results Altogether, 84% of the patients suspected that the symptoms emanated from the heart. Despite this fact, 59% delayed going to the hospital more than 1 hour after the onset of symptoms. In the multiple regression analysis, a “dull pain,” the patients’ belief that it was nothing serious, and contact with the general practitioner were associated with prolonged delay. The decision to contact the emergency service shortened the delay time. Conclusions The patient’s subjective feeling of the severity of symptoms is an important predictor for delay times. There is still a need for public awareness of the appropriate responses to AMI symptoms, that is, to call for an ambulance instead of contacting the general practitioner.
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| 3. |
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| 4. |
- Johansson, Ingela, 1968-, et al.
(författare)
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Manageability, vulnerability and interaction : A qualitative analysis of acute myocardial infarction patients' conceptions of the event
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 6:3, s. 184-191
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Tidskriftsartikel (refereegranskat)abstract
- Background: Delay in seeking care remains a problem for many patients with myocardial infarction. There is a great deal of knowledge available about clinical factors contributing to this delay, while studies focusing on the patients' own experiences are few. Aim: Describe variations in how individuals perceived suffering symptoms of an acute myocardial infarction. Design: A qualitative method using phenomenographic design was applied. Interviews were conducted with 15 strategically selected patients with myocardial infarction. Findings: Eight sub-categories in the pre-hospital phase were summarised into three categories: manageability, vulnerability, and interaction. To manage their situation, patients expressed a need to understand it and to have a similar situation to compare with. They also described coping with the arising threat to their lives by self-medication or denying their symptoms. Patients expressed vulnerability, with feelings of anxiety, both as triggers and barriers to seeking medical care. In interaction with others, psychosocial support and guidance from the environment, was fundamental in helping the patients to manage the situation. Conclusions: There were large variations in myocardial infarction patients' conceptions of the event. To improve disease management in the pre-hospital phase, the awareness of this large variation in conceptions about suffering symptoms of an myocardial infarction could be used in the dialogue between patients and health care professionals, in cardiac prevention programmes, as well as in health care education. © 2006 European Society of Cardiology.
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| 5. |
- Johansson, Ingela, et al.
(författare)
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Spouses conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction - A qualitative analysis
- 2008
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:3, s. 182-188
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Tidskriftsartikel (refereegranskat)abstract
- Background: Delay from onset of acute myocardial infarction symptoms to the delivery of medical care is a major determinant of prognosis. Although studies have explored patient reasons for delay, there are only limited data concerning experiences of the spouse. Aim: Was to describe spouses conceptions of the pre-hospital phase when their partners suffered an acute myocardial infarction. Method: A phenomenographic approach was applied. Fifteen spouses were interviewed <48 h after the partners hospital admittance. Findings: Two categories with underlying sub-categories conceptualised the spouses experiences. The category being resourceful contained: sharing the experience, having knowledge, understanding the severity, being rational, and consulting others. The category respecting independence contained: accepting the need for control, marital roles and experiences, restraining emotions, and seeking agreement. Conclusion: Our findings suggest that spouses have a strong influence on the course of events. When accepting the partners need for control through following earlier marital roles and experiences, restraining own emotions and seeking agreement, this seemed to contribute to delay. However, when the spouse was resourceful by sharing the experience, having knowledge, understanding the severity, being rational and consulting others when needed, this seemed to have a positive influence on the pre-hospital time.
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| 7. |
- Rönning, Helén, et al.
(författare)
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Description and initial evaluation of an educational and psychosocial support model for adults with congenitally malformed hearts
- 2011
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Ingår i: Patient Education and Counseling. - : Elsevier. - 0738-3991 .- 1873-5134. ; 83:2, s. 247-251
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Various programmes for adults with congenitally malformed hearts have been developed, but detailed descriptions of content, rationale and goals are often missing. The aim of this study was to describe and make an initial evaluation of a follow-up model for adults with congenitally malformed hearts, focusing on education and psychosocial support by a multidisciplinary team (EPS). METHODS: The model is described in steps and evaluated with regards to perceptions of knowledge, anxiety and satisfaction. RESULTS: The EPS model included a policlinic visit to the physician/nurse (medical consultation, computer-based and individual education face-to-face as well as psychosocial support) and a 1-month telephone follow-up. Fifty-five adults (mean age 34, 29 women) with the nine most common forms of congenitally malformed hearts participated in the EPS model as well as the 3-months follow-up. Knowledge about congenital heart malformation had increased in 40% of the participants at the 3-months follow-up. CONCLUSION: This study describes and evaluates a model that combines a multidisciplinary approach and computer-based education for follow-up of adults with congenitally malformed hearts. The EPS model was found to increase self-estimated knowledge, but further evaluations need to be conducted to prove patient-centred outcomes over time. PRACTICE IMPLICATIONS: The model is now ready to be implemented in adults with congenitally malformed hearts.
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| 8. |
- Rönning, Helén, et al.
(författare)
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Development and evaluation of a computer-based educational program for adults with congenitally malformed hearts
- 2013
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 12:1, s. 78-86
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a lack o educational material for adults with congenitally malformed hearts. Computer-based education has shown to have significant effects on knowledge and management of chronic diseases. Aim: The aim of this study was to develop and evaluate a computer-based educational program for adults with congenitally malformed hearts. Methods: The program was developed by a multidisciplinary team. Data were collected by questionnaires, observations, and structured interviews. Results: The final product was a computer-based educational program consisting of ten separate modules, one for each particular malformation. The program was experienced as stimulating and easy to use. The appearance and quantity of the text was graded as good and the content as relevant and very useful. Conclusion: This is the first computer-based program developed for adults with congenitally malformed hearts. The evaluation found the program to have great potential as an important tool for improving care. Further studies are needed to test the outcomes of the program on knowledge, perceived control over the heart condition, anxiety/depression. and health-related quality of life. Practice implications: The program may be used as a complement to verbal information and every adult with a congenitally malformed hearts can receive individualized information from a personal CD.
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| 9. |
- Rönning, Helén, et al.
(författare)
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Development and psychometric evaluation of the knowledge scale for adults with congenitally malformed hearts
- 2013
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Ingår i: Journal of Cardiovascular Nursing. - 0889-4655 .- 1550-5049. ; 28:3, s. 228-237
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Tidskriftsartikel (refereegranskat)abstract
- Background and Research Objective: Adults with congenitally malformed hearts have knowledge gaps regarding their heart condition, and their level of knowledge is not routinely assessed during follow-up. One reason for this is that there are few validated, user-friendly questionnaires to assess knowledge about congenital heart disease and its effects on daily life. Failure to identify low levels of knowledge could lead to less motivated and insecure individuals not actively involved in treatment and care of their heart condition. Therefore, the objective of this study was to develop and test a knowledge scale for adults with congenitally malformed hearts.Participants and Methods: The development and psychometric evaluation of the Knowledge Scale for Adults With Congenitally Malformed Hearts (KnoCoMH) followed 2 phases: (1) development and evaluation of the initial version, with face validity and content validity assessed by experts and adults with congenitally malformed hearts, and (2) evaluation and refinement of the KnoCoMH in adults with congenitally malformed hearts, including item difficulty level, internal consistency, and test-retest reliability.Results: The development and evaluation of a knowledge scale for adults with congenitally malformed hearts resulted in the KnoCoMH including 46 items in 4 domains: General Knowledge, with a Kuder-Richardson formula 20 (KR-20) value of 0.68; Medical Treatment, with a KR-20 value of 0.74; Endocarditis Prophylaxis, with a KR-20 value of 0.90; and Contraceptives and Pregnancy, with a KR-20 value of 0.65. Test-retest evaluation showed significant correlations between 0.50 and 0.67 (P < .01) in all 4 domains. There was good variation in item difficulty, with a mean value of 0.56 in General Knowledge, 0.62 in Medical Treatment, 0.33 in Endocarditis Prophylaxis, and 0.48 in Contraceptives and Pregnancy.Conclusions: The KnoCoMH has acceptable psychometric properties for most of the knowledge domains included. It can be used for evaluating knowledge among adults with congenitally malformed hearts and its associations with other outcomes. However, further studies are advisable to test construct validity, predictive validity, and responsiveness.
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| 10. |
- Rönning, Helén, et al.
(författare)
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Educational needs in adults with congenitally malformed hearts
- 2008
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Ingår i: Cardiology in the Young. - 1047-9511 .- 1467-1107. ; 18:5, s. 473-479
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim: The number of adults with congenitally malformed hearts is growing, and there is an increasing demand for their continuous follow-up. At present, different programmes have been established for adults with congenital cardiac disease, but there is a lack of knowledge regarding how education and psychosocial support should be given to achieve effects. Before developing educational programmes, it is necessary to be aware of the perspective of the patients. The aim of our study, therefore, was to describe how adults with congenitally malformed hearts experience their educational needs. Methods: The study had a qualitative design. We interviewed 16 adults, aged from 19 to 55 years, with congenitally malformed hearts. Results: Two-way communication emerged as crucial to individualising education. Without good communication, those with congenitally malformed hearts, receiving information from providers of healthcare, are unable to transfer the information received. Thus, individualised education gives access to knowledge and the tools required to manage important areas in life, such as the congenital cardiac malformation, physical activity, the situation of life, treatment, and resources available for healthcare. The information given should provide easy access to knowledge through proper educational materials and methods, and be given with respect for the individual. This is facilitated if the education is tailored to the requirements of the individual in a holistic approach, and is provided through good communication. Conclusion: Our investigation shows that a structured educational programme needs to start from the perspective of the individual patient, and that two-way Communication needs to be taken into consideration to enhance knowledge.
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