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Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Annan medicin och hälsovetenskap) > Karolinska Institutet

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1.
  • Eilertsen, M. E. B., et al. (författare)
  • Impact of Social Support on Bereaved Siblings' Anxiety: A Nationwide Follow-Up
  • 2013
  • Ingår i: Journal of Pediatric Oncology Nursing. - : SAGE Publications. - 1043-4542 .- 1532-8457. ; 30:6, s. 301-310
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose:To assess adolescent and young adult siblings' perception of social support prior to and following the loss of their brother or sister to cancer, 2 to 9 years earlier, and their anxiety at follow-up. Method: In 2009, 174 (73%) bereaved siblings (12-25 years) participated in a nationwide, long-term follow-up study in Sweden using an anonymous study-specific questionnaire. The Hospital Anxiety and Depression Scale was used to measure self-assessed anxiety. Results: Siblings had a higher risk of anxiety if they perceived their need for social support was unsatisfied during their brother or sisters' last month before death, relative risk (RR) = 3.6 (95% confidence interval [CI] = 1.8-7.3); time after death, RR = 2.9 (95% CI = 1.5-5.6); and at follow-up, RR = 3.8 (95% CI = 2.0-7.2). Furthermore, a higher risk for anxiety was shown for siblings if they did not perceive that their parents and neighbors cared for them after their brother or sisters' death, RR = 2.7 (95% CI = 1.3-5.5), RR = 5.4 (95% CI = 1.3-21.9), respectively. Conclusion: Bereaved siblings had a greater probability to report self-assessed anxiety if they perceived that their need for social support was not satisfied prior to and following death. Information from both nurses and other health care professionals to families about the impact of social support may contribute to lessen the siblings' risk of anxiety.
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2.
  • Flink, Maria, et al. (författare)
  • Measuring care transitions in Sweden : validation of the care transitions measure
  • 2018
  • Ingår i: International Journal for Quality in Health Care. - : Oxford University Press. - 1353-4505 .- 1464-3677. ; 30:4, s. 291-297
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To translate and assess the validity and reliability of the original American Care Transitions Measure, both the 15-item and the shortened 3-item versions, in a sample of people in transition from hospital to home within Sweden.Design: Translation of survey items, evaluation of psychometric properties.Setting: Ten surgical and medical wards at five hospitals in Sweden.Participants: Patients discharged from surgical and medical wards.Main outcome measure: Psychometric properties of the Swedish versions of the 15-item (CTM-15) and the 3-item (CTM-3) Care Transition Measure.Results: We compared the fit of nine models among a sample of 194 Swedish patients. Cronbach's alpha was 0.946 for CTM-15 and 0.74 for CTM-3. The model indices for CTM-15 and CTM-3 were strongly indicative of inferior goodness-of-fit between the hypothesized one-factor model and the sample data. A multidimensional three-factor model revealed a better fit compared with CTM-15 and CTM-3 one factor models. The one-factor solution, representing 4 items (CTM-4), showed an acceptable fit of the data, and was far superior to the one-factor CTM-15 and CTM-3 and the three-factor multidimensional models. The Cronbach's alpha for CTM-4 was 0.85.Conclusions: CTM-15 with multidimensional three-factor model was a better model than both CTM-15 and CTM-3 one-factor models. CTM-4 is a valid and reliable measure of care transfer among patients in medical and surgical wards in Sweden. It seems the Swedish CTM is best represented by the short Swedish version (CTM-4) unidimensional construct.
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3.
  • Hallvig, D., et al. (författare)
  • Sleepy driving on the real road and in the simulator - A comparison
  • 2013
  • Ingår i: Accident Analysis and Prevention. - : Elsevier BV. - 0001-4575 .- 1879-2057. ; 50, s. 44-50
  • Tidskriftsartikel (refereegranskat)abstract
    • Sleepiness has been identified as one of the most important factors contributing to road crashes. However, almost all work on the detailed changes in behavior and physiology leading up to sleep related crashes has been carried out in driving simulators. It is not clear, however, to what extent simulator results can be generalized to real driving. This study compared real driving with driving in a high fidelity, moving base, driving simulator with respect to driving performance, sleep related physiology (using electroencephalography and electrooculography) and subjective sleepiness during night and day driving for 10 participants. The real road was emulated in the simulator. The results show that the simulator was associated with higher levels of subjective and physiological sleepiness than real driving. However, both for real and simulated driving, the response to night driving appears to be rather similar for subjective sleepiness and sleep physiology. Lateral variability was more responsive to night driving in the simulator, while real driving at night involved a movement to the left in the lane and a reduction of speed, both of which effects were absent in the simulator. It was concluded that the relative validity of simulators is acceptable for many variables, but that in absolute terms simulators cause higher sleepiness levels than real driving. Thus, generalizations from simulators to real driving must be made with great caution.
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4.
  • Hanan, El Malla, et al. (författare)
  • Adherence to medication : A nation-wide study from the Children's Cancer Hospital, Egypt
  • 2013
  • Ingår i: World journal of psychiatry. - : Baishideng Publishing Group Inc.. - 2220-3206. ; 22, s. 62-62
  • Tidskriftsartikel (refereegranskat)abstract
    • AIM: To investigate adherence to medical regimen and predictors for non-adherence among children with cancer in Egypt.METHODS: We administered two study specific questionnaires to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital in Cairo, Egypt, one before the first chemotherapy treatment and the other before the third. The questionnaires were translated to colloquial Egyptian Arabic, and due, to the high illiteracy level in Egypt an interviewer read the questions in Arabic to each parent and registered the answers. Both questionnaires consisted of almost 90 questions each. In addition, a Case Report Form was filled in from the child's medical journal. The study period consisted of 7 mo (February until September 2008) and we had a participation rate of 97%. Descriptive statistics are presented and Fisher's exact test was used to check for possible differences between the adherent and non-adherent groups. A P-value below 0.05 was considered significant. Software used was SAS version 9.3 for Windows (SAS Institute Inc., Cary, NC, United States).RESULTS: Two hundred and eighty-one (90%) parents answered the second questionnaire, regarding their child's adherence behaviour. Approximately two thirds of the children admitted to their third chemotherapy treatment had received medical recommendations upon discharge from the first or second chemotherapy treatment (181/281, 64%). Sixty-eight percent (123/181) of the parents who were given medical recommendations reported that their child did not follow the recommendations. Two main predictors were found for non-adherence: child resistance (111/123, 90%) and inadequate information (100/123, 81%). In the adherent group, 20% of the parents (n = 12/58) reported trust in their child's doctor while 14 percent 8/58 reported trust in the other health-care professionals. Corresponding numbers for the non-adherent group are 8/123 (7%) for both their child's doctor and other health-care professionals. Almost all of the parents expressed a lack of optimism towards the treatment (116/121, 96%), yet they reported an intention to continue with the treatment for two main reasons, for the sake of their child's life (70%) (P = 0.005) and worry that their child would die if they discontinued the treatment (81%) (P < 0.0001).CONCLUSION: Non-adherence to medical regimen is common among children diagnosed with cancer in Egypt, the main reasons being child resistance and inadequate information.
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5.
  • Hanan, El Malla, et al. (författare)
  • Cancer disclosure-account from a pediatric oncology ward in Egypt
  • 2017
  • Ingår i: Psycho-Oncology. - Chichester : Wiley. - 1057-9249 .- 1099-1611. ; 26:5, s. 679-685
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: Informing the child about his/her diagnosis and treatment plan is essential; research has shown that it is related to the patient's quality of life and adherence to medication.METHODS: For 7 months during 2008 (February to September), 2 study-specific questionnaires were constructed and administered to 304 parents of children diagnosed with cancer at the Children's Cancer Hospital Egypt.RESULTS: Among the 313 eligible parents of children diagnosed with cancer, 304 (97%) answered the first questionnaire and 281 (92%) answered the second questionnaire. We found that nearly three-quarters (72%) of the parents had their child's cancer diagnosis communicated by the physician. Among the 72%, the rate of the children present with the parent or parents during the disease disclosure conversation was 39% (n = 85/219). The majority of the children were in the age group 5-18 years (55%).CONCLUSIONS: Our findings indicate that cancer disclosure at the Children's Cancer Hospital is to a certain degree common; yet even when disclosure does take place, it is mainly in the absence of the child. Moreover, the information provided during the conversation may not be fully comprehended by the parent or the child because of the physician's misleading use of terms when disclosing the disease. Therefore, better practice should be developed for disease disclosure, and proper communication should be established between the patients and the provider; patient autonomy should also have an influence in the clinical practice.
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6.
  • Jakobsson, Sofie, 1968, et al. (författare)
  • Performance of the Swedish version of the Revised Piper Fatigue Scale.
  • 2013
  • Ingår i: European Journal of Oncology Nursing. - : Elsevier BV. - 1462-3889 .- 1532-2122. ; 17:6, s. 808-13
  • Tidskriftsartikel (refereegranskat)abstract
    • PURPOSE: The Revised Piper Fatigue scale is one of the most widely used instruments internationally to assess cancer-related fatigue. The aim of the present study was to evaluate selected psychometric properties of a Swedish version of the RPFS (SPFS).METHODS: An earlier translation of the SPFS was further evaluated and developed. The new version was mailed to 300 patients undergoing curative radiotherapy. The internal validity was assessed using Principal Axis Factor Analysis with oblimin rotation and multitrait analysis. External validity was examined in relation to the Multidimensional Fatigue Inventory-20 (MFI-20) and in known-groups analyses.RESULTS: Totally 196 patients (response rate = 65%) returned evaluable questionnaires. Principal axis factoring analysis yielded three factors (74% of the variance) rather than four as in the original RPFS. Multitrait analyses confirmed the adequacy of scaling assumptions. Known-groups analyses failed to support the discriminative validity. Concurrent validity was satisfactory.CONCLUSION: The new Swedish version of the RPFS showed good acceptability, reliability and convergent and- discriminant item-scale validity. Our results converge with other international versions of the RPFS in failing to support the four-dimension conceptual model of the instrument. Hence, RPFS suitability for use in international comparisons may be limited which also may have implications for cross-cultural validity of the newly released 12-item version of the RPFS. Further research on the Swedish version should address reasons for high missing rates for certain items in the subscale of affective meaning, further evaluation of the discriminative validity and assessment of its sensitivity in detecting changes over time.
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7.
  • Karlsson, Fredrik, Docent, 1975-, et al. (författare)
  • Assessment of speech impairment in patients with Parkinson's disease from acoustic quantifications of oral diadochokinetic sequences
  • 2020
  • Ingår i: Journal of the Acoustical Society of America. - : Acoustical Society of America (ASA). - 0001-4966 .- 1520-8524. ; 147:2, s. 839-851
  • Tidskriftsartikel (refereegranskat)abstract
    • This investigation aimed at determining whether an acoustic quantification of the oral diadochokinetic (DDK) task may be used to predict the perceived level of speech impairment when speakers with Parkinson's disease (PD) are reading a standard passage. DDK sequences with repeated [pa], [ta], and [ka] syllables were collected from 108 recordings (68 unique speakers with PD), along with recordings of the speakers reading a standardized text. The passage readings were assessed in five dimensions individually by four speech-language pathologists in a blinded and randomized procedure. The 46 acoustic DDK measures were merged with the perceptual ratings of read speech in the same recording session. Ordinal regression models were trained repeatedly on 80% of ratings and acoustic DDK predictors per dimension in 10-folds, and evaluated in testing data. The models developed from [ka] sequences achieved the best performance overall in predicting the clinicians' ratings of passage readings. The developed [pa] and [ta] models showed a much lower performance across all dimensions. The addition of samples with severe impairments and further automation of the procedure is required for the models to be used for screening purposes by non-expert clinical staff.
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8.
  • Peny-Dahlstrand, Marie, 1953, et al. (författare)
  • Patterns of participation in school-related activities and settings in children with spina bifida
  • 2013
  • Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 35:21, s. 1821-1827
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose: To evaluate how children with spina bifida (SB) participate in school-related activities and to explore if their motor and process skills in task performance were related to their level of active participation in school. Method: Fifty children from a geographical cohort of children with SB (aged 6-14 years) and their teachers rated the children's frequency of participation in school-related activities using a Swedish adaptation of the Availability and Participation Scale. The teachers also rated each child's level of active participation with the School Function Assessment, part one. Each child's motor and process skills were evaluated with the Assessment of Motor and Process Skills. The relation between levels of active participation and motor and process skills was subjected to binary logistic regression analysis. Results: The children participated very frequently in school activities, but their level of active participation was restricted, particularly in the recess/playground setting. There was a highly significant relation between full active participation in most school settings and the children's motor and process skills. Conclusion: Children with SB need support to become more actively involved, particularly in unstructured peer activities. The school staff need to be informed that not only the motor skills but also the process skills have an impact on the children's active participation.
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9.
  • Wassenius, Ola, et al. (författare)
  • Variability in Skin Exposure in Machine Operators Exposed to Cutting Fluids
  • 1998
  • Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 24:2, s. 125 - 129
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective. This study describes a new technique for measuring skin exposure to cutting fluids and evaluates the variability of skin exposure among machine operators performing cyclic (repetitive) work. Methods. The technique is based on video recording and subsequent analysis of the videotape by means of computer-synchronized video equipment. The time intervals at which the machine operator's hand was exposed to fluid were registered, and the total wet time of the skin was calculated by assuming different evaporation times for the fluid. The exposure of twelve operators with different work methods was analyzed in six different workshops, which included a range of machine types, from highly automated metal cutting machines (ie, actual cutting and chip removal machines) requiring operator supervision to conventional metal cutting machines, where the operator was required to maneuver the machine and manually exchange products. Results; the relative wet time varied between 0% and 100%. A significant association between short cycle time and high relative wet time was noted. However, there was no relationship between the degree of automatization of the metal cutting machines and wet time. Conclusions. The study shows that skin exposure to cutting fluids can vary considerably between machine operators involved in manufacturing processes using different types of metal cutting machines. The machine type was not associated with dermal wetness. The technique appears to give objective information about dermal wetness. A comment: This publication is a result of a cooperation between the authors at Chalmers University of Technology and Gothenburg University, i.e. between the Department of Transportation and the Department of Occupational Health and the Department of Sociology.
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10.
  • Mosallanezhad, Z., et al. (författare)
  • A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people
  • 2017
  • Ingår i: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 70, s. 123-129
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aim: Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. Methods: Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chisquare tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. Results: The measurement model yielded a reasonable fit to the data, chi(2) = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037-0.058. The model fit for the conceptual model was acceptable; chi(2) = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074-0.093. SES itself was not a direct predictor of HS (beta = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (beta = 0.31, p < 0.001) or I (beta = 0.57, p < 0.001). Conclusion: Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL. (C) 2017 Elsevier B.V. All rights reserved.
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