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- Säfström, Emma, et al.
(author)
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Patient Continuity of Care Questionnaire in a cardiac sample : A Confirmatory Factor Analysis
- 2020
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In: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 10:7, s. 1-10
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Journal article (peer-reviewed)abstract
- Objective Even though continuity is essential after discharge, there is a lack of reliable questionnaires to measure and assess patients' perceptions of continuity of care. The Patient Continuity of Care Questionnaire (PCCQ) addresses the period before and after discharge from hospital. However, previous studies show that the factor structure needs to be confirmed and validated in larger samples, and the aim of this study was to evaluate the psychometric properties of the PCCQ with focus on factor structure, internal consistency and stability. Design A psychometric evaluation study. The questionnaire was translated into Swedish using a forward-backward technique and culturally adapted through cognitive interviews (n=12) and reviewed by researchers (n=8). Setting Data were collected in four healthcare settings in two Swedish counties. Participants A consecutive sampling procedure included 725 patients discharged after hospitalisation due to angina, acute myocardial infarction, heart failure or atrial fibrillation. Measurement To evaluate the factor structure, confirmatory factor analyses based on polychoric correlations were performed (n=721). Internal consistency was evaluated by ordinal alpha. Test-retest reliability (n=289) was assessed with intraclass correlation coefficient (ICC). Results The original six-factor structure was overall confirmed, but minor refinements were required to reach satisfactory model fit. The standardised factor loadings ranged between 0.68 and 0.94, and ordinal alpha ranged between 0.82 and 0.95. All subscales demonstrated satisfactory test-retest reliability (ICC=0.76-0.94). Conclusion The revised version of the PCCQ showed sound psychometric properties and is ready to be used to measure perceptions of continuity of care. High ordinal alpha in some subscales indicates that a shorter version of the questionnaire can be developed.
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| 2. |
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| 3. |
- Näsström, Anna-Lena
(author)
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"Är jag en sån där anhörigvårdare jag?"
- 2002
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Reports (other academic/artistic)abstract
- Det nationella projektet ”Anhörig-300” har pågått under en treårsperiod i samtliga kommuner i landet. Målsättningen har varit att de anslagna medlen skulle stödja och underlätta samt på andra sätt bidra till en ökad livskvalitet för anhörigvårdare och andra närstående till äldre, funktionshindrade och långvarigt sjuka. Projekten har skett i samverkan med anhörig- och frivilligorganisationer. Utvärderingens syfte har varit att se vilka effekter satsningen gett av projektet ”Anhörig-300” i Jämtlands län. Utvärderingen vill bidra med kunskap om anhörigas livssituation, förståelse för anhörigas situation, hur anhöriggruppen synliggjorts, vilken roll frivilligorganisationer har haft samt ge förslag på hur anhörigvården kan utvecklas i framtiden. Metoden har varit enkäter till alla kända anhörigvårdare i länet. Därutöver ett urval av olika personalgrupper som bi-ståndsbedömare, enhetschefer, distriktssköterskor, baspersonal, personal vid hälsocentraler samt politiker. Därtill samtliga personer från frivilligorganisationer som ingått i projektet och intervju med samtliga projektle-dare. Ett omfattande inventerings- och informationsarbete har gjorts i kommunerna för att nå anhörigvårdarna. Genom de olika aktiviteter som kommit igång genom projektet anser ett flertal av såväl frivilliga som politiker och personal att anhöriggruppen både synliggjorts och det har blivit en större medvetenhet om deras situation. I svaren från anhörigvår-darna har de själva inte märkt av det i någon större utsträckning. Samverkan med frivilliga blev inte som man förväntade sig. De frivilliga anser att man får dålig respons från kommunens personal och personalen tycker att de frivilliga är för passiva. Att vara anhörigvårdare är ofta ett lång-tidsprojekt och varje situation är i sig unik vilket också kräver flexibla lösningar av stödinsatser som ger trygghet för såväl den som vårdas som den som vårdar. För att ha en god livssituation som anhörigvårdare ska man ha ett starkt socialt kontaktnät, upplevd god fysisk och psykisk häl-sa, få avlöning i hemmet eller korttidsvård där båda parter kan känna trygghet. Därutöver någon förtrogen att prata med samt en speciell kontaktperson från hemtjänsten.
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| 4. |
- Näsström, Lena, 1967-, et al.
(author)
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Exploring partners' perspectives on participation in heart failure home care : a mixed-method design
- 2017
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In: Journal of Advanced Nursing. - : Blackwell Munksgaard. - 0309-2402 .- 1365-2648. ; 73:5, s. 1208-1219
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Journal article (peer-reviewed)abstract
- Aim. To describe the partners' perspectives on participation in the care for patients with heart failure receiving home care. Background. Partners are often involved in care of patients with heart failure and have an important role in improving patients' well-being and self-care. Partners have described both negative and positive experiences of involvement, but knowledge of how partners of patients with heart failure view participation in care when the patient receives home care is lacking. Design. A convergent parallel mixed-method design was used, including data from interviews and questionnaires. Methods. A purposeful sample of 15 partners was used. Data collection lasted between February 2010 - December 2011. Interviews were analysed with content analysis and data from questionnaires (participation, caregiving, health-related quality of life, depressive symptoms) were analysed statistically. Finally, results were merged, interpreted and labelled as comparable and convergent or as being inconsistent. Results. Partners were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation: adapting to the caring needs and illness trajectory, coping with caregiving demands, interacting with healthcare providers and need for knowledge to comprehend the health situation. Results showed confirmatory results that were convergent and expanded knowledge that gave a broader understanding of partner participation in this context. Conclusion. The results revealed different levels of partner participation. Heart failure home care included good opportunities for both participation and contact during home visits, necessary to meet partners' ongoing need for information to comprehend the situation.
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| 5. |
- Näsström, Lena, et al.
(author)
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Exploring partners' perspectives on participation in heart failure home-care - a mixed method design
- 2016
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 15:1 Suppl, s. S70-S70
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Journal article (other academic/artistic)abstract
- Introduction: Previous research has shown that partners and other family members are involved in the care for patients with heart failure, and have an important role regarding outcomes in chronic illness. This involvement included support, both emotionally and practically, and partners often contributed to self-care activities. Partners quality of life may be negatively affected when caring for a person with heart failure, and worse mental health have also been reported. Partners have described both positive and negative experiences of involvement in care, but there is a lack of knowledge of how partners of patients with heart failure view participation in care when the patients receive home-care.Purpose: The aim of this study was to gain a broader understanding of the partners’ perspectives on participation in the care for patients with heart failure receiving structured home-care.Methods: A convergent parallel mixed method design was applied with data from interviews analysed with qualitative content analysis, and questionnaires statistically analysed (n=15). Initially results were analysed separately and thereafter merged in a final interpretation with regard to whether they were comparable and convergent, expanded the understanding, or were inconsistent.Results: Partners scored that they were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation; adapting to the caring needs and illness trajectory, coping with caregiving demands, interacting with health care providers, and need for knowledge to comprehend the situation. Combining the two datasets showed both confirmatory results that were convergent and also gave expanded knowledge that broaden the understanding of partner participation in this context.Conclusions: The results revealed different levels of partner participation, with most partners being satisfied with their participation in care, but some partners expressed a fear of demands to come in the future. Heart failure home-care included good opportunities for both participation and contact during home visits, necessary to meet partners’ ongoing need for information to comprehend the situation.
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| 8. |
- Näsström, Lena, et al.
(author)
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Heart failure patients’ descriptions of participation in structured home care
- 2015
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In: Health Expectations. - : Wiley-Blackwell. - 1369-6513 .- 1369-7625. ; 18:5, s. 1384-1396
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Journal article (peer-reviewed)abstract
- Background:To strengthen the patient’s position in health care, patient participation has been decreed in policy documents and legalizations. For patients suffering from heart failure, self-care is an important part of disease management and participation is crucial to succeed with this. Objective: To examine how heart failure patients receiving structured home care described participation in the care. Design: Qualitative study. Setting and participants: Thirteen men and six women, aged between 63 and 90 years, were interviewed. The informants received structured home care at four home care units in Sweden. The interviews were analysed using qualitative content analysis. Results: Five categories with associated subcategories describing participation in care were identified: communication between patients and health-care professionals (HCPs) including time and space for dialogue and exchange of care-related information, accessibility to care through awareness of the plan for home visits or feasibility to initiate home visits, active involvement in care by engaging in self-care and collaboration with HCPs, trustful relation with HCPs, with confidence in competence and individually adapted care, options for decision making, by making decisions or entrusting decisions. Conclusions: Patient participation could be strengthened through structured home care. Participation was facilitated when there was a balance between the patient’s own preferences to influence care and the health-care professional’s actions and values and the organization of care. Barriers to participation could depend on the health-care organization, lack of continuity and confidence in HCPs.
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| 9. |
- Näsström, Lena L, et al.
(author)
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Patients Descriptions of Participation in Structured Heart Failure Home Care
- 2012
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In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 11:suppl 1, s. S72-S72
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Journal article (other academic/artistic)abstract
- Background: A growing number of patients with heart failure (HF) will need lifelong care and one option is to provide advanced HF care in the patient’s home. A Euro - pean integrated home care model has been developed and tested in the Netherlands and Sweden. The model pro - vides structured home care with the goal that patients will experience participation, safety and have knowledge about their disease and treatment. The aim of this study was to examine how HF patients, who receive a structured home care, describe participation in the care. Method: Swedish HF patients receiving structured home care at four different settings were included in the study. Strategic sampling was used to reach a variation regard - ing severity of HF, different needs of home-care, age and gender. A total of 19 open ended interviews have been con - ducted. The interviews were analyzed with qualitative con - tent analysis, where categories were developed inductively. Results: In the preliminary findings 5 categories with asso - ciated subcategories emerged on how patients with HF described participation in structured home care. To expe - rience room for communication including having room for dialogue and receiving care-related information was described as important for participation. To have accessi - bility to care through planned home visits or patient initi - ated visits facilitated participation. The patients described participation by engaging in self care and to collaborate with the home care team. To have trust in the home care team with confidence for competence and have continu - ity to meet individual needs was of importance. To have options to make decisions was expressed as a will to make decisions or to entrust decisions to the caregiver, but some - times patients opportunity to choose was restricted due to different aspects and impeded participation. Conclusion/significance of the study: The findings describe different aspects of participation among patients with HF who receive structured home care. Home visits facilitated communication between the patient and care - giver and enables participation. Getting information was an important condition for participation that often was met during home visits. Good accessibility to care increased feeling of participation as well as to meet caregivers of whom they trust. Own desire to make choices vary depend - ing on what choice it regards and also between different individuals. However, several patients expressed a complex situation with several health care contacts, where the opportunity for participation was limited.
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| 10. |
- Näsström, Lena, 1967-, et al.
(author)
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Participation in Care Encounters in Heart Failure Home-Care
- 2017
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In: Clinical Nursing Research. - : Sage Publications. - 1054-7738 .- 1552-3799. ; 26:6, s. 713-730
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Journal article (peer-reviewed)abstract
- The purpose of this qualitative study was to observe care encounters during home visits in Heart failure (HF) home-care to identify and describe participation in care. Seventeen patients diagnosed with HF, and 10 registered nurses participated. Data from 19 video-recorded home visits were analyzed using qualitative content analysis. Two themes were identified: (a) Participation in the care encounter is made possible by interaction, including exchanging care-related information, care-related reasoning, collaboration; and (b) participation in the care encounter is made possible by an enabling approach, including the patients expressing their own wishes, showing an active interest, while the nurse is committed and invites to having a dialogue. The HF home-care context showed good potential for patient participation. Room for discussions and collaboration facilitated for the patients to be active partners in their care, which in turn may have positive effects on outcomes.
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