| 1. |
- Möllerberg, Marie-Louise, et al.
(author)
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Managing an altered social context-Patients experiences of staying away from home while undergoing proton beam therapy
- 2020
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In: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 7:4, s. 1157-1163
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Journal article (peer-reviewed)abstract
- Aim: To illuminate the experience of an altered social context for patients with primary brain tumours living away from home while undergoing proton beam therapy.Design: A descriptive, qualitative cross-sectional interview study.Methods: Nineteen patients were interviewed between December 2015-August 2016, either during (N = 7) or before and after (N = 12) their proton beam therapy. A hermeneutical analysis was performed.Results: Participants made adjustments to achieve control and well-being during the treatment period. The analysis also revealed two interrelated patterns that helped participants adjust: being part of the family from a distance and seeking affinity.Conclusion: It is important that patients receiving treatment far from home find a way to remain a part of their family and find affinity in the altered social context. Health professionals can prepare patients for the treatment period and can implement interventions to promote well-being for both patients and their relatives.
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| 2. |
- Möllerberg, Marie-Louise, et al.
(author)
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Evaluation of skin reactions during proton beam radiotherapy : patient-reported versus clinician-reporte
- 2021
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In: Technical innovations & patient support in radiation oncology. - : Elsevier. - 2405-6324. ; 19, s. 11-17
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Journal article (peer-reviewed)abstract
- Background: Skin reaction is a common side-effect of radiotherapy and often only assessed as clinician-reported outcome (CRO). The aim was to examine and compare patient-reported outcome (PRO) of skin reactions with CRO for signs of acute skin reactions for patients with primary brain tumour receiving proton beam radiotherapy (PBT). A further aim was to explore patients' experiences of the skin reactions.Methods: Acute skin reactions were assessed one week after start of treatment, mid-treatment and end of treatment among 253 patients with primary brain tumour who underwent PBT. PRO skin reactions were assessed with the RSAS and CRO according to the RTOG scale. Fleiss' kappa was performed to measure the inter-rater agreement of the assessments of skin reactions.Results: The results showed a discrepancy between PRO and CRO acute skin reactions. Radiation dose was associated with increased skin reactions, but no correlations were seen for age, gender, education, occupation, other treatment or smoking. There was a poor agreement between patients and clinicians (κ = -0.016) one week after the start of PBT, poor (κ = -0.045) to (κ = 0.396) moderate agreement at mid treatment and poor (κ = -0.010) to (κ = 0.296) moderate agreement at end of treatment. Generally, patients' symptom distress toward skin reactions was low at all time points.Conclusion: The poor agreement between PRO and CRO shows that the patient needs to be involved in assessments of skin reactions for a more complete understanding of skin reactions due to PBT. This may also improve patient experience regarding involvement in their own care.
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| 3. |
- Ohlsson-Nevo, Emma, et al.
(author)
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Patients' perspective in the context of proton beam therapy : summary of a Nordic workshop
- 2020
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In: Acta Oncologica. - : Taylor & Francis. - 0284-186X .- 1651-226X. ; 59:10, s. 1139-1144
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Journal article (peer-reviewed)abstract
- INTRODUCTION: On 15-16 November 2019, the Skandion Clinic in Sweden hosted the first Nordic workshop on 'Patients' perspective in proton beam therapy'. The workshop was conducted to describe and compare the patient care in PBT clinics in the Nordic countries and to initiate a collaboration, with the target to ensure patient participation and reduce the risk of inequity of access by lowering the barriers for accepting PBT in a distant clinic. The overarching aim of this workshop was to describe and compare the use of patients' perspectives in the Nordic PBT clinics.MATERIAL AND METHODS: Twelve participants attended the workshop, representing Denmark, Norway and Sweden. The participants were registered nurses working in patient care, researchers, physicist and leaders of the Skandion Clinic.RESULTS: The consensus of the workshop was that systematic use of patient experiences on individual and group level is essential for developing clinical practice and understanding the overall effects of PBT. A difference in how the Nordic countries use patient experiences in clinical practise was found. The importance of lowering the barriers for participation in national proton trials and proton treatment were emphasized, however, there is a lack of knowledge about individual and organizational barriers to accepting PBT, and further research is therefore needed.CONCLUSION: Collaboration between the Nordic countries regarding patients' perspectives in the context of PBT is of importance to compare national differences as well as to find similarities, but most importantly to learn from each other and to improve patient care. Nordic collaboration with focus on systematic collection of patient-reported outcomes in the context of PBT is unique. Collaboration in research offers the possibility to increase the inclusion of patients' perspectives in study protocols.
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| 4. |
- Ohlsson Nevo, Emma, 1960-, et al.
(author)
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In the hands of nurses : A focus group study of how nurses perceive and promote inpatients' needs for physical activity
- 2020
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In: Nursing Open. - : Wiley-Blackwell Publishing Inc.. - 2054-1058. ; 7:1, s. 334-344
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Journal article (peer-reviewed)abstract
- Aims: To describe how nurses perceive and promote inpatients' needs for physical activity during their stay at the ward.Design: A qualitative descriptive design was employed providing an exploration of how nurses perceive and promote inpatients' need for physical activity.Methods: Seven semi-structured focus group discussions were held between November 2016 and February 2017 with 29 nurses in three hospitals in Sweden. Both interaction analysis and content analysis of the data were conducted.Results: Patients are dependent on nurses' prioritizations and promotions to be sufficiently physically active during their stay at the ward. The external environment and the integration of physical activity affected the promotion of physical activity. The nurses perceived that understanding the patient's expectations was important and that promotion of physical activity was a joint responsibility of patient, relatives and healthcare professionals. The interaction analysis revealed no clear hierarchical pattern as all members in each focus group took initiative to open the discussions. The Registered Nurses contributed with more new ideas.
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| 5. |
- Ohlsson Nevo, Emma, 1960-, et al.
(author)
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Nurses’ perceptions of hospitalized patients’ need for progressed physical activity : a focus group study
- 2018
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Conference paper (peer-reviewed)abstract
- Background: Patients enrolled in wards at hospitals spend time in bed even if rest is not medically indicated. The inactivity in the hospital reduces muscle strength and can create a need for assistants that did not exist before or justified by the treated condition. Early and progressive mobilization is a key factor to maintain physical functioning during the care period in hospital. Despite the knowledge of the importance of physical activity, patients are not sufficiently mobilized. Reasons why patients are not mobilized are related to organizational factors as well as patient and nurse personal characteristics. With an understanding of nurses’ experiences, interventions to enhance patients’ physical activity can be develop aiming at reducing the risk of physical deterioration due to inactivity.Objective: The aim of the study was to describe how nurses perceive hospitalized patients’ needs for progressed physical activity during their stay at the wards.Method: A total of seven focus group discussions were conducted in seven wards at three different hospitals in Sweden. A total of 16 nurses and 14 nurse assistants participated. The analysis was conducted in two steps; First an interaction analysis of the communication and respond pattern in the focus groups and thereafter a content analysis of the transcribed text.Results: The analysis is in progress and the results will be presented at the conference.
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| 7. |
- Höglund, Erik, 1983-, et al.
(author)
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Characteristics of non-conveyed patients in emergency medical services (EMS) : a one-year prospective descriptive and comparative study in a region of Sweden
- 2020
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In: BMC Emergency Medicine. - : Springer Science and Business Media LLC. - 1471-227X. ; 20:1
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Journal article (peer-reviewed)abstract
- BackgroundThere has been an increasing demand for emergency medical services (EMS), and a growing number of patients are not conveyed; i.e., they are referred to levels of care other than ambulance conveyance to the emergency department. Patient safety issues have been raised regarding the ability of EMS to decide not to convey patients. To improve non-conveyance guidelines, information is needed about patients who are not conveyed by EMS. Therefore, the purpose of this study was to describe and compare the proportion and characteristics of non-conveyed EMS patients, together with assignment data.MethodsA descriptive and comparative consecutive cohort design was undertaken. The decision of whether to convey patients was made by EMS according to a region-specific non-conveyance guideline. Non-conveyed patients’ medical record data were prospectively gathered from February 2016 to January 2017. Analyses was conducted using the chi-squared test, two-sample t test, proportion test and Mann-Whitneys U-test.ResultsOut of the 23,250 patients served during the study period, 2691 (12%) were not conveyed. For non-conveyed adults, the most commonly used Emergency Signs and Symptoms (ESS) codes were unspecific symptoms/malaise, abdomen/flank/groin pain, and breathing difficulties. For non-conveyed children, the most common ESS codes were breathing difficulties and fever of unclear origin. Most of the non-conveyed patients had normal vital signs. Half of all patients with a designated non-conveyance level of care were referred to self-care. There were statistically significant differences between men and women.ConclusionsFewer patients were non-conveyed in the studied region compared to national and international non-conveyance rates. The differences seen between men and women were not of clinical significance. Follow-up studies are needed to understand what effect patient outcome so that guidelines might improve.
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| 9. |
- Höglund, Erik, 1983-
(author)
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Non-conveyance within the Swedish ambulance service : A prehospital patient safety study
- 2022
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Doctoral thesis (other academic/artistic)abstract
- BackgroundThere is an increasing demand for ambulance services and more patients than before are requesting ambulance assistance for low acuity conditions. Ambulance services non-convey patients because they lack acute care needs. Non-conveying patients can be a person-centred, resource- and cost-efficient measure and can allow the ambulance to become available sooner for patients with more acute illnesses or injuries. However, validated non-conveyance guidelines are lacking and non-conveying patients raises patient safety issues.AimThe overarching aim of the research project was to describe the patients that were non-conveyed, to explore if there were any potential patient safety issues with the regional non-conveyance guidelines, and to describe how patients and nurses experience non-conveyance.MethodsAll non-conveyance assignments during one year in a region in Sweden (n=2691) were consecutively and prospectively included. The quantitative data was described, compared, and analysed (Studies I and II). Two interview studies were carried out. Phenomenography and conventional content analysis were used to analyse the qualitative data. In total 14 patients were interviewed in Study III and 20 nurses were interviewed in Study IV.Conclusions Patients of all ages with varying characteristics and complaints were non-conveyed. No patient received intensive care, and few were admitted to in-hospital care or died within seven days after being non-conveyed. Older age increases the risk of hospitalisation and death. Patients could feel ashamed for being non-conveyed, and the ambulance nurse could feel frustration when believing that the ambulance resource was misused
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