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1.	Johansson, Elsie, 1952-, et al. (author) Nurse’s consolation : A grounded theory study 2008 In: Vård i Norden. - London : Sage Publications. - 0107-4083 .- 1890-4238. ; 28:2, s. 19-22 Journal article (peer-reviewed)abstract To date, consolation has not been clearly defined in nursing science. The purpose of this study was to identify the phenomenon of consolation from the perspective of practising nurses. Data from interviews with 21 nurses were analysed by means of the grounded theory approach. Consolation comprised supportive consolation, avoiding consolation, insufficient consolation and inaccessible consolation, which were integrated into the nurses’ professional approach and personal outlook. More basic research is required in order to illuminate the meaning of the phenomenon of consolation with focus on supportive consolation as well as the non-consolation phenomenon comprising the so-called avoiding, insufficient and inaccessible consolation. In order for nurses to be able to prescribe, carry out and evaluate consoling care which alleviates patient suffering, there is a need for further knowledge of what constitutes and does not constitute consolation.
2.	Larsson, Ingrid, 1968-, et al. (author) Biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic 2014 In: Annals of the Rheumatic Diseases. - London : BMJ Books. - 0003-4967 .- 1468-2060. ; 72, Suppl. 3, s. 139-140 Journal article (peer-reviewed)abstract Background: Patients with chronic inflammatory arthritis (CIA) treated with biological therapy are usually monitored by rheumatologists. Research shows that a nurse-led rheumatology clinic is safe and effective in monitoring biological therapy (1) and contributed added value in patients within rheumatology care, because the encounter with the nurse led to a sense of security, familiarity and participation (2).Objectives: To compare the cost of monitoring biological therapy in a nurse-led rheumatology clinic with those of a rheumatologist-led clinic in patients with low disease activity or in remission.Methods: Cost comparison was based on data from a 12 month randomised controlled trial (1). A total of 107 patients were randomly assigned to either a rheumatologist-led clinic or to a nurse-led rheumatology clinic. The purpose of the intervention was to replace one of two annual monitoring visits at the rheumatologist-led clinic (control group; n=54) by a visit to a nurse-led rheumatology clinic (intervention group; n=53), based on person-centred care. Inclusion criteria were ongoing biological therapy and Disease Activity Score 28 (DAS28) ≤3.2. All patients met the rheumatologist at inclusion and after 12 months. All outpatient visits, team rehabilitation and all the telephone advice at the Rheumatology Clinic were registered for the patients who participated in the trial. Main outcome measures were direct costs related to rheumatology care during the 12 month follow-up period.Results: After 12 months 97 patients completed the study. At the inclusion the patients had mean age of 55.4 years, disease duration of 16.7 years, and DAS28 was 2.1, with no significant differences between the two groups. There was no mean difference in changes in clinical outcome between the two groups (DAS28 -0.06; p=0.66). The total annual cost of team rehabilitation in rheumatology care, per patient monitored by the nurse-led rheumatology clinic was €580 compared with €1278 for monitoring by a rheumatologist-led clinic, translating in a €698 (55%) lower annual cost. The annual cost of just the outpatient rheumatology care provided by rheumatologist and rheumatology nurse, per patient was €457 for monitoring by the nurse-led rheumatology clinic compared with €598 for monitoring by a rheumatologist-led clinic, translating in a €141 (24%) lower annual cost.Conclusions: Patients with stable CIA undergoing biological therapy can be monitored more cost effectively by a nurse-led rheumatology clinic compared to a rheumatologist-led clinic, with no difference in clinical outcome as measured by DAS28.ReferencesLarsson et al. (2014). Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy. J Adv Nurs, 70(1): 164-175.Larsson et al. (2012). Patients’ experiences of a nurse-led rheumatology clinic in Sweden – a qualitative study in patients undergoing biological therapy. Nurs Health Sci, 14(4): 501-507.
3.	Almerud, Sofia, et al. (author) Beleaguered by technology : care in technologically intense environments. 2008 In: Nursing Philosophy. - : Wiley-Blackwell Publishing Ltd.. - 1466-7681 .- 1466-769X. ; 9:1, s. 55-61 Journal article (peer-reviewed)abstract Modern technology has enabled the use of new forms of information in the care of critically ill patients. In intensive care units (ICUs), technology can simultaneously reduce the lived experience of illness and magnify the objective dimensions of patient care. The aim of this study, based upon two empirical studies, is to find from a philosophical point of view a more comprehensive understanding for the dominance of technology within intensive care. Along with caring for critically ill patients, technology is part of the ICU staff's everyday life. Both technology and caring relationships are of indispensable value. Tools are useful, but technology can never replace the closeness and empathy of the human touch. It is a question of harmonizing the demands of subjectivity with objective signs. The challenge for caregivers in ICU is to know when to heighten the importance of the objective and measurable dimensions provided by technology and when to magnify the patients' lived experiences, and to live and deal with the ambiguity of the technical dimension of care and the human side of nursing.
4.	Almerud, S, et al. (author) Caught in an artificial split : a phenomenological study of being a caregiver in the technologically intense environment. 2008 In: Intensive & Critical Care Nursing. - 0964-3397 .- 1532-4036. ; 24:2, s. 130-136 Journal article (peer-reviewed)abstract A symbiotic relationship exists between technology and caring, however, technologically advanced environments challenge caregivers. The aim of this study is to uncover the meaning of being a caregiver in the technologically intense environment. Ten open-ended interviews with intensive care personnel comprise the data. A phenomenological analysis shows that ambiguity abounds in the setting. The act of responsibly reading and regulating instruments easily melds the patient and the machinery into one clinical picture. The fusion skews the balance between objective distance and interpersonal closeness. The exciting captivating lure of technological gadgets seduces the caregivers and lulls them into a fictive sense of security and safety. It is mind-boggling and heart-rending to juggle 'moments' of slavish mastery and security menaced by insecurity in the act of monitoring a machine while caring for a patient. Whenever the beleaguered caregiver splits technique from human touch, ambiguity decays into ambivalence. Caring and technology become polarized. Everyone loses. Caregiver competence wanes; patients suffer. The intensive care unit should be technologically sophisticated, but also build-in a disclosive space where solace, trust, and reassurance naturally happen. Caring professionals need to balance state-of-the-art technology with integrated and comprehensive care and harmonize the demands of subjectivity with objective signs
5.	Amofah, H. A., et al. (author) Factors affecting in-hospital sleep-wake pattern in octogenarians during the early postoperative phase after transcutaneous aortic valve replacement 2017 In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S53-S53 Journal article (peer-reviewed)abstract Background: Octogenarian patients are an increasing group admitted for advanced cardiac treatment. Little is known about factors disturbing their sleep-wake pattern in the early postoperative phase after transcutaneous aortic valve replacement (TAVI), as current knowledge is based upon studies on younger age groups treated for surgical aortic valve replacement.Aim: To determine factors affecting the in-hospital sleep wake pattern in octogenarian patients after TAVI.Methods: This is a prospective cohort study in a tertiary university hospital. Inclusion criteria were age > 80 years with severe aortic stenosis accepted for TAVI. Actigraphy was used to identify sleep-wake pattern (sleep time night and sleep time day), and the Minimal Insomnia Symptom Scale (MISS) to measure self-reported insomnia daily during the first five postoperative days. Charlson`s comorbidity index was used as a measure of comorbidities and the Visual Analog Scale (VAS) to rate pain severity. Information regarding duration of anesthesia, blood transfusion and parenteral administration of morphine equivalents were derived from the patients’ medical journals. Multiple regression analysis was used to test associations between variables.Results: In all, 65 patients (41 women) were included. Mean age was 85 years (SD 2.8). No significant associations were found between age, comorbidities, blood transfusion and morphine equivalents and sleep. Gender was significantly associated with sleep time night and sleep efficiency as men had shortest duration of sleep from the third to the fifth postoperative night (p < .001, and adjusted R2=.230 to .283). Duration of anesthesia had a significant association with sleep time night and sleep efficiency from the third to the fifth postoperative night (p=.013 to p < .001, and adjusted R2=.230 to .283), where longer duration gave less total sleep and lower sleep efficiency. VAS score correlated with wake time night the third night, where a higher VAS score gave more wake time (p=.006 and adjusted R2 .236).Conclusion: Male gender, longer duration of perioperative anesthesia and postoperative pain were associated with disturbances in the postoperative sleep-wake pattern in octogenarian patients in the early postoperative phase after TAVI. This knowledge is important and relevant and should have implications in improving patient care.
6.	Amofah, H. A., et al. (author) Factors associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after surgical aortic valve replacement 2017 In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S63-S64 Journal article (peer-reviewed)abstract Background: Disturbances of the sleep-wake pattern are known phenomenon in the postoperative phase after aortic valve replacement (SAVR) that have negative impact on the morbidity, quality of life and mortality. Octogenarian patients are an increasing group admitted for cardiac surgery, however knowledge is based on younger patients.Aims: To determine factors associated with disturbances in postoperative sleep-wake pattern in octogenarian patients after SAVR.Methods: A prospective cohort study of octogenarian patients in a single center university hospital. Inclusion criteria were age > 80 years, severe aortic stenosis, accepted for SAVR. Actigraphy was used to identify the sleep-wake pattern (sleep-time, sleep efficiency and wake time night and sleep- and wake-time day) for the five first postoperative days, and the sleep questionnaires Minimal Insomnia Symptom scale (MISS) to measure the selfreported insomnia at baseline and daily for the five first postoperative days. Charlsons comorbidity index was used to score comorbidities and the Visual Analog Scale (VAS), was used to rate pain severity. The patients’ medical journals were used to record duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusions and parenteral administration of morphine equivalents. Multiple regression analysis was used to test associations between variables.Results: In all, 78 patients were included (40 women). Mean age was 82 years (SD 2.0). For the sleep-wake pattern first to fifth postoperative night, mean sleep-time night was 330-370 minutes (SD 32-124). Mean sleep efficiency was 68-77% (SD 21-26). Mean sleep-time day was 545-712 minutes (SD 146-169). Mean insomnia score was 1,8-5,3 (SD 2,6-3,8). On the first postoperative night the pain VAS score correlated with wake time night, where a higher VAS indicated more wake time (p=.014, adjusted R2=.213). No other variable; age, gender, duration of anesthesia, duration of cardiopulmonary by-pass, blood transfusion or morphine equivalents showed significant association with the sleep-wake pattern or insomnia.Conclusion: Postoperative pain was associated with disturbances in sleep-wake pattern in octogenarian patients in the early postoperative phase after SAVR. This indicates that pain management may be inadequate for patients after SAVR. More research on this issue is needed to establish data needed to improve treatment and care.
7.	Amofah, H. A., et al. (author) Octogenarian patients experiences with hypnotics in relation to sleep disturbances and delirium after aortic valve therapy 2018 In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17, s. 104-105 Journal article (peer-reviewed)abstract Background: Sleep disturbance and delirium are complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve replacement (TAVI), especially in octogenarian patients. Sedatives and z-hypnotics are medications distributed to promote sleep. However, a knowledge-gap exists on patient experiences with these medications, and sleep and delirium after the cardiac treatment.Aim: To explore and describe how octogenarians suffering from delirium after SAVR/TAVI experience their sleep situation related to sedatives and z-hypnotics, in a long-term perspective.Methods An explorative and descriptive design with a longitudinal qualitative approach was applied. Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium. Information about administration of sedatives and z-hypnotics was collected from the patients journals. The Confusion Assessment Method (CAM) was used to assess delirium, the Sleep Sufficient Index (SSI) and Minimal Insomnia Symptom Scale (MISS) were used to document self-reported sleep and insomnia. All measures were performed at baseline and daily the five first postoperative days. Ten patients were interviewed 6-12 months after treatment with focus on delirium. Five of these patients were re-interviewed four years later, focusing on their sleep situation.Findings: For the initial interview, five men and five woman, four after TAVI and six after SAVR, mean age 83 were included. One overarching theme revealed; hours in bed represented an emotional chaos. Three sub-themes described the patients experiences with sleep and delirium, a cascade of distressful experiences, the struggle between sleep and activity and elements influencing sleep. In the category physical sleep distractions, sleep medications emerged as a sleep disturbing element but also to evoke delirium. Patients described to be offered sedatives and z-hypnotics in hospital. However, they did not have a positive experience with this as the medication did not make them sleep better. Moreover, they associated the nightmares by the sedatives Four years after the cardiac treatment, the octogenarian patients described that medication did not have a sleep promoting effect, and they did not want it.Conclusion: Octogenarian patients are vulnerable to complications like sleep disturbances and delirium. In preventing and treating these conditions, health-care professionals should be aware of the effect and side-effect of sedatives and z-hypnotics in the octogenarian patients. Our findings show that medications should be cautiously used within this group of patients.
8.	Andersson, Bodil T., et al. (author) Radiographers' areas of professional competence related to good nursing care 2008 In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:3, s. 401-409 Journal article (peer-reviewed)abstract BACKGROUND: Radiographers' ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer's work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.AIM: The aim was to describe the radiographer's areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.METHOD: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.ETHICAL ISSUES: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.RESULTS: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers' skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient's immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.CONCLUSIONS: The study highlights the different areas of the radiographer's unique professional competence. The findings provide insight into the radiographer's profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer's work encompasses a variety of components--from caring for the patient to handling and checking the technical equipment.
9.	Arenhall, Eva, 1974-, et al. (author) Decreased sexual function in partners after patients’ first-time myocardial infarction 2018 In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 17:6, s. 521-526 Journal article (peer-reviewed)abstract Background: A myocardial infarction event affects not only patients but also partners, although how it affects the partners’ sexual function is not studied.Aim: The purpose of this study was to describe and compare how partners experienced their sexual function one year before with one year after first-time myocardial infarction of their partner.Methods: A longitudinal and comparative design was used. Self-reported data on Watts Sexual Function Questionnaire was collected retrospectively at two occasions from 123 partners (87 women and 36 men), measuring the year prior to the first-time myocardial infarction and the year after. Data were analysed using descriptive and inferential statistics.Results: The total score for Watts Sexual Function Questionnaire showed a significant decrease over time. In all four subscales a decrease was found, which were statistically significant in three out of the four subscales (sexual desire, 19.39 vs 18.61; p<0.001, orgasm, 14.11 vs 13.64; p=0.027 and satisfaction, 12.61 vs 12.31; p=0.042). Twenty-six partners reported that their intercourse frequencies decreased over time, while six partners reported an increased intercourse frequency.Conclusions: Partners’ sexual function decreased after patients’ first-time myocardial infarction. It is important for health personnel to offer information and discussion about sexual function and concerns with both patients and partners after a first-time myocardial infarction.
10.	Arvidsson, Barbro, et al. (author) Process-oriented group supervision implemented during nursing education : nurses’ conceptions 1 year after their nursing degree 2008 In: Journal of Nursing Management. - Oxford : Blackwell Publishing. - 0966-0429 .- 1365-2834. ; 16:7, s. 868-875 Journal article (peer-reviewed)abstract AIM: To describe the variation in how nurses conceive process-oriented group supervision, implemented during nursing education, 1 year after their nursing degree. BACKGROUND: Process-oriented group supervision can be an effective support system for helping nursing students and nurses to reflect on their activities. METHODS: A descriptive qualitative design was chosen for the study. Conceptions were collected through interviews with 18 strategically selected Swedish nurses in 2005. RESULTS: Three descriptive categories comprising seven conceptions were emerged. Supportive actions comprised: a sense of security, belonging and encouragement. Learning actions involved: sharing and reflecting while developmental actions described: enabling professional identity and facilitating personal development. CONCLUSIONS: Process-oriented group supervision has a lasting influence on nurses' development. The possibility to reflect over new stances during nursing education was a prerequisite for the provision of high-quality care. Process-oriented group supervision can make an important contribution to nursing education. IMPLICATIONS: for Nursing Management Process-oriented group supervision provides nurses with the strength to achieve resilience to stress in their work. It may lead to autonomy as well as clarity in the nurse's professional function. This indicates the need for nurse managers to organize reflective group supervision as an integral part of the nurse's work.
11.	Arvidsson, Barbro, et al. (author) The development of a questionnaire for evaluating process-oriented group supervision during nursing education 2008 In: Nurse Education in Practice. - Amsterdam : Elsevier. - 1471-5953 .- 1873-5223. ; 8:2, s. 88-93 Journal article (peer-reviewed)abstract The benefits of process-oriented group supervision are difficult to evaluate, as the validity and reliability of the existing instruments have been questioned. The aim was to develop and test the psychometric properties of a questionnaire in order to evaluate the effects of process-oriented group supervision on nursing students during their three-year nursing education. A 55-item Process-oriented Group Supervision Questionnaire (PGSQ) with a developmental design was formulated on the basis of a literature review and the expectations of nursing students who participated in a three-year nursing education programme (N = 176). Construct validity and internal consistency reliability were tested at the end of each study year: year 1 (T1), year 2 (T2), and year 3 (T3) by means of exploratory factor analysis and Cronbach’s coefficient. An adequate explorative factor analysis (principal component analysis, varimax rotation) with an Eigenvalue >1.0 and factor loadings >0.40, reduced the questionnaire to 18 items comprising three factors labelled educative, supportive and developmental, which explained 60.2% at T1, 71.8% at T2, and 69.3% at T3 of the total cumulative variance. The corresponding Cronbach’s coefficient figures were 0.89 (T1), 0.94 (T2) and 0.93 (T3). The 18-item PGSQ is considered to be a short and useful tool due to its satisfactory validity and reliability figures.
12.	Arvidsson, Susann, 1965-, et al. (author) Chronic musculoskeletal pain and sleep disturbances as predictors for lower vitality measured by the short form 36 (SF-36) - A eight-year follow up study 2006 In: Annals of the Rheumatic Diseases. - London : BMJ Books. - 0003-4967 .- 1468-2060. ; 65:Suppl. 2, s. 656-656 Journal article (other academic/artistic)abstract Background: Subjects with chronic musculoskeletal pain or sleep disturbances have been shown to have a poor healthstatus as measured by the SF-36 health survey. Fatigue is commonly reported by subjects with chronic musculoskeletal pain and sleep disturbances. There is little known about the temporal relationship between chronic pain, sleep disturbances and changes of vitality.Objectives: The aim of this study was to evaluate the predictive value of chronic musculoskeletal pain and sleep disturbances with regard to changes in vitality as measured by SF-36 over an eight year period.Method: An eight year follow up of 2 425 subjects aged 20-74 from the general population that in 1995 answered the same postal questionnaire. The questionnaire assessed chronic musculoskeletal pain, sleep disturbances, and included the SF-36 health survey. Pain was considered "chronic" if persistent for three months or more. Sleep disturbances assessed were difficulty in falling asleep, frequent awakenings, early awakenings and not feeling rested. Main outcome measure was change of vitality as measured by SF-36 in those that at baseline reported vitality over the median value. Statistical analyses were done with use of logistic regression. Besides the studied variables, the logistic regression analyses also controlled for gender, age, socio-economic group, and the use of analgesics and sleeping pills.Results: At baseline 1212 subjects reported a vitality score on SF-36 above the median score of 75. There were 943 subjects (78%) responding at the eight-year follow up. Chronic pain at baseline predicted (OR=1,64, 95% CI 1,14-2,36%, p=0,01) worsening of vitality over time. Loss of vitality was also predicted by moderate problems with falling asleep (OR=2,17, 95% CI 1,31-3,60%, p<0,01), and problems with not feeling rested (moderate problems OR=2,08, 95% CI 1,23-3,50%, p=0,01, and major problems OR=4,76, 95% CI 1,53-14,78%, p=0,01).Conclusion: Loss of vitality in SF-36 over an eight-year period was predicted by chronic musculoskeletal pain, problems with falling asleep and problems with not feeling rested. Problems with frequent awakenings and early awakenings did not predict lower value of vitality over an eight-year period. It could thus be important to attend to sleeping problems and especially the feeling of not being rested in subjects with chronic musculoskeletal pain.
13.	Arvidsson, Susann, 1965-, et al. (author) Factors promoting health-related quality of life in patients with rheumatic diseases 12 months after rehabilitation 2010 In: Svenska Läkaresällskapets Riksstämma 2010. ; , s. 3-3 Conference paper (peer-reviewed)abstract Rheumatic diseases have significant adverse impact on the individual from physical, mental and social aspects, resulting in a low estimation of health-related quality of life (HRQL). Patients with rheumatoid arthritis who receive a multi-disciplinary team-based care in a rheumatology clinic could get improved HRQL. Several factors can be supposed to promote health in patients with rheumatic diseases and in health-promoting work within the clinical practice it would be valuable to identify health factors that affect HRQL in a positive direction.This is a longitudinal cohort study in 185 patients with rheumatic diseases with test one week and 12 months after rehabilitation on a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors (chronic musculoskeletal pain, sleep quality, food habits, exercise habits, leisure habits, sexual lust, sense of coherence (SOC), social support and socio-demographic variables). The association between SF-36 subscales and suggested health factors were estimated by OR and 95 % CI calculated by multivariable logistic regressions.Factors predicting better outcome in HRQL in one or several SF-36 subscales were being of younger ages or middle-ages, feeling painless, having good sleep structure, feeling rested after sleep, doing low effort of exercise more than twice a week, having strong SOC, having emotional support and practical assistance, having higher educational level, and having working capacity. The most important factors were having strong SOC, feeling rested after sleep, having working capacity, being of younger ages or middle-ages, and having no/small problem with sleep structure.The most important factors promoting HRQL in patients with rheumatic diseases 12 months after rehabilitation were having strong SOC, feeling rested after sleep, having working capacity, being of younger ages or middle-ages, and having no/small problem with sleep structure. These health factors are important to address in clinical work with rheumatic diseases to optimise treatment strategies.
14.	Arvidsson, Susann, 1965-, et al. (author) Factors promoting health-related quality of life in people with rheumatic diseases : a 12 month longitudinal study 2011 In: BMC Musculoskeletal Disorders. - London : BioMed Central. - 1471-2474. ; 12 Journal article (peer-reviewed)abstract Background: Rheumatic diseases have a significant adverse impact on the individual from physical, mental and social aspects, resulting in a low health-related quality of life (HRQL). There is a lack of longitudinal studies on HRQL in people with rheumatic diseases that focus on factors promoting HRQL instead of risk factors. The aim of this study was to investigate the associations between suggested health promoting factors at baseline and outcome in HRQL at a 12 month follow-up in people with rheumatic diseases.Methods: A longitudinal cohort study was conducted in 185 individuals with rheumatic diseases with questionnaires one week and 12 months after rehabilitation in a Swedish rheumatology clinic. HRQL was assessed by SF-36 together with suggested health factors. The associations between SF-36 subscales and the health factors were analysed by multivariable logistic regressions.Results: Factors predicting better outcome in HRQL in one or several SF-36 subscales were being younger or middle-aged, feeling painless, having good sleep structure, feeling rested after sleep, performing low effort of exercise more than twice per week, having strong sense of coherence (SOC), emotional support and practical assistance, higher educational level and work capacity. The most important factors were having strong SOC, feeling rested after sleep, having work capacity, being younger or middle-aged, and having good sleep structure.Conclusions: This study identified several factors that promoted a good outcome in HRQL to people with rheumatic diseases. These health factors could be important to address in clinical work with rheumatic diseases in order to optimise treatment strategies. © 2011 Arvidsson et al; licensee BioMed Central Ltd.
15.	Arvidsson, Susann, 1965-, et al. (author) Feeling rested predicts good health in subjects with and without chronic musculoskeletal pain 2008 In: Annals of the Rheumatic Diseases. - London : BMJ Books. - 0003-4967 .- 1468-2060. ; 67:Suppl. II, s. 552-552 Journal article (peer-reviewed)abstract Background: Musculoskeletal pain is a public health problem and a common cause for people to seek health care. It has also been shown that people with musculoskeletal pain estimates their health-related quality of life very low compared to a pain free population. Earlier studies have primarily looked at risk factors and there are little known about health predicting factors in a general population.Objectives: To investigate the associations between suggested health factors and health-related quality of life at baseline and in an eight-year follow up in subjects with and without chronic musculoskeletal pain.Methods: A longitudinal study in a Swedish general population (N=1 849) with a postal questionnaire at baseline 1995 and at a follow up 2003. Subjects were divided into two groups, according to their response about chronic musculoskeletal pain at baseline. Health-related quality of life was assessed by the SF-36 together with suggested health factors. The associations between the dependent variables (SF-36 subscales) and the independent variables (i.e. the suggested health factors; socioeconomic status, immigrant status, emotional support, regularly exercise, sleep structure, feeling rested, smoking and alcohol habits) were estimated by OR and 95% CI calculated by multivariable logistic regressions, with adjustment for all health factors, age, sex and baseline SF-36 values.Results: The most consistent finding for subjects with and without chronic musculoskeletal pain at baseline and in the eight-year follow up was a statistical significant (p<0.05) better health outcome in SF-36 subscales for subjects that were feeling rested at baseline. At baseline feeling rested was associated with having a health status better than the mean score in seven SF-36 subscales for both subjects with chronic pain (OR 1.5 (95% CI 1.0-2.3) – OR 4.4 (95% CI 2.9-6.6)) and subjects without chronic pain (OR 2.6 (95% CI 1.6-4.1) – OR 4.4 (95% CI 3.0-6.5)). At the follow up feeling rested predicted a better outcome in five subscales for subjects with chronic pain (OR 1.6 (95% CI 1.0-2.4) – OR 2.2 (95% CI 1.4-3.6)) and in six subscales for subjects without chronic pain (OR 1.6 (95% CI 1.0-2.5) – OR 2.7 (95% CI 1.8-4.1)). Other factors that in some aspects predicted a better outcome were belonging to higher socioeconomic group, being an inborn Swede, having emotional support, having good sleep structure, never being or being a former smoker, and regularly drinking alcohol.Conclusion: ''Feeling rested'' was the most consistent factor predicting a good health outcome, both in subjects with and without chronic musculoskeletal pain, and should be attended to in health promotion work. Emotional support, sleep structure, smoking and alcoholic habits also appears to be important health factors to take into account.
16.	Arvidsson, Susann, 1965-, et al. (author) Feeling rested predicts good health in subjects with and without chronic musculoskeletal pain 2008 Conference paper (peer-reviewed)
17.	Arvidsson, Susann, 1965-, et al. (author) Health predicting factors in a general population over an eight-year period in subjects with and without chronic musculoskeletal pain 2008 In: Health and Quality of Life Outcomes. - London : BioMed Central. - 1477-7525. ; 6 Journal article (peer-reviewed)abstract Background: Many factors are proposed to be associated with health-related quality of life. Knowledge of health factors associated to development of a good health-related quality of life could be of use in clinical practice and public health work. The aim of this study was to investigate the associations between suggested health factors and health-related quality of life at baseline and in an eight-year follow up in subjects with and without chronic musculoskeletal pain in a cohort from a general population.Methods: The study was designed as a longitudinal study in a Swedish general population (N = 1 849) with a postal questionnaire at baseline 1995 and at follow up 2003. Subjects were divided into two groups, according to their response about chronic musculoskeletal pain at baseline. Health-related quality of life was assessed by the SF-36 together with suggested health factors. The associations between SF-36 subscales and suggested health factors were estimated by OR and 95% CI calculated by multivariable logistic regressions, with adjustment for all health factors, age, sex and baseline SF-36 values.Results: Although subjects without chronic musculoskeletal pain reported better health-related quality of life than subjects with chronic pain, similar health factors were found to be associated to higher scores in SF-36 at baseline and predicted a better outcome in the eight-year follow up. The most consistent finding was a better health outcome in the eight-year follow up for subjects that were feeling rested after sleep. Other factors that in some aspects predicted a better outcome were belonging to higher socioeconomic group, being a native Swede, having emotional support, having good sleep structure, never being or being a former smoker, and regularly drinking alcohol.Conclusion: The most important health factor in subjects with and without chronic musculoskeletal pain was feeling rested after sleep, but also emotional support, sleep structure, smoking and alcoholic habits appears to be important components. These health factors could be important to address in clinical work with painful musculoskeletal disorders. Since several health factors are common in both subjects with and without pain there could be a common strategy to be formed in public health programmes.
18.	Arvidsson, Susann, 1965-, et al. (author) People with Rheumatic Diseases Experiences of Health-Promoting Self-Care 2010 In: Annals of the Rheumatic Diseases. - London : BMJ Books. - 0003-4967 .- 1468-2060. ; 69:Suppl. 3, s. 743-743 Journal article (peer-reviewed)abstract Background: People with rheumatic diseases estimate their health status low. The health status and health belief are influencing the choice of self-care behaviours. Self-care behaviours are common and could prevent loss of valued life activities and health. Little is known of how people with rheumatic diseases experience self-care.Objectives: To describe people with rheumatic diseases experiences of health-promoting self-care.Methods: The study had a phenomenological approach based on a reflective life-world perspective. Data were gathered by unstructured and open-ended interviews with 12 individuals with various diagnoses of rheumatic diseases.Results: For people with rheumatic diseases, self-care was a way of life and implied being ready at all times to understand and respond to signals from the lived body. Self-care was experienced as an internal dialogue within the lived body but also as an external dialogue with the immediate environment. Self-care could also be described as a power struggle where the individuals strived and forced themselves to fight the diseases and its concrete consequences. The self-care also required that choices were made. Crucial for the choices were trust in oneself and belief in one's own ability to chosen health-promoting self-care. The individual prioritised self-care that was experienced as a beneficial and/or a reward for the lived body.Conclusion: People with rheumatic diseases experienced self-care as a way of life and that it meant to be ready at all times to understand and respond to signals that the lived body sends out. Self-care required dialogue, power struggle and choice. This knowledge ads to a fuller understanding of factors that from a patient perspective are important for health when living with a chronic rheumatic disease.Disclosure of Interest: None declared
19.	Arvidsson, Susann, 1965-, et al. (author) People with Rheumatic Diseases Experiences of Health-Promoting Self-Care 2010 In: QMSH 10. - Uppsala : Uppsala universitet. ; , s. 67-67 Conference paper (peer-reviewed)
20.	Arvidsson, Susann, 1965-, et al. (author) Psychometric Properties of the Swedish Rheumatic Disease Empowerment Scale, SWE-RES-23 2010 In: Svenska Läkaresällskapets Riksstämma 2010. ; , s. 3-3 Conference paper (peer-reviewed)abstract Empowerment is a central concept in a patient-focused rheumatology care. WHO describes empowerment as a process in which the person receives more control over decisions and actions that affect the own life and health. Today there is no Swedish empowerment instrument for rheumatic diseases created or transl[...]The already existing questionnaire, Swedish Diabetes Empowerment Scale (SWE-DES-23), was adapted for use in patients with rheumatic diseases by exchanging the word diabetes with rheumatic disease in all the questions. No items were added or removed. The adapted questionnaire was called SWE-RES-23. In 2009, 260 patients with rheumatic diseases from a rheumatology unit in the southwest of Sweden completed the questionnaire.In order to establish discriminant validity, a question about self-perceived health from SF-36 was used in addition to SWE-RES-23.Construct validity was tested by using exploratory factor analysis. In order to determine unidimensionality of the empowerment subscales, inter-item correlations were calculated. Internal consistency reliability was tested by the use of the Cronbach-α coefficient.The exploratory factor analysis resulted in five factors (empowerment subscales) with Eigenvalues >1 explaining 64.1% of the variance. The five empowerment subscales were: Goal achievement and overcoming barriers to goal achievement, Self-awareness, Managing stress, Assessing dissatisfaction and readiness to change, and Support for caring. The Cronbach-α values ranged from 0.59 to 0.91 and for the total score 0.92. All inter-item correlations were significant. Patients with very good and good self-reported health scored significantly higher on three empowerment subscales (Goal achievement, Self-awareness and Managing stress). The same patterns were seen in the other two empowerment subscales (Readiness to change and Support for change), but did not reach significance.The SWE-RES-23 was a first step in developing a questionnaire for assessment of empowerment of patients with rheumatic diseases. The questionnaire possesses acceptable validity and reliability. To fully validate the SWE-RES-23 further studies are needed, but the instrument is even now possible to use in empowerment education programmes for patients with rheumatic diseases.
21.	Arvidsson, Susann, 1965-, et al. (author) Upplevelse av hälsobefrämjande egenvård vid reumatisk sjukdom 2009 Conference paper (peer-reviewed)abstract BakgrundPersoner med reumatiska sjukdomar skattar sitt hälsostatus lågt. Hälsostatus och tron på den egna förmågan att kunna påverka hälsan påverkar i sin tur valet av egenvårdsbeteenden. Egenvårdsbeteenden är vanliga och kan förhindra försämrad hälsa och förlust av värdefull fysisk och psykisk aktivitet. Kunskaperna är små om hur personer med reumatiska sjukdomar upplever att utföra egenvård. Syftet är därmed att beskriva hur personer med reumatiska sjukdomar erfar att utföra egenvård för att nå hälsa.MetodStudien har en kvalitativ design med en fenomenlogisk ansats och en livsvärldsteoretisk grund. Data har samlats in genom ostrukturerade och öppna intervjuer med 12 personer med olika diagnostiserade reumatiska sjukdomar.ResultatPersoner med reumatiska sjukdomar upplever att egenvård är ett sätt att leva och att det innebär att ständigt vara redo för att förstå och reagera på signaler från den levda kroppen. Egenvård upplevs som en inre dialog inom den levda kroppen, men också en yttre dialog med närmiljön. Egenvård beskrivs också som en maktkamp där personen strävar efter och tvingar sig att kämpa mot sjukdomen och dess konkreta konsekvenser. Egenvården kräver också att val görs. Avgörande för valet är att personen har tillit till sig själv och tror på sin egen förmåga att välja hälsobefrämjande egenvård. Personer med reumatiska sjukdomar prioriterar egenvård som upplevs som positiv och/eller ger en belöning till den levda kroppen.SammanfattningPersoner med reumatiska sjukdomar upplever egenvård som ett sätt att leva och det innebär att vara i beredskap för att förstå och reagera på signaler som den levda kroppen sänder ut. Egenvård kräver dialog, maktkamp och val. Denna kunskap bidrar till en mer fullständig förståelse av faktorer som från ett patientperspektiv är viktiga för hälsan vid kronisk reumatisk sjukdom.
22.	Axelsson, Åsa B., 1955, et al. (author) European cardiovascular nurses and allied professions’ practical skills in cardiopulmonary resuscitation 2009 In: Cardiology. - 0008-6312. - 9783805591430 ; 113:S1 Conference paper (other academic/artistic)abstract The purpose of this study was to test practical skills of cardiopulmonary resuscitation (CPR) in European cardiovascular nurses and allied professions. Methods: Eighty-six delegates at the Spring Meeting on Cardiovascular Nursing in Malmö, Sweden, in 2008, were recruited for this study. Laerdal Resusci Anne SkillReporter manikins connected to a computer with the Laerdal PC SkillReporting System were used. The participants were told to perform CPR according to the “new”guidelines from 2005; 30:2 for three minutes. Results: 88% of the tested participants were nurses and 79% were female. Mean age were 42 years (range 19–63 years). They came from 14 different European countries, though one third was from Sweden. About two thirds had trained CPR within the last year. Seven per cent had no previous CPR training. According to practical skills the average inflations per minute were five (SD+1.5), average inflation volume 992 ml (SD+423) and average flow rate 857 ml/second (SD+401). According assessment of chest compressions the average compression rate was 121 (SD+22.5), average compression per minute 79.5 (SD+14.4), average compression depth 43.8 mm (SD+9.4) and average compression duty cycle 43.8% (SD+5.7). Hand position “too low”was the most common committed error. Conclusion: The practical skill in CPR among the tested delegates was rather satisfying regarding chest compressions. However, there were wide ranges as shown by large standard deviations. Regarding ventilations, too large volumes together with flow rates as high as those performed by many of these delegates may easily lead to gastric inflation during clinical CPR.
23.	Backe, Marita, et al. (author) Patients’ conceptions of their life situation within the first week after a stroke event : A qualitative analysis 1996 In: Intensive & Critical Care Nursing. - London : Churchill Livingstone. - 0964-3397 .- 1532-4036. ; 12:5, s. 285-294 Journal article (peer-reviewed)abstract The aim of this study was to find out how stroke patients conceived their life situation within the first week of the acute care phase as seen from the nurses’ viewpoint. Six patients were interviewed within 3 weeks from their first stroke, using questions based on a holistic philosophy and analysed with the phenomonographic approach. Two main categories emerged from the results: the feeling of unreality and the awareness of a changed role in life, together with six subcategories; feeling of a changed perception of the body; feeling of being confused; loss of capability; awareness of confined life space; the importance of support and encouragement; and the will to look for new opportunities. The study concludes that the body change resulting from a stroke leads to both physical and psychological trauma, in which the psychological crisis can be very deep and best described as a personal catastrophe. The patient’s capability to receive and understand information becomes blocked, which influences both the nurse and the patient’s next of kin with regard to their care of the patient. Conversations with the patient must be frequent so that the acute care can be evaluated and agreement reached between the patient’s wishes and the nurses’ objectives. The results indicate the significance of intervention programmes based on crisis theory within the first week of a stroke event.
24.	Baigi, Amir, 1953, et al. (author) Sense of coherence as well as social support and network as perceived by patients with a suspected or manifest myocardial infarction: a short-term follow-up study 2008 In: Clinical Rehabilitation. - London : SAGE Publications. - 0269-2155 .- 1477-0873. ; 22:7, s. 646-652 Journal article (peer-reviewed)abstract Objective: To compare sense of coherence as well as social support and network as perceived by ischaemic heart disease patients at baseline and two weeks post-discharge in terms of age, sex, educational and marital status. Design: Multicentre study with a prospective short-term follow-up design. Setting: A university hospital, a central hospital and a district hospital in southern Sweden. Subjects: Consecutive sample of 246 patients with a suspect or manifest myocardial infarction. Main measures: The Lubben Social Network Scale (LSNS-R), the Medical Outcome Study (MOS) Social Support Survey and the Sense of Coherence Scale were included in a self-administered questionnaire and answered twice, together with sociodemographic variables. Results: Bivariate analyses indicated changes in social support (practical support increased in men and decreased in women; both P= 0.003) and social network (family network increased among >65 year olds; P= 0.001, men; P= 0.013, and women; P= 0.033, those with a low; P=0.017, and intermediate; P= 0.033, educational level, as well as those cohabiting; P= 0.0001), but did not reveal any difference in sense of coherence. Conclusions: Sociodemographic variables have no influence on sense of coherence but do affect social support (i.e. practical support and social network, family). Ischaemic heart disease patients' short stay in hospital implies that the network outside the hospital has to assume responsibility, but at the same time it is important for health care professionals to have sufficient knowledge to be able to support the specific needs of patients and their family members.
25.	Bala, Sidona Valentina, et al. (author) Measuring person-centred care in nurse-led outpatient rheumatology clinics 2018 In: Musculoskeletal Care. - : John Wiley & Sons. - 1478-2189 .- 1557-0681. ; 16:2, s. 296-304 Journal article (peer-reviewed)abstract Background: Measurement of person-centred care (PCC) outcomes is underdeveloped owing to the complexity of the concept and lack of conceptual clarity. A framework conceptualizing outpatient PCC in rheumatology nurse-led clinics has therefore been suggested and operationalized into the PCC instrument for outpatient care in rheumatology (PCCoc/rheum).Objective: The aim of the present study was to test the extent to which the PCCoc/rheum represents the underpinning conceptual outpatient PCC framework, and to assess its measurement properties as applied in nurse-led outpatient rheumatology clinics.Methods: The 24-item PCCoc/rheum was administered to 343 persons with rheumatoid arthritis from six nurse-led outpatient rheumatology clinics. Its measurement properties were tested by Rasch measurement theory.Results: Ninety-two per cent of individuals (n = 316) answered the PCCoc/rheum. Items successfully operationalized a quantitative continuum from lower to higher degrees of perceived PCC. Model fit was generally good, including lack of differential item functioning (DIF), and the PCCoc/rheum was able to separate individuals with a reliability of 0.88. The four response categories worked as intended, with the exception of one item. Item ordering provided general empirical support of a priori expectations, with the exception of three items that were omitted owing to multidimensionality, dysfunctional response categories and unexpected ordering. The 21-item PCCoc/rheum showed good accordance with the conceptual framework, improved fit, functioning response categories and no DIF, and its reliability was 0.86.Conclusion: We found general support for the appropriateness of the PCCoc/rheum as an outcome measure of patient-perceived PCC in nurse-led outpatient rheumatology clinics. While in need of further testing, the 21-item PCCoc/rheum has the potential to evaluate outpatient PCC from a patient perspective.
26.	Bala, V., et al. (author) Towards measurement of person-centered care outcomes in outpatient nurse-led clinics 2017 In: Annals of the Rheumatic Diseases. - : BMJ Publishing Group. - 0003-4967 .- 1468-2060. ; 76, s. 1520-1520 Journal article (peer-reviewed)abstract Background Person-centered care (PCC) is increasingly emphasized as a key component of effective illness management and of developing high quality of care. Despite considerable progress of PCC in many areas of care there is currently a gap and a need for means to assess PCC practice in outpatient care. In rheumatology, PCC is considered an unmet need and further development and evaluation of this approach to care is thus of high priority. Objectives To develop an instrument for measuring person-centered care from the perspective of the person with rheumatoid arthritis (RA) in nurse-led outpatient clinics. Methods A conceptual framework of PCC in the outpatient context and focusing on the meeting between the person with RA and the nurse and on the patient as an active care partner was undertaken. Based on this framework, qualitative interviews (1,2) and a literature review, a 35-item questionnaire was proposed and qualitatively tested regarding acceptability and content validity among 50 persons with RA attending a nurse-led outpatient clinic. Two versions of the questionnaire were tested: one using four response categories (0 = Totally disagree; 3 = Completely agree), and one using two response categories (0 = Disagree; 1 = Agree). Content validity was estimated by calculating Content Validity Index of the individual items (I-CVI) and of the overall instrument (S-CVI). Results Respondents found the items easy to understand (77%) and relevant (93%). Seventy-three percent of the respondents preferred the questionnaire version with four response categories. This version took a mean (SD) of 5.3 (2.5) minutes to complete. I-CVI values ranged from 0.87 to 1.00 and S-CVI was 0.94. About 80% of the respondents considered some items to be redundant. This resulted in a reduced 24-item draft questionnaire that yield a total score between 0–72. Conclusions A preliminary 24-item patient-reported PCC questionnaire was developed. Psychometric testing is needed for validation of this tool before implementation.
27.	Brahm, Carl-Otto, et al. (author) Patients with head and neck cancer treated with radiotherapy : Their experiences after 6 months of prophylactic tooth extractions and temporary removable dentures 2021 In: Clinical and Experimental Dental Research. - : John Wiley & Sons. - 2057-4347. ; 7:5, s. 894-902 Journal article (peer-reviewed)abstract Objectives: The impact of dental occlusion on the experiences of head and neck cancer patients and their oral, social and psychological functioning has been sparsely investigated. There is a lack of knowledge regarding the experience of tooth loss and dentures among patients treated for head and neck cancer. The aim of this study was to describe the experiences of head and neck cancer patients of prophylactic tooth extractions and temporary removable dentures, 6 months after radiotherapy treatment. Material and methods: An individual interview with 25 patients 6 months after radiotherapy was subjected to a qualitative content analysis. Results: Two categories, Impaired oral function and Belief in the future, and seven subcategories described the patients' experiences of temporary removable dentures during the first 6 months after prophylactic tooth extractions. The temporary removable dentures affected the patients' ability to chew, swallow and speak, caused pain, and were experienced as an enemy. Despite that, the patients were hopeful and had a wish for recovery, which gave them the energy to live. Conclusion: Prophylactic tooth extractions and temporary removable dentures 6 months after radiotherapy treatment affect head and neck cancer patients' recovery and everyday life. However, they have the will to take on these challenges, pertaining not only to themselves, but also to relatives and health professionals. At the individual level, the patient needs individualized professional support to get through the arduous procedure, from the acute situation until the end of the rehabilitation phase.
28.	Broström, Anders, et al. (author) 6-month CPAP-treatment in a young male patient with severe obstructive sleep apnoea syndrome - A case study from the couples perspective 2008 In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 7:2, s. 103-112 Journal article (peer-reviewed)abstract Background: Obstructive sleep apnoea syndrome (OSAS) is independently associated with an increased risk for hypertension and cardiovascular disease. Continuous positive airway pressure (CPAP) can reduce mortality and morbidity, but low compliance rates are seen. Aim: To explore and describe the experiences of CPAP-treatment in a young male patient with severe OSAS during a 6-month period from the couples perspective. Methods and the case: A single case study with a phenomenographic approach was employed. Diagnostic procedures of OSAS and initiation of treatment with Auto-CPAP, humidifier and a nasal mask were performed during 4 visits. Conceptions were collected at 4 different occasions during the 6-month period (before, and 2 weeks, 3 months, and 6 months after treatment initiation) by means of interviews with a 33-year old male patient and his female partner. Findings: Totally 17 different structural aspects were found to fluctuate during the 6-month period in relation to; influence of stressors, social reactions and adaptation to increase compliance. Conclusion: An increased knowledge about the influence of stressors, the social reactions, and the adaptation can help healthcare personnel to identify and better understand concerns of other patients and spouses during different time phases of the initial 6-month period of CPAP-treatment.
29.	Eide, L. S. P., et al. (author) Urinary catheter use and delirium after aortic valve therapy 2017 In: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 16:Suppl. 1, s. S3-S4 Journal article (peer-reviewed)abstract Background: Indwelling urinary catheters (IUC) are valuable devices that help to control and monitor urine output under and after invasive procedures. However, adverse outcomes might arise following use of IUC, and several studies show that IUC can be a risk factor for postoperative delirium. Delirium is an acute and fluctuating change in attention and cognition that might lead to extended hospital stay, and more morbidity and mortality. The association between delirium and the duration of IUC use in octogenarians after Surgical Aortic Valve Replacement (SAVR) and Transcatheter Aortic Valve Implantation (TAVI) remains to be established.Purpose: To determine if the duration of IUC use after SAVR or TAVI predicts the development of delirium in older people.Methods: This is a prospective cohort study of octogenarian patients (N=136) in a tertiary university hospital. Inclusion criteria: ⩾80 years, severe aortic stenosis, and elective TAVI or SAVR. Exclusion criteria: Inability to speak Norwegian or declined consent to participate in the study. The Mini-Mental State examination was used to evaluate global cognitive function at baseline. The Confusion Assessment Method allowed the identification of delirium during five postoperative days. The duration of IUC use was collected from patients’ medical records. The predictive effect of IUC in the development of delirium was examined using multiple regression.Results: The majority (57%) of patients was female, and 46% received TAVI. Patients in the TAVI group were older (85 vs. 82 years-old, P<0.001), had more comorbidities (2.5 vs.1.8, P=0.001) and higher logistic EuroSCORE (19.6 vs. 9.4,P<0.001). Delirium was present in 66% of patients treated with SAVR vs. 44% of those receiving TAVI. The average duration of IUC use in SAVR patients with delirium was 66 hours (SD=29) compared to 59 hours (SD=27) in those without delirium (P=0.307), and in TAVI patients with delirium was 58 hours (SD=38) compared to 32 hours (SD=15) for those without delirium (P=0.001). Multivariate regression analysis shows that lower cognitive function (P=0.040), type of aortic valve treatment (P=0.043) and longer of IUC use (P=0.002) predicted the development of delirium.Conclusion: In octogenarian patients undergoing aortic valve treatment, the duration of IUC use can predict delirium. Further research is needed to mitigate the risks of delirium in patients undergoing aortic valve treatment.
30.	Elmqvist, C, et al. (author) More than medical treatment : the patient's first encounter with prehospital emergency care 2008 In: Accident and Emergency Nursing. - : Elsevier Ltd. - 0965-2302 .- 1532-9267 .- 1755-599X .- 1878-013X. ; 16:3, s. 185-192 Journal article (peer-reviewed)abstract A common feature of emergency care services is the short, fragmented encounters with great demands for rapid treatment and efficiency. The aim of this study was to describe and understand the patient's first encounter with prehospital emergency care as experienced by the patient and the first responders. A lifeworld perspective was used in four different traumatic situations. The data consisted of 18 unstructured interviews with patients and first responders. The phenomenological analysis showed that the concept of lifesaving means more than just upholding vital functions. The patient needs to retain his/her identity by means of a communicative contact, to be confirmed in the lived encounter and to recapitulate the elapsed time of the unexpected event in order to regain a state of equilibrium. Five constituents further described the variations of the patients' first encounter; the encounter with the helpless injured body, the confirming existential encounter, the encounter while waiting, the lived encounter and the recapitulated encounter. This finding highlights the importance of a new understanding about empowering the patient with narratives throughout the whole caring process. There are also implications for educating personnel and students in emergency care about the first encounter with the patient in emergency care where the senses, the time and the narrative are essential elements that are unique for each person.
31.	Fridlund, Bengt, 1952-, et al. (author) Kritisk incident-teknik 2023. - 3. uppl In: Vetenskaplig teori och metod. - Lund : Studentlitteratur AB. - 9789144161389 ; , s. 185-196 Book chapter (other academic/artistic)
32.	Fridlund, Bengt, 1952- (author) Nursing interventions : when are they the rule rather than the exception? 2007 In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 6:4, s. 253-254 Journal article (pop. science, debate, etc.)
33.	Fridlund, Bengt, 1952- (author) Qualitative methods in healthcare research : Some issues related to utilisation and scrutiny 1998 In: Care of the Critically Ill. - London : Nature Publishing Group. - 0266-0970. ; 14:6, s. 212-214 Research review (peer-reviewed)abstract The use of qualitative methods (QM) in investigations within the healthcare area has increased dramatically around the world during the past decade. In Sweden, the Health and Medical Services Act has crucially influenced the development of QM from a second rate analysis method to a valued and compatible method to established statistical approaches. This article aims to describe and explain nine methodological issues related to QM based on science theory topics and content valuation premises. © Copyright 2004 Elsevier Science B.V., Amsterdam. All rights reserved.
34.	Gavois, Helena, 1952-, et al. (author) Mental health professional support in families with a member suffering from severe mental illness : a grounded theory model 2006 In: Scandinavian Journal of Caring Sciences. - Oxford : Blackwell Publishing. - 0283-9318 .- 1471-6712. ; 20, s. 102-9 Journal article (peer-reviewed)abstract The aim of this study was to develop a model of mental health professional (MHP) support based on the needs of families with a member suffering from severe mental illness (SMI). Twelve family members were interviewed with the focus on their needs of support by MHP, then the interviews were analyzed according to the grounded theory method. The generated model of MHP support had two core categories: the family members’ process from crisis to recovery and their interaction with the MHP about mental health/illness and daily living of the person with SMI. Interaction based on ongoing contact between MHP and family members influenced the family members’ process from crisis towards recovery. Four MHP strategies – being present, listening, sharing and empowering – met the family members’ needs of support in the different stages of the crisis. Being present includes early contact, early information and protection by MHP at onset of illness or relapse. Listening includes assessing burden, maintaining contact and confirmation in daily living for the person with SMI. Sharing between MHP and family members includes co-ordination, open communication and security in daily living for the person with SMI. Finally, the MHP strategy empowering includes creating a context, counselling and encouraging development for the family members. The present model has a holistic approach and can be used as an overall guide for MHP support in clinical care of families of persons with SMI. For future studies, it is important to study the interaction of the family with SMI and the connection between hope, coping and empowerment.
35.	Haraldsson, Katarina, 1958, et al. (author) Evaluation of a school-based health promotion programme for adolescents aged 12-15 years with focus on well-being related to stress. 2008 In: Public health. - London : Elsevier BV. - 0033-3506 .- 1476-5616. ; 122:1, s. 25-33 Journal article (peer-reviewed)abstract OBJECTIVE: The aim of this study was to evaluate a school-based adolescent health promotion programme with focus on well-being related to stress. STUDY DESIGN: Interventional and evaluative with tests before and after the intervention. The study was performed in two secondary schools in a town on the west coast of Sweden. METHODS: A health promotion programme comprising massage and mental training was implemented for a single academic year in one school (intervention school, 153 participants) in order to strengthen and maintain well-being. No intervention was implemented in the other school (non-intervention school, 287 participants). A questionnaire was developed and tested, resulting in 23 items distributed across the following six areas: self-reliance; leisure time; being an outsider; general and home satisfaction; school satisfaction; and school environment. RESULTS: A pre- and postintervention comparison of the six areas was made within each school. In the intervention school, the boys maintained a very good or good sense of well-being related to stress in all six areas, while the girls' sense of well-being was maintained in five areas and deteriorated in one area. In the non-intervention school, the boys maintained a very good or good sense of well-being related to stress in four areas and deteriorated in two areas, while the girls' sense of well-being was maintained in two areas and deteriorated in four areas. CONCLUSION: Massage and mental training helped to maintain adolescents' very good or good sense of well-being related to stress. A questionnaire with acceptable validity and reliability was developed and tested in order to evaluate the health promotional approach. However, there is a need for further study to develop both the intervention and the questionnaire for young people.
36.	Henricson, Maria, 1972-, et al. (author) The validation of the Supervision of Thesis Questionnaire (STQ) 2018 In: Nurse Education Today. - : Elsevier. - 0260-6917 .- 1532-2793. ; 65, s. 11-16 Journal article (peer-reviewed)abstract Background: The supervision process is characterized by differences between the supervisors’ and the students’ expectations before the start of writing a bachelor thesis as well as after its completion. A review of the literature did not reveal any scientifically tested questionnaire for evaluating nursing students’ expectations of the supervision process when writing a bachelor thesis.Objectives: The aim of the study was to determine the construct validity and internal consistency reliability of a questionnaire for measuring nursing students’ expectations of the bachelor thesis supervision process.Design & Methods: The study had a developmental and methodological design carried out in four steps including construct validity and internal consistency reliability statistical procedures: construction of the items, assessment of face validity, data collection and data analysis.Settings & Participants: This study was conducted at a university in southern Sweden, where students on the “Nursing student thesis, 15 ECTS” course were consecutively selected for participation. Of the 512 questionnaires distributed, 327 were returned, a response rate of 64%.Results: Five factors with a total variance of 74% and good communalities, ≥0.64, were extracted from the 10-item STQ. The internal consistency of the 10 items was 0.68. The five factors were labelled: The nature of the supervision process, The supervisor's role as a coach, The students’ progression to self-support, The interaction between students and supervisor and supervisor competence.Conclusions: A didactic, useful and secure questionnaire measuring nursing students’ expectations of the bachelor thesis supervision process based on three main forms of supervision was created.
37.	Henriksen, Eva, 1952- (author) Understanding in Healthcare Organisations- a prerequisite for development 2002 Doctoral thesis (other academic/artistic)abstract This study proposes that poor understanding of the structures, processes and outcomes of organisations seriously hampers collaboration between professional groups in care organisations. Three care settings were investigated: follow-up of patients with heart disease, an intensive care unit and care services for older people. The overall aim was to investigate how people understand structures, processes and outcomes in care organisations. The participants were patients, patient representatives, healthcare professionals, managers and politicians. A qualitative approach was used. Thematic analysis and grounded theory were employed in analysing the data. Despite considerable efforts, no major changes took place over a 7-year period as to how cardiac follow-up services were understood. The system of cardiac follow-up services was found fragmented in its organisation and in the way individuals understood it. The results indicate that care professionals, patients and leaders have dissimilar understandings. The data suggest that care is organised from a professional-centred perspective rather than from a holistic worldview of the patients’ total context. Leaders in intensive care perceive their organisation as a learning organisation. However, in daily work healthcare tends to function to what can be described as a mass production approach to care. This state of conflict caused confusion and chaos among the leaders. The municipal elderly care services and the county council’s geriatric organisation had difficulties in co-ordination. Older people were perceived as passive recipients of healthcare, rather than as consumers whose well being and outcome were a reflection to the quality of the service. The study concludes that despite the major changes that have taken place in the Swedish health and elderly care organisations over the past years, healthcare professionals’ understanding of their work has gone largely unchanged. Their understanding of care structures and processes did not change despite outside pressures. Lack of understanding of what others understand hampers development with the result that care organisations risk stagnation.
38.	hildingh, cathrine, 1949-, et al. (author) A 3-year follow-up of participation in the Heart & Lung School after a cardiac event 2004 Conference paper (peer-reviewed)
39.	hildingh, cathrine, 1949-, et al. (author) Peer support groups after a cardiac event, a 12-month follow-up 2002 Conference paper (peer-reviewed)
40.	Hildingh, Cathrine, 1949-, et al. (author) Social network and experiences of social support among women 12 months after their first myocardial infarction 1997 In: International Journal of Rehabilitation and Health. - New York, NY : Kluwer Academic Publishers. - 1068-9591 .- 1573-1537. ; 3:2, s. 131-142 Journal article (peer-reviewed)abstract Few studies exist concerning the situation of women after a myocardial infarction (MI). The aim of this longitudinal study was to map out women’s social network and social support 12 months after a first MI. A sample of 200 consecutively chosen female patients below 70 years of age (ranges 35-70 years) answered a similar questionnaire on different occasions: before hospital discharge and at 3 and 12 months after the MI event. We analyzed the data with descriptive and inferential statistics. The results showed that 90% of the women had network members available who provided them with support. The strongest bonds existed between patient and close relatives, such as children, parents, or siblings, and then with spouse and intimate friends, in that order. The bonds between patients and health care professionals were not strong at the time of the MI, but subjects reported a significant increase (p < .0007) during the following 12 months. The need for material support was highest directly after the MI and for informational support 3 months later, and after 12 months the need for belonging dominated. More than half of the women had participated in secondary prevention programs. Further research is necessary to be able to understand enabling and limiting aspects of social support in connection with recovery from MI. © 1997 Springer Nature Switzerland AG. Part of Springer Nature.
41.	Isaksson, Rita, et al. (author) Evaluation of an oral health education program for nursing personnel in special housing facilities for the elderly. Part II : Clinical aspects 2000 In: Special Care in Dentistry. - Hoboken, NJ : Wiley-Blackwell Publishing Inc.. - 0275-1879 .- 1754-4505. ; 20:3, s. 109-113 Journal article (peer-reviewed)abstract In Sweden, efforts are being made to create strategies for evaluating realistic dental treatment needs among the elderly, who are retaining more natural teeth. These strategies focus on the importance of maintaining adequate oral hygiene. Elderly in long-term-care facilities often depend on nursing personnel for carrying out daily oral hygiene procedures. Therefore, the nursing personnel’s knowledge about and attitudes toward oral health make oral health education for health care professionals an important concern. The purpose of this study was to evaluate the clinical oral health outcome in residents after their caregivers had undergone a one-session, four-hour oral health education program. The study consisted of an intervention with a pre- and a post-test and was carried out in three municipalities in the southwestern part of Sweden. A newly developed oral health screening protocol was carried out for 170 subjects living in long-term-care facilities both before and 3-4 months after nursing personnel had attended an oral health education program. Following the Intervention, a statistically significant improvement was recorded for changes In oral mucosal color, a modified plaque index which measured oral hygiene status, and a mucosal index which recorded mucosal inflammation. This study indicated that a limited, one-session, four-hour oral health education, offered to caregivers within long-term-care facilities, had a positive impact on the oral health status of residents.
42.	Jørgensen, Lene Bastrup, et al. (author) Intacting Integrity in Coping with Health Issues 2017 In: The Grounded Theory Review. - : Sociology Press. - 1556-1542 .- 1556-1550. ; 16:1, s. 10-25 Journal article (peer-reviewed)abstract The aim of this study was to discover and elaborate a general substantive theory (GST) on the multidimensional behavioral process of coping with health issues. Intacting integrity while coping with health issues emerged as the core category of this GST. People facing health issues strive to safeguard and keep intact their integrity not only on an individual level but also as members of a group or a system. The intacting process is executed by attunement, continuously minimizing the discrepancy between personal values, personal health, self-expectations, and external conditions as health-and culturally-related recommendations and demands. Multifaceted coping strategies are available and used as implements in the attuning process.
43.	Koinberg, Inga-Lill, 1955-, et al. (author) Nurse-led follow-up on demand or by a physician after breast cancer surgery : A randomised study 2004 In: European Journal of Oncology Nursing. - London : Churchill Livingstone. - 1462-3889 .- 1532-2122. ; 8:2, s. 109-117 Journal article (peer-reviewed)abstract The value of routine follow-up with frequent visits to a breast cancer specialist - both in terms of detection of recurrence and patient satisfaction - has been questioned. The aim of this study was to compare nurse-ted follow-up on demand versus physician follow-up after breast cancer treatment with regards to patients’ well-being, satisfaction, access to medical care and medical safety. Two hundred and sixty-four consecutively selected women with newly diagnosed breast cancer, classified as UICC stage I or stage II, were randomised to follow-up at two hospitals in Sweden, either by routine medical follow-up, the physician group (PG, n = 131), or on demand by a specialist nurse, the nurse group (NG, n = 133). Measures were done at baseline and twice a year over a period of 5 years by means of a questionnaire containing the Hospital Anxiety and Depression Scale (HAD), and the Satisfaction and Accessibility (SaaC) scale. Number of contacts with the health care services, number of diagnostic procedures, and time to recurrence or death were monitored. The ratings of HAD and SaaC did not show any statistically significant differences between the groups. The levels of anxiety and depression were generally low and levels of patient satisfaction high. There were no differences between the groups concerning time to recurrence or death. This study indicates that women with breast cancer in stages I to II can be followed up by a specialist nurse with high patient satisfaction and good medical safety. © 2004 Published by Elsevier Ltd.
44.	Kristén, Lars, 1956-, et al. (author) Benefits of sport activities for disabled children and youth. / Die Bedeutung des Sports fuer behinderte Kinder und Jugendliche 2003 In: Towards a society for all through adapted physical activity. - Wien : Institut für Sportwissenschaft. ; , s. 394-398 Conference paper (peer-reviewed)abstract Describes a phenomenography-based study that attempted to show how children and adolescents with disabilities felt about the consequences of taking part in sports activities. Provides information about the sports program involved, informants, interviews, and results.
45.	Kristén, Lars, 1956-, et al. (author) Conceptions of Children and Adolescents with Physical Disabilities about Their Participation in a Sports Programme 2002 In: European Physical Education Review. - London : Sage Publications. - 1356-336X .- 1741-2749. ; 8:2, s. 139-156 Journal article (peer-reviewed)abstract Sport and leisure can be of significant importance for the well-being and social support of children and adolescents with physical disabilities. However, it has been established that organized sport sometimes has a social construction, in that those without disabilities are favoured at the expense of others. The aim of this study was, therefore, to describe conceptions of children and adolescents with physical disabilities about their participation in a sports programme. Using questions based on a holistic view of the human being, 20 children and adolescents were interviewed. The method of analysis used was inspired by phenomenography. Six categories emerged: Getting new friends, learning, strengthening one’s physique, becoming someone, experiencing nature and having a good time. The findings show the great diversity of sports participation. Further, the conceptions mirror the difficulty of dividing people into groups and of delimiting important areas. The findings highlight the importance of programmes where actors from different sections of society cooperate. Even if the findings cannot be generalized, they nevertheless demonstrate that physical activity involves many positive factors both at the individual and at the society level. © 2002, North West Counties Physical Education Association and SAGE Publications. All rights reserved.
46.	Kristén, Lars, 1956-, et al. (author) Parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities 2003 In: European Physical Education Review. - London : Sage Publications. - 1356-336X .- 1741-2749. ; 9:1, s. 23-41 Journal article (peer-reviewed)abstract Parents of children and adolescents with physical disabilities have an important role in strengthening and supporting their children in everyday life. Children and adolescents with physical disabilities do not ordinarily have natural access to club activities, nor do they receive the same support for physical activities as their peers without disabilities. The aim of this Swedish study was to describe parents' conceptions of the influences of participation in a sports programme on their children and adolescents with physical disabilities. The data were collected from 20 parents of children and adolescents with disabilities in the 9-15 year age group through interviews based on a holistic view. The method of analysis used was inspired by phenomenography. Three descriptive categories emerged: achieving good health, being part of a social group and learning a sporting activity. The findings show that the parents regarded sport as a form of health education and as a means for their children to achieve increased participation in society. The findings also show that the learning process was important for empowering the children to influence their life situation.
47.	Larsson, Ingrid, 1968-, et al. (author) Biological therapy could be monitored by a rheumatology nurse-led clinic without any differences in outcome – a randomised controlled study 2012 Conference paper (peer-reviewed)abstract Background: Patients with rheumatic diseases treated with biological therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients who are in low disease activity or remission.Objectives: To compare treatment outcomes from a nurse-led rheumatology clinic and a rheumatologist clinic for patients treated with biological therapy with low disease activity or in remission.Methods: In a prospective controlled study 107 patients were randomised into two groups with six months follow up to a rheumatology nurse (intervention group; n=53) or to a rheumatologist (control group; n=54). Inclusion criteria were ongoing biological therapy and Disease Activity Score 28 (DAS28) ≤3.2. All patients met the rheumatologist at inclusion and after 12 months. In the nurse-led rheumatology clinic the patients´ disease activity was assessed by examination of tender or swollen joints and laboratory tests. The rheumatology nurse also had a dialogue concerning the patient’s needs with regard to drug therapy, smoking habits and psychosocial aspects. After 12 months 97 patients completed the study. Main outcome was disease activity measured by DAS28.Results: Patients had mean age of 55.4 years and disease duration of 16.7 years. DAS28 was 2.1. At inclusion there were no significant differences in DAS28 between the groups. There were no differences (p=0.67) in change of DAS28 between the intervention group (0.14) or control group (0.20) from inclusion to 12 months.Conclusions: In patients with low disease activity biological therapy could be monitored by a nurse-led rheumatology clinic without any differences in outcome as measured by DAS28.
48.	Larsson, Ingrid, 1968-, et al. (author) Patients' dependence on a nurse for the administration of their intravenous anti-TNF therapy : A phenomenographic study 2009 In: Musculoskeletal care. - London : Wiley. - 1478-2189 .- 1557-0681. ; 7:2, s. 93-105 Journal article (peer-reviewed)abstract Background: Pain, stiffness and functional restriction of the joints are the main problems for many patients with inflammatory rheumatic conditions. When conventional drugs fail to delay the development of the disease, the patient may require biological treatment such as anti-TNF therapy. Some biological drugs are administered in the form of intravenous infusions and thus the patient is obliged to attend a clinic in order to receive his/her medication, which can affect everyday life as well as independence. It is therefore important to focus on the patient perspective.Aim: The aim of this study was to describe variations in how patients with rheumatic conditions conceive their dependence on a nurse for the administration of their intravenous anti-TNF therapy.Method: The study had a descriptive qualitative design with a phenomenographic approach. Interviews were conducted with 20 patients.Result: Three descriptive categories and seven sub-categories emerged: Dependence that affords security (encountering continuity, encountering competence and obtaining information); Dependence that creates involvement (being allowed influence and being given freedom); Dependence that invigorates (obtaining relaxation and encountering the environment).Conclusion: The patients had not reflected on the fact that they were dependent on a nurse for the administration of their intravenous anti-TNF therapy, which may be due to their possibility to influence the treatment. The patients' needs should constitute the basis for the nurse's role in the provision of care. Copyright (c) 2008 John Wiley & Sons, Ltd.
49.	Larsson, Ingrid, 1968-, et al. (author) Sjuksköterskemottagning för patienter med en reumatisk sjukdom behandlade med biologiska läkemedel – ett randomiserat, kontrollerat försök jämförande sjuksköterskemottagning med läkarmottagning 2012 Conference paper (peer-reviewed)abstract Bakgrund Målet med behandling av reumatiska sjukdomar är att ta kontroll över ledsmärta och svullnad, reducera ledskador samt förebygga funktionsnedsättningar. För patienter med otillräcklig respons på traditionella läkemedel har forskningen inom reumatologin varit av stor betydelse och medfört utveckling av biologiska läkemedel. Behandling med biologiska läkemedel för patienter med reumatisk sjukdom följs vanligtvis upp av en reumatolog. För patienter som är lågaktiva i sin sjukdom eller i remission har uppföljning via en sjuksköterskemottagning föreslagits. Syfte var att jämföra sjuksköterskemottagning med läkarmottagning avseende behandlingsresultat för patienter behandlade med biologiska läkemedel med låg eller ingen sjukdomsaktivitet.Metod Ett randomiserat kontrollerat öppet försök med 12 månaders uppföljning genomfördes mellan oktober 2009 och augusti 2011. Avsikten var att ersätta ett av de två årliga läkarbesöken med ett sjuksköterskebesök. En sjuksköterskemottagning utformades utifrån en personcentrerad vård med patientens behov i fokus. Inklussionskriterier var patienter med en reumatisk sjukdom behandlade med biologiskt läkemedel och en sjukdomsaktivitet, Disease Active Score 28 (DAS28) ≤3.2. Av 107 patienter randomiserades 53 patienter till uppföljning av sjuksköterska och 54 patienter till uppföljning av läkare. Hypotesen var att behandlingsresultatet på en sjuksköterskemottagning inte skulle vara sämre än på en läkarmottagning vid 12 månaders uppföljning. Huvudutfallsmått var DAS28.Resultat Efter 12 månader hade 47 patienter i sjuksköterskegruppen och 50 patienter i läkargruppen fullföljt studien. Patienterna hade en medelålder på 55.4 år, sjukdomsduration på 16.7 år och DAS28 var 2.1. Det fanns ingen statistiskt signifikant skillnad mellan grupperna. Efter 12 månader var det inte någon statistisk signifikant skillnad (p=0.66) i förändring av DAS28 mellan sjuksköterskegruppen (0.14) eller läkargruppen (0.20). I utfallsmåtten sänka, svullna och ömma leder, global hälsa och smärta (VAS) eller Health Assessment Questionnaire (HAQ) var det inte heller någon statistisk signifikant skillnad i förändring efter 12 månader mellan grupperna. Båda grupperna var lika nöjda med vården och säkra på att få hjälp från reumatologmottagningen vid problem med lederna.Sammanfattning Patienter med en stabil reumatisk sjukdom behandlade med biologiskt läkemedel kan följas upp vid en sjuksköterskemottagning utan någon skillnad i behandlingsresultat med avseende på DAS28.
50.	Larsson, Ingrid, 1968-, et al. (author) Treatment Outcomes From a Nurse-Led Rheumatology Clinic in Monitoring of anti-TNF Therapy – a Randomised Controlled Trial 2012 In: Arthritis and Rheumatism. - Hoboken, NJ : John Wiley & Sons. - 0004-3591 .- 1529-0131. ; 64:10, s. S667-S667 Journal article (peer-reviewed)abstract Background: Patients with chronic inflammatory arthritis (CIA) treated with anti-TNF therapy are usually followed up by rheumatologists. Nurse-led rheumatology clinics have been proposed for patients with low disease activity or in remission. The purpose of this trial was to compare treatment outcomes from a nurse-led rheumatology clinic and a rheumatologist clinic for patients undergoing anti-TNF therapy with low disease activity or in remission.Methods: A randomized controlled trial (RCT) with a 12-month follow-up was conducted with 107 patients randomised into two groups with a 6-month follow up to a nurse-led rheumatology clinic based on a person-centred care (intervention group; n=53) or to a rheumatologist-led clinic (control group; n=54). The intention of the interventional trial was to replace one of the two annual rheumatologist monitoring visits by a nurse-led rheumatology monitoring visit for patients undergoing anti-TNF therapy. Inclusion criteria were patients undergoing anti-TNF therapy and Disease Activity Score 28 (DAS28) ≤3.2. The hypothesis was that the outcomes from nurse-led clinic will not be inferior to those obtained by rheumatologist-led clinic at 12-month follow-up. Primary outcome was disease activity measured by DAS28.Results: After 12 months 47 patients in the intervention group and 50 patients in the control group completed the trial and there were no differences (p=0.66) in mean change of DAS28 between the intervention or control group. There were no differences (p>0.05) in mean change in Visual Analogue Scales (VAS) for pain, Health Assessment Questionnaire (HAQ), satisfaction or security with the rheumatology care between the two groups, see table.Conclusion: In monitoring of anti-TNF therapy treatment outcomes for patients at a nurse-led rheumatology clinic are not inferior to those obtained by rheumatologist-led clinic at 12-month follow-up. The follow-up care of anti-TNF therapy may advantageously be performed by a nurse-led clinic based on a person-centred care. The results from this trial demonstrated that patients with CIA undergoing anti-TNF therapy, with low disease activity or in remission, could be monitored by a nurse-led rheumatology clinic without any differences in outcome as measured by DAS28.

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