| 1. |
- Boström, Barbro, et al.
(author)
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Cancer patients' experiences of care related to pain management before and after palliative care referral
- 2004
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In: European Journal of Cancer Care. - : Wiley-Blackwell. - 0961-5423 .- 1365-2354. ; 13:3, s. 238-245
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Journal article (peer-reviewed)abstract
- Pain is the main problem for patients with cancer referred to palliative care (PC). Pain management in PC requires a multidimensional approach. A questionnaire was used to determine cancer patients' experiences of care related to pain management, before and after being referred to PC, and to also discover possible correlations between pain control and other aspects of care. Seventy-five consecutive patients from two PC teams were included in the study. The patients had experienced a statistically significant (P < 0.01) improvement in care after being referred to PC, despite the fact that pain control had not been optimized. Patients' description of 'pain control' after being referred to PC had a statistically significant correlation with their 'feeling of security' and 'continuity of care' throughout the same period. The conclusion is that care provided in PC is vital to successful pain management. Pain control depends not only on analgesics but also on many other aspects of care provided by the nurse. Continuity of care and the opportunity to talk increases the patients' feeling of security, which is also of utmost importance to successful pain management.
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| 2. |
- Boström, Barbro, et al.
(author)
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Cancer-related pain in palliative care : patients' perceptions of pain management
- 2004
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In: Journal of Advanced Nursing. - : Blackwell Publishing. - 0309-2402 .- 1365-2648. ; 45:4, s. 410-419
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Journal article (peer-reviewed)abstract
- Background: Pain is still a significant problem for many patients with cancer, despite numerous, clear and concise guidelines for the treatment of cancer-related pain. The impact of pain cognition on patients' experiences of cancer-related pain remains relatively unexplored. Aim: The aim of this study was to describe how patients with cancer-related pain in palliative care perceive the management of their pain. Method: Thirty patients were strategically selected for interviews with open-ended questions, designed to explore the pain and pain management related to their cancer. The interviews were analysed using a phenomenographic approach. Findings: Patients described 10 different perceptions of pain and pain management summarized in the three categories: communication, planning and trust. In terms of communication, patients expressed a need for an open and honest dialogue with health care professionals about all problems concerning pain. Patients expressed an urgent need for planning of their pain treatment including all caring activities around them. When they felt trust in the health care organization as a whole, and in nurses and physicians in particular, they described improved ability and willingness to participate in pain management. While the findings are limited to patients in palliative care, questions are raised about others with cancer-related pain without access to a palliative care team. Conclusion: The opportunity for patients to discuss pain and its treatment seems to have occurred late in the course of disease, mostly not until coming in contact with a palliative care team. They expressed a wish to be pain-free, or attain as much pain relief as possible, with as few side effects as possible.
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| 3. |
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| 4. |
- Broström, Anders, 1963-, et al.
(author)
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Sleep difficulties, daytime sleepiness, and health-related quality of life in patients with chronic heart failure
- 2004
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In: Journal of Cardiovascular Nursing. - Philadelphia : Lippincott Williams & Wilkins. - 0889-4655 .- 1550-5049 .- 1474-5151 .- 1873-1953. ; 19:4, s. 234-242
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Journal article (peer-reviewed)abstract
- Background: Normal sleep changes with age in duration, fragmentation, and depth. The prevalence of insomnia is high in the elderly general population. In patients with chronic heart failure (HF) objective sleep assessments have shown disturbances such as a shorter total duration of sleep, frequent arousals, and sleep stage changes. Objective: To describe self- assessed sleep difficulties, daytime sleepiness, and their relation to health-related quality of life (HRQOL) in men and women with HF, as well as to make a comparison to data from a norm population. Methods: Cross-sectional design including 223 patients with HF, New York Heart Association classification II-IV, assessed using the Uppsala Sleep Inventory-Chronic Heart Failure, the Epworth Sleepiness Scale, Medical Outcomes Study 36-Item Short Form Health Survey, and Minnesota Living With Heart Failure Questionnaire. Results: The most commonly reported sleep difficulties were initiating and maintaining sleep. The ratio of habitual sleep to the amount of estimated need for sleep was significantly shorter for women (P < .05), and the number of awakenings per night was significantly increased for men (P < .001). A total of 21% suffered from daytime sleepiness. Patients suffering from difficulties maintaining sleep, initiating sleep, and early morning awakenings reported significantly lower HRQOL in almost all dimensions of the SF-36 (P < .05-P < .001) compared to patients without sleeping difficulties, as well as to the normal population. The disease-specific Minnesota living With Heart Failure Questionnaire showed significantly reduced (P < .05-P < 001) HRQOL as measured by the total and subscale scores for patients suffering from sleeping difficulties compared to patients without sleeping difficulties. Conclusion: Patients with, HF have a reduced HRQOL especially if difficulties maintaining sleep, initiating sleep, and early morning awakenings are involved.
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| 5. |
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| 6. |
- Flemme, Inger, 1947-, et al.
(author)
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Livskvalitet och upplevda chocker under ICD-behandling : en 5-års uppföljning
- 2004
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Conference paper (peer-reviewed)abstract
- ICD–behandling ökar överlevnaden hos patienter (pat), som har överlevt en malign ventrikulär tachyarytmi. Pats livskvalitet (QoL) har angivits variera betydande och långtidseffekterna är ännu mindre väl kända. Vi följde ett antal konsekutiva pat under minst 5 år med avseende på livskvaliteten.Metod. Pat undersöktes med MUIS-C (Mishel Uncertainty in Illness Scale – community version) och QLI-CV (Quality of Life Index – cardiac version) och multipel regressionsanalys användes hos 35 patienter. Formulären fylldes i vid tre tillfällen: före implantationen, efter 1 och 5 år. Pats egen uppfattning om antalet upplevda chocker oavsett anledning noterades.Patienter. Ur en grupp pat, som tidigare undersöktes efter 1 år, hade 39 pat överlevt med sin ICD i minst 5 år. Av dessa avböjde tre deltagande i uppföljningen utan orsak och en pga cancer. Alla pat hade fått sin ICD på indikationen sekundär prevention. Resultat. Under det första året rapporterade 13 pat totalt 79 chocker och 22 pat ingen chock. Tio pat hade ingen chock vare sig efter 1 eller 5 år, och deras QoL var likvärdig med dem som hade haft ≤5 chocker. Tre pat rapporterade ≥6 chocker och hade sänkt QoL. Mellan år 1 och 5 rapporterade 20 pat 94 shocker och 15 pat ingen shock. Det var ingen skillnad mellan pat med eller utan chocker i deras QoL år 5 vs. år 1. Pat med chocker blev mindre besvärade med tiden.QoL var generellt sänkt år 1 vs baseline. En försämring i den socio-ekonomiska domänen sågs år 1 men var förbättrad år 5. En försämring i familjedomänen var oförändrad vid 1 och 5 år vs. baseline. En förbättring av otrygghet noterades vid 5 år vs år 1.Konklusioner. Pat med ICD mådde bättre år 5 än år 1 efter implantationen. Livskvaliteten var rimligt god 5 år efter implantationen och pat kände sig mer trygga och upplevde sin ICD som en livräddare. Pat med många chocker under det första året mådde sämre än övriga. Under resten av observationsperioden var chocktätheten lägre, möjligen delvis pga farmakologisk behandling, och pat upplevde mindre besvär av chockerna.
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| 7. |
- Flemme, Inger, et al.
(author)
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Quality of profile 1 and 5 years after ICD implantation
- 2004
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In: European Journal of Cardiovascular Nursing. - Amsterdam : Elsevier. - 1873-1953.
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Conference paper (peer-reviewed)abstract
- Aim: Treatment with implantable cardioverter defibrillators (ICDs) increases survival in patients suffering from ventricular tachyarrhythmias. The physiologic effects of having an ICD implanted are well-known but there is still limited knowledge about quality of life (QoL), especially in a long-term perspective. Therefore, the aim of this prospective, follow-up study was to describe and compare uncertainty and QoL at year 1 and year 5 after implantation in patients living with an ICD.Methods: The Mishel Uncertainty in Illness Scale-community version (MUIS-C) and Quality of Life Index-cardiac version (QLI) was used for 35 patients, living with an ICD in average 6 years 9 months. Higher scores indicate higher uncertainty and QoL.Results: An improvement in uncertainty was found at year 5 compared to year 1 (p=0.009), and at year 5 compared to baseline (p = 0.009). Overall QoL decreased at year 1 compared to baseline (p = 0.033). QoL in the socioeconomic domain decreased at year 1 compared to baseline (p = 0.006), and increased at year 5 compared to year 1 (p=0.027). QoL in the family domain decreased at year 5 compared to year 1 (p=0.039), and at year 5 compared to baseline (p=<0.001).Conclusion: Patients with ICD feel better at year 5 than at year 1. The QoL is reasonable good 5 years after implant once they have passed the first years and adapted to lifestyle changes, and patients are more certain and perceive the ICD as a parachute of life.
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| 8. |
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| 9. |
- Fridlund, Bengt
(author)
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Disseminating cardiovascular nursing.
- 2004
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In: European Journal of Cardiovascular Nursing. - : Oxford University Press (OUP). - 1474-5151 .- 1873-1953. ; 3:1, s. 1-2
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Journal article (peer-reviewed)
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| 10. |
- Hildingh, Cathrine, et al.
(author)
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A 3-year follow-up of participation in peer support groups after a cardiac event
- 2004
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In: European Journal of Cardiovascular Nursing. - London : Sage Publications. - 1474-5151 .- 1873-1953. ; 3, s. 315-20
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Journal article (peer-reviewed)abstract
- Secondary prevention is an important component of a structured rehabilitation programme following a cardiac event. Comprehensive programmes have been developed in many European countries, the vast majority of which are hospital based. In Sweden, all patients with cardiac disease are also given the opportunity to participate in secondary prevention activities arranged by the National Association for Heart and Lung Patients [The Heart & Lung School (HL)]. The aim of this 3-year longitudinal study was to compare persons who attended the HL after a cardiac event and those who declined participation, with regard to health aspects, life situation, social network and support, clinical data, rehospitalisation and mortality. Totally 220 patients were included in the study. The patients were asked to fill in a questionnaire on four occasions, in addition to visiting a health care center for physical examination. After 3 years, 160 persons were still participating, 35 of whom attended the HL. The results show that persons who participated in the HL exercised more regularly, smoked less and had a denser network as well as more social support from nonfamily members than the comparison groups. This study contributes to increased knowledge among healthcare professionals, politicians and decision makers about peer support groups as a support strategy after a cardiac event.
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