| 1. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Detecting decreased sexual health with MDHAQ-S
- 2013
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Ingår i: Health (Irvine). - 1949-4998 .- 1949-5005. ; :5, s. 38-47
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Tidskriftsartikel (refereegranskat)abstract
- There are instruments that measure sexual function or sexual health for persons with RA, but since sexual health is a sensitive issue, the hypothesis is that it would be easier to have a standard questionnaire that could indicate the need for communication about sexual health issues instead of an extra questionnaire with more detailed questions on sexual health. The aim of the study is to find out whether sexual health difficulties can be screened by factors included in the MDHAQ-S for persons with RA. This study explores the relation between factors included in the MDHAQ-S and the Sexual Health Questionnaire (QSH) using a mixed methods design combining quantitative and qualitative data. The MDHAQ-S covers sexual health issues, not only by using the question on sexual health, but also on other factors included in the questionnaire such as increased pain, fatigue, depression, anxiety, physical capacity, level of physical activity and body weight. To explore decreased sexual arousal, decreased sexual satisfaction and decreased sexual well-being, in-depth interviews must be held with persons with RA, either using a sexual health questionnaire or in a clinical interview.
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| 2. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Evidence-based practice in a multiprofessional context
- 2012
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Ingår i: International Journal of Evidence-Based Healthcare. - : Ovid Technologies (Wolters Kluwer Health). - 1744-1595 .- 1744-1609. ; 10:2, s. 117-125
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Tidskriftsartikel (refereegranskat)abstract
- Background Healthcare today is a complex system with increasing needs of specific knowledge of evaluation of research and implementation into clinical practice. A critical issue is that we all apply evidence-based practice (EBP) with standardised methods and continuing and systematic improvements. EBP includes both scientific and critical assessed experience-based knowledge. For the individual, this means applying evidence-based knowledge to a specific situation, and for the organisation, it means catering for a systematic critical review and evaluation and compiling research into guidelines and programmes. In 2009, the County Council of Jönköping had approximately 335 000 inhabitants and the healthcare organisation had more than 10 000 employees. As the County Council actively promotes clinical improvement, it is interesting to explore how healthcare employees think about and act upon EBP. The aim of this survey was therefore to describe factors that facilitate or hinder the application of EBP in the clinical context.Method A quantitative study was performed with a questionnaire to healthcare staff employed in the County Council of Jönköping in 2009. The questionnaire consisted of questions concerning which factors are experienced to affect the development of evidence-based healthcare. There were 59 open and closed questions, divided into the following areas:• Sources of knowledge used in practice• Barriers to finding and evaluating research reports and guidelines• Barriers to changing practice on the basis of best evidence• Facilitating factors for changing practice on the basis of best evidence• Experience in finding, evaluating and using different sources of evidenceThe participants were selected using the county council's staff database and included medical, caring and rehabilitative staff within hospitals, primary care, dentistry and laboratory medicine. The inclusion criteria were permanent employment and clinical work. Invitations were sent to 5787 persons to participate in the study and 1445 persons answered the questionnaire.Results Knowledge used in daily clinical practice was mainly based on information about the patient, personal experience and local guidelines. Twenty per cent answered that they worked ‘in the way they always had’, and 11% responded that they used evidence from research as a basis for change. The participants experienced that EBP was not used enough in clinical healthcare and explained this with practical and structural barriers, which they thought should be better monitored by the organisation and directors.Conclusion Overall, the results indicate that the scientific evidence for healthcare is not used sufficiently as a base for decisions in daily practice as well as for changing practice. This is more prominent among assistant staff. As a consequence, this might affect the care of the patients in a negative way. Increased awareness of EBP and a stronger evidence-based approach are keys in the ongoing improvement work in the county. Local guidelines seem to be a way to implement knowledge. But, as the arena of activities is complex and the employees have diverse education levels, different strategies to facilitate and promote EBP are necessary.
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| 3. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Sexual health in patients with rheumatoid arthritis : experiences, needs and communication with health care professionals
- 2012
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Ingår i: Musculoskeletal Care. - : Wiley. - 1478-2189 .- 1557-0681. ; 10:2, s. 76-89
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Tidskriftsartikel (refereegranskat)abstract
- Pain, fatigue and decreased joint mobility caused by rheumatoid arthritis (RA) often decrease sexual health in RA patients. Regular physiotherapy interventions in patients with RA are often aimed at improving those factors. The aim of the present study was to explore the experiences and views of patients concerning the impact of RA on their sexual health, the possible impact of physiotherapy interventions, and communication in clinical situations. A self-administered questionnaire was sent to patients with RA at two rehabilitation clinics in Sweden. The questionnaire included questions concerning the impact of RA on intimate relationships and sexual function, as well as experiences of physiotherapy and sexual health communication with health professionals. The questionnaire was answered by 63 patients. The majority of the patients thought that pain, stiffness, fatigue and physical capacity were related to sexual health. Communication between health professionals and patients about sexual health was less common, even if the desire for communication about sexual health was higher in this study than in other studies. The authors concluded that physiotherapists need to be aware that pain, fatigue, decreased joint mobility and physical capacity can affect sexual health and that physiotherapy can make a difference in sexual health in patients with RA. The impact of RA on sexual health is rarely discussed by health professionals and RA patients, and needs greater attention
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| 4. |
- Areskoug Josefsson, Kristina
(författare)
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Sexual health in Rheumatoid Arthritis - a physiotherapeutic approach
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to study how persons experience the influence of Rheumatoid Arthritis (RA) on their sexual health and their experiences of communication about sexual health, in order to improve physiotherapy within the field of rheumatology. Sexual health is an integrated part of life, and persons with Rheumatoid Arthritis, RA, often experience a decreased sexual health, which can affect their overall quality of life. RA is a chronic systematic inflammatory disease with physical, social and psychological impact on the functioning of the patient. Common symptoms of RA are pain, fatigue, morning stiffness, reduced physical capacity, and joint swelling. Symptoms during flares are complex and experienced in different ways. They can be described as multilayered symptoms affecting the whole body experience. Physiotherapy for persons with RA is usually directed towards improving activities of daily living, dealing with specific symptoms, such as pain or limited joint mobility, and it is important to widen this context to also include sexual relations. The thesis has a mixed paradigm design in a fixed multiphase model, including qualitative, quantitative and psychometric methods, in order to respond to the research question and the aims of the thesis. The first study explored the views of persons living with RA concerning sexual health in relation to physiotherapy, and covered how the body and the total life situation affected sexual health. The impact of RA was experienced as multidimensional. The findings consisted of three themes: 1) Sexual health – physical and psychological dimensions, 2) Impacts of RA and 3) Possibilities of increasing sexual health – does physiotherapy make a difference? The findings from the first study were used as a base for the questionnaire used in the second study in order to further investigate views and experiences of the impact of RA on sexual health, experiences and needs of physiotherapy in this context, as well as communication between patients and health professionals concerning sexual health. The results of the second study clarified the need to improve communication and interaction between healthcare professionals and persons with RA concerning sexual health. This was investigated in the fourth study, where the question of whether decreased sexual health can be detected with a standard outcome measurement tool was explored. In order to perform the fourth study, the Multi Dimensional Health Assessment Questionnaire had to be validated and tested for reliability in a Swedish context, which was performed in the third psychometric study. To conclude, sexual health is affected in different ways for persons with RA, and there is a lack of communication concerning sexual health between health professionals and persons with RA. Physiotherapists can play an active role in improving sexual health for persons with RA by being aware that pain, fatigue, decreased mobility, and level of physical capacity can affect sexual health negatively. Improvement of communication concerning sexual health between persons with RA and their partners, as well as with health professionals, may improve sexual health among persons with RA. The Swedish version of the Multi Dimensional Health Assessment Questionnaire (MDHAQ-S) was found to have acceptable reliability and validity, and can be used as a base for sexual health communication since it correlates significantly with results of the Questionnaire of Sexual Health in persons with RA. The MDHAQ-S covers issues concerning sexual health in a multiple way to deepen the prerequisites for sexual health communication, but to uncover sexual health difficulties, an in-depth clinical interview or a more specific sexual health questionnaire is needed.
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| 5. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Swedish version of the multi dimensional health assessment questionnaire – translation and psychometric evaluation
- 2013
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHealth assessment measurements for patients with Rheumatoid arthritis (RA) have to be meaningful, valid and relevant. A commonly used questionnaire for patients with RA is the Stanford Health Assessment Questionnaire Disability Index (HAQ), which has been available in Swedish since 1988. The HAQ has been revised and improved several times and the latest version is the Multi Dimensional Health Assessment Questionnaire (MDHAQ). The aim of this study was to translate the MDHAQ to Swedish conditions and to test the validity and reliability of this version for persons with RA. MethodsTranslation and adaption of the MDHAQ were performed according to guidelines by Guillemin et al. The translated version was tested for face validity and test-retest in a group of 30 patients with RA. Content validity, criterion validity and internal consistency were tested in a larger study group of 83 patients with RA. Reliability was tested with test-retest and Cronbach´s alpha for internal consistency. Two aspects of validity were explored: content and criterion validity. Content validity was tested with a content validity index. Criterion validity was tested with concurrent validity by exploring the correlation between the MDHAQ-S and the AIMS2-SF. Floor and ceiling effects were explored. ResultsTest-retest with intra-class correlation coefficient (ICC) gave a coefficient of 0.85 for physical function and 0.79 for psychological properties. Reliability test with Cronbach´s alpha gave an alpha of 0.65 for the psychological dimension and an alpha of 0.88 for the physical dimension of the MDHAQ-S. The average sum of the content validity index for each item was of the MDHAQ-S was 0.94. The MDHAQ-S had mainly a moderate correlation with the AIMS2-SF, except for the social dimension of the AIMS2-SF, which had a very low correlation with the MDHAQ-S. ConclusionsThe MDHAQ-S was considered to be reliable and valid, but further research is needed concerning sensitivity to change.
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| 6. |
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| 7. |
- Areskoug Josefsson, Kristina, et al.
(författare)
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Women's experiences of sexual health when living with Rheumatoid Arthritis : an explorative qualitative study
- 2010
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Ingår i: BMC Musculoskeletal Disorders. - : Springer Science and Business Media LLC. - 1471-2474. ; 11, s. 240-247
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Tidskriftsartikel (refereegranskat)abstract
- Background: The ICF core sets for patients with Rheumatoid Arthritis (RA) acknowledge sexual function and intimate relationships as important since the patients' sexual health can be affected by the disease. About 36-70% of all RA-patients experience a reduced sexual health, and their perceived problems are directly or indirectly caused by their disease. Physiotherapy is often used as non-pharmacological treatment for RA. Mobility treatment, pain reduction, and physical activities are often included in physiotherapy for patients with RA. The aim of the study was to explore sexual health in relation to physiotherapy in women living with RA. Method: An explorative qualitative interview study with a phenomenological approach was performed. The study consisted of ten interviews with women with RA. The analysis was performed according to Giorgi. Results: The main theme that emerged in the material was that the body and the total life situation affected sexual health. Three categories were included in the theme: 1) sexual health - physical and psychological dimensions, 2) Impacts of RA, and 3) Possibilities to increase sexual health - does physiotherapy make a difference?. Conclusions: Sexual health was affected by RA in different ways for the informants. Possibilities to improve sexual health were improved partner communication and physiotherapy. Physiotherapy can play an active role in improving sexual health for patients with RA
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