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- Forsgärde, Elin-Sofie, et al.
(author)
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Powerlessness : dissatisfied patients' and relatives' experiences of their emergency department visit
- 2016
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In: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 25:March 2016, s. 32-36
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Journal article (peer-reviewed)abstract
- AimThe aim of this study was to disclose the meaning of patients and relatives lived experience of dissatisfaction when visiting an emergency department.IntroductionEven though most patients are pleased with the emergency department care, there are areas that dissatisfy them, for example lack of communication and unoccupied wait time. However, there are few studies that describe both patients and relatives experience of dissatisfaction.MethodsThis explorative study uses a phenomenological hermeneutic approach where patients and relatives were interviewed.ResultsPatients and relatives meaning of dissatisfaction mainly contain powerlessness, struggling for control over the situation, lacking knowledge and information, receiving and providing support.ConclusionsThe results showed that the experiences of dissatisfaction were similar among patients and relatives. They suffer in the same way when being treated like objects during their visits. Nursing rounds are one way to decrease dissatisfaction by making patients and relatives participating in the care continually updated with information.
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- From Attebring, Mona, 1947
(author)
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Evaluation of risk factor modification management in patients with coronary heart disease and patients´ experiences of secondary prevention
- 2004
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Doctoral thesis (other academic/artistic)abstract
- Aim: To evaluate management of risk factor modification among patients suffering from coronary heart disease and to explore patients experiences of secondary prevention. Methods: After establishing a secondary prevention programme, patients were offered follow-up visits to a nurse, one year after the coronary event for evaluation of various risk factors associated with recurrence (I, II). Self-report of smoking cessation was validated against biochemical markers for smoking, cotinine in plasma and carbon monoxide in expired air (III). Factors that can predict who will resume smoking after an acute coronary syndrome were identified (IV). An in-depth interview with a narrative approach and hermeneutical analysis was conducted in patients after a myocardial infarction (V).Results: The evaluation showed that 70% of all patients had one or more of the following risk indicators; s-cholesterol >6.5 mmol/l (30%), s-triglycerides >3.0 mmol/l (19%), fasting blood glucose > 6.7 mmol/l (29%), systolic blood pressure >160 mmHg (9%), diastolic blood pressure >90 mmHg (8%) or smoking (36%), compared with 67% at follow up (I). No change in mean body weight was observed (I, II). Over time a substantial lowering of serum lipids was observed parallel to a three-fold increase in the use of lipid-lowering drugs. Out of 1320 patients, with acute coronary syndromes (IV), 434 (33%) were current smokers. Three months after discharge 51% of those were still smoking. Six factors were independently associated with smoking at follow-up: non-participation in the cardiac rehabilitation programme, treatment with sedatives or antidepressants at time of admission, a previously known cardiac event or cerebral vascular disease, smoking related pulmonary disease and high average cigarette consumption. Of 260 former smokers, 17 (6.5%) had biochemical markers that contradicted their self-report. The experiences of patients following a first myocardial infarction were described as impact of medication and impact of health professionals (V). Patients interpreted bodily symptoms as a consequence of being medicated rather than as a result of their heart attack. The medication led to feelings of being intruded upon but also to feelings of security. The communication with different physicians and other health professionals led to some perplexity about the illness and its treatment. Patients expressed a need of being reassured by the physician regarding their physical health status. Conclusions: The findings indicate difficulties in the management of risk factor modification in secondary prevention. Although there has been a marked improvement in serum lipids levels by increased use of lipid lowering drugs, there are still problems with modification of life style related risk factors, such as overweight and smoking. With even lower treatment targets for hypertension there is a potential for improvement of this risk factor as well. Self-reported smoking cessation and biochemical markers corresponded in the majority of cases. Following a first myocardial infarction, care of patients has to be considerated regarding the impact of the pharmacological treatment on patients life. The point initiation in secondary preventive work must be patients beliefs about their condition and the treatment they receive.
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- From Attebring, Mona, 1947, et al.
(author)
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Smoking habits and predictors of continued smoking in patients with acute coronary syndromes
- 2004
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In: J Adv Nurs. - : Wiley. - 0309-2402 .- 1365-2648. ; 46:6, s. 614-23
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Journal article (peer-reviewed)abstract
- BACKGROUND: Most patients with acute coronary syndrome quit smoking when hospitalized, although several have been found to relapse and resume smoking within 3 months. AIM: This paper reports a study to identify factors that can predict who will resume smoking after hospitalization for an acute coronary syndrome. METHODS: Patients (n = 1320) below the age of 75 years, admitted to a Swedish university hospital coronary care unit with acute coronary syndromes, between September 1995 and September 1999, were consecutively included. Data were collected from hospital medical records and included information on previous clinical history, former illnesses and smoking. During their hospitalization, an experienced nurse interviewed the patients by using a structured questionnaire to obtain additional information. Patients were followed up 3 months after the discharge. Those who continued to smoke (non-quitters) were compared with those who had stopped (quitters) with regard to age, sex, medical history, clinical course, and intention to quit. To identify factors independently related to continued smoking, a logistical regression in a formal forward stepwise mode was used. RESULTS: Of the patients admitted, 33% were current smokers. Three months after discharge, 51% of these patients were still smoking. There were no significant differences in age, gender or marital status between non-quitters and quitters. In a multivariate analysis, independent predictors of continued smoking were: non-participation in the heart rehabilitation programme (P = 0.0008); use of sedatives/antidepressants at time of admission (P = 0.001); history of cerebral vascular disease (P = 0.002), history of previous cardiac event (P = 0.01); history of smoking-related pulmonary disease (P = 0.03) and cigarette consumption at index (P = 0.03). CONCLUSIONS: Smoking patients who do not participate in a heart rehabilitation programme may need extra help with smoking cessation. The findings may provide means of identifying patients in need of special intervention.
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- Gustafsson, Ingrid, et al.
(author)
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The nurse anesthetists' adherence to Swedish national recommendations to maintain normothermia in patients during surgery
- 2017
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In: Journal of Perianesthesia Nursing. - : Elsevier. - 1089-9472 .- 1532-8473. ; 32:5, s. 409-418
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Journal article (peer-reviewed)abstract
- PurposeThe aim of this study was to determine if nurse anesthetists (NAs) have access, knowledge, and adhere to recommended guidelines to maintain normal body temperature during the perioperative period.DesignA descriptive survey design.MethodsQuestionnaires were sent to heads of the department (n = 56) and NAs in the operating departments in Sweden.FindingThe level of access to the recommendations is high, but only one third of the operating departments have included the recommendations in their own local guidelines. The NAs' adherence was low, between 5% and 67%, and their knowledge levels were 57% to 60%.ConclusionsA high level of knowledge, access, and adherence are important for the organization of operating departments to prevent barriers against implementation of new recommendations or guidelines. There are needs for education about patients' heat loss due to redistribution and clear recommendations.
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- Hambraeus, Kristina, et al.
(author)
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SWEDEHEART annual report 2012
- 2014
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In: Scandinavian Cardiovascular Journal. - : Informa Healthcare. - 1401-7431 .- 1651-2006. ; 48:SUPPL. 63, s. 1-333
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Journal article (peer-reviewed)abstract
- The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) supports continuous monitoring and improvement of care for coronary artery disease, catheter-based and surgical coronary interventions, secondary prevention as well as catheter based and surgical valve intervention, by providing extensive data on base-line, diagnostic, procedural and outcome variables. Design. This national quality registry collects information from all Swedish hospitals treating patients with acute coronary artery disease and all patients undergoing coronary angiography, catheter-based interventions or heart surgery. Combination with other national mandatory official registries enables complete follow-up of all individuals regarding myocardial infarction, new interventional procedures, death and all-cause hospitalizations. The registry is governed by an independent steering committee and funded by the Swedish National Health care provider. The software is developed by Uppsala Clinical Research Center. Results. The SWEDEHEART Quality Index reflects overall quality of care for coronary artery disease including secondary prevention. In comparison with 2011, an improvement of the index occurred in 2012 overall. There was however, still a wide range in performance between individual centers, emphasizing the need for continuous monitoring of quality of care at a national as well as on a center level. © 2014 Informa Healthcare.
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- Harnek, Jan, et al.
(author)
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The 2011 outcome from the Swedish Health Care Registry on Heart Disease (SWEDEHEART)
- 2013
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In: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 47, s. 1-10
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Journal article (peer-reviewed)abstract
- Objectives. The Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) collects data to support the improvement of care for heart disease. Design. SWEDEHEART collects on-line data from consecutive patients treated at any coronary care unit n = (74), followed for secondary prevention, undergoing any coronary angiography, percutaneous coronary intervention, percutaneous valve or cardiac surgery. The registry is governed by an independent steering committee, the software is developed by Uppsala Clinical Research Center and it is funded by The Swedish national health care provider independent of industry support. Approximately 80,000 patients per year enter the database which consists of more than 3 million patients. Results. Base-line, procedural, complications and discharge data consists of several hundred variables. The data quality is secured by monitoring. Outcomes are validated by linkage to other registries such as the National Cause of Death Register, the National Patient Registry, and the National Registry of Drug prescriptions. Thanks to the unique social security number provided to all citizens follow-up is complete. The 2011 outcomes with special emphasis on patients more than 80 years of age are presented. Conclusion. SWEDEHEART is a unique complete national registry for heart disease.
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- Libungan, Berglind, et al.
(author)
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Secondary prevention in coronary artery disease. Achieved goals and possibilities for improvements.
- 2012
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In: International journal of cardiology. - : Elsevier BV. - 1874-1754 .- 0167-5273. ; 161:1, s. 18-24
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Journal article (peer-reviewed)abstract
- AIM: To describe presence of risk indicators of recurrence 6months after hospitalisation due to coronary artery disease at a university clinic. METHODS: The presence of risk indicators, including tobacco use, lipid levels, blood pressure and glucometabolic status, including 24-hour blood pressure monitoring and an oral glucose-tolerance test, was analysed. RESULTS: Of 1465 patients who were screened, 402 took part in the survey (50% previous myocardial infarction and 50% angina pectoris). Mean age was 64years (range 40-85years) and 23% were women. Present medications were: lipid lowering drugs (statins; 94%), beta-blockers (85%), aspirin or warfarin (100%) and ACE-inhibitors or angiotensin II blockers (66%). Values above target levels recommended in guidelines were: a) low density lipoprotein (LDL) in 40%; b) mean blood pressure (day or night) in 38% and c) smoking in 13%. Of all patients, 66% had at least one risk factor (LDL or blood pressure above target levels or current smoking). An abnormal glucose-tolerance test was found in 59% of patients without known diabetes. If no history of diabetes, 85% had either LDL or blood pressure above target levels, current smoking or an abnormal glucose-tolerance test. However, with treatment intensification to patients with elevated risk factors 56% reached target levels for blood pressure and 79% reached target levels for LDL. CONCLUSION: Six months after hospitalisation due to coronary artery disease, despite the high use of medication aimed at prophylaxis against recurrence, the majority were either above target levels for LDL or blood pressure or continued to smoke.
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