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Hjortswang, Henrik
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Lovén Wickman, U., Yngman Uhlin, P., Hjortswang, H., Wenemark, M., Stjernman, H., Riegel, B. & Hollman Frisman, G. (2019). Development of a self-care questionnaire for clinical assessment of self-care in patients with inflammatory bowel disease: A psychometric evaluation. International Journal of Nursing Studies, 89
Åpne denne publikasjonen i ny fane eller vindu >>Development of a self-care questionnaire for clinical assessment of self-care in patients with inflammatory bowel disease: A psychometric evaluation
Vise andre…
2019 (engelsk)Inngår i: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 89Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background

Patients with inflammatory bowel disease have lifelong needs to learn how to manage their symptoms and life situation. The range of actions that patients take in order to manage daily life and maintain health is referred to as self-care. Assessment of self-care in patients with inflammatory bowel disease could allow targeted support and education by health careprofessionals. There are no existing measures assessing self-care in patients with inflammatory bowel disease.

Objectives

The aim was to develop and evaluate the self-care questionnaire for assessment of self-care among patients with inflammatory bowel disease.

Methods

Qualitative and quantitative methods were used to develop the inflammatory bowel disease self-care questionnaire. The development and evaluation process was performed in three phases: (1) item generation based on interviews with patients with inflammatory bowel disease (n = 20), (2) content validation in a panel of experts (n = 6) and patients (n = 100) assessed with the content validity index, cognitive interviews and quantifying and ranking the items to determine the usability of the questionnaire, and (3) final evaluation through a pilot study (n = 93) with test-retest evaluation (n = 50). An expert review group of three nurses and one physician continuously discussed the result during the development process.

Results

A total of 91 patients with Crohn's disease and 102 with ulcerative colitis participated. The final self-care questionnaire consists of 22 items. Assessment of content validity indicated that the items were adequate and easy to understand. Test-retest reliability was confirmed with intraclass correlations above 0.6 after a three week interval, for all items except one.

Conclusion

An inflammatory bowel disease-specific self-care questionnaire was developed using structured methods. The evaluation indicated good validity and reliability. The questionnaire may be a useful tool to assess the ability of patients with inflammatory bowel disease to perform routine self-care.

sted, utgiver, år, opplag, sider
Elsevier, 2019
Emneord
Content validity; Inflammatory bowel disease; Nursing; Reliability; Questionnaire development; Self-care; Swedish version
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-153966 (URN)10.1016/j.ijnurstu.2018.08.016 (DOI)000454965700001 ()30316054 (PubMedID)2-s2.0-85054459236 (Scopus ID)
Merknad

Funding Agencies|Medical Research Council of Southeast Sweden (FORSS) [371201, 464691, 554261, 599461]; County Council of Kalmar

Tilgjengelig fra: 2019-01-22 Laget: 2019-01-22 Sist oppdatert: 2019-09-04bibliografisk kontrollert
Rundquist, S., Eriksson, C., Nilsson, L., Angelison, L., Jaghult, S., Bjork, J., . . . Halfvarson, J. (2018). Clinical effectiveness of golimumab in Crohns disease: an observational study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG). Scandinavian Journal of Gastroenterology, 53(10-11), 1257-1263
Åpne denne publikasjonen i ny fane eller vindu >>Clinical effectiveness of golimumab in Crohns disease: an observational study based on the Swedish National Quality Registry for Inflammatory Bowel Disease (SWIBREG)
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2018 (engelsk)Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 53, nr 10-11, s. 1257-1263Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objective: The effectiveness of golimumab in Crohns disease (CD) is largely unknown as it is not approved for the treatment of the disease. We aimed to identify the population of CD patients treated with golimumab in Sweden, to assess the effectiveness of golimumab (defined as the drug retention rate), and to identify predictors of drug discontinuation. Methods: Patients with CD who received at least one injection of golimumab were identified through the Swedish National Quality Registry for Inflammatory Bowel Disease, which includes prospectively collected clinical information. Cox regression models were used to identify predictors of golimumab discontinuation. Results: The study cohort involved 94 patients of whom the majority (96.8%) had previously discontinued at least one anti-tumour necrosis factor (anti-TNF) agent. The drug retention rate at 12 weeks was 85.1%. Predictors of golimumab discontinuation at 12 weeks were previous surgery (adjusted HR = 7.52, 95% CI: 1.12-50.36), concomitant corticosteroid use at baseline (adjusted HR = 5.70, 95% CI: 1.13-28.68) and female sex (adjusted HR = 6.59; 95% CI: 1.04-41.62). The median duration of follow-up was 89 (IQR: 32-158) weeks. The drug retention at the most recent follow-up was 35.1%. Predictors of golimumab discontinuation at the most recent follow-up were corticosteroid use at baseline (adjusted HR = 2.60, 95% CI: 1.17-5.79) and female sex (adjusted HR = 2.24; 95% CI: 1.19-4.23). Conclusion: Patients with CD treated with golimumab were a treatment-refractory group. Despite this, more than one-third of the patients appeared to have had clinical benefit after a median follow-up of more than 1.5 years.

sted, utgiver, år, opplag, sider
TAYLOR & FRANCIS LTD, 2018
Emneord
Golimumab; Crohns disease; biological treatment; SWIBREG; IBD
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-154736 (URN)10.1080/00365521.2018.1519597 (DOI)000457980900016 ()30353751 (PubMedID)
Tilgjengelig fra: 2019-02-27 Laget: 2019-02-27 Sist oppdatert: 2019-04-12
Tribonias, G., Daferera, N., Manola, M.-E., Svernlöv, R., Ignatova, S. & Hjortswang, H. (2018). How familiar are we with decision-making concerning the treatment of perforation after endoscopic mucosal resection (EMR) in the colon? A case report. Endoscopy International Open, 6(3), E308-E312
Åpne denne publikasjonen i ny fane eller vindu >>How familiar are we with decision-making concerning the treatment of perforation after endoscopic mucosal resection (EMR) in the colon? A case report
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2018 (engelsk)Inngår i: Endoscopy International Open, ISSN 2196-9736, E-ISSN 2196-9736, Vol. 6, nr 3, s. E308-E312Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background and study aims We describe a case of perforation after colonic endoscopic mucosal resection (EMR) that was treated conservatively. We would like to highlight the importance of decision-making mainly based on the endoscopists point of view in combination with the surgical consultation. Although the radiological imaging is always needed, it cannot solely lead to a decision for operation. Intraperitoneal gas in computed tomography is not always associated with a hole in the endoscopic field and could be possibly explained from a "balloon" phenomenon. The amount of extraluminal air after an EMR does not correlate reciprocally with patients pain after the procedure. Even though perforation is a radiological diagnosis and endoscopists should be aware of the common post-EMR radiological findings, the surgical examination is mandatory and should be coupled with the endoscopic opinion in order to guide appropriately the treatment in patients with acute pain.

sted, utgiver, år, opplag, sider
Georg Thieme Verlag KG, 2018
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-155833 (URN)10.1055/s-0043-123932 (DOI)29507871 (PubMedID)
Tilgjengelig fra: 2019-03-28 Laget: 2019-03-28 Sist oppdatert: 2019-04-12
Pihl Lesnovska, K., Börjeson, S., Hollman Frisman, G., Hjortswang, H. & Wenemark, M. (2018). The quality of care questionnaire: development of a valid measure for persons with inflammatory bowel disease. Scandinavian Journal of Gastroenterology, 53(9), 1043-1050
Åpne denne publikasjonen i ny fane eller vindu >>The quality of care questionnaire: development of a valid measure for persons with inflammatory bowel disease
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2018 (engelsk)Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 53, nr 9, s. 1043-1050Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background and aims: Quality of care is important in lifelong illnesses such as inflammatory bowel disease (IBD). Valid, reliable and short questionnaires to measure quality of care among persons with IBD are needed. The aim of this study was to develop a patient-derived questionnaire measuring quality of care in persons with IBD.Methods and results: The development of the questionnaire The Quality of Care -Questionnaire (QoC-Q) was based on a literature review of studies measuring quality of care, and the results of two qualitative studies aiming to identify the knowledge need and perception of health care among persons with IBD. Further development and evaluation was done by focus groups, individual testing and cognitive interviews with persons with IBD, as well as evaluation by a group of professionals. After the development, the questionnaire was tested for validity and test-retest reliability in 294 persons with IBD.Conclusions: The QoC-Q is showing promising validity and reliability for measuring the subjective perception of quality of care. Further testing in clinical practice is suggested to assess if the QoC-Q can be used to evaluate care and areas of improvement in health care for persons living with IBD.

sted, utgiver, år, opplag, sider
TAYLOR & FRANCIS LTD, 2018
Emneord
Quality of care; inflammatory bowel disease; Crohns disease; ulcerative colitis; perception of health care
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-153423 (URN)10.1080/00365521.2018.1495759 (DOI)000450634000003 ()30299173 (PubMedID)
Merknad

Funding Agencies|Ferring Pharmaceuticals; County Council of ostergotland, Linkoping, Sweden

Tilgjengelig fra: 2018-12-13 Laget: 2018-12-13 Sist oppdatert: 2019-05-01
Pihl Lesnovska, K., Hollman Frisman, G., Hjortswang, H. & Börjeson, S. (2016). Critical situations in daily life as experienced by patients with inflammatory bowel disease. Gastroenterology Nursing, 39(3), 195-203
Åpne denne publikasjonen i ny fane eller vindu >>Critical situations in daily life as experienced by patients with inflammatory bowel disease
2016 (engelsk)Inngår i: Gastroenterology Nursing, ISSN 1042-895X, Vol. 39, nr 3, s. 195-203Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Crohn disease and ulcerative colitis, collectively known as inflammatory bowel disease (IBD), are chronic and have a fluctuating clinical course that impacts daily life. Daily life with a chronic disease involves thinking and worrying about the limitations that chronic disease causes. Knowledge about how patients who suffer from IBD manage critical incidents in daily life is lacking. The aim of the study was to describe how patients living with IBD experience critical incidents in daily life in relation to their disease and symptoms. Thirty adult patients were interviewed focusing on critical incidents in daily life. Data were analyzed using the critical incident technique. The study comprised 224 critical incidents and was grouped into 21 subcategories and 5 categories: losing bowel control, having a body that smells, being unable to meet own and others' expectations, not being believed or seen, and experiencing frustration due to side effects and ineffective treatment. These categories formed one main area describing the overall result "The bowels rule life." The uncertain nature of IBD created critical incidents in which the bowel ruled life, causing patients to avoid social interaction. It also placed considerable demands on the family and sometimes had a negative effect on the afflicted person's career.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

sted, utgiver, år, opplag, sider
Lippincott Williams & Wilkins, 2016
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-126621 (URN)10.1097/SGA.0000000000000211 (DOI)000380804500004 ()26870902 (PubMedID)
Merknad

Funding agencies: We acknowledge funding from the County Council of Ostergotland.

Tilgjengelig fra: 2016-03-31 Laget: 2016-03-31 Sist oppdatert: 2017-11-01bibliografisk kontrollert
Rendek, Z., Falk, M., Grodzinsky, E., Wahlin, K., Kechagias, S., Svernlöv, R. & Hjortswang, H. (2016). Effect of oral diclofenac intake on faecal calprotectin. Scandinavian Journal of Gastroenterology, 51(1), 28-32
Åpne denne publikasjonen i ny fane eller vindu >>Effect of oral diclofenac intake on faecal calprotectin
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2016 (engelsk)Inngår i: Scandinavian Journal of Gastroenterology, ISSN 0036-5521, E-ISSN 1502-7708, Vol. 51, nr 1, s. 28-32Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background. NSAIDs are a known source of increased faecal calprotectin (FC) levels. Currently, there is a lack of knowledge about how long it takes for an increased FC level to return to normal after NSAID intake. Objective. The aim was to investigate how oral diclofenac intake affects FC levels and assess how long it takes for an increased FC level to return to normal after oral diclofenac intake. Material and methods. Thirty healthy volunteers received diclofenac 50 mg three times daily for 14 days. Participants provided a stool sample on Days 0, 2, 4, 7, 14 during intake and Days 17, 21, 28 after discontinuation. FC levels were then followed at 7-day intervals until normalization. Results. During diclofenac intake, eight participants (27%) had FC levels exceeding the upper limit of normal (median, 76 mu g/g; range, 60-958 mu g/g), corresponding to 8.3% of measurements. FC was not constantly increased and became normal in most participants during diclofenac intake. FC levels were on average significantly higher during intake (M = 9.5, interquartile range (IQR) = 13.4) than on baseline (M = 7.5, IQR = 0.0), p = 0.003. After discontinuation, two participants had increased FC on Days 17 and 21, respectively. No significant differences in FC levels were found between baseline and measurements after discontinuation. Two weeks after discontinuation, all participants had normal FC levels. Conclusions. Short-term oral diclofenac intake is associated with increased FC levels. However, the likelihood of an increased test result is low. Our results suggest that 2 weeks of diclofenac withdrawal is sufficient to get an uninfluenced FC test result.

sted, utgiver, år, opplag, sider
TAYLOR & FRANCIS LTD, 2016
Emneord
intestinal inflammation; proton pump inhibitors; NSAIDs; non-steroidal anti-inflammatory agents; diclofenac; calprotectin
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-127586 (URN)10.3109/00365521.2015.1066421 (DOI)000373621900005 ()26200803 (PubMedID)
Merknad

Funding Agencies|County Council of Ostergotland, Sweden

Tilgjengelig fra: 2016-05-03 Laget: 2016-05-03 Sist oppdatert: 2018-03-22
Lovén Wickman, U., Yngman Uhlin, P., Hjortswang, H., Riegel, B., Stjernman, H. & Hollman Frisman, G. (2016). Self-care among patients with Inflammatory Bowel Disease: An interview study. Gastroenterology Nursing, 39(2), 121-128
Åpne denne publikasjonen i ny fane eller vindu >>Self-care among patients with Inflammatory Bowel Disease: An interview study
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2016 (engelsk)Inngår i: Gastroenterology Nursing, ISSN 1042-895X, Vol. 39, nr 2, s. 121-128Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Inflammatory bowel disease (IBD) is a chronic disease of unknown etiology. The disease occurs early in life and the burden of symptoms is significant. Patients need to perform self-care to handle their symptoms, but knowledge about what kind of self-care patients do is limited and these individuals need to learn how to manage the symptoms that arise. The aim of this study was to explore self-care among patients with IBD. Twenty adult patients with IBD, 25-66 years of age, were interviewed. Data were analyzed by performing a qualitative content analysis. Four categories with 10 subcategories emerged from the analysis of the interviews. The self-care patients perform consists of symptom recognition (subcategories: physiological sensations and psychological sensations), handling of symptoms (subcategories: adapting the diet, using medical treatment, stress management, and using complementary alternative medicine), planning life (subcategories: planning for when to do activities and when to refrain from activities), and seeking new options (subcategories: seeking knowledge and personal contacts). Self-care consists of symptom recognition, handling life through planning, and accommodating the existing situation with the ultimate goal of maintaining well-being. Being one step ahead facilitates living with IBD. A decision to actively participate in care of a chronic illness is a prerequisite for self-care. Healthcare professionals must consider patients' potential for and desire for self-care when giving advice on self-care activities. Doing so may help people better cope with IBD.

sted, utgiver, år, opplag, sider
Lippincott Williams & Wilkins, 2016
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-126617 (URN)10.1097/SGA.0000000000000120 (DOI)000377983500007 ()26166423 (PubMedID)
Merknad

Funding agencies: Medical Research Council of Southeast Sweden-FORSS; County Council of Kalmar; Florence Nightingale Foundation; Ruth and Richard Juhlins foundation

Tilgjengelig fra: 2016-03-31 Laget: 2016-03-31 Sist oppdatert: 2019-09-04bibliografisk kontrollert
Lovén Wickman, U., Riegel, B., Yngman Uhlin, P., Hjortswang, H. & Hollman Frisman, G. (2016). Self-care of inflammatory bowel disease may be associated with better well-being. In: : . Paper presented at 11th Congress of ECCO - Inflammatory Bowel Diseases, MArch 16-19, Amsterdam, The Netherlands.
Åpne denne publikasjonen i ny fane eller vindu >>Self-care of inflammatory bowel disease may be associated with better well-being
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2016 (engelsk)Konferansepaper, Poster (with or without abstract) (Fagfellevurdert)
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-126623 (URN)
Konferanse
11th Congress of ECCO - Inflammatory Bowel Diseases, MArch 16-19, Amsterdam, The Netherlands
Tilgjengelig fra: 2016-03-31 Laget: 2016-03-31 Sist oppdatert: 2018-12-11
Krarup, A. L., Peterson, E., Ringstroem, G., Toernblom, H., Hjortswang, H. & Simren, M. (2015). The Short Health Scale A Simple, Valid, Reliable, and Responsive Way of Measuring Subjective Health in Patients With Irritable Bowel Syndrome. Journal of Clinical Gastroenterology, 49(7), 565-570
Åpne denne publikasjonen i ny fane eller vindu >>The Short Health Scale A Simple, Valid, Reliable, and Responsive Way of Measuring Subjective Health in Patients With Irritable Bowel Syndrome
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2015 (engelsk)Inngår i: Journal of Clinical Gastroenterology, ISSN 0192-0790, E-ISSN 1539-2031, Vol. 49, nr 7, s. 565-570Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Goals:To evaluate validity, reliability, and responsiveness of the Short Health Scale (SHS) in irritable bowel syndrome (IBS) patients.Background:Subjective health assessment is central when treating patients with IBS. The Short Health Scale is a quick 4-item questionnaire covering most aspects of subjective health that has been validated for inflammatory bowel disease.Study:To test validity, 451 patients with IBS (mean age, 38 y; 81% females) completed the SHS and questionnaires assessing IBS symptom severity (IBS-SSS), gastrointestinal (GI)-specific anxiety (VSI), and quality of life (IBSQOL). To evaluate reliability and responsiveness to changes, the questionnaires were repeated after 2 weeks in 18 patients, and after 12 weeks in 212 patients who had completed a patient-education program.Results:Validity was documented with (1) gradually increasing mean scores for all 4 SHS items with increasing IBS-SSS (Pless than0.0001), and (2) correlations between the 4 SHS items and the corresponding items from the other subjective health assessment tools [item 1 (symptom burden): =0.67, item 2 (daily function): =-0.44 to -0.46, item 3 (disease-related worry): =-0.51 to 0.57, item 4 (general well-being): =-0.34 to -0.46, Pless than0.0001]. Reliability was confirmed (Spearman greater than0.7 and intraclass correlations greater than0.7). Responsiveness was good with responders to the patient-education program (IBS-SSS reduction 50 points) having significant reductions in 3 of the SHS items (Pless than0.05), and borderline change for the fourth SHS item (P=0.06).Conclusions:SHS is a health measure that shows promising evidence of validity, reliability, and responsiveness in IBS patients. It is quickly completed and evaluated, which supports its usefulness in the busy clinical practice.

sted, utgiver, år, opplag, sider
Lippincott, Williams andamp; Wilkins: No Hybrid Open Access, 2015
Emneord
irritable bowel syndrome; validation; reliability; responsiveness; questionnaire; subjective health assessment
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-120643 (URN)10.1097/MCG.0000000000000209 (DOI)000358209900005 ()25216385 (PubMedID)
Merknad

Funding Agencies|Swedish Medical Research Council [13409, 21691, 21692]; Marianne and Marcus Wallenberg Foundation, University of Gothenburg; Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg; Faculty of Medicine, University of Gothenburg; Abbvie; Ferring; Danone; AstraZeneca

Tilgjengelig fra: 2015-08-20 Laget: 2015-08-20 Sist oppdatert: 2017-12-04
Lovén Wickman, U., Yngman-Uhlin, P., Hjortswang, H., Riegel, B., Stjernman, H. & Hollman Frisman, G. (2014). Self-care among patients with Inflammatory Bowel Disease - an interview study. In: : . Paper presented at 9th Congress of ECCO - Inflammatory Bowel Diseases, 20-22 February 2014, Copenhagen, Denmark.
Åpne denne publikasjonen i ny fane eller vindu >>Self-care among patients with Inflammatory Bowel Disease - an interview study
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2014 (engelsk)Konferansepaper, Oral presentation with published abstract (Annet vitenskapelig)
HSV kategori
Identifikatorer
urn:nbn:se:liu:diva-109059 (URN)
Konferanse
9th Congress of ECCO - Inflammatory Bowel Diseases, 20-22 February 2014, Copenhagen, Denmark
Tilgjengelig fra: 2014-08-04 Laget: 2014-08-04 Sist oppdatert: 2015-04-08
Organisasjoner