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Bachrach-Lindström, Margareta
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Publications (10 of 46) Show all publications
Gutefeldt, K., Hedman, C. A., Thyberg, I. S., Bachrach-Lindström, M., Arnqvist, H. & Spångeus, A. (2019). Upper extremity impairments in type 1 diabetes with long duration: common problems with great impact on daily life. Disability and Rehabilitation, 41(6), 633-640
Open this publication in new window or tab >>Upper extremity impairments in type 1 diabetes with long duration: common problems with great impact on daily life
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2019 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 6, p. 633-640Article in journal (Refereed) Published
Abstract [en]

PURPOSE: To investigate the prevalence, activity limitations and potential risk factors of upper extremity impairments in type 1 diabetes in comparison to controls.

METHODS: In a cross-sectional population-based study in the southeast of Sweden, patients with type 1 diabetes <35 years at onset, duration ≥20 years, <67 years old and matched controls were invited to answer a questionnaire on upper extremity impairments and activity limitations and to take blood samples.

RESULTS: Seven hundred and seventy-three patients (ages 50 ± 10 years, diabetes duration 35 ± 10 years) and 708 controls (ages 54 ± 9 years) were included. Shoulder pain and stiffness, hand paraesthesia and finger impairments were common in patients with a prevalence of 28-48%, which was 2-4-folds higher than in controls. Compared to controls, the patients had more bilateral impairments, often had coexistence of several upper extremity impairments, and in the presence of impairments, reported more pronounced activity limitations. Female gender (1.72 (1.066-2.272), p = 0.014), longer duration (1.046 (1.015-1.077), p = 0.003), higher body mass index (1.08 (1.017-1.147), p = 0.013) and HbA1c (1.029 (1.008-1.05), p = 0.007) were associated with upper extremity impairments.

CONCLUSIONS: Compared to controls, patients with type 1 diabetes have a high prevalence of upper extremity impairments, often bilateral, which are strongly associated with activity limitations. Recognising these in clinical practise is crucial, and improved preventative, therapeutic and rehabilitative interventions are needed. Implications for rehabilitation Upper extremity impairments affecting the shoulder, hand and fingers are common in patients with type 1 diabetes, the prevalence being 2-4-fold higher compared to non-diabetic persons. Patients with diabetes type 1 with upper extremity impairments have more pronounced limitations in daily activities compared to controls with similar impairments. Recognising upper extremity impairments and activity limitations are important and improved preventive, therapeutic and rehabilitation methods are needed.

Place, publisher, year, edition, pages
Taylor & Francis, 2019
Keywords
Dupuytren’s disease, Type 1 diabetes, carpal tunnel syndrome, frozen shoulder, trigger finger disorder
National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-144020 (URN)10.1080/09638288.2017.1397202 (DOI)000461521100002 ()29105514 (PubMedID)2-s2.0-85033477270 (Scopus ID)
Note

Funding agencies: Medical Research Council of Southeast Sweden (FORSS); County council of Region Ostergotland, Sweden; Stiftelseforvaltningen of Region Ostergotland, Sweden

Available from: 2018-01-03 Created: 2018-01-03 Last updated: 2019-04-01Bibliographically approved
Wärdig, R., Foldemo, A., Hultsjö, S., Lindström, T. & Bachrach-Lindström, M. (2016). An intervention with physical activity and lifestyle counseling improves health-related quality of life and shows small improvements in metabolic risk factors in persons with psychosis. Issues in Mental Health Nursing, 37(1), 43-52
Open this publication in new window or tab >>An intervention with physical activity and lifestyle counseling improves health-related quality of life and shows small improvements in metabolic risk factors in persons with psychosis
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2016 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 1, p. 43-52Article in journal (Refereed) Published
Abstract [en]

General purpose: To study the effects of a lifestyle intervention on health-related quality of life (HRQoL) and metabolic risk factors in persons with psychosis.

Methodology: A longitudinal intervention study with a matched reference sample.

Results: HRQoL measured by the EQ-VAS improved from 57.6 to 63.3 (17.8) in the intervention group (p=0.05). The HDL cholesterol concentration increased from 1.03 to 1.11 (0.19) mmol/l in the intervention group (p=0.02). There was no significant change in body weight.

Conclusion: A lifestyle intervention based on group meetings improves HRQoL in patients with psychosis. There are also small improvements in metabolic risk factors.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keywords
Health-related quality of life, lifestyle intervention, metabolic syndrome, physical health, psychosis
National Category
Nursing Psychiatry
Identifiers
urn:nbn:se:liu:diva-122367 (URN)10.3109/01612840.2015.1092187 (DOI)000369505500007 ()26818932 (PubMedID)
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2018-01-08Bibliographically approved
Johansson Stark, Å., Salanterä, S., Sigurdardottir, A. K., Valkeapää, K. & Bachrach-Lindström, M. (2016). Spouse-related factors associated with Quality of Recovery of patients after hip or knee replacement: a Nordic perspective. International Journal of Orthopaedic and Trauma Nursing, 23, 32-46
Open this publication in new window or tab >>Spouse-related factors associated with Quality of Recovery of patients after hip or knee replacement: a Nordic perspective
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2016 (English)In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 23, p. 32-46Article in journal (Refereed) Published
Abstract [en]

Background: Today’s shorter hospital stays means that patients may need support from informal caregivers during their recovery period. The responsibility for providing this support shifts from the health care staff to their family members fairly early in the recovery process. Spousal caregivers are considered to be primary caregivers as their relationship with the patient is more interdependent than other family members or caregivers.

Objectives: The aim was to describe spouse-related factors that were associated with patients’ quality of recovery on discharge from hospital after elective hip or knee replacement.

Design: The design was prospective, descriptive and comparative with two measurements; before arthroplasty and on discharge.

Settings: Two Finnish, three Icelandic and two Swedish university or community hospitals.

Participants: The sample consisted of spouses and patients. The inclusion criteria were: age ≥ 18 years, able to complete the questionnaires, and able to understand Finnish/Icelandic/Swedish. The patients were asked to identify one family member. Spouses were those defining themselves as; wife, husband or cohabiting partner. Out of 463 spouses, 306 (66%) were included. The mean age of the included spouses was 64 years, and 54% of them were females.

Methods: Self-reported instruments on; expected and received knowledge, access to knowledge, emotional state and quality of recovery were used.

Results: If the spouses were or had been employed in the social services or healthcare their partner had greater quality of recovery (p=0.006). Spouses experiencing negative emotions had partners who experienced lower quality of recovery (p<0.001). Spouses who experienced that nurses had enough time and explained matters concerning their family members’ care and treatment had partners who experienced greater quality of recovery (p=0.011, 0.044).

Conclusions: Spouses’ emotional state played an important role in the patients’ quality of recovery, with uncertainty and depressive state as the main predictors. The importance of nurses explaining matters sufficiently to spouses was emphasized, while spouses’ fulfilment of knowledge expectations was not associated with patients’ recovery.

Place, publisher, year, edition, pages
Elsevier, 2016
Keywords
Access to knowledge, empowering knowledge, emotional state, fulfilment of knowledge expectations, hip replacement, knee replacement, recovery, spousal caregivers
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-125236 (URN)10.1016/j.ijotn.2016.03.001 (DOI)
Note

At the time for thesis presentation publication was in status: Manuscript

Available from: 2016-02-17 Created: 2016-02-17 Last updated: 2017-04-21Bibliographically approved
Johansson Stark, Å., Charalambous, A., Istomina, N., Salanterä, S., Sigurdardottir, A. K., Sourtzi, P., . . . Bachrach-Lindström, M. (2016). The quality of recovery on discharge from hospital, a comparison between patients undergoing hip and knee replacement: a European study. Journal of Clinical Nursing, 25(17-18), 2489-2501
Open this publication in new window or tab >>The quality of recovery on discharge from hospital, a comparison between patients undergoing hip and knee replacement: a European study
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2016 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 17-18, p. 2489-2501Article in journal (Refereed) Published
Abstract [en]

Aims and objectives. To describe and compare the quality of recovery (QoR) on discharge from hospital between patients undergoing elective hip or knee replacement. The study will also attempt to identify any predicting factors.

Background. Arthroplasty is commonly used for an increasing population of patients with osteoarthritis, and the recovery process starts directly after surgery. Today’s shorter hospital stay may be a challenge for the patients during the early period of recovery. It is therefore important to identify factors associated with QoR at discharge from hospital.

Design. A descriptive, comparative study including 12 hospitals in five European countries; Cyprus, Finland, Greece, Iceland and Sweden.

Methods. Consecutively included patients responded on: Health-Related Quality of Life, and emotions before surgery and at hospital discharge; Quality of Recovery, Patient Satisfaction and fulfilment of knowledge expectations. Related factors and associations were analysed separately for each kind of arthroplasty. In total 865 patients were included (hip n=413, knee n=452).

Results. In the dimension of pain, patients undergoing hip replacement had significantly better QoR compared to those undergoing knee replacement. Both patient groups experienced negative emotions before surgery that were related to poorer QoR. Fulfilment of knowledge expectations has a limited effect on QoR. Greater satisfaction with care predicted better QoR.

Conclusions. Negative preoperative emotions were related to poorer QoR. For both kinds of arthroplasty, greater satisfaction with care was associated with better QoR.

Relevance to clinical practice. The result emphasises the need to detect patients in need of support in their preparation and recovery process, taking into account the perspective of their emotional state.

Place, publisher, year, edition, pages
Wiley-Blackwell Publishing Inc., 2016
Keywords
Fulfilment of knowledge expectations, health-related quality of life, hip replacement, knee replacement, preoperative emotional state, quality of recovery, satisfaction with care
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:liu:diva-125235 (URN)10.1111/jocn.13278 (DOI)
Note

At the time of thesis presentation publication was in status: Manuscript

Available from: 2016-02-17 Created: 2016-02-17 Last updated: 2017-04-21Bibliographically approved
Wärdig, R., Bachrach-Lindström, M., Hultsjö, S., Lindström, T. & Foldemo, A. (2015). Persons with psychosis perceptions of participating in a lifestyle intervention. Journal of Clinical Nursing, 24(13-14), 1815-1824
Open this publication in new window or tab >>Persons with psychosis perceptions of participating in a lifestyle intervention
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2015 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 13-14, p. 1815-1824Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES:

To describe how persons with psychosis perceive participation in a lifestyle intervention, and use these perceptions to present factors to for consideration in future interventions.

BACKGROUND:

Metabolic syndrome is common in persons with psychosis. A healthy lifestyle is the primary option for preventing and treating metabolic syndrome, which is why the importance of lifestyle interventions has come into focus among health care professionals. Identifying perceptions of participation in a lifestyle intervention can increase the understanding of how to design future interventions.

DESIGN:

A qualitative, phenomenographic approach was selected, using semi-structured interviews.

METHODS:

The sample consisted of 40 participants with a psychotic disorder, who had undergone a lifestyle intervention focusing on theoretical education in healthy eating and physical activities. The interviews were conducted in 2011 and 2012, six to seven months after the intervention had been completed.

RESULTS:

The findings comprise three categories that emphasise the need for a moderate intervention level that facilitates participation and thereby social interactions among group members. The experience of success in the intervention supported the perception of oneself as a capable individual. However, it could also be the opposite, another experience of failure.

CONCLUSION:

Content in moderation can facilitate participation, and participants can thereby achieve health benefits and find social contacts. In addition to physical activity and lifestyle habits, interventions should have a social focus and be continuous. Professional support is a prerequisite and should facilitate the participants' ability to mirror themselves against healthy people in society by introducing activities that ordinary people do.

RELEVANCE FOR CLINICAL PRACTICE:

Identifying perceptions of participation in a lifestyle intervention can increase the understanding of how to design and manage future interventions. This is also an aspect that is important to consider in everyday clinical practice.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-115726 (URN)10.1111/jocn.12782 (DOI)000356872900007 ()25664402 (PubMedID)
Available from: 2015-03-18 Created: 2015-03-18 Last updated: 2017-12-04
Ekman, B., Alstrand, N., Bachrach-Lindström, M., Jenmalm, M. C. & Wahlberg, J. (2014). Altered Chemokine Th1/Th2 Balance in Addison's Disease: Relationship with Hydrocortisone Dosing and Quality of Life. Hormone and Metabolic Research, 46(1), 48-53
Open this publication in new window or tab >>Altered Chemokine Th1/Th2 Balance in Addison's Disease: Relationship with Hydrocortisone Dosing and Quality of Life
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2014 (English)In: Hormone and Metabolic Research, ISSN 0018-5043, E-ISSN 1439-4286, Vol. 46, no 1, p. 48-53Article in journal (Refereed) Published
Abstract [en]

The adrenalitis found in autoimmune Addison’s disease (AAD) is considered having a Th1-driven pathogenesis. Circulating Th1- and Th2-associated chemokines responsible for the trafficking of leukocytes to inflammatory sites are markers for the Th1/Th2 balance. The aim of the study was to assess if the same daily hydrocortisone dose of 30 mg given in either 2 or 4 doses to patients with AAD could affect the Th1/Th2 balance of circulating chemokines.

Fifteen patients (6 women) with AAD were included in this randomised, placebo controlled, double blind cross-over study. Samples for chemokines, Th1-associated (CXCL10, CXCL11) and Th2-associated (CCL17, CCL22), were drawn 5 times during a 24-h period at the end of each treatment period and analysed with Luminex. Seven control subjects did the same diurnal blood sampling once. Subjects with AAD had higher median diurnal levels of the Th1-associated chemokines than controls, CXCL10 [43 (33–56) pg/ml vs. 22 (19–34) pg/ml, p<0.01] and CXCL11 [37 (29–48) pg/ml vs. 16 (9–24) pg/ml, p<0.001], whereas no significant difference was found regarding the Th2-related chemokines. Similar chemokine levels were found when the same hydrocortisone dose of 30 mg was divided in 2 or 4 doses. Levels of CXCL11 correlated negatively with scores of SF-36 domains (high score indicate better health) of General Health (GH) and total score for Physical Component Summary (PCS), and these negative correlations were most pronounced at 04:00 h on the 2-dose regimen. Patients with AAD have a dominant Th1 chemokine profile that partially correlates to reduced quality of life.

National Category
Endocrinology and Diabetes
Identifiers
urn:nbn:se:liu:diva-104003 (URN)10.1055/s-0033-1351291 (DOI)000329563500004 ()
Available from: 2014-02-06 Created: 2014-02-06 Last updated: 2019-01-09
Johansson Stark, Å., Ingadottir, B., Salanterä, S., Sigurdardottir, A. K., Valkeapää, K., Bachrach-Lindström, M. & Unosson, M. (2014). Fulfilment of knowledge expectations and emotional state among people undergoing hip replacement: A multi-national survey. International Journal of Nursing Studies, 51(11), 1491-1499
Open this publication in new window or tab >>Fulfilment of knowledge expectations and emotional state among people undergoing hip replacement: A multi-national survey
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2014 (English)In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 11, p. 1491-1499Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Patient education in connection with hip replacement is intended to prepare patients for surgery, discharge and postoperative recovery. Patients experience symptoms and emotions due to disease or upcoming surgery which can affect how their knowledge expectations are fulfilled.

OBJECTIVES:

To describe the differences between received and expected knowledge in patients undergoing elective hip replacement in three Nordic countries, and to analyse how these differences are related to patients' characteristics, preoperative symptoms and emotions.

DESIGN:

A descriptive, prospective survey with two data collection points; before admission and at hospital discharge after surgery.

SETTINGS:

Two Finnish, three Icelandic and two Swedish hospitals.

PARTICIPANTS:

The population consisted of patients on a waiting list for hip replacement. Of the consecutively included patients, 320 answered questionnaires both before admission and at discharge and were included in the study. The mean age of the patients was 64 years, and 55% were women.

METHODS:

Structured questionnaires were used; the knowledge expectations of hospital patients scale and self-reported scales for symptoms and emotions before admission and received knowledge of hospital patients scale at discharge. Fulfilment of knowledge expectation was assessed by calculating the difference between received and expected knowledge with a paired sample t-test. A multiple stepwise regression model was used to explain the variance of fulfilled knowledge expectations.

RESULTS:

Patients expected more knowledge than they received (p<0.001) and 77% of them had unfulfilled knowledge expectations. Patients with a higher level of education were more likely to have unfulfilled knowledge expectations. A higher level of education was also related to a greater difference between received and expected knowledge. The difference was more correlated with patients' emotions than their symptoms. A depressive state was the major predictor of the variance in the difference between received and expected knowledge.

CONCLUSIONS:

In order to better support patients by education it is necessary to assess their emotional state, educational level and knowledge expectations before surgery.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Emotions, Empowering knowledge, Hip replacement, Knowledge expectations, Orthopaedic nursing, Patient education, Symptoms
National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-109769 (URN)10.1016/j.ijnurstu.2014.03.006 (DOI)000343351900009 ()24751503 (PubMedID)
Projects
Empowering Patient Education
Available from: 2014-08-27 Created: 2014-08-27 Last updated: 2017-12-05Bibliographically approved
Johansson Stark, Å., Ingadottir, B., Sigurdardottir, A. K., Valkeapää, K., Bachrach-Lindström, M. & Unosson, M. (2014). Fulfilment of patients’ knowledge expectations in connection with hip or knee replacement – a Nordic perspective. In: : . Paper presented at Nordic Conference in Nursing Research, Methods and Networks for the future, 10-12 June 2014, Odense, Denmark.
Open this publication in new window or tab >>Fulfilment of patients’ knowledge expectations in connection with hip or knee replacement – a Nordic perspective
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2014 (English)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Objective: To describe and compare the differences between received and expected knowledge in patients undergoing elective hip or knee replacement in three Nordic countries, and to analyse if these differences are related to patients’ characteristics.

Method: A descriptive, prospective and comparative survey of patients with osteoarthritis treated at two Finnish, three Icelandic and two Swedish hospitals (n=612). Patients answered questionnaires about their knowledge expectations (KEhp) before surgery and about received knowledge (RKhp) at discharge. These two parallel instruments include: bio-physiological, functional, experiential, ethical, social and financial dimensions of knowledge.

Results: Among the 29% Finnish, 34% Icelandic and 37% Swedish patients (hip: 53%, knee: 47%) were 54% females and the mean age was 65 years. Patients` knowledge expectations were higher, mean: 3.6 (±SD 0.5), than their perception of received knowledge 3.0 (0.7). The difference between expected and received knowledge was larger in Sweden -0.9(0.8) compared with Finland -0.4(0.8) and Iceland -0.5(0.7) (p<0.001) but not statistically different between patients having hip or knee replacement. Patients perceived having received most bio-physiological -0.3(0.6) and functional -0.3(0.6) knowledge but least financial -1.2(1.2) knowledge. A relationship was found between the difference of expected and received knowledge and whether the hospital stay was as expected. For patients undergoing hip replacement this difference was also related to the level of education, for knee replacement patients if they had their first arthroplasty and employment in social or health care.

Conclusions: Patients expect multidimensional knowledge during hospital stay which was inadequately met. Assessing patients’ knowledge needs could improve patient education.

National Category
Health Sciences
Identifiers
urn:nbn:se:liu:diva-109770 (URN)
Conference
Nordic Conference in Nursing Research, Methods and Networks for the future, 10-12 June 2014, Odense, Denmark
Projects
Empowering Patient Education
Available from: 2014-08-27 Created: 2014-08-27 Last updated: 2014-09-25
Foldemo, A., Wärdig, R., Bachrach-Lindstrom, M., Edman, G., Holmberg, T., Lindström, T., . . . Osby, U. (2014). Health-related quality of life and metabolic risk in patients with psychosis. Schizophrenia Research, 152(1), 295-299
Open this publication in new window or tab >>Health-related quality of life and metabolic risk in patients with psychosis
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2014 (English)In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 152, no 1, p. 295-299Article in journal (Refereed) Published
Abstract [en]

Improved Health-related quality of life (HRQoL) is an alternative treatment goal for individuals with psychosis, who have up to two times greater prevalence of type 2 diabetes, hypertension and obesity than the general population. Aim: to compare HRQoL in patients with psychosis, especially schizophrenia, with a reference sample and explore the relationship between HRQoL and metabolic risk factors in these patients. Methods: a prospective cohort study was carried out in specialized psychiatric outpatient departments in Sweden. The patients were invited consecutively. A prospective population-based study of public health in the south-east of Sweden served as reference group. Patients were assessed with psychiatric questionnaires that included Global Assessment of Functioning (GAF). Health-related quality of life was assessed using the questionnaire EQ5D, both for patients and the population, and several other health status outcomes were used. Results: At 73%, schizophrenia and schizoaffective disorder were the most common diagnoses in the patient group. The results in patients (n = 903) and population (n = 7238) showed significant differences in lower EQ5D among patients. According to the definition by the International Diabetes Federation (IDF), elevated blood pressure was the only metabolic risk associated with lower HRQoL in patients. Raised LDL-cholesterol levels were also significantly related to lower HRQoL. Conclusion: patients suffering from psychosis had significantly lower HRQoL regarding all components in EQ5D, except for the pain/discomfort component. Almost half of the patient group met the criteria for metabolic syndrome. According to the IDF criteria, elevated blood pressure was the only metabolic risk factor that had an impact on HRQoL.

Place, publisher, year, edition, pages
Elsevier, 2014
Keywords
Metabolic syndrome; Schizophrenia; Health-related quality of life; Reference group
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-104125 (URN)10.1016/j.schres.2013.11.029 (DOI)000329217000043 ()
Available from: 2014-02-07 Created: 2014-02-07 Last updated: 2017-12-06
Wärdig, R., Bachrach-Lindström, M., Hultsjö, S., Lindström, T. & Foldemo, A. (2014). Perceptions of participating in a lifestyle intervention - from the perspective of patients with psychosis. In: : . Paper presented at The 4th Biennial Schizophrenia International Research Society Conference, 5-9 April 2014, Florens, Italy.
Open this publication in new window or tab >>Perceptions of participating in a lifestyle intervention - from the perspective of patients with psychosis
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2014 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

 

 

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107561 (URN)
Conference
The 4th Biennial Schizophrenia International Research Society Conference, 5-9 April 2014, Florens, Italy
Available from: 2014-06-16 Created: 2014-06-16 Last updated: 2014-08-07
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