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Ågren, Susanna
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Publications (10 of 51) Show all publications
Ågren, S., Sjöberg, T., Ekmehag, B., Wiborg, M.-B. & Ivarsson, B. (2017). Psycho-social aspects before and up to 2 years after heart or lung transplantation - experience of patients and their next of kin.. Clinical Transplantation, 31(3), Article ID e12905.
Open this publication in new window or tab >>Psycho-social aspects before and up to 2 years after heart or lung transplantation - experience of patients and their next of kin.
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2017 (English)In: Clinical Transplantation, ISSN 0902-0063, E-ISSN 1399-0012, Vol. 31, no 3, article id e12905Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Psychosocial factors are important for patients undergoing heart (HTx) or lung (LTx) transplantation, and for their next of kin (NoK).

AIM: To describe health-related quality of life (patients only), anxiety, depression, stress, coping ability and burden (NoK only) for patients and their NoK before and up to 2 years after HTx or LTx.

DESIGN: Adult patients (28 heart and 26 lung) and their appointed NoK were surveyed with questionnaires about specific psychosocial topics when they were accepted for the transplantation waiting list and 6 months, 1 year, and 2 years after transplantation.

FINDINGS: Patients' coping ability and self-perceived health were low at baseline and improved over time after the transplantation. However, lung patients took longer time to recover in terms of health-related quality of life, depression, and stress than heart patients. Similarly, NoK of lung patients experienced a higher burden and more stress 1 year after transplantation than NoK of heart patients.

CONCLUSIONS: Healthcare professionals should be aware of the psychosocial challenges patients and their NoK face in daily living and provide support both before and after heart or lung transplantation. Especially, given that these patients have a serious, chronic, underlying disease. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017
Keywords
chronic illness, end-stage cardiac diseases, end-stage lung diseases, family, health-related quality of life, longitudinal study, psychosocial adjustment, transplantation
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-133979 (URN)10.1111/ctr.12905 (DOI)000395382200017 ()28039882 (PubMedID)2-s2.0-85012050815 (Scopus ID)
Note

Funding agencies: Skane University Hospital; Region Ostergotland; Dahlback foundation, Lund

Available from: 2017-01-17 Created: 2017-01-17 Last updated: 2018-05-02Bibliographically approved
Jonkman, N. H., Westland, H., Groenwold, R. H. H., Ågren, S., Atienza, F., Blue, L., . . . Hoes, A. W. (2016). Do Self-Management Interventions Work in Patients With Heart Failure? An Individual Patient Data Meta-Analysis. Circulation, 133(12), 1189-1198
Open this publication in new window or tab >>Do Self-Management Interventions Work in Patients With Heart Failure? An Individual Patient Data Meta-Analysis
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2016 (English)In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 133, no 12, p. 1189-1198Article in journal (Refereed) Published
Abstract [en]

Background- Self-management interventions are widely implemented in the care for patients with heart failure (HF). However, trials show inconsistent results, and whether specific patient groups respond differently is unknown. This individual patient data meta-analysis assessed the effectiveness of self-management interventions in patients with HF and whether subgroups of patients respond differently. Methods and Results- A systematic literature search identified randomized trials of self-management interventions. Data from 20 studies, representing 5624 patients, were included and analyzed with the use of mixed-effects models and Cox proportional-hazard models, including interaction terms. Self-management interventions reduced the risk of time to the combined end point of HF-related hospitalization or all-cause death (hazard ratio, 0.80; 95% confidence interval [CI], 0.71-0.89), time to HF-related hospitalization (hazard ratio, 0.80; 95% CI, 0.69-0.92), and improved 12-month HF-related quality of life (standardized mean difference, 0.15; 95% CI, 0.00-0.30). Subgroup analysis revealed a protective effect of self-management on the number of HF-related hospital days in patients < 65 years of age (mean, 0.70 versus 5.35 days; interaction P=0.03). Patients without depression did not show an effect of self-management on survival (hazard ratio for all-cause mortality, 0.86; 95% CI, 0.69-1.06), whereas in patients with moderate/severe depression, self-management reduced survival (hazard ratio, 1.39; 95% CI, 1.06-1.83, interaction P=0.01). Conclusions- This study shows that self-management interventions had a beneficial effect on time to HF-related hospitalization or all-cause death and HF-related hospitalization alone and elicited a small increase in HF-related quality of life. The findings do not endorse limiting self-management interventions to subgroups of patients with HF, but increased mortality in depressed patients warrants caution in applying self-management strategies in these patients.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2016
Keywords
meta-analysis; self care; heart failure
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-127263 (URN)10.1161/CIRCULATIONAHA.115.018006 (DOI)000372406100006 ()26873943 (PubMedID)
Note

Funding Agencies|Netherlands Organisation for Health Research and Development, ZonMw [520001002]

Available from: 2016-04-20 Created: 2016-04-19 Last updated: 2017-11-30Bibliographically approved
Årestedt, K., Ågren, S., Flemme, I., Moser, D. K. & Strömberg, A. (2015). A psychometric evaluation of the four-item version of the Control Attitudes Scale for patients with cardiac disease and their partners. European Journal of Cardiovascular Nursing, 14(4), 317-325
Open this publication in new window or tab >>A psychometric evaluation of the four-item version of the Control Attitudes Scale for patients with cardiac disease and their partners
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2015 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 14, no 4, p. 317-325Article in journal (Refereed) Published
Abstract [en]

Background:The four-item Control Attitudes Scale (CAS) was developed to measure control perceived by patients with cardiac disease and their family members, but extensive psychometric evaluation has not been performed.Objective:The aim was to translate, culturally adapt and psychometrically evaluate the CAS in a Swedish sample of implantable cardioverter defibrillator (ICD) recipients, heart failure (HF) patients and their partners.Methods:A sample (n=391) of ICD recipients, HF patients and partners were used. Descriptive statistics, item-total and inter-item correlations, exploratory factor analysis, ordinal regression modelling and Cronbach's alpha were used to validate the CAS.Results:The findings from the factor analyses revealed that the CAS is a multidimensional scale including two factors, Control and Helplessness. The internal consistency was satisfactory for all scales (α=0.74-0.85), except the family version total scale (α=0.62). No differential item functioning was detected which implies that the CAS can be used to make invariant comparisons between groups of different age and sex.Conclusions:The psychometric properties, together with the simple and short format of the CAS, make it to a useful tool for measuring perceived control among patients with cardiac diseases and their family members. When using the CAS, subscale scores should be preferred.

Place, publisher, year, edition, pages
Sage Publications, 2015
Keywords
Family; heart disease; prevention and control; psychometrics
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-107731 (URN)10.1177/1474515114529685 (DOI)000357949600006 ()24671774 (PubMedID)
Available from: 2014-06-19 Created: 2014-06-19 Last updated: 2017-12-05
Ågren, S., Strömberg, A., Jaarsma, T. & Luttik, M. L. (2015). Caregiving tasks and caregiver burden; effects of an psycho-educational intervention in partners of patients with post-operative heart failure. Heart & Lung, 44(4), 270-275
Open this publication in new window or tab >>Caregiving tasks and caregiver burden; effects of an psycho-educational intervention in partners of patients with post-operative heart failure
2015 (English)In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 44, no 4, p. 270-275Article in journal (Refereed) Published
Abstract [en]

Objective: To evaluate the effects of a psycho-educational intervention on caregiver burden in partners of patients with postoperative heart failure. Background: Since partners of cardiac surgery patients play a significant role in the patients recovery, it is important to address their needs during hospitalization and after discharge. Methods: Forty-two patients with postoperative heart failure and their partners participated in a randomized controlled pilot study. Dyads in the intervention group received psycho-educational support from a multidisciplinary team. Dyads in the control group received usual care. Results: No significant differences were found in the performance of caregiving tasks and perceived caregiver burden in the control versus the intervention group. Conclusion: A pilot study exploring the effects of a psycho-educational intervention in patients and their partners did not reveal significant effects with regard to reduced feelings of burden in partners. Alleviating caregiver burden in partners may need a more intense or specific approach. (C) 2015 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Postoperative complications; Heart failure; Psychosocial support; Education; Quality of life; Family; Depression
National Category
Clinical Medicine Sociology
Identifiers
urn:nbn:se:liu:diva-120214 (URN)10.1016/j.hrtlng.2015.04.003 (DOI)000356994600003 ()26026801 (PubMedID)
Note

Funding Agencies|Swedish National Association of Heart and Lung disease [E094/10, E 104/09]

Available from: 2015-07-21 Created: 2015-07-20 Last updated: 2017-12-04
Ågren, S. & Eriksson, A. (2015). Hälsostödjande samtal. In: : . Paper presented at ANIVA Congress Upplands Väsby, Stockholm, 19-20 November 2015. Riksföreningen för Anestesi och Intensivvård
Open this publication in new window or tab >>Hälsostödjande samtal
2015 (Swedish)Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Families who have a seriously ill family member in an intensive care unit face a demanding situation,threatening the normal functioning of the family. The burden onfamilies can be reduced by usingavailable resources, cohesiveness, supportive communication, flexibility and othersocial resources outsidethe family.If health promoting conversationsoffered to the family's ownabilities is strengthened, thisshould result in health promoting values to the family. In order to gain a better understanding of familyadaptation, we must not only see the family as a unit but also acknowledge the experiences of eachmember of the family.

To investigate outcomes of the nurse led intervention, “Health promoting conversations with families” on family functioning and wellbeing in families with a member who has had critical illness.

The study is a RCT study using a pre-test, post-test intervention and control group design. The inclusioncriteria will be: Patients over the age of 18, a minimum of 72 hours at the intensive care unit, and at leastone family member (>15 years) to each patient interested in participating. Within the study, quantitativeand qualitative data will be collected and analysed with descriptive and analytical statistical methods ofthe quantitative data and content analysis of the qualitative data.

The conversations were considered to be healing and learning, because the family members can completememory loss from other family members' stories. Families showed a tendency to less stress and morehope, better mental health but poorer physical health in a pilot study. The project highlights knowledgeabout the health benefits of conversations about families where a family member has suffered from poorhealth. The health promoting conversations has a structure that makes conversations relatively easy toimplement in everyday healthcare and will be beneficial for many patients with critical illness and theirfamilies.

Place, publisher, year, edition, pages
Riksföreningen för Anestesi och Intensivvård, 2015
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-124333 (URN)
Conference
ANIVA Congress Upplands Väsby, Stockholm, 19-20 November 2015
Available from: 2016-01-26 Created: 2016-01-26 Last updated: 2016-02-08Bibliographically approved
Liljeroos, M., Ågren, S., Jaarsma, T., Årestedt, K. & Strömberg, A. (2015). Long Term Follow-Up after a Randomized Integrated Educational and Psychosocial Intervention in Patient-Partner Dyads Affected by Heart Failure. PLoS ONE, 10(9), e0138058
Open this publication in new window or tab >>Long Term Follow-Up after a Randomized Integrated Educational and Psychosocial Intervention in Patient-Partner Dyads Affected by Heart Failure
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2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 9, p. e0138058-Article in journal (Refereed) Published
Abstract [en]

Background To date, contemporary heart failure care remains patient-focused, but awareness of the partners and families situation is increasing. Randomized studies have mainly evaluated the short-term effects of dyadic interventions. Therefore, the aim of this study was to determine the 24-month effects of an intervention with psych-educational support in dyads of heart failure patients and their partners. Methods This study used a randomized study design and 155 patient-partner dyads were enrolled. The intervention included a nurse-led program of three sessions addressing psychoeducational support. Results The intervention did not have any effect on health, depressive symptoms or perceived control among the patient-partner dyads after 24 months. Furthermore, time to first event did not differ significantly between the intervention group and the control patients. Conclusion This study may be regarded as a first step in trying to understand dyads need for supportive care. Individualized and more targeted interventions seem necessary to achieve a higher impact on dyad outcomes.

Place, publisher, year, edition, pages
PUBLIC LIBRARY SCIENCE, 2015
National Category
Clinical Medicine Sociology
Identifiers
urn:nbn:se:liu:diva-122211 (URN)10.1371/journal.pone.0138058 (DOI)000361800700030 ()26406475 (PubMedID)
Note

Funding Agencies|Centre for Clinical Research Sormland; Linkoping University; Swedish Research Council; Swedish Institute for Health Sciences

Available from: 2015-10-26 Created: 2015-10-23 Last updated: 2017-12-01
Ågren, S., Sjöberg, T., Ekmehag, B., Wiborg, M.-B. & Ivarsson, B. (2015). Patients' self-perceived health, coping, anxiety, depression and stress before and up to 2 years after a heart or lung transplantation.. In: : . Paper presented at Svenska Kardiovaskulära Vårmötet, Örebro, 22-24 april 2015 (pp. 111-112). Svenska Hjärtförbundet
Open this publication in new window or tab >>Patients' self-perceived health, coping, anxiety, depression and stress before and up to 2 years after a heart or lung transplantation.
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2015 (English)Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Background: Psychosocial factors are important aspects for patients before, on waiting list, and after a heart or lung transplantation.

Aim: To illuminate patients' self-­‐perceived health, coping, anxiety, depression and stress before and up to 2 years after heart or lung transplantation.

Method: Fifty-­‐four adult patients (28 cardiac and 26 lung) were included. They responded to questionnaires about quality of life, coping, anxiety, depression and stress when they were accepted for the transplant waiting list, then 6 months, 1 year and 2 years after a heart or lung transplantation. 

Result: Mean waiting time was 37 weeks for cardiac patients and 29 weeks for lung patients. The patients had a lower coping ability and self-­‐perceived health at baseline and showed an improvement over time after the transplantation. Excluding pain, which increased and persisted over time after the transplantation, especially for the lung patients. Twenty-­‐three percent of all patients showed clinically anxiety before transplantation compared to 0-­‐8 % after transplantation. However, both before and after, clinical depression was significantly less frequent. Nearly half (44 %) of the patients scored medium or high level of intrusion stress and 38% of avoidance stress before the transplantation, which declined gradually over the years.

Conclusion: Transplantation has led to positive psychosocial effects at 6 months, 1 year and 2 years after the heart or lung transplantation for most of the patients. The healthcare professionals must ensure to be aware of the challenges faced by their patients in daily living, not only the symptoms of their severe chronic disease but also psychosocial factors mainly before but even after a heart or lung transplantation. Patients have an underlying serious, chronic disease where severe long-­‐term life-­‐threatening complications suddenly can occur

Place, publisher, year, edition, pages
Svenska Hjärtförbundet, 2015
National Category
Other Health Sciences
Identifiers
urn:nbn:se:liu:diva-124330 (URN)
Conference
Svenska Kardiovaskulära Vårmötet, Örebro, 22-24 april 2015
Available from: 2016-01-26 Created: 2016-01-26 Last updated: 2016-02-08Bibliographically approved
Ågren, S., Berg, S., Svedjeholm, R. & Strömberg, A. (2015). Psychoeducational support to post cardiac surgery heart failure patients and their partners: A randomised pilot study. Intensive & Critical Care Nursing, 31(1), 10-18
Open this publication in new window or tab >>Psychoeducational support to post cardiac surgery heart failure patients and their partners: A randomised pilot study
2015 (English)In: Intensive & Critical Care Nursing, ISSN 0964-3397, E-ISSN 1532-4036, Vol. 31, no 1, p. 10-18Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Postoperative heart failure is a serious complication that changes the lives of both the person who is critically ill and family in many ways. The purpose of this study was to evaluate the effects of an intervention in postoperative heart failure patient-partner dyads regarding health, symptoms of depression and perceived control.

RESEARCH METHODOLOGY/DESIGN: Pilot study with a randomised controlled design evaluating psychosocial support and education from an interdisciplinary team.

SETTING: Patients with postoperative heart failure and their partners.

MAIN OUTCOME MEASURES: SF-36, Beck Depression Inventory, Perceived Control at baseline, 3 and 12 months.

RESULTS: A total of 42 patient-partner completed baseline assessment. Partners in the intervention group increased health in the role emotional and mental health dimensions and patients increased health in vitality, social function and mental health dimensions compared with the control group. Patients' perceived control improved significantly in the intervention group over time.

CONCLUSION: Psychoeducational support to post cardiac surgery heart failure dyads improved health in both patients and partners at short term follow-up and improved patients' perceived control at both short and long-term follow-up. Psychoeducational support appears to be a promising intervention but the results need to be confirmed in larger studies.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
Education; Family; Heart failure; Intervention; Postoperative complications; Psychosocial support; Quality of life
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-109501 (URN)10.1016/j.iccn.2014.04.005 (DOI)000349930300002 ()24969363 (PubMedID)
Available from: 2014-08-20 Created: 2014-08-20 Last updated: 2017-12-05Bibliographically approved
Ågren, S. & Ivarsson, B. (2015). Psychosocial impact in family members before and up to two years after heart or lung transplantation.. In: : . Paper presented at 6th International Carers Conference, Gothenburg, Sweden, 4-6 September 2015.
Open this publication in new window or tab >>Psychosocial impact in family members before and up to two years after heart or lung transplantation.
2015 (English)Conference paper, Oral presentation only (Other academic)
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-124331 (URN)
Conference
6th International Carers Conference, Gothenburg, Sweden, 4-6 September 2015
Available from: 2016-01-26 Created: 2016-01-26 Last updated: 2016-02-08Bibliographically approved
Liljeroos, M., Ågren, S., Jaarsma, T. & Strömberg, A. (2015). The cognitive, supportive and behaviour needs of participants in a nurse-led intervention targeting patients with heart failure and their partners. In: : . Paper presented at EuroHeartCare 2015 Dubrovnik Croatia, 14–15 June 2015 (pp. S1-S120). , 14 (S1)
Open this publication in new window or tab >>The cognitive, supportive and behaviour needs of participants in a nurse-led intervention targeting patients with heart failure and their partners
2015 (English)Conference paper, Poster (with or without abstract) (Other academic)
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-126579 (URN)
Conference
EuroHeartCare 2015 Dubrovnik Croatia, 14–15 June 2015
Available from: 2016-03-30 Created: 2016-03-30 Last updated: 2017-03-27
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