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Jaarsma, Tiny, ProfessorORCID iD iconorcid.org/0000-0002-4197-4026
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Publications (10 of 312) Show all publications
Jaarsma, T. & Strömberg, A. (2019). We told you so: knowledge is not enough to improve heart failure self-care behaviour. ESC Heart Failure
Open this publication in new window or tab >>We told you so: knowledge is not enough to improve heart failure self-care behaviour
2019 (English)In: ESC Heart Failure, E-ISSN 2055-5822Article in journal, Editorial material (Refereed) Epub ahead of print
Abstract [en]

n/a

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-160422 (URN)10.1002/ejhf.1580 (DOI)000483562500001 ()31452305 (PubMedID)2-s2.0-85071650967 (Scopus ID)
Available from: 2019-09-23 Created: 2019-09-23 Last updated: 2019-10-01Bibliographically approved
Mourad, G., Verheijden Klompstra, L., Jaarsma, T., Strömberg, A. & Alwin, J. (2019). What are patients with heart failure willing to pay for an exergame intervention?. In: : . Paper presented at EuroHeartCare.
Open this publication in new window or tab >>What are patients with heart failure willing to pay for an exergame intervention?
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2019 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Regular physical activity in patients with heart failure (HF) improves physical capacity and quality of life, and may reduce health care utilization. One low-cost effective physical activity intervention to increase exercise capacity is exergaming. Exploring patients’ willingness to pay (WTP) for treatments/interventions is a way to obtain a monetary value for the health consequences of an intervention. This can further be used in economic evaluations.

Aim: The aim of this study was to describe patients´ WTP for an exergame intervention and to determine factors influencing the WTP.

Methods: This is a substudy of the Swedish cohort of the HF-Wii study (evaluating the effect of exergaming on exercise capacity in patients with HF; clinicaltrial.gov NCT01785121) including 34 patients who finished the 1-year follow-up. Structured telephone interviews were conducted focusing on WTP for the exergame intervention they received during the study including an exergame platform, an introduction lesson, installation of the exergame computer, and telephone follow-ups, and with an estimated cost of ∼€440 per patient. The WTP methodology used was adjusted for this specific study.

Patients were also asked to rate their level of satisfaction with the intervention on a Numeric Rating Scale (NRS) from 0-10. In addition, information on background variables and income was collected during the interview, while data on six minute walk test (6MWT) and quality of life was retrieved from previous data collection in the main study.

Results: In total, 29 patients with HF participated in this substudy, mean age 68±9 years, 69% males, and with a mean household disposable income/month of ∼€2700 (±1360). Ten patients (34.5%) had a clinically significant effect of the exergaming and improved more than 30 meters on the 6MWT.

The average WTP for the exergame intervention was ∼€160 (range €0-580). Most patients were satisfied with the exergame intervention and the median score was 8 on the NRS. The satisfaction level was significantly related to WTP (rs=0.468, p=0.012). Patients with higher satisfaction levels were willing to pay more (€210±165) for the exergame intervention than those with lower satisfaction levels (€60±70), p=0.015. Income, changes in 6MWT, and quality of life showed no significant relationship to WTP.

Conclusions: The WTP for an exergame intervention varied largely in patients with HF despite high satisfaction level with the intervention. The satisfaction level was the only factor influencing patients´ WTP. On average, patients were willing to pay about one-third of the cost of the exergame intervention. Future studies should focus on the cost-effectiveness of this intervention.

National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-158027 (URN)
Conference
EuroHeartCare
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-09-16
Säfström, E., Jaarsma, T. & Strömberg, A. (2018). Continuity and utilization of health and community care in elderly patients with heart failure before and after hospitalization. BMC Geriatrics, 18, Article ID 177.
Open this publication in new window or tab >>Continuity and utilization of health and community care in elderly patients with heart failure before and after hospitalization
2018 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, article id 177Article in journal (Refereed) Published
Abstract [en]

Background: The period after hospitalization due to deteriorated heart failure (HF) is characterized as a time of high generalized risk. The transition from hospital to home is often problematic due to insufficient coordination of care, leading to a fragmentation of care rather than a seamless continuum of care. The aim was to describe health and community care utilization prior to and 30 days after hospitalization, and the continuity of care in patients hospitalized due to de novo or deteriorated HF from the patients perspective and from a medical chart review. Methods: This was a cross-sectional study with consecutive inclusion of patients hospitalized at a county hospital in Sweden due to deteriorated HF during 2014. Data were collected by structured telephone interviews and medical chart review and analyzed with the Spearmans rank correlation coefficient and Chi square. A P value of 0. 05 was considered significant. Results: A total of 121 patients were included in the study, mean age 82.5 (+/- 6.8) and 49% were women. Half of the patients had not visited any health care facility during the month prior to the index hospital admission, and 79% of the patients visited the emergency room (ER) without a referral. Among these elderly patients, a total of 40% received assistance at home prior to hospitalization and 52% after discharge. A total of 86% received written discharge information, one third felt insecure after hospitalization and lacked knowledge of which health care provider to consult with and contact in the event of deterioration or complications. Health care utilization increased significantly after hospitalization. Conclusion: Most patients had not visited any health care facility within 30 days before hospitalization. Health care utilization increased significantly after hospitalization. Flaws in the continuity of care were found; even though most patients received written information at discharge, one third of the patients lacked knowledge about which health care provider to contact in the event of deterioration and felt insecure at home after discharge.

Place, publisher, year, edition, pages
BMC, 2018
Keywords
Heart failure; Health care utilization; Hospitalization; Continuity of care; Discharge; Elderly patients
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-150865 (URN)10.1186/s12877-018-0861-9 (DOI)000441406000001 ()30103688 (PubMedID)
Note

Funding Agencies|Linkoping University; Sormland County Council

Available from: 2018-09-06 Created: 2018-09-06 Last updated: 2019-06-27
Waldreus, N., Jaarsma, T., van der Wal, M. & Perkiö Kato, N. (2018). Development and psychometric evaluation of the Thirst Distress Scale for patients with heart failure. European Journal of Cardiovascular Nursing, 17(3), 226-234
Open this publication in new window or tab >>Development and psychometric evaluation of the Thirst Distress Scale for patients with heart failure
2018 (English)In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 17, no 3, p. 226-234Article in journal (Refereed) Published
Abstract [en]

Background:

Patients with heart failure can experience thirst distress. However, there is no instrument to measure this in patients with heart failure. The aim of the present study was to develop the Thirst Distress Scale for patients with Heart Failure (TDS-HF) and to evaluate psychometric properties of the scale.

Methods and results:

The TDS-HF was developed to measure thirst distress in patients with heart failure. Face and content validity was confirmed using expert panels including patients and healthcare professionals. Data on the TDS-HF was collected from patients with heart failure at outpatient heart failure clinics and hospitals in Sweden, the Netherlands and Japan. Psychometric properties were evaluated using data from 256 heart failure patients (age 72±11 years). Concurrent validity of the scale was assessed using a thirst intensity visual analogue scale. Patients did not have any difficulties answering the questions, and time taken to answer the questions was about five minutes. Factor analysis of the scale showed one factor. After psychometric testing, one item was deleted. For the eight item TDS-HF, a single factor explained 61% of the variance and Cronbach’s alpha was 0.90. The eight item TDS-HF was significantly associated with the thirst intensity score (r=0.55, p<0.001). Regarding test-retest reliability, the intraclass correlation coefficient was 0.88, and the weighted kappa values ranged from 0.29–0.60.

Conclusion:

The eight-item TDS-HF is valid and reliable for measuring thirst distress in patients with heart failure.

Place, publisher, year, edition, pages
Sage Publications, 2018
Keywords
Thirst distress; heart failure; scale
National Category
Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-147585 (URN)10.1177/1474515117728624 (DOI)000429799300005 ()28838260 (PubMedID)2-s2.0-85041391093 (Scopus ID)
Note

Funding Agencies|Riksforbundet-HjartLung [E100/13]; Stockholms lans landsting (Pick-Up project); Svensk Sjukskoterskeforening; Japan Society for the Promotion Science KAKENHI [JP25893059]

Available from: 2018-04-26 Created: 2018-04-26 Last updated: 2019-06-27Bibliographically approved
Kraai, I. H., Vermeulen, K. M., Hillege, H. L. & Jaarsma, T. (2018). "Not getting worse": a qualitative study of patients perceptions of treatment goals in patients with heart failure. Applied Nursing Research, 39, 41-45
Open this publication in new window or tab >>"Not getting worse": a qualitative study of patients perceptions of treatment goals in patients with heart failure
2018 (English)In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 39, p. 41-45Article in journal (Refereed) Published
Abstract [en]

Background Knowledge of patient reported outcomes helps to provide personalized care on a patient level, optimize care on a population level, and identify the most appropriate patient reported outcomes for clinical trials. To be able to provide personalized care to patients with HF, it is important to know which treatment goals patients with HF consider the most important. This is particularly useful for interventions aimed at improving symptoms, functional status, or health-related quality of life. Aim: The aim of this study was (1) to explore which treatment goals patients with heart failure (HF) perceive as important for their treatment and (2) to identify which treatment goals take priority over other treatment goals. Methods: The study had a qualitative design and included one focus group interview with 6 patients with HF. Data were analyzed using qualitative content analysis. Results: The overall theme of this study was found to be Not getting worse. This theme was composed of 4 categories that described how the patients perceived the goals of treatment: to decrease symptoms, to improve physical function, to prevent readmission, and to live a normal life. None of the participants mentioned improved survival or being cured of their HF as a treatment goal. Conclusion Not getting worse was perceived as the treatment goal that matters to patients with HF and is in line with currently used endpoints for the evaluation of a treatment in a clinical trial. More research is necessary to develop endpoints that are consistent with the perception of patients, useful for clinical practice, and measurable.

Place, publisher, year, edition, pages
Saunders Elsevier, 2018
Keywords
Cardiovascular; Focus group; Patient centered care; Qualitative; Heart failure
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:liu:diva-145774 (URN)10.1016/j.apnr.2017.10.010 (DOI)000425838500007 ()29422175 (PubMedID)
Note

Funding Agencies|Dutch Ministry of Health, Welfare, and Sport

Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2019-06-27
Tromp, J., Richards, A. M., Tay, W. T., Teng, T.-H. K., Yeo, P. S., Sim, D., . . . Lam, C. S. P. (2018). N-terminal pro-B-type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure. ESC Heart Failure, 5(2), 279-287
Open this publication in new window or tab >>N-terminal pro-B-type natriuretic peptide and prognosis in Caucasian vs. Asian patients with heart failure
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2018 (English)In: ESC Heart Failure, E-ISSN 2055-5822, Vol. 5, no 2, p. 279-287Article in journal (Refereed) Published
Abstract [en]

N-terminal pro-B-type natriuretic peptide (NT-proBNP) is the most frequently used biomarker in heart failure (HF), but its prognostic utility across ethnicities is unclear.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
Ethnicity; HFpEF; Heart failure; NT-proBNP; Prognosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-152531 (URN)10.1002/ehf2.12252 (DOI)000428992300008 ()29380931 (PubMedID)
Available from: 2019-03-28 Created: 2019-03-28 Last updated: 2019-10-07
Tingström, P., Jaarsma, T. & Nilsson, S. (2018). Patient empowerment and general self-efficacy in patients with coronary heart disease: a cross-sectional study. BMC Family Practice, 19, Article ID 76.
Open this publication in new window or tab >>Patient empowerment and general self-efficacy in patients with coronary heart disease: a cross-sectional study
2018 (English)In: BMC Family Practice, ISSN 1471-2296, E-ISSN 1471-2296, Vol. 19, article id 76Article in journal (Refereed) Published
Abstract [en]

Abstract

Background:

In managing a life with coronary heart disease and the possibility of planning and following a

rehabilitation plan, patients

’ empowerment and self-efficacy are considered important. However, currently there is

limited data on levels of empowerment among patients with coronary heart disease, and demographic and clinical

characteristics associated with patient empowerment are not known.

The purpose of this study was to assess the level of patient empowerment and general self-efficacy in patients six

to 12 months after the cardiac event. We also aimed to explore the relationship between patient empowerment,

general self-efficacy and other related factors such as quality of life and demographic variables.

Methods:

A sample of 157 cardiac patients (78% male; age 68 ± 8.5 years) was recruited from a Swedish hospital.

Patient empowerment was assessed using the SWE-CES-10. Additional data was collected on general self-efficacy

and well-being (EQ5D and Ladder of Life). Demographic and clinical variables were collected from medical records

and interviews.

Results:

The mean levels of patient empowerment and general self-efficacy on a 0–4 scale were 3.69 (±0.54) and

3.13 (±0.52) respectively, and the relationship between patient empowerment and general self-efficacy was weak

(

r = 0.38). In a simple linear regression, patient empowerment and general self-efficacy were significantly correlated

with marital status, current self-rated health and future well-being. Multiple linear regressions on patient empowerment

(Model 1) and general self-efficacy (Model 2) showed an independent significant association between patient

empowerment and current self-rated health. General self-efficacy was not independently associated with any of the

variables.

Conclusions:

Patients with a diagnosis of coronary heart disease reported high levels of empowerment and general

self-efficacy at six to 12 months after the event. Clinical and demographic variables were not independently associated

with empowerment or low general self-efficacy. Patient empowerment and general self-efficacy were not mutually

interchangeable, and therefore both need to be measured when planning for secondary prevention in primary health

care.

Trial registration:

NCT01462799.

Place, publisher, year, edition, pages
BioMed Central, 2018
Keywords
Patient empowerment, General self-efficacy, Coronary heart disease, Self-rated health, Well-being, Primary health care
National Category
Other Health Sciences Cardiac and Cardiovascular Systems General Practice
Identifiers
urn:nbn:se:liu:diva-148478 (URN)10.1186/s12875-018-0749-y (DOI)000434076700001 ()
Funder
The Swedish Heart and Lung Association, E091/10, E122/11, E083/12, E103/13
Note

Funding agencies: Swedish Heart and Lung Association [E091/10, E122/11, E083/12, E103/13]; County Council/Region Ostergotland, Sweden [LIO-92281, LIO-125151, LIO-27535, LIO-354951, LIO-433801]

Available from: 2018-06-12 Created: 2018-06-12 Last updated: 2019-06-27
Lee, C. S., Bidwell, J. T., Paturzo, M., Alvaro, R., Cocchieri, A., Jaarsma, T., . . . Vellone, E. (2018). Patterns of self-care and clinical events in a cohort of adults with heart failure: 1 year follow-up. Heart & Lung, 47(1), 40-46
Open this publication in new window or tab >>Patterns of self-care and clinical events in a cohort of adults with heart failure: 1 year follow-up
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2018 (English)In: Heart & Lung, ISSN 0147-9563, E-ISSN 1527-3288, Vol. 47, no 1, p. 40-46Article in journal (Refereed) Published
Abstract [en]

Background: Heart failure (HF) self-care is important in reducing clinical events (all-cause mortality, emergency room visits and hospitalizations). HF self-care behaviors are multidimensional and include maintenance (i.e. daily adherence behaviors), management (i.e. symptom response behaviors) and consulting behaviors (i.e. contacting a provider when appropriate). Across these dimensions, patterns of successful patient engagement in self-care have been observed (e.g. successful in one dimension but not in others), but no previous studies have linked patterns of HF self care to clinical events. Objectives: To identify patterns of self-care behaviors in HF patients and their association with clinical events. Methods: This was a prospective, non-experimental, cohort study. Community-dwelling HF patients (n = 459) were enrolled across Italy, and clinical events were collected one year after enrollment. We measured dimensions of self-care behavior with the Self-Care of HF Index (maintenance, management, and confidence) and the European HF Self-care Behavior Scale (consulting behaviors). We used latent class mixture modeling to identify patterns of HF self-care across dimensions, and Cox proportional hazards modeling to quantify event-free survival over 12 months of follow-up. Results: Patients (mean age 71.8 +/- 12.1 years) were mostly males (54.9%). Three patterns of self-care behavior were identified; we labeled each by their most prominent dimensional characteristic: poor symptom response, good symptom response, and maintenance-focused behaviors. Patients with good symptom response behaviors had fewer clinical events compared with those who had poor symptom response behaviors (adjusted hazard ratio = 0.66 10.46-0.96], p = 0.03). Patients with poor symptom response behaviors had the most frequent clinical events. Patients with poor symptom response and those with maintenance-focused behaviors had a similar frequency of clinical events. Conclusions: Self-care is significantly associated with clinical events. Routine assessment, mitigation of barriers, and interventions targeting self-care are needed to reduce clinical events in HF patients. (C) 2017 Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
MOSBY-ELSEVIER, 2018
Keywords
Mortality; Heart failure; Prospective study; Self-care; Survival
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-143984 (URN)10.1016/j.hrtlng.2017.09.004 (DOI)000418210000006 ()29054487 (PubMedID)
Note

Funding Agencies|Center of Excellence for Nursing Scholarship, Rome, Italy

Available from: 2018-01-02 Created: 2018-01-02 Last updated: 2019-06-27
Verheijden Klompstra, L., Jaarsma, T. & Strömberg, A. (2018). Self-efficacy Mediates the Relationship Between Motivation and Physical Activity Patients With Heart Failure. Journal of Cardiovascular Nursing, 33(3), 211-216
Open this publication in new window or tab >>Self-efficacy Mediates the Relationship Between Motivation and Physical Activity Patients With Heart Failure
2018 (English)In: Journal of Cardiovascular Nursing, ISSN 0889-4655, E-ISSN 1550-5049, Vol. 33, no 3, p. 211-216Article in journal (Refereed) Published
Abstract [en]

Motivation is necessary in patients with heart failure (HF) who are attempting to become more physically active but may not be sufficient to initiate physical activity. Self-efficacy might explain the relationship between motivation and physical activity. Objective: The aim of this study was to examine the role of exercise self-efficacy in the relationship between exercise motivation and physical activity in patients with HF. Methods: A total of 100 stable patients with HF (88% in New York Heart Association class IVIII; mean age, 67 +/- 13 years; 62% men) were studied. Self-efficacy was measured with the Exercise Self-Efficacy Scale; motivation, with the Exercise Motivation Index; and physical activity, with a self-report questionnaire. Logistic regression analyses were made to examine the mediation effect of exercise self-efficacy on the relationship between exercise motivation and physical activity. Result: Forty-two percent of the 100 patients reported engaging in less than 60 minutes per week of physical activity. Motivation predicted physical activity (b = 0.58, P amp;lt; .05), but after controlling for self-efficacy, the relationship between motivation and physical activity was no longer significant (b = 0.76, P = .06), indicating full mediation. Conclusion: Motivation to be physically active is important but not sufficient. In addition to a high level of motivation to be physically active, it is important that patients with HF have a high degree of self-efficacy.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS & WILKINS, 2018
Keywords
mediation; moderation; motivation; physical activity; self-efficacy
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:liu:diva-150298 (URN)10.1097/JCN.0000000000000456 (DOI)000440243400012 ()29189427 (PubMedID)
Note

Funding Agencies|Swedish National Science Council [K2013-69X-22302-01-3]; Swedish Heart and Lung Association [E085/12]; Swedish Heart-Lung Foundation [20130340]; Vardal Foundation [2014-0018]; FORSS [474681]; Swedish National Science Council/Swedish Research Council for Health, Working Life and Welfare (VR-FORTE) [2014-4100]

Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2019-06-27
Mourad, G., Jaarsma, T., Strömberg, A., Svensson, E. & Johansson, P. (2018). The associations between psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter?. BMC Psychiatry, 18(1), Article ID 172.
Open this publication in new window or tab >>The associations between psychological distress and healthcare use in patients with non-cardiac chest pain: does a history of cardiac disease matter?
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2018 (English)In: BMC Psychiatry, ISSN ISSN 1471-244X, Vol. 18, no 1, article id 172Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Psychological distress such as somatization, fear of body sensations, cardiac anxiety and depressive symptoms is common among patients with non-cardiac chest pain, and this may lead to increased healthcare use. However, the relationships between the psychological distress variables and healthcare use, and the differences in relation to history of cardiac disease in these patients has not been studied earlier. Therefore, our aim was to explore and model the associations between different variables of psychological distress (i.e. somatization, fear of body sensations, cardiac anxiety, and depressive symptoms) and healthcare use in patients with non-cardiac chest pain in relation to history of cardiac disease.

METHODS: In total, 552 patients with non-cardiac chest pain (mean age 64 years, 51% women) responded to the Patient Health Questionnaire-15, Body Sensations Questionnaire, Cardiac Anxiety Questionnaire, Patient Health Questionnaire-9 and one question regarding number of healthcare visits. The relationships between the psychological distress variables and healthcare visits were analysed using Structural Equation Modeling in two models representing patients with or without history of cardiac disease.

RESULTS: A total of 34% of the patients had previous cardiac disease. These patients were older, more males, and reported more comorbidities, psychological distress and healthcare visits. In both models, no direct association between depressive symptoms and healthcare use was found. However, depressive symptoms had an indirect effect on healthcare use, which was mediated by somatization, fear of body sensations, and cardiac anxiety, and this effect was significantly stronger in patients with history of cardiac disease. Additionally, all the direct and indirect effects between depressive symptoms, somatization, fear of body sensations, cardiac anxiety, and healthcare use were significantly stronger in patients with history of cardiac disease.

CONCLUSIONS: In patients with non-cardiac chest pain, in particular those with history of cardiac disease, psychological mechanisms play an important role for seeking healthcare. Development of interventions targeting psychological distress in these patients is warranted. Furthermore, there is also a need of more research to clarify as to whether such interventions should be tailored with regard to history of cardiac disease or not.

Keywords
Cardiac anxiety, Cardiac disease, Depressive symptoms, Fear of body sensations, Healthcare visits, Non-cardiac chest pain, Somatization
National Category
Nursing
Identifiers
urn:nbn:se:liu:diva-148445 (URN)10.1186/s12888-018-1689-8 (DOI)000434313300001 ()29866125 (PubMedID)
Note

Funding agencies: County Council of Ostergotland, Sweden [LIO-439131]; Medical Research of Southeast Sweden [FORSS-475291]

Available from: 2018-06-11 Created: 2018-06-11 Last updated: 2019-06-27
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4197-4026

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