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  • 1.
    Bergstrand, Sara
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Källman, Ulrika
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Department of Dermatology, Södra Älvsborgs Sjukhus, Borås, Sweden.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care in Linköping.
    Engström, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV). Linköping University, Faculty of Health Sciences.
    Lindgren, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Microcirculatory responses of sacral tissue in healthy individuals and inpatients on different pressure-redistribution mattresses2015In: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 24, no 8, p. 346-358Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore the interaction between interface pressure and pressure-induced vasodilation and reactive hyperemia with different pressureredistribution mattresses.

    Method: A cross-sectional study was performed with a convenience sample of 42 healthy individuals between 18 and 64 years of age, 38 healthy individuals 65 years or older, and 35 inpatients 65 years or older at a university hospital in Sweden. Blood flow was measured at depths of 1 mm, 2 mm, and 10 mm using a combined system of laser Doppler flowmetry and photoplethysmography. The blood flow, interface pressure and skin temperature were measured in the sacral tissue before, during, and after load while lying on one standard hospital mattress and three different pressure-redistribution mattresses.

    Results: There were significant differences between the three foam mattresses with regard to average sacral pressure, peak sacral pressure, and local probe pressure with the lowest values at the visco-elastic foam/air mattress (23.5 ± 2.5 mmHg, 49.3 ± 11.1 mmHg, 29.2 ± 14.0 mmHg respectively). A greater proportion of subjects had affected blood flow in terms of lack of pressure-induced vasodilation on the visco-elastic foam/air mattress compared to the alternating pressure mattress at tissue depths of 2 mm (39.0% vs. 20.0%, respectively) and 10 mm (56.9 % vs. 35.1%, respectively). Eleven individuals, including subjects in all three subject groups were identified with no pressure-induced vasodilation or reactive hyperemia in any mattress, and this was considered a high-risk blood flow response.

    Conclusion: Interface pressure magnitudes considered not harmful during pressure-exposure lying on different pressure-redistribution mattresses can affect the microcirculation in different tissue structures. Despite having the lowest pressure values compared to the other mattresses, the visco-elastic foam/air mattress had the highest proportion of subjects with decreased blood flow indicating a more affected blood flow. Three young healthy individuals were identified with the high-risk blood flow response, indicating an innate vulnerability to pressure exposure and may not benefit from pressure-redistribution mattresses. Finally it was shown that the evaluation of pressure-redistribution support surfaces in terms of mean blood flow during and after tissue exposure is not feasible but assessment of pressure-induced vasodilation and reactive hyperemia could be a new possibility to assess individualized physiological measurements of mechanisms known to be related to pressure ulcer development.

  • 2.
    Hjelm, Katarina
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Apelqvist, J.
    Lund University, Sweden.
    Influence of beliefs about health and illness on self-care and care-seeking in foreign-born people with diabetic foot ulcers: dissimilarities related to origin2016In: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 25, no 11, p. 602-616Article in journal (Refereed)
    Abstract [en]

    Objective: To describe beliefs about health and illness among foreign-born people with diabetic foot ulcers that might affect self-reported self-care and health-care seeking and to study whether there are dissimilarities related to origin. Method: Qualitative descriptive study. Semi-structured interviews with people aged 38-86 years; 13 born in European and 13 in non-European countries (all except one in the Middle East). All resident in Sweden for 7-60 years (median: 18.5years). Results: Most believed foot ulcers were unavoidable and difficult to detect. Foot problems were mainly believed to be due to internal factors (diabetes), sometimes combined with external factors (inappropriate footwear, hot water, or barefoot walking). Health was described as freedom from illness and health professionals were seen as important sources of information. Perceived health deteriorated after the onset of the foot problems due to immobility and pain. People from the Middle East differed from other respondents as they discussed the importance of adapting to the will of Allah, leading to even poorer quality of life and a more negative view of future health. They also described more foot problems and perceived religion (Islam) with ritual washing of the feet to be important for health. However, they were regularly monitored to a lesser extent than European migrants. Economy affected health, more so in Europeans, due to expenses for medications and shoes. Many described limited activity in self-care, few had sought help for their problems and then solely among professionals, and had limited knowledge about the influence of glycaemic control on diabetes and foot status. Conclusion: Foreign-born people felt unable to prevent the incidence of foot ulcers, experienced problems with detection, and had limited knowledge of self-care. Dissimilarities in beliefs related to origin negatively influenced self-care of the feet, so it is important to assess individual beliefs and plan care and education accordingly. Declaration of interest: None to declare.

  • 3.
    Törnvall, Eva
    et al.
    Östergötlands Läns Landsting. Linköping University. Linköping University, Faculty of Health Sciences.
    Wilhelmsson, Susan
    Östergötlands Läns Landsting. Linköping University. Linköping University, Faculty of Health Sciences.
    Quality of Nursing care from the perspective of patients with leg ulcers2010In: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, ISSN 0969-0700, Vol. 19, no 9, p. 388-395Article in journal (Refereed)
    Abstract [en]

     

    Objective: To investigate and analyse the quality of nursing care in a primary care setting from the perspective of patients with leg ulcers and determine the subjective importance that patients attach to various aspects of quality of care. • Method: All of the patients with leg ulcers at 15 primary care centres in the south east of Sweden were invited to participate.They were given the short version of the Quality from the Patient's Perspective questionnaire (QPP) to fill in.This included a number of closed and open questions relating to their perceptions of the quality of their nursing care and the importance of this care to them. • Results: Overall, the patients in this study perceived that the quality of nursing care was high. However, important areas for improvement were revealed, including the need for an increase in patient-focused care, continuity of care and better pain relief. • Conclusion: To address the weak points highlighted by the study, we recommend that nurses explore patient perceptions of pain in greater detail and invite patients take a more active role in the management of their leg ulcers. • Conflict of interest: None.This study was funded by the county council of Östergötland and by Linköping University, Sweden.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    Objective: To investigate and analyse the quality of nursing care in a primary care setting from the perspective of patients with leg ulcers and determine the subjective importance that patients attach to various aspects of quality of care.

    Method: All of the patients with leg ulcers at 15 primary care centres in the south east of Sweden were invited to participate. They were given the short version of the Quality from Patient’s Perspective questionnaire (QPP) to fill in. This included a number of closed and open questions relating to their perceptions of the quality of their nursing care and the importance of this care to them.

    Results: Overall, the patients in this study perceived that the quality of nursing care was high. However, important areas for improvement were revealed, including the need for an increase in patient-focused care, continuity of care and better pain relief.

    Conclusion: To address the weak points highlighted by the study, we recommend that nurses explore patient perceptions of pain in greater detail and invite patients take a more active role in the management of their leg ulcers.

  • 4.
    Wissing, Ulla
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Ek, Anna-Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Wengström, Y
    Norrköping.
    Sköld, G
    Norrköping.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Can individualised nutritional support improve healing in therapy-resistant leg ulcers?2002In: Journal of Wound Care, ISSN 0969-0700, E-ISSN 2052-2916, Vol. 11, no 1, p. 15-20Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study investigated whether an individually designed programme of nutritional support can improve healing in otherwise therapy-resistant venous leg ulcers. METHOD: Six primary health-care patients, aged between 79 and 93 years, with venous ulcers that had been open for one year or more (range: 1.5-8 years) were recruited into the study. The patients were asked to follow an individualised diet plan which included the use of liquid dietary supplements. Ulcer area, anthropometric and biochemical variables, and energy and nutrient intake were assessed before intervention and then regularly for nine months. RESULTS: At nine months ulcer healing had occurred in two patients, of whom one had had ulcers on both legs. In a third patient the ulceration on one leg had healed and that on the other leg had almost healed. In a fourth patient, the ulcer area reduced by approximately 90%. CONCLUSION: The use of nutritional support might have assisted the wound healing in these patients. Although the relationship between nutritional supplementation and wound healing is not well defined, an appropriate nutritional plan is recommended if undernourishment is suspected and leg ulcers are not healing.

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