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  • 1.
    Johansson, Peter
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Riegel, Barbara
    University of Pennsylvania, Philadelphia, PA, USA.
    Svensson, Erland
    Swedish Defence Research Agency, Linköping, Sweden.
    Broström, Anders
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology.
    Alehagen, Urban
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Dahlström, Ulf
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Cardiology in Linköping.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Sickness behavior in community-dwelling elderly associations with impaired cardiac function and inflammation2014In: Biological Research for Nursing, ISSN 1099-8004, E-ISSN 1552-4175, Vol. 16, no 1, p. 105-113Article in journal (Refereed)
    Abstract [en]

    Sickness behavior is a cluster of symptoms that occur as a response to an infection and alterations in the inflammatory response. Under normal circumstances, sickness behavior is fully reversible once the pathogen has been cleared. Aging and chronic illness such as heart failure are associated with enhanced inflammatory activity that lasts for a long duration and no longer represents an adaptive response. The aim of this study was to explore whether inflammation mediates the relationship between impaired cardiac function and a symptom cluster including anhedonia, fatigue, and sleepiness, which might represent sickness behavior in community-dwelling elders. Structural equation modeling (SEM) showed that the factor impaired cardiac function (i.e., N-terminal fragment of pro-brain natriuretic peptide, left ventricular ejection fraction, and the heart failure medications angiotensin converting enzyme inhibitor, angiotensin receptor blockade, β-blocker, and diuretics) was associated with both inflammation (i.e., C-reactive protein; β = .26) and the symptom cluster (β = .31). Inflammation had a significant direct, but smaller, association with the symptom cluster (β = .21). By this pathway, inflammation also mediated an indirect association between impaired cardiac function and the symptom cluster (β = .05). Including creatinine, blood glucose, ischemic heart disease, previous and current tumor, respiratory disease, age, and body mass index in the SEM model did not change these associations. Our results imply that some aspects of the symptom panorama in elderly individuals with impaired cardiac function or heart failure could represent sickness behavior.

  • 2.
    Källman, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Södra Älvsborgs Sjukhus, Borås, Sweden .
    Engström, Maria
    Linköping University, Department of Medical and Health Sciences, Division of Radiological Sciences. Linköping University, Faculty of Health Sciences. Linköping University, Center for Medical Image Science and Visualization (CMIV).
    Bergstrand, Sara
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Cristina
    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.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
    Lindberg, Lars-Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Physiological Measurements.
    Lindgren, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    The Effects of Different Lying Positions on Interface Pressure, Skin Temperature, and Tissue Blood Flow in Nursing Home Residents2015In: Biological Research for Nursing, ISSN 1099-8004, E-ISSN 1552-4175, Vol. 17, no 2, p. 142-151Article in journal (Refereed)
    Abstract [en]

    Background: Although repositioning is considered an important intervention to prevent pressure ulcers, tissue response during loading in different lying positions has not been adequately explored.

    Aim: To compare the effects of different lying positions on interface pressure, skin temperature, and tissue blood flow in nursing home residents.

    Method: From May 2011 to August 2012, interface pressure, skin temperature, and blood flow at three tissue depths were measured for 1 hr over the sacrum in 30 supine tilt and 0 supine positions and over the trochanter major in 30lateral and 90lateral positions in 25 residents aged 65 years or older. Measurement of interface pressure was accomplished using a pneumatic pressure transmitter connected to a digital manometer, skin temperature using a temperature sensor, and blood flow using photoplethysmography and laser Doppler flowmetry.

    Results: Interface pressure was significantly higher in the 0supine and 90lateral positions than in 30supine tilt and 30 lateral positions. The mean skin temperature increased from baseline in all positions. Blood flow was significantly higher in the 30 supine tilt position compared to the other positions. A hyperemic response in the post pressure period was seen at almost all tissue depths and positions.

    Conclusion: The 30supine tilt position generated less interface pressure and allowed greater tissue perfusion, suggesting that this position is the most beneficial.

  • 3.
    Raak, Ragnhild
    et al.
    Linköping University, Department of Medicine and Care, Pharmacology. Linköping University, Faculty of Health Sciences.
    Hurtig, Ingrid
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wahren, Lis Karin
    Linköping University, Department of Welfare and Care (IVV). Linköping University, Faculty of Health Sciences.
    Coping strategies and life satisfaction in subgrouped fibromyalgia patients2003In: Biological Research for Nursing, ISSN 1099-8004, E-ISSN 1552-4175, Vol. 4, no 3, p. 193-202Article in journal (Refereed)
    Abstract [en]

    The present study describes pain- and stress-coping strategies and life satisfaction in subgroups of fibromyalgia patients. Thirty-two females with fibromyalgia syndrome (FMS) and 21 healthy pain-free women were studied. Those with FMS were classified as thermal (both heat and cold) pain sensitive or slightly cold pain sensitive based on pain thresholds determined using a Thermotest device. Global stress-coping styles, life satisfaction, and specific pain-coping strategies were measured. Patients classified as thermal pain sensitive were affected by physical symptoms to a greater extent than were those classified as slightly cold pain sensitive. The thermal pain sensitive group used more diverting attention coping strategies than the slightly cold pain sensitive group did. Separating fibromyalgia patients into subgroups might increase the potential for improving nursing care of these patients. Through the use of effective coping strategies in dealing with stress and pain, life satisfaction may also be enhanced.

  • 4.
    Raak, Ragnhild
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Wallin, Mia
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Thermal thresholds and catastrophizing in individuals with chronic pain after whiplash injury2006In: Biological Research for Nursing, ISSN 1099-8004, E-ISSN 1552-4175, Vol. 8, no 2, p. 138-146Article in journal (Refereed)
    Abstract [en]

    Thermal sensitivity, thermal pain thresholds, and catastrophizing were examined in individuals with whiplash associated disorders (WAD) and in healthy pain-free participants. Quantitative sensory testing (QST) was used to measure skin sensitivity to cold and warmth and cold and heat pain thresholds over both the thenar eminence and the trapezius muscle (TrM) in 17 participants with WAD (age 50.8± 11.3 years) and 18 healthy participants (age 44.8± 10.2 years). The Pain Catastrophizing Scale (PCS) was used to determine pain coping strategies, and visual analogue scales were used for self-assessment of current background pain in individuals in the WAD group as well as experienced pain intensity and unpleasantness after QST and sleep quality in all participants. There were significant differences in warmth threshold and cold and heat pain thresholds of the TrM site between the WAD and pain-free groups. Significant differences between the two groups were also found for the catastrophizing dimension of helplessness in the PCS and in self-assessed quality of sleep. A correlational analysis showed that current background pain is significantly correlated with both cold discrimination and cold pain threshold in the skin over the TrM in individuals with WAD. These findings imply that thermal sensitivity is an important factor to consider in providing nursing care to individuals with WAD. Because biopsychosocial factors also influence the experience of pain in individuals with WAD, the role of nurses includes not only the description of the pain phenomenon but also the identification of relieving and aggravating factors.

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