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  • 1.
    Bachrach-Lindström, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Näringstillstånd och höftfraktur2005In: Incitament, ISSN 1103-503X, Vol. 1, p. 59-62Article in journal (Refereed)
  • 2.
    Bachrach-Lindström, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Christensson, Lennart
    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.
    Idvall, Ewa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Lindgren, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Unosson, Mitra
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Kvalitetsindikationer för områdena smärta, munhålan, nutrition, trycksår2005Report (Other academic)
  • 3.
    Bachrach-Lindström, Margareta
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Jensen, Sara
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland. Linköping University, Faculty of Health Sciences.
    Lundin, Richard
    Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland.
    Christensson, Lennart
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Attitudes of nursing staff working with older people towards nutritional nursing care2007In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 11, p. 2007-2014Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim of this study was to examine attitudes of the nursing staff in geriatric care towards factors of importance for nutritional nursing care.

    Background.  Studies show that nutritional risk assessment is seldom performed on older patients as routine and very few patients have a nutritional care plan. Patients in long-term care who are easy to feed are also found to be looked upon more positively than those with high feeding needs.

    Methods.  A total of 252 registered nurses and nurse aids working at geriatric rehabilitation and medical care clinics and resident homes participated in the study. Attitudes were examined using the Staff Attitudes to Nutritional Nursing Care Geriatric scale. The scale includes 18 items and was designed as a one to five-point Lickert-type scale. It gives a total score and five subscales representing the dimensions ‘Norms’, ‘Habits’, ‘Assessment’, ‘Intervention’ and ‘Individualization’. A higher score indicates a more positive attitude.

    Results.  Of all nursing staff, 53% displayed a positive attitude towards factors of importance for nutritional nursing care and the rest displayed a neutral or negative attitude. The ‘Intervention’ dimension, dealing with nutritional problems and how to manage them, reflected the highest level of positive attitudes, which represents 71% of the nursing staff. The ‘Norms’ dimension had the lowest relative frequency of positive attitudes, 27%. The registered nurses held significantly more positive attitudes than the nurse aids did.

    Conclusions.  Nutritional issues comprise an important and time-consuming responsibility in geriatric care; however, nursing staff do not show an unequivocal positive attitude regarding this responsibility. The consequences this entails for the older patient need to be examined further.

    Relevance to clinical practice.  Nursing staff play an important role in caring for patients who are malnourished or at risk for malnutrition. Positive attitudes might hinder the development of undernourishment or the further worsening of an already undernourished patient's condition.

  • 4.
    Bachrach-Lindström, Margareta
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Johansson, Torsten
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Wahlström, Ola
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics. Linköping University, Faculty of Health Sciences.
    Nutritional status and functional capacity after femoral neck fractures: a prospective randomized one-year follow-up study2000In: Aging, ISSN 1945-4589, E-ISSN 1945-4589, Vol. 12, no 5, p. 366-374Article in journal (Refereed)
    Abstract [en]

    The primary aim of this study was to evaluate the effect of two different surgical methods on nutritional status and functional capacity during the first postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatment group received protein- and energy-enriched food in the hospital in addition to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity were examined at baseline, one and three months, and one year after the operation. Pain was examined at three months and one year. The effect of nutritional intervention was equal within both surgical groups. Logistic regression showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental impairment and deteriorated nutritional status were predominant in the non-survivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pain. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rate.

  • 5.
    Bachrach-Lindström, Margareta
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Nursing Science.
    Karlsson, Susanne
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Pettersson, Lars-Goran
    Kalmar Central Hospital.
    Johansson, Torsten
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Patients on the waiting list for total hip replacement: a 1-year follow-up study2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 4, p. 536-542Article in journal (Refereed)
    Abstract [en]

    Patients on the waiting list for total hip replacement: a 1-year follow-up study

    Untreated osteoarthritis (OA) in the hip causes pain and reduced physical and social functioning. The aim of this study was to evaluate the effect of waiting time on health-related quality of life (HRQOL), functional condition and dependence on help at the time of surgery and during follow-up 1 year after surgery. A further aim was to elucidate possible differences between men and women. Two hundred and twenty-nine consecutively included patients with OA in the hip were interviewed when assigned to the waiting list, again 1 week prior to surgery with unilateral total hip replacement (THR), and 1 year after surgery. Health-related quality of life and function were measured using the Nottingham Health Profile, EuroQoL and the Western Ontario and McMaster Universities Osteoarthritis Index. The result showed that the average waiting time was 239 days, that 15% of the patients were operated on within 3 months, and that 21% had to wait more than 6 months. At the time of surgery, HRQOL had deteriorated significantly (p < 0.05) and the number of patients receiving support from relatives had increased from 31% to 58% during the wait. At the 1-year follow-up, both HRQOL and functional condition had improved significantly despite the wait, and the need for support from relatives had decreased to 11% (p < 0.001). In conclusion, long waiting time for THR is detrimental to patients HRQOL causing reduced functional condition, pain and increased need for support from relatives, which limit the independence in daily life.

  • 6.
    Bachrach-Lindström, Margaretha
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nutritional status and functional capacity in elderly people with hip fracture2000Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim was to study nutritional status and functional capacity in elderly men and women admitted to hospital with a hip fractnre, and to evaluate the effect of nutritional intervention and surgical method. A total of 176 patients participated in the study. Of them 84 received protein- and energy-enriched meals at hospital and nutritional advice on discharge and at home. A total of 100 patients with displaced femoral neck fracture were randomised to treatment with either total hip arthroplasty or osteosynthesis with Olmed® screws.

    The patients were examined and interviewed the first time within 4-6 days after surgery, as well as one and three months aud one year after surgery. The nutritional status was assessed with body mass index, measures of triceps skinfold thickness, estimation of muscle mass and body composition. Serum albumin, insulin-like growth factor-I and hormones were measured. Functional capacity was assessed with the Modified Norton scale, Katz index of ADL and a questionnaire measuring instrumental activities of daily living.

    Mentally impaired patients had worse nutritional status aud functional condition compared with the lucid group at inclusion, deteriorated more in activity and mobility fimctions and had a higher one-year mortality rate. The nutritional intervention was not powerful enough to have effect on anthropometric or biochemical measurements. The patients treated with total hip arthroplasty had reduced pain, better locomotion ability and a slight weight gain compared with the osteosynthesis group.

    In conclusion, a marked deterioration of nutritional and functional status was found after a hip fracture. Studies of the effect of a more powerful nutritional intervention on nutritional status and functional capacity in this group are warranted. Patients treated with total hip arthroplasty had a more favourable rehabilitation period with regard to nutritional status and locomotion ability.

    List of papers
    1. Nutritional state and functional capacity among elderly Swedish people with acute hip fracture
    Open this publication in new window or tab >>Nutritional state and functional capacity among elderly Swedish people with acute hip fracture
    2000 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 4, p. 268-274Article in journal (Refereed) Published
    Abstract [en]

    The objective of this study was to describe characteristics in a group of elderly men and women with hip fracture, regarding presumed risk factors, such as nutritional state and functional capacity. A total of 142 men and women aged 75 years or more were consecutively included on admittance to the hospital. Anthropometry and body composition were measured 4-6 days after the fracture. Data on functional status, activities of daily living and living arrangements at the time of the fracture were collected. The women and men had a body mass index (BMI) of 22.3 ▒ 3.7 kg/m2 and 21.7 ▒ 2.1 kg/m2, respectively. Of the whole group, 71% had a BMI < 24 kg/m2 and 25% a BMI < 20.0 kg/m2. Forty-five percent of the patients needed daily home help, and a majority of them were mentally impaired (p < 0.0001). Women with a trochanteric hip fracture were shorter, had lower body weight, lower lean body mass and lower arm muscle circumference (AMC) than the cervical fracture group (p < 0.05). Fewer women with a trochanteric fracture and fewer women with mental impairment took walks outside before the fracture, (p = 0.023 and p = 0.002, respectively). Characteristics found in the group were low BMI, low muscle mass as indicated by low lean body mass and mental impairment. It seems important to evaluate such factors when developing post-operative care plans aimed at avoiding further deterioration. Extra frail sub-groups of patients, such as people who are mentally impaired, women with trochanteric fracture and women with high dependency concerning ADL functions were identified.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26796 (URN)12035218 (PubMedID)11402 (Local ID)11402 (Archive number)11402 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    2. Mental Impairment as a Risk Indicator for Underweight and Aggravated Rehabilitation After Hip Fracture in Elderly Women
    Open this publication in new window or tab >>Mental Impairment as a Risk Indicator for Underweight and Aggravated Rehabilitation After Hip Fracture in Elderly Women
    1999 (English)In: Journal of Nutritional & Environmental Medicine, ISSN 1359-0847, E-ISSN 1364-6907, Vol. 9, no 1, p. 55-61Article in journal (Refereed) Published
    Abstract [en]

    The objective of this prospective study was to analyze the role of mental impairment on nutritional status and functional capacity after hip fracture. Fifty-seven women aged 75 years or older, acutely admitted to a university hospital with a hip fracture, were consecutively included. Nutritional status with anthropometry and body composition, functional condition and activities of daily living (ADL) were collected 4-6 days and 3 months after surgery. Both lucid and mentally impaired women deteriorated in nutritional status in the postoperative period owing to loss of fat and muscle mass. In the mentally impaired group there was a 50% greater loss of body weight (not significant), causing underweight, mean body mass index 19.5 +/- 3.0 kg m-2, whereas body mass index remained normal in the lucid group, 21.3 +/- 3.0 kg m-2. Ability for activity, mobility and continence deteriorated significantly, whereas food and fluid intake remained unchanged in the mentally impaired group. Mental impairment is a major risk indicator for loss of functional capacities after an acute hip fracture. The development of malnutrition and underweight is explained by the lower pre-fracture body weight, giving little margin for the further post-fracture weight loss in this group. Actions to preserve preoperative ability regarding activity, mobility and continence among mentally impaired women seem warranted. A special caring programme directed towards the special needs of this high-risk group might increase their well-being and ability to continue living in their own homes.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26795 (URN)10.1080/13590849961843 (DOI)11400 (Local ID)11400 (Archive number)11400 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Assessment of nutritional status using biochemical and anthropometric variables in a nutritional intervention study of women with hip fracture
    Open this publication in new window or tab >>Assessment of nutritional status using biochemical and anthropometric variables in a nutritional intervention study of women with hip fracture
    2001 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 20, no 3, p. 217-223Article in journal (Refereed) Published
    Abstract [en]

    Background & Aims: The aim of this study of women with hip fracture was to describe nutritional status with biochemical markers and anthropometric variables, and to evaluate the effect of nutritional intervention with the intention of increasing protein and energy intake.

    Methods: The first consecutive 44 women were included, and used as controls. The next 44 were matched for age, fracture and mental state. Anthropometric variables, IGF-I, hormones and serum albumin were collected 4–6 days (baseline), 1 and 3 months after surgery. Twenty-four women filled out a 7-day food record.

    Results: At baseline, one fourth had BMI <20 kg/m2and subnormal triceps skinfold thickness. Baseline serum albumin, IGF-I and growth hormone levels were low, probably as an acute response to trauma. Women with BMI <20 kg/m2had lower IGF-I levels compared to those with higher BMI. At 3 months, one-third of both groups were protein and energy malnourished. The intervention group obtained higher daily energy percentage from fat but none of the groups reached their calculated energy need.

    Conclusions: Using biochemical markers in the acute postoperative situation to assess nutritional status is not recommended. The intervention had no impact on anthropometric or biochemical variables.

    Keywords
    nutritional status, IGF-I, hip fracture
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-24915 (URN)10.1054/clnu.2000.0383 (DOI)9319 (Local ID)9319 (Archive number)9319 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
    4. Nutritional status and functional capacity after femoral neck fractures: a prospective randomized one-year follow-up study
    Open this publication in new window or tab >>Nutritional status and functional capacity after femoral neck fractures: a prospective randomized one-year follow-up study
    Show others...
    2000 (English)In: Aging, ISSN 1945-4589, E-ISSN 1945-4589, Vol. 12, no 5, p. 366-374Article in journal (Refereed) Published
    Abstract [en]

    The primary aim of this study was to evaluate the effect of two different surgical methods on nutritional status and functional capacity during the first postoperative year in patients with displaced femoral neck fractures. A further aim was to evaluate the effect of nutritional support. One hundred patients were randomly assigned to treatment with either primary total hip arthroplasty (THA) or osteosynthesis. Half of the patients in each treatment group received protein- and energy-enriched food in the hospital in addition to individual nutritional advice in order to optimize their intake of protein- and energy-rich food. Nutritional state and functional capacity were examined at baseline, one and three months, and one year after the operation. Pain was examined at three months and one year. The effect of nutritional intervention was equal within both surgical groups. Logistic regression showed that the dependent variable "living at one year" was significantly associated with serum albumin levels at one month. Advanced age, mental impairment and deteriorated nutritional status were predominant in the non-survivors. Overall, the primary THA group performed better compared with the osteosynthesis group concerning weight change over time, locomotion and pain. This study also showed that primary THA could safely be performed in the elderly without an increased postoperative mortality rate.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13730 (URN)11126523 (PubMedID)
    Available from: 2002-05-12 Created: 2002-05-12 Last updated: 2017-12-13Bibliographically approved
  • 7.
    Bachrach-Lindström, Margaretha
    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.
    Förebygg undernäring!2002In: Äldre i centrum, ISSN 1401-5110, Vol. 3, p. 16-17Article in journal (Other (popular science, discussion, etc.))
  • 8.
    Bachrach-Lindström, Margaretha
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nutritional state and functional capacity among elderly Swedish people with acute hip fracture2000In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 14, no 4, p. 268-274Article in journal (Refereed)
    Abstract [en]

    The objective of this study was to describe characteristics in a group of elderly men and women with hip fracture, regarding presumed risk factors, such as nutritional state and functional capacity. A total of 142 men and women aged 75 years or more were consecutively included on admittance to the hospital. Anthropometry and body composition were measured 4-6 days after the fracture. Data on functional status, activities of daily living and living arrangements at the time of the fracture were collected. The women and men had a body mass index (BMI) of 22.3 ▒ 3.7 kg/m2 and 21.7 ▒ 2.1 kg/m2, respectively. Of the whole group, 71% had a BMI < 24 kg/m2 and 25% a BMI < 20.0 kg/m2. Forty-five percent of the patients needed daily home help, and a majority of them were mentally impaired (p < 0.0001). Women with a trochanteric hip fracture were shorter, had lower body weight, lower lean body mass and lower arm muscle circumference (AMC) than the cervical fracture group (p < 0.05). Fewer women with a trochanteric fracture and fewer women with mental impairment took walks outside before the fracture, (p = 0.023 and p = 0.002, respectively). Characteristics found in the group were low BMI, low muscle mass as indicated by low lean body mass and mental impairment. It seems important to evaluate such factors when developing post-operative care plans aimed at avoiding further deterioration. Extra frail sub-groups of patients, such as people who are mentally impaired, women with trochanteric fracture and women with high dependency concerning ADL functions were identified.

  • 9.
    Bachrach-Lindström, Margaretha
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Mental Impairment as a Risk Indicator for Underweight and Aggravated Rehabilitation After Hip Fracture in Elderly Women1999In: Journal of Nutritional & Environmental Medicine, ISSN 1359-0847, E-ISSN 1364-6907, Vol. 9, no 1, p. 55-61Article in journal (Refereed)
    Abstract [en]

    The objective of this prospective study was to analyze the role of mental impairment on nutritional status and functional capacity after hip fracture. Fifty-seven women aged 75 years or older, acutely admitted to a university hospital with a hip fracture, were consecutively included. Nutritional status with anthropometry and body composition, functional condition and activities of daily living (ADL) were collected 4-6 days and 3 months after surgery. Both lucid and mentally impaired women deteriorated in nutritional status in the postoperative period owing to loss of fat and muscle mass. In the mentally impaired group there was a 50% greater loss of body weight (not significant), causing underweight, mean body mass index 19.5 +/- 3.0 kg m-2, whereas body mass index remained normal in the lucid group, 21.3 +/- 3.0 kg m-2. Ability for activity, mobility and continence deteriorated significantly, whereas food and fluid intake remained unchanged in the mentally impaired group. Mental impairment is a major risk indicator for loss of functional capacities after an acute hip fracture. The development of malnutrition and underweight is explained by the lower pre-fracture body weight, giving little margin for the further post-fracture weight loss in this group. Actions to preserve preoperative ability regarding activity, mobility and continence among mentally impaired women seem warranted. A special caring programme directed towards the special needs of this high-risk group might increase their well-being and ability to continue living in their own homes.

  • 10.
    Bachrach-Lindström, Margaretha
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Arnqvist, Hans
    Linköping University, Department of Biomedicine and Surgery, Cell biology. Linköping University, Faculty of Health Sciences.
    Assessment of nutritional status using biochemical and anthropometric variables in a nutritional intervention study of women with hip fracture2001In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 20, no 3, p. 217-223Article in journal (Refereed)
    Abstract [en]

    Background & Aims: The aim of this study of women with hip fracture was to describe nutritional status with biochemical markers and anthropometric variables, and to evaluate the effect of nutritional intervention with the intention of increasing protein and energy intake.

    Methods: The first consecutive 44 women were included, and used as controls. The next 44 were matched for age, fracture and mental state. Anthropometric variables, IGF-I, hormones and serum albumin were collected 4–6 days (baseline), 1 and 3 months after surgery. Twenty-four women filled out a 7-day food record.

    Results: At baseline, one fourth had BMI <20 kg/m2and subnormal triceps skinfold thickness. Baseline serum albumin, IGF-I and growth hormone levels were low, probably as an acute response to trauma. Women with BMI <20 kg/m2had lower IGF-I levels compared to those with higher BMI. At 3 months, one-third of both groups were protein and energy malnourished. The intervention group obtained higher daily energy percentage from fat but none of the groups reached their calculated energy need.

    Conclusions: Using biochemical markers in the acute postoperative situation to assess nutritional status is not recommended. The intervention had no impact on anthropometric or biochemical variables.

  • 11.
    Christensson, L
    et al.
    Jönköping University.
    Bachrach-Lindström , Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Adapting "The Staff Attitudes to Nutritional Nursing Care scale" to geriatric nursing care2009In: JOURNAL OF NUTRITION HEALTH and AGING, ISSN 1279-7707 , Vol. 13, no 2, p. 102-107Article in journal (Refereed)
    Abstract [en]

    A positive attitude is assumed to be important in nursing staffs help and support of elderly people during meals. As there is no specific tool for measuring staffs attitudes regarding important issues within eating and nutrition, the SANN (Staff Attitudes to Nutritional Nursing Care) scale was developed. The scale was developed and tested in nursing staff working at resident homes, and the number of items was reduced from 63 to 19 with five underlying factors. The aim of this study was to describe how the SANN scale was adapted and tested in nursing staff working in different types of elderly care. Design: The raw 63-item version went through minor changes, and one unclear worded item was excluded. The changed raw 62-item version was answered by 188 nursing staff working at six hospital care clinics and 64 staff working at one resident home.

    The analysis reduced the 62 items to 18, and the adapted scale was named the SANN-G scale, G standing for "geriatric care". A rotated factor analysis gave a five-factor solution, explaining 54% of the variance. The scale achieved good internal reliability, with a Cronbachs alpha of 0.83. Fourteen items fulfilled inclusion criteria in both the SANN and the SANN-G scales.

    The SANN-G scale is practicable for use in staff working in different types of elderly care. It can be used to explore existing attitudes and identify areas with a low degree of prevailing positive attitudes as well as to evaluate whether and how attitudes change after nutritional education and intervention.

  • 12.
    Christensson, Lennart
    et al.
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margaretha
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care. Linköping University, Faculty of Health Sciences.
    Attitudes of nursing staff towards nutritional nursing care2003In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 3, p. 223-231Article in journal (Refereed)
    Abstract [en]

    Fulfilling nutritional requirements in residents with eating problems can be a challenge for both the person in need of help and for the caregiver. In helping and supporting these residents, a positive attitude is assumed to be as important as practical skill. The aim of this study was to test the hypothesis that nutritional education and implementation of a nutritional programme would change the attitudes towards nutritional nursing care among nursing staff with daily experience of serving food and helping residents in municipal care. The study was carried out as a before and after experimental design. An attitude scale, staff attitudes to nutritional nursing care (SANN scale), was developed and used. The response on the scale gives a total SANN-score and scores in five underlying dimensions: self ability, individualization, importance of food, assessment and secured food intake. Nursing staff at eight different residential units (n = 176) responded to the attitude scale and, of these, staff at three of the units entered the study as the experimental group. After responding to the attitude scale, nutritional education was introduced and a nutritional programme was implemented in the experimental units. One year later, attitudes were measured a second time (n = 192). Of these, 151 had also responded on the first occasion. Education and implementation of a nutritional programme did not significantly change attitudes. Overall, nursing staff responded with positive attitudes towards nutritional nursing care. Most of the positive attitudes concerned items within the dimension importance of food. In contrast, items within self ability showed the lowest number of staff with positive attitudes.

  • 13.
    Ekman, Bertil
    et al.
    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 Endocrinology.
    Alstrand, N
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. County Hospital, Kalmar .
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Jenmalm, Maria C
    Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences.
    Wahlberg, Jeanette
    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 Endocrinology.
    Altered Chemokine Th1/Th2 Balance in Addison's Disease: Relationship with Hydrocortisone Dosing and Quality of Life2014In: Hormone and Metabolic Research, ISSN 0018-5043, E-ISSN 1439-4286, Vol. 46, no 1, p. 48-53Article in journal (Refereed)
    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.

  • 14.
    Ekman, Bertil
    et al.
    Linköping University, Department of Medical and Health Sciences, Endocrinology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Endocrinology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Wahlberg, Jeanette
    Linköping University, Department of Medical and Health Sciences, Endocrinology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Blomgren, Johan
    Internal Medicine County Hospital, Eksjö.
    Arnqvist, Hans
    Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    A randomised double blind crossover study comparing two and four dose hydrocortisone regimen with regard to quality for life, cortisol and ACTH profiles in patients with primary adrenal insufficiency2012In: Clinical Endocrinology, ISSN 0300-0664, E-ISSN 1365-2265, Vol. 77, no 1, p. 18-25Article in journal (Refereed)
    Abstract [en]

    Context

    Current guidelines on how to divide the daily cortisol substitution dose in patients with primary adrenal insufficiency (PAI) are controversial and mainly based on empirical data.

    Objective

    To assess how an equal dose of hydrocortisone given either four times daily or twice daily influence diurnal profiles of cortisol and ACTH, patient preferences and health related quality of life (HRQoL).

    Design

    Double blind, crossover.

    Methods

    Fifteen patients with PAI (6 women) were included. Capsules of hydrocortisone or placebo were given at 07:00, 12:00, 16:00 and 22:00 h in 4-week treatment periods: either one period with four doses (10+10+5+5 mg) or one period with two doses (20+0+10+0 mg). Diurnal profiles of cortisol and ACTH were collected and area under the curve (AUC) was calculated. Questionnaires were used to evaluate patient preferences and HRQoL.

    Results

    The four-dose regimen gave a higher serum cortisol before tablet intake in the morning (P = 0.027) and a higher 24-h-cortisolAUC (P < 0.0001) compared with the two-dose period. In contrast a lower median plasma ACTH in the morning before tablet intake (P = 0.003) and a lower 24-h-ln(ACTHAUC) were found during the four-dose period. The patients preferred the four-dose regimen (P = 0.03), and the HRQoL scores tended to be higher (high score indicates better HRQoL) for the four-dose period.

    In summary a four-dose regimen gives increased availability of cortisol and an enhanced effect with a less elevated ACTH in the morning in comparison with a two-dose regimen but the effect on HRQoL remains inconclusive.

  • 15.
    Foldemo, Anniqa
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Wärdig, Rikard
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindstrom, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Edman, Gunnar
    Karolinska Institute, Sweden Karolinska Institute, Sweden .
    Holmberg, Tommy
    Tiohundra AB, Sweden .
    Lindström, Torbjörn
    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 Endocrinology.
    Valter, Lars
    Tiohundra AB, Sweden .
    Osby, Urban
    Karolinska Institute, Sweden Karolinska Institute, Sweden Tiohundra AB, Sweden .
    Health-related quality of life and metabolic risk in patients with psychosis2014In: Schizophrenia Research, ISSN 0920-9964, E-ISSN 1573-2509, Vol. 152, no 1, p. 295-299Article in journal (Refereed)
    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.

  • 16.
    Guldbrand, Hans
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Dizdar, B.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Bunjaku, B.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Department of Medical and Health Sciences, Endocrinology. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Fredrikson, Mats
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Health Sciences.
    Östgren, Carl Johan
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Primary Health Care in Motala.
    Nyström, Fredrik H.
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Department of Medical and Health Sciences, Endocrinology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    In type 2 diabetes, randomisation to advice to follow a low-carbohydrate diet transiently improves glycaemic control compared with advice to follow a low-fat diet producing a similar weight loss2012In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 55, no 8, p. 2118-2127Article in journal (Refereed)
    Abstract [en]

    AIMS/HYPOTHESIS: The study aimed to compare the effects of a 2 year intervention with a low-fat diet (LFD) or a low-carbohydrate diet (LCD), based on four group meetings to achieve compliance. METHODS: This was a prospective randomised parallel trial involving 61 adults with type 2 diabetes consecutively recruited in primary care and randomised by drawing ballots. Patients that did not speak Swedish could not be recruited. The primary outcomes in this non-blinded study were weight and HbA(1c). Patients on the LFD aimed for 55-60 energy per cent (E%) and those on LCD for 20 E% from carbohydrate. RESULTS: The mean BMI and HbA(1c) of the participants were 32.7 ± 5.4 kg/m(2) and 57.0 ± 9.2 mmol/mol, respectively. No patients were lost to follow-up. Weight loss did not differ between groups and was maximal at 6 months: LFD -3.99 ± 4.1 kg (n = 31); LCD -4.31 ± 3.6 kg (n = 30); p < 0.001 within groups. At 24 months, patients on the LFD had lost -2.97 ± 4.9 kg and those on LCD -2.34 ± 5.1 kg compared with baseline (p = 0.002 and p = 0.020 within groups, respectively). HbA(1c) fell in the LCD group only (LCD at 6 months -4.8 ± 8.3 mmol/mol, p = 0.004, at 12 months -2.2 ± 7.7 mmol/mol, p = 0.12; LFD at 6 months -0.9 ± 8.8 mmol/mol, p = 0.56). At 6 months, HDL-cholesterol had increased with the LCD (from 1.13 ± 0.33 mmol/l to 1.25 ± 0.47 mmol/l, p = 0.018) while LDL-cholesterol did not differ between groups. Insulin doses were reduced in the LCD group (0 months, LCD 42 ± 65 E, LFD 39 ± 51 E; 6 months, LCD 30 ± 47 E, LFD 38 ± 48 E; p = 0.046 for between-group change). CONCLUSIONS/INTERPRETATION: Weight changes did not differ between the diet groups, while insulin doses were reduced significantly more with the LCD at 6 months, when compliance was good. Thus, aiming for 20% of energy intake from carbohydrates is safe with respect to cardiovascular risk compared with the traditional LFD and this approach could constitute a treatment alternative. TRIAL REGISTRATION: ClinicalTrials.gov NCT01005498 FUNDING: University Hospital of Linköping Research Funds, Linköping University, the County Council of Östergötland, and the Diabetes Research Centre of Linköping University.

  • 17.
    Guldbrand, Hans
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Primary Health Care in Motala.
    Lindström, Torbjörn
    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 Endocrinology.
    Dizdar, B.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Bunjaku, B.
    Östergötlands Läns Landsting. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Östgren, Carl Johan
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, West County Primary Health Care.
    Nyström, Fredrik H.
    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 Endocrinology.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Randomization to a low-carbohydrate diet advice improves health related quality of life compared with a low-fat diet at similar weight-loss in Type 2 diabetes mellitus2014In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 106, no 2, p. 221-227Article in journal (Refereed)
    Abstract [en]

    Aims

    To compare the effects on health-related quality of life (HRQoL) of a 2-year intervention with a low-fat diet (LFD) or a low-carbohydrate diet (LCD) based on four group-meetings to achieve compliance. To describe different aspects of taking part in the intervention following the LFD or LCD.

    Methods

    Prospective, randomized trial of 61 adults with Type 2 diabetes mellitus. The SF-36 questionnaire was used at baseline, 6, 12 and 24 months. Patients on LFD aimed for 55–60 energy percent (E%) and those on LCD for 20 E% from carbohydrates. The patients were interviewed about their experiences of the intervention.

    Results

    Mean body-mass-index was 32.7 ± 5.4 kg/m2 at baseline. Weight-loss did not differ between groups and was maximal at 6 months, LFD: −3.99 ± 4.1 kg, LCD: −4.31 ± 3.6 kg (p < 0.001 within groups). There was an increase in the physical component score of SF-36 from 44.1 (10.0) to 46.7 (10.5) at 12 months in the LCD group (p < 0.009) while no change occurred in the LFD group (p < 0.03 between groups). At 12 months the physical function, bodily pain and general health scores improved within the LCD group (p values 0.042–0.009) while there was no change within the LFD group.

    Conclusions

    Weight-changes did not differ between the diet groups while improvements in HRQoL only occurred after one year during treatment with LCD. No changes of HRQoL occurred in the LFD group in spite of a similar reduction in body weight.

     

  • 18.
    Gutefeldt, Kerstin
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases.
    Hedman, Christina A
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Thyberg, Ingrid S M
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Rheumatology.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Arnqvist, Hans
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Spångeus, Anna
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Upper extremity impairments in type 1 diabetes with long duration: common problems with great impact on daily life2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 6, p. 633-640Article in journal (Refereed)
    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.

  • 19.
    Hallberg, I
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Toss, G
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Endocrinology and Gastroenterology UHL.
    Ek, A-C
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hjortswang, H
    Linköping University, Department of Clinical and Experimental Medicine, Gastroenterology and Hepatology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Endocrinology and Gastroenterology UHL.
    Bachrach-Lindström, M
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Health-related Quality of Life after Vertebral or Hip Fracture in Women - Short Health Scale Useful for Clinical Practice?2010Conference paper (Other academic)
  • 20.
    Hallberg, Inger
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hammerby, Staffan
    Linköping University, Department of Medicine and Health Sciences, Radiology . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medical Imaging, Department of Radiology in Linköping.
    Toss, Göran
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Health-related quality of life after vertebral or hip fracture: a seven-year follow-up study2009In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 10, no 135Article in journal (Refereed)
    Abstract [en]

    Background

    The negative impact of vertebral and hip low-energy fractures on health-related quality-of-life (HRQOL) has been demonstrated previously, but few prospective long-term follow-up studies have been conducted. This study aims to (i) investigate the changes and long-term impact of vertebral or hip fracture and between fracture groups on HRQOL in postmenopausal women prospectively between two and seven years after the inclusion fracture, (ii) compare HRQOL results between fracture and reference groups and (iii) study the relationship between HRQOL and physical performance, spinal deformity index and bone mineral density at seven-year follow-up.

    Methods

    Ninety-one women examined two years after a low-energy vertebral or hip fracture were invited to a new examination seven years after the diagnosis. HRQOL was examined using the SF-36 questionnaire and was compared with an age and sex-matched reference group. Physical function was assessed using tests and questionnaires. Bone mineral density was measured. Radiographs of the spine were evaluated using the visual semiquantitative technique. A longitudinal and cross-sectional design was used in this study. Statistical analyses included descriptive statistics, Student’s t-tests, ANCOVA, and partial correlation.

    Results

    Sixty-seven women participated. In the 42 women (mean age 75.8, SD 4.7) with vertebral fracture as inclusion fracture, bodily pain had deteriorated between two and seven years and might be explained by new fracture. Remaining pronounced reduction of HRQOL was seen in all domains except general health and mental health at seven-year follow-up in women with vertebral fractures compared to the reference group (p<0.05). All 25 women (mean age 75.0, SD 4.7) with hip fracture as inclusion fracture had no significant changes in HRQOL between two and seven years and did not differ from the reference group regarding HRQOL after seven years. The vertebral group had significantly lower values for bodily pain, vitality, role-emotional function and mental health compared to the hip group. HRQOL showed a positive relationship between physical activity, static balance and handgrip strength.

    Conclusions

    The long-term reduction of HRQOL in women with vertebral fracture emerged clearly in this study. The relationships between HRQOL and physical performance in women with vertebral and hip fracture raise questions for more research.

  • 21.
    Hallberg, Inger
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Toss, Göran
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Endocrinology and Gastroenterology UHL.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Health Care.
    Health-Related Quality of Life 7 Years After Hip or Vertebral fractures2007Conference paper (Other academic)
  • 22.
    Hallberg, Inger
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Toss, Göran
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Endocrinology and Gastroenterology.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    A striving for independence: a qualitative study of women living with vertebral fractureManuscript (preprint) (Other academic)
    Abstract [en]

    Background: Quantitative studies using generic and disease-specific health-related quality of life (HRQOL) questionnaires have shown that osteoporosis-related vertebral fractures have a significant negative effect on HRQOL, but there are only few studies that address what it means to live with vertebral fracture from a deeper experiential perspective. How HRQOL and daily life are affected several years after vertebral fracture and how women cope with this are more unclear. This study aimed to describe how HRQOL and daily life had been affected in women with vertebral fracture several years after diagnosis.

    Methods: The study design was qualitative. Semi-structured interviews were conducted with ten Swedish women during 2008. Data were analysed using qualitative inductive content analysis.

    Results: The findings of this study revealed three themes related to the influence on HRQOL and daily life: A threatened independence, i.e. back pain, anxiety, negative impact on self-image and consequences in daily life; Strategies for maintaining independence, i.e. coping, self-care and support; and The importance of maintaining independence, i.e. the ability to perform everyday activities, social interaction and having something meaningful to do. As a result of how their HRQOL and daily life have been affected by their vertebral fractures, the women in this study are striving for independence or maintaining their independence by trying to manage the different types of symptoms and consequences in different ways.

    Conclusion: HRQOL and daily life were strongly affected in a negative way by the impact of the vertebral fracture. One possible effective intervention for the future may be to support women in using self-management strategies so that they can be in charge of their situation and positively influence their HRQOL and daily life to achieve independence, but further evaluation is still needed. Information from this study may provide a foundation for guidelines for health care professionals to offer empathic and supportive care to women living with prevalent vertebral fracture.

  • 23.
    Hallberg, Inger
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Toss, Göran
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    A striving for independence: a qualitative study of women living with vertebral fracture2010In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 9, no 7Article in journal (Refereed)
    Abstract [en]

    Background

    Quantitative studies using generic and disease-specific health-related quality of life (HRQOL) questionnaires have shown that osteoporosis-related vertebral fractures have a significant negative effect on HRQOL, but there are only few studies that address what it means to live with vertebral fracture from a deeper experiential perspective. How HRQOL and daily life are affected several years after vertebral fracture and how women cope with this are more unclear. This study aimed to describe how HRQOL and daily life had been affected in women with vertebral fracture several years after diagnosis.

    Methods

    The study design was qualitative. Semi-structured interviews were conducted with ten Swedish women during 2008. Data were analysed using qualitative inductive content analysis.

    Results

    The findings of this study revealed three themes related to the influence on HRQOL and daily life: A threatened independence, i.e. back pain, anxiety, negative impact on self-image and consequences in daily life; Strategies for maintaining independence, i.e. coping, self-care and support; and The importance of maintaining independence, i.e. the ability to perform everyday activities, social interaction and having something meaningful to do. The women were striving for independence or maintaining their independence by trying to manage different types of symptoms and consequences in different ways.

    Conclusion

    HRQOL and daily life were strongly affected in a negative way by the impact of the vertebral fracture. Information from this study may provide new knowledge and understanding of the women's experiences of living with vertebral fracture from an insider's point of view in order to obtain a deeper understanding of the women's everyday life. However, further evaluation is still needed in larger study groups.

  • 24.
    Hambre, David
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Vergara, Marta
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Lood, Yvonne
    Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Sweden.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    Nyström, Fredrik H
    Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology and Gastroenterology UHL.
    A randomized trial of protein supplementation compared with extra fast food on the effects of resistance training to increase metabolism2012In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 72, no 6, p. 471-478Article in journal (Refereed)
    Abstract [en]

    Objective. To prospectively evaluate the effects of resistance training combined with increased energy intake or protein-supplementation on lean body-mass, resting metabolic-rate (RMR) and cardiovascular risk factors. Methods. Twenty-four healthy males (aged 19-32 years) performed resistance exercise for 12 weeks aiming for at least 1 hour training-sessions 3 times a week. The participants were randomized to consume extra protein (33 g whey protein/day) or a meal of fast-food/day (1350 kcal, 41 g protein). Body-composition was measured with Dual-Energy X-ray Absorptiometry (DEXA) and RMR by indirect calorimetry. Fasting blood samples were drawn before and after the 3-month training period and after 12 months. Results. The body weight increased from 75.1 +/- 6.9 kg to 78.7 +/- 7.2 kg (p andlt; 0.0001), without differences between the groups. RMR increased from 1787 +/- 143 kcal/24 h to 1954 +/- 187 kcal/24 h (p andlt; 0.0001, N = 24), which was more than expected from the increase in lean body-mass (increase from 59.7 +/- 4.3 kg to 61.8 +/- 4.1 kg p = 0.004). Fasting serum-insulin levels increased in the fast-food group compared with the extra-protein group (p = 0.03). ApoB increased from 0.691 +/- 0.14 g/L to 0.768 +/- 0.17 g/L, p = 0.004, in the fast-food group only. Long-term follow up after 12 months showed that RMR, body weight, total fat and lean body-masses did not differ from baseline (n = 19). Conclusions. Resistance training for 12 weeks increased RMR and lean body-mass similarly when based on either an increased energy-intake or protein supplement. However, the increase in RMR was higher than expected from the increase in lean body-mass. Thus resistance training could potentially decrease the risk of obesity by induction of increased RMR.

  • 25.
    Jamali, Reza
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of cell biology.
    Bachrach-Lindström, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Mohseni, Simin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of cell biology.
    Continuous glucose monitoring system signals the occurrence of marked postprandial hyperglycemia in the elderly2005In: Diabetes Technology & Therapeutics, ISSN 1520-9156, E-ISSN 1557-8593, Vol. 7, no 3, p. 509-515Article in journal (Refereed)
    Abstract [en]

    Background: The aim of this study was to ascertain whether dysglycemic episodes occur in institutionalized elderly persons and, if that is the case, to determine whether such episodes are related to meal patterns. Another objective was to investigate the feasibility of subcutaneous (s.c.) glucose measurements in the elderly using a Medtronic MiniMed (Sylmar, CA) continuous glucose monitoring system (CGMS®). Methods: Nine nursing home residents (74-95 years old) without known diabetes or other metabolic disorders were included. The s.c. glucose level was measured for 3 days with the Medtronic MiniMed CGMS. Capillary blood glucose was measured four times daily with a Glucometer Elite® device (Bayer, Leverkusen, Germany). Body mass index and basal metabolic rate were calculated, and food intake was recorded. Results: The s.c. glucose level fluctuated noticeably over time, 22.5% of the values recorded during the 3-day period were ≥8 mmol/L, and values <3.5 mmol/L were rarely seen. A marked (>5 mmol/L) and short-term (2-4 h) increase in s.c. glucose was seen after a meal. The mean capillary blood glucose concentration was 7.5 ± 1.8 mmol/L. Capillary blood glucose ≥8 mmol/L was recorded on 32.5% of the measurement occasions, and no values were <3.5 mmol/L. The s.c. glucose values agreed with corresponding capillary blood glucose levels (mean r = 0.75, range 0.43-0.86). Five participants consumed less energy than recommended according to their age, weight, and physical activity level. Conclusions: Postprandial hyperglycemia frequently occurs in elderly people living in nursing homes. The CGMS is convenient to use to detect hyperglycemia in this age group.

  • 26.
    Johansson, I.
    et al.
    Gjøvik University College.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Struksnes, S.
    Gjøvik University College.
    Hedelin , B.
    Gjøvik University College.
    Balancing integrity vs. risk of falling - Nurses experiences of caring for elderly people with dementia in nursing homes2009In: Journal of Research in Nursing, ISSN 1744-9871, Vol. 14, no 1, p. 61-73Article in journal (Refereed)
    Abstract [en]

    Dementia is recognized as being a major risk for falls that cause suffering and increase dependency for the individual. The purpose of this study was to explore registered nurses and nurse assistants experiences of caring for elderly people with dementia who are at risk of falling, and factors that contribute or reduce falls in this group. A phenomenographic design was chosen. Ten nurses and 18 nurse assistants with experience of fall events were strategically selected for a recorded interview. The informants were chosen from 10 nursing homes in Sweden and Norway. They were asked to describe a fall situation they had been involved in when caring for elderly people with dementia. The findings shed light on an ethical dilemma in the main category Balancing integrity and autonomy versus risk of falling � which was comprehensively related to two descriptive categories. The first one was Adjusting to the older person�s condition� with the concepts of forgetfulness, anxiety and confusion, ability to express oneself and understand, bodily build and function. The second category was Adjusting the care environment�, comprising these conceptions: the physical environment, the psychosocial environment, organization and human resources. Based on the staff�s perceived difficulties in preventing falls in elderly people with dementia, there is a need for additional support or professional supervision in their work to enhance possibilities for successful fall prevention.

  • 27.
    Johansson Stark, Åsa
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Charalambous, Andreas
    Cyprus University of Technology, Limassol, Cyprus; Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland.
    Istomina, Natalja
    Department of Nursing, Klaipeda University, Lithuania.
    Salanterä, Sanna
    University of Turku, Department of Nursing Science, Turku University Hospital, Turku, Finland.
    Sigurdardottir, Arun K
    School of Health Sciences, University of Akureyri, Iceland .
    Sourtzi, Panayota
    University of Athens, Faculty of Nursing, Athens, Greece.
    Valkeapää, Kirsi
    University of Turku, Department of nursing Science, Turku, Finland and Dean Lahti University of Applied Sciences, Lahti Finland.
    Zabalegui, Adelaida
    Nursing, Hospital Clinic of Barcelona, Spain.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    The quality of recovery on discharge from hospital, a comparison between patients undergoing hip and knee replacement: a European study2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 17-18, p. 2489-2501Article in journal (Refereed)
    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.

  • 28.
    Johansson Stark, Åsa
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Ingadottir, Brynja
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Salanterä, Sanna
    Turku University, Finland.
    Sigurdardottir, Arun K
    University of Akureyri, Iceland.
    Valkeapää, Kirsi
    University of Turku, Finland.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Fulfilment of knowledge expectations and emotional state among people undergoing hip replacement: A multi-national survey2014In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 51, no 11, p. 1491-1499Article in journal (Refereed)
    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.

  • 29.
    Johansson Stark, Åsa
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Ingadottir, Brynja
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Sigurdardottir, Arun K
    University of Akureyri, Iceland.
    Valkeapää, Kirsi
    University of Turku, Finland.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Fulfilment of patients’ knowledge expectations in connection with hip or knee replacement – a Nordic perspective2014Conference paper (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.

  • 30.
    Johansson Stark, Åsa
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Salanterä, Sanna
    University of Turku, Department of Nursing Science, Turku University Hospital, Turku, Finland.
    Sigurdardottir, Arun K
    School of Health Sciences, University of Akureyri, Iceland .
    Valkeapää, Kirsi
    University of Turku, Department of nursing Science, Turku, Finland and Dean Lahti University of Applied Sciences, Lahti Finland.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Spouse-related factors associated with Quality of Recovery of patients after hip or knee replacement: a Nordic perspective2016In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 23, p. 32-46Article in journal (Refereed)
    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.

  • 31.
    Johansson, Torsten
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Aspenberg, Per
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Linköping University, Faculty of Health Sciences.
    Jonsson, Dick
    Linköping University, Department of Medicine and Health Sciences, Health Technology Assessment. Linköping University, Faculty of Health Sciences.
    Wahlström, Ola
    Linköping University, Department of Clinical and Experimental Medicine, Orthopaedics and Sports Medicine . Linköping University, Faculty of Health Sciences.
    The total costs of a displaced femoral neck fracture: comparison of internal fixation and total hip replacement. A randomised study of 146 hips2006In: International Orthopaedics, ISSN 0341-2695, Vol. 30, no 1, p. 1-6Article in journal (Refereed)
    Abstract [en]

    We randomised 143 patients –age 75 years or older–with displaced femoral neck fracture to either internal fixation or total hip replacement (THR) and compared the socio-economic consequences. In the internal fixation group, 34 of 78 hips underwent secondary surgery. In the THR group, 12 of 68 hips dislocated, the majority in mentally impaired patients. We calculated the total hospital costs for two years after operation. When secondary surgery was included, there was no difference in costs between the internal fixation and THR groups, or between the mentally impaired and lucid subgroups. The costs to the community were calculated comparing the baseline cost before surgery with the average cost per month during the first postoperative year. No difference was found between the treatment groups. The Harris hip scores were higher in the THR group, and pain was more common in the internal fixation group. In lucid patients, THR gives a better clinical result at the same cost.

  • 32.
    Johansson, Yvonne
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medicine and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study2009In: JOURNAL OF CLINICAL NURSING, ISSN 0962-1067, Vol. 18, no 9, p. 1354-1364Article in journal (Refereed)
    Abstract [en]

    To prospectively investigate and describe the prevalence and incidence of malnutrition among home-living older people, related to demographic and medical factors, self-perceived health and health-related quality of life. Another aim was to find predictors for developing risk of malnutrition.

    Risk factors for malnutrition have previously been identified as diseases, several medications, low functional status, symptoms of depression and inadequate nutrient intake. Most studies are cross-sectionally performed at hospitals or in nursing care settings.

    A prospective study with a sample of 579 home-living older people, randomly selected from a local national register. Examinations were performed at baseline and yearly follow-ups two to four times.

    Questionnaires validated and tested for reliability, to detect risk of malnutrition (Mini Nutritional Assessment), symptoms of depression (Geriatric Depression Scale-20), cognitive function (Mini Mental State Examination), health-related quality of life (Nottingham Health Profile), well-being (Philadelphia Geriatric Center Multilevel Assessment Instrument) self-perceived health, demographic factors, anthropometry and biochemical examinations. Predictors were searched for through multiple logistic regression analysis with the MNA as dependent factor.

    The prevalence of risk for malnutrition was 14.5%, according to the MNA. Two risk factors for malnutrition were lower handgrip strength and lower self-perceived health. The incidence of risk for malnutrition at follow-ups was between 7.6% and 16.2%. Predictors for developing malnutrition were higher age, lower self-perceived health and more symptoms of depression. Men with symptoms of depression had a higher risk of developing malnutrition.

    Lower self-perceived health had the highest power to predict risk for malnutrition, with increased number of depression symptoms and higher age as second and third predictors.

    A regular and combined assessment using the Mini Nutrition Assessment, Geriatric Depression Scale-20 and self-perceived health as a base for identifying people in need, is one way to prevent the development of malnutrition.

  • 33.
    Johansson, Yvonne
    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.
    Bachrach-Lindström, Margareta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Self-perceived health among older women living in their own residence2007In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 2, no 2, p. 111-118Article in journal (Refereed)
    Abstract [en]

    Aim. The aim was to characterize women who perceived themselves as healthy and to compare them with women who perceived themselves as less healthy with regard to demographical, social, medical and functional factors. Another aim was to describe changes within the healthy group after one year.

    Background. Self-perceived health is influenced by several factors, of which diseases and illness are only a part.

    Method and participants. Two hundred and seventy-eight women, 75 and 80 years old, of which 50% (n ¼ 139) perceived themselves as healthy and less healthy, respectively. Data were collected by using the Nottingham Health Profile, Geriatric Depression Scale, Mini Nutritional Assessment, Mini Mental State Examination and Philadelphia Geriatric Center Multilevel Assessment Instrument, in two examinations at intervals of one year.

    Results. The women in the healthy group were characterized as having no or low depression symptoms (P ¼ 0.016), better physical mobility (P ¼ 0.029) and better physical health (P < 0.001). Furthermore no or less pain, fewer doctor visits, more energy and fewer negative emotional reactions were predictors for self-perceived health in the healthy group at the one-year follow-up.

    Conclusion. The most important predictors associated with perceiving oneself as healthy were no or few depression symptoms, physical mobility and good physical health.

    Relevance to clinical practice. Attention has to be paid to women’s mood, physical health, mobility, pain and energy to help them stay healthy.

  • 34.
    Johansson, Yvonne
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Self-reported energy and nutrient intake among older people: a two year follow-up studyManuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: The aim was to investigate older people’s energy intake regarding macro- and micronutrients, related to nutritional status, symptoms of depression, self-perceived health and demographical factors, and describe possible changes of energy intake during a period of two years.

    Method: The study included 115 individuals 80 years-old who performed a yearly 24h recallvof food intake, a total of three times. Energy requirement was estimated using weight, agevand gender and a Physical Activity Level of 1.6, and the Nordic Nutrition Recommendationsvwere used as a reference for nutrients. Nutritional status was assessed using the MinivNutritional Assessment and symptoms of depression using the Geriatric Depression Scale-20.

    Result: Three groups with different self-reported energy intakes appeared in the analysis, onev with <1500 kcal, a second with a fluctuating intake over time (±1500 kcal), and a third with ≥1500 kcal. Intake of vitamins A, D, E, folate and fibre were below the recommended levels in all groups. The same pattern of energy intake and micronutrients was found over time. No correlation between energy intake and MNA and GDS-20 was found.

    Conclusion: Reported energy intake and some micronutrients were low in relation to estimated energy requirement. This might be due to a combination of low energy intake, underreporting and the day on which the 24h recall was performed. Weight loss was found in women and men who reported a fluctuating energy intake and among men who reported an energy intake <1500 kcal. This might indicate an inadequate energy intake and an increased vulnerability to malnutrition.

  • 35.
    Johansson, Yvonne
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Self-perceived health among older men living in their own residence: a four year follow-up studyManuscript (preprint) (Other academic)
    Abstract [en]

    This study characterize older men, who perceived themselves as healthy, with focus on demographical, social, medical and functional factors, and describe changes within the healthy group over time and find predictors of self-perceived health. The study has a prospective design and included 303 men, 75 and 80 years old, living in a municipality in the south of Sweden. Data collection took place 2001-2006 in a total of three – five examinations at an interval of one year. The examinations included questionnaires validated and tested for reliability, assessing the nutritional status, (Mini Nutritional Assessment), symptoms of depression (Geriatric Depression Scale-20), cognitive function (Mini Mental State Examination), health-related quality of life (Nottingham Health Profile), wellbeing (Philadelphia Geriatric Centre Multilevel Assessment Instrument), demographic factors, physical- and biochemical assessments. The men were divided into two groups according to their self-perceived health, 58% (n=175) perceived themselves as healthy and 42% n=128) as less healthy. Good physical health, the ability to walk a distance outdoors, an ability to maintain a social network and having energy were factors important to feeling healthy among men at baseline. Analyses at the follow-ups included men whom still perceived themselves as healthy and men who perceived their health as being impaired. Seventy five percent (n=132) of the healthy group at baseline still perceived themselves as healthy at the first follow-up. Important factors for a self perceived good health when growing older were feeling mentally well and being able to walk up and downstairs. These results indicated that areas representing the individuals own perception and ability are important to feel healthy.

  • 36.
    Solveig, Struksnes
    et al.
    Gjovik University College.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hall-Lord, Marie Louise
    Karlstad University.
    Randi, Slaasletten
    Gjovik University College, Gjovik, Norway .
    Inger, Johansson
    Gjovik University College.
    The nursing staffs experiences and reactions when older people with dementia fall in nursing homes in JOURNAL OF CLINICAL NURSING, vol 19, issue , pp 26-262010In: JOURNAL OF CLINICAL NURSING, Blackwell Publishing Ltd , 2010, Vol. 19, p. 26-26Conference paper (Refereed)
    Abstract [en]

    n/a

  • 37.
    Struksnes, Solveig
    et al.
    Center of Care Research, Department of Health, Care and Nursing, Gjövik University College, Norway.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hall-Lord, Marie Louise
    Center of Care Research, Department of Health, Care and Nursing, Gjövik University College, Norway.
    Slaasletten, Randi
    Center of Care Research, Department of Health, Care and Nursing, Gjövik University College, Norway.
    Johansson, Inger
    Center of Care Research, Department of Health, Care and Nursing, Gjövik University College, Norway.
    The nursing staff's opinion of falls among older persons with dementia. A cross-sectional study2011In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 10, no 13Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe the nursing staff's opinion of caring for older persons with dementia with the focus on causes of falls, fall-preventing interventions, routines of documentation and report and the nursing staff's experiences and reactions when fall incidents occur. A further aim was to compare these areas between registered nurses (RNs) and enrolled nurses (ENs) and staff with ≤5 and >5 years of employment in the care units in question.

    Background

    Falls are common among older people and persons with dementia constitute an additional risk group.

    Methods

    The study had a cross-sectional design and included nursing staff (n = 63, response rate 66%) working in four special care units for older persons with dementia. Data collection was conducted with a questionnaire consisting of 64 questions.

    Results

    The respondents reported that the individuals' mental and physical impairment constitute the most frequent causes of falls. The findings also revealed a lack of, or uncertainty about, routines of documentation and reporting fall-risk and fall-preventing interventions. Respondents who had been employed in the care units more than five years reported to a higher degree that colours and material on floors caused falls. RNs considered the residents' autonomy and freedom of movement as a cause of falls to a significantly higher degree than ENs. RNs also reported a significantly longer time than ENs before fall incidents were discovered, and they used conversation and closeness as fall-preventing interventions to a significantly higher degree than ENs.

    Conclusions

    Individual factors were the most common causes to falls according to the nursing staff. RNs used closeness and dialog as interventions to a significantly higher degree to prevent falls than ENs. Caring of for older people with dementia consisted of a comprehensive on-going assessment by the nursing staff to balance the residents' autonomy-versus-control to minimise fall-risk. This ethical dilemma should initiate development of feasible routines of systematic risk-assessment, report and documentation.

  • 38.
    Söderhamn, Ulrika
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Nutritional screening and perceived health in a group of geriatric rehabilitation patients2006In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 16, no 11, p. 1997-2006Article in journal (Refereed)
    Abstract [en]

    Aims and objectives. (i) To perform a nutritional screening using the Nutritional Form For the Elderly and relate the results to perceived health in a group of geriatric rehabilitation patients; and (ii) to compare the screening results and nurses' nutritional notes in the nursing documentation.

    Background. Undernutrition is an under-recognized problem among older patients. Using a screening instrument is a way to detect patients at risk for undernutrition.

    Design. A cross-sectional study conducted in Sweden.

    Methods. A sample of 147 geriatric rehabilitation patients was consecutively included and was interviewed with the screening instrument, questions about background variables, perceived health and health-related issues. Higher screening scores indicate higher risk for undernutrition. Parametric and nonparametric statistical tests were used. When nurses' nutritional notes in the nursing documentation were corresponding to the content in any of the response alternatives for each screening item, the notes were marked as existent.

    Results. The screening results showed that 55% of the patients were at medium risk and 14% at high risk for undernutrition. Patients in perceived ill health had higher screening scores than those in perceived good health. Associations were also found between receiving help, perceiving helplessness, not being active and not feeling satisfied and higher screening scores. The content of nine of 15 items in the instrument was mentioned in a number of nursing records.

    Conclusions. The prevalence of older patients at medium or high risk for undernutrition was high. To be at high risk for undernutrition was associated with perceived ill health. Nurses' nutritional notes in the nursing documentation showed deficiencies, indicating that all patients at medium or high risk for undernutrition were not identified.

    Relevance to clinical practice. The results suggest that nurses need a screening instrument to highlight older nutritional at-risk patients in need of further awareness and investigation.

  • 39.
    Söderhamn, Ulrika
    et al.
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Self-care ability and sense of coherence in older nutritional at-risk patients2008In: European Journal of Clinical Nutrition, ISSN 0954-3007, E-ISSN 1476-5640, Vol. 62, p. 96-103Article in journal (Refereed)
    Abstract [en]

    Objective: To investigate self-care ability and sense of coherence in geriatric rehabilitation patients nutritionally screened using the Nutritional Form For the Elderly and to relate the patients' perceived health to self-care ability and sense of coherence.

    Design: Cross-sectional study.

    Setting: A geriatric rehabilitation ward in a hospital in western Sweden.

    Subjects: A sample of 172 consecutively recruited patients (65+ years) fulfilled the inclusion criteria. One hundred forty-four patients were included in the study because 16 patients refused to take part and 12 could not complete the entire data collection procedure.

    Methods: Interviews, using one instrument for nutritional screening and other instruments measuring self-care ability and sense of coherence and one question about perceived health, were performed.

    Results: Patients at medium or high risk for undernutrition had lower self-care ability (P<0.001) and weaker sense of coherence (P=0.007) than patients at low risk for undernutrition. Lower self-care ability, being single and admitted from another hospital ward was found to be predictors for being at medium or high risk for undernutrition. Patients who perceived good health had higher self-care ability (P<0.001) and stronger sense of coherence (P<0.001) than patients who perceived ill health.

    Conclusions: There is an indication that older patients at low risk for undernutrition have a greater capability to care for themselves than patients at medium or high risk for undernutrition. Perceived ill health in older patients is associated with lower self-care ability and weaker sense of coherence.

    Sponsorship: Supported by grants from The Research and Development Council Fyrbodal, Trollhättan; The Lions Research Foundation, Linköping, Sweden.

  • 40.
    Söderhamn, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Christensson, Lennart
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Idvall, Ewa
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Johansson, Annakarin
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Factors associated with nutritional risk in 75-year-old community living people2010In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Article in journal (Refereed)
    Abstract [en]

    Aim.  To identify risk factors for being at nutritional risk, by means of a nutritional screening, in a population based sample of 75-year-old people living in three county councils in Sweden.

    Background.  Undernutrition in older people is known to contribute to poor health. The instrument ‘Nutritional Form For the Elderly’ (NUFFE) helps to identify those at nutritional risk.

    Method.  The screening instrument ‘Nutritional Form For the Elderly’, background variables and health related questions were mail distributed. A total of 1461 persons (75 years old) were included in the study. Descriptive statistical methods were used in the analyses.

    Results.  One percent of the participants had high risk, 21.3% medium and 77.7% low risk for undernutrition. Medium or high risk was predicted by: living alone, receiving help and impaired perceived health. Low Body Mass Index was associated with low risk for undernutrition.

    Conclusion.  By using a simple nutritional screening instrument, significant risk factors were highlighted.

    Relevance to practice.  This instrument can identify older people at nutritional risk and is easy to use. Older people living alone have an increased risk of undernutrition. Body Mass Index (BMI) should be used with caution as one and only indicator of nutritional risk in older people.

  • 41.
    Wahlberg, J
    et al.
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medicine and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Jenmalm, Maria
    Linköping University, Department of Clinical and Experimental Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Ekman, Bertil
    Linköping University, Department of Medicine and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre for Medicine, Department of Endocrinology and Gastroenterology UHL.
    Alterations in the Chemokine Th1/Th2 Balance and Not the Mode of Dosing Hydrocortisone May Explain the Increased Fatigue in Addisons Disease. in ENDOCRINE REVIEWS, vol 31, issue 3, pp2010In: ENDOCRINE REVIEWS, Endocrine Society , 2010, Vol. 31, no 3Conference paper (Refereed)
    Abstract [en]

    n/a

  • 42.
    Wärdig, Rikard
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the West of Östergötland, Unit of Research and Development in Local Health Care, County of Östergötland.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Hultsjö, Sally
    Psykiatriska kliniken, Ryhovs länssjukhus, Jönköping.
    Conditions for a healthy lifestyle - from the perspective of individuals with psychosis2013Conference paper (Refereed)
  • 43.
    Wärdig, Rikard
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Hultsjö, Sally
    Psykiatriska kliniken, Länssjukhuset Ryhov, Jönköping, Sweden.
    Prerequisites for a healthy lifestyle - experiences of persons with psychosis2013In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, no 8, p. 602-610Article in journal (Refereed)
    Abstract [en]

    The purpose of this study is to explore prerequisites for a healthy lifestyle as described by individuals diagnosed with psychosis. Forty participants who had performed a lifestyle intervention focusing on physical activities and lifestyle education were interviewed. Conventional content analysis was used. The results are described in two categories: (1) Individual Prerequisites and (2) Being a Part of Society. The individuals said that they got stuck in a state of planning without taking action. It was pointless to make a bigger effort because the psychotic disorder could, at any time, worsen the prerequisites. They also said that they wanted to live like everybody else and therefore tried to adopt a normal lifestyle. Future interventions or professional support by mental health nurses and other health care givers should target the transition from planning to action to achieve a healthy lifestyle, and should help the individual to taking part in society.

  • 44.
    Wärdig, Rikard
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Hultsjö, Sally
    Psykiatriska kliniken, Ryhovs länssjukhus, Jönköping.
    Lindström, Torbjörn
    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 Endocrinology.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Perceptions of participating in a lifestyle intervention - from the perspective of patients with psychosis2014Conference paper (Other academic)
    Abstract [en]

     

     

  • 45.
    Wärdig, Rikard
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Hultsjö, Sally
    Psykiatriska kliniken, Ryhovs länssjukhus, Jönköping.
    Lindström, Torbjörn
    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 Endocrinology.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Persons with psychosis perceptions of participating in a lifestyle intervention2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 13-14, p. 1815-1824Article in journal (Refereed)
    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.

  • 46.
    Wärdig, Rikard
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Foldemo, Anniqa
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Hultsjö, Sally
    Psychiatric Clinic, Ryhov County Hospital, Jönköping, Sweden / School of Health and Welfare, University of Jönköping; Sweden.
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Endocrinology.
    Bachrach-Lindström, Margareta
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    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 psychosis2016In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 37, no 1, p. 43-52Article in journal (Refereed)
    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.

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