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  • 1. Ahlberg, M
    et al.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Jones, C
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Hollman Frisman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Group communication confirm feelings among partners of former intensive care patients2014Konferensbidrag (Övrigt vetenskapligt)
  • 2.
    Ahlberg, Mona
    et al.
    Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken VIN.
    Jones, Christina
    Musculoskeletal Biology, Institute of Ageing & Chronic Disease, University of Liverpool, Liverpool, UK.
    Walther, Sten
    Region Östergötland, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland. Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Medicinska fakulteten.
    Hollman Frisman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum.
    Moving on in life after intensive care - partners' experience of group communication2015Ingår i: Nursing in Critical Care, ISSN 1362-1017, E-ISSN 1478-5153, Vol. 20, nr 5, s. 256-263Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background:Partners have a burdensome time during and after their partners’ intensive care period. They may appear to be coping welloutwardly but inside feel vulnerable and lost. Evaluated interventions for partners on this aspect are limited.

    Aim:The aim of this study was to describe the experience of participating in group communication with other partners of former intensivecare patients.

    Design:The study has a descriptive intervention-based design where group communication for partners of former, surviving intensive careunit (ICU) patients was evaluated.

    Methods:A strategic selection was made of adult partners to former adult intensive care patients (n=15), 5 men and 10 women, aged37–89 years. Two group communication sessions lasting 2 h were held at monthly intervals with three to five partners. The partners later wrote,in a notebook, about their feelings of participating in group communications. To deepen the understanding of the impact of the sessions, six ofthe partners were interviewed. Content analysis was used to analyse the notebooks and the interviews.

    Findings:Three categories were identified: (1) Emotional impact, the partners felt togetherness and experienced worries and gratitude, (2)Confirmation, consciousness through insight and reflection and (3) The meeting design, group constellation and recommendation to participatein group communication.

    Conclusion:Partners of an intensive care patient are on a journey, constantly trying to adapt to the new situation and find new strategiesto ever-changing circumstances. Group communications contributed to togetherness and confirmation. To share experiences with others is oneway for partners to be able to move forward in life.

    Relevance to clinical practice:Group communication with other patients’ partners eases the process of going through the burden ofbeing a partner to an intensive care patient. Group communications needs to be further developed and evaluated to obtain consensus andevidence for the best practice.

  • 3.
    Bäckman, Carl
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Ahlberg, M
    Jones, C
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för kardiovaskulär medicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Hollman Frisman, Gunilla
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för omvårdnad. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Magtarmmedicinska kliniken.
    Group conversations after a long stay in the intensive care2014Konferensbidrag (Övrigt vetenskapligt)
  • 4.
    Bäckman, Carl G
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    The photo-diary and follow-up appointment on the ICU: Giving back the time to patients and relatives.: A descriptive and interventional study2011Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
    Abstract [en]

    Background: Patients on the ICU often spend a great deal of their time either unconscious or heavily sedated. When they return from the zone between life and death they are often in a state of confusion where dreams and delusions are intertwined with reality and it is not always easy to distinguish them apart. These experiences could lead to psychological problems and post-traumatic stress disorder (PTSD). Recovery may be improved by filling in the significant memory gaps and explaining what really happened during the “chaotic” time on the ICU. The provision of a diary describing the patients’ stay in ICU on a day to day basis and a follow-up meeting (together named the ICU-diary concept), may help the whole family to understand.

    Aim: The principal aim of this thesis was to see if the ICU-diary concept was of help to patients and relatives in the recovery after critical illness. A further aim was to look for precipitants in the ICU of PTSD.

    Material and Methods: ICU patients in a handful of European countries and their relatives have been studied. The studies have been single and multi-centred and we have used descriptive observational, randomised controlled and cohort study designs, including matched case-control designs. Quantitative methods have been used with questionnaires and structured interviews using established instruments (i.e Post-traumatic stress syndrome screening-14, Post-traumatic diagnostic scale, ICU memory tool, Short Form-36, Pearlin-Schooler Mastery Scale, Hopelessness scale) as the principal means of data collection.

    Results: The ICU-diary concept was seen to be a positive and useful aid in helping patients and their relatives understand the events that took place during the time on the ICU. It also decreased the risk for PTSD among patients and relatives. Patients that were supported with the ICU-diary concept perceived a better health-related quality of life even 3 years after the ICU stay. We did not find any definite improvement by the ICU-diary concept in mastery and hope. Variations in how the patients were cared for in the ICU had a significant effect on the development of PTSD. The implementation of an ICU diary, for instance, was associated with a lower frequency of PTSD.

    Conclusions: The ICU-diary concept was found helpful by patients and their relatives. It was associated with a reduction in new onset PTSD and improved health-related quality of life. The results are encouraging and suggest that an ICU diary may represent an important first step to help patients and relatives come to terms with their experiences during critical illness.ISBN 978-

    Delarbeten
    1. Use of a personal diary written on the ICU during critical illness
    Öppna denna publikation i ny flik eller fönster >>Use of a personal diary written on the ICU during critical illness
    2001 (Engelska)Ingår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 27, nr 2, s. 426-9Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Objective: To explore the use of a diary as an aid in debriefing patients and relatives following critical illness. Design: Observation study. Setting: Intensive care unit of a 500-bed hospital. Patients and participants: Fifty-one critically ill patients and their relatives. Method: A daily account of the patient's progress was written in everyday language by nursing staff, photographs were added as necessary. The booklet was given to the patient or a relative at a follow-up appointment 2 weeks after discharge from the unit. A standard questionnaire was mailed 6 months later, responses were analyzed by an independent observer. Measurements and results: All diaries had been read by survivors (n=41) or relatives (n=10), 51% of the diaries had been read more than 10 times. Comments in the questionnaires were graded as very positive (39%), positive (28%) and neutral (33%). Conclusions: A detailed narrative of the patient's stay is a useful tool in the debriefing process following intensive care.

    Ort, förlag, år, upplaga, sidor
    SpringerLink, 2001
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-70479 (URN)10.1007/s001340000692 (DOI)11396288 (PubMedID)
    Tillgänglig från: 2011-09-09 Skapad: 2011-09-09 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
    2. Precipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care
    Öppna denna publikation i ny flik eller fönster >>Precipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care
    Visa övriga...
    2007 (Engelska)Ingår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 33, nr 6, s. 978-85Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    The development of PTSD following critical illness is associated with a number of different precipitating factors that are in part related to how patients are cared for within intensive care. This study raises the hypothesis that the impact of care within the ICU has an impact on subsequent psychological morbidity and therefore must be assessed in future studies looking at the way patients are sedated in the ICU and how physical restraint is used.

    Nyckelord
    ICU · Critical illness · Delusional memories · Physical restraint · PTSD
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-70480 (URN)10.1007/s00134-007-0600-8 (DOI)17384929 (PubMedID)
    Tillgänglig från: 2011-09-09 Skapad: 2011-09-09 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
    3. Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial
    Öppna denna publikation i ny flik eller fönster >>Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial
    Visa övriga...
    2010 (Engelska)Ingår i: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 14, nr 5, artikel-id R168Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    INTRODUCTION: Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD.

    METHODS: Intensive care patients with an ICU stay of more than 72 hours were recruited to a randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD. The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months.

    RESULTS: 352 patients were randomised to the study at 1 month. The incidence of new cases of PTSD was reduced in the intervention group compared to the control patients (5% versus 13%, P = 0.02).

    CONCLUSIONS: The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD.

    Ort, förlag, år, upplaga, sidor
    BioMed Central, 2010
    Nationell ämneskategori
    Anestesi och intensivvård
    Identifikatorer
    urn:nbn:se:liu:diva-70481 (URN)10.1186/cc9260 (DOI)000284596500007 ()20843344 (PubMedID)
    Anmärkning

    RACHEL GROUP in addition to the authors: Denmark, Christensen D, Bogø I, Hansen R, Kjerrumgård H, Mathiasen L, Hyldested C, Toft C, Nordsjaelland Hospital; Bagger C, Larsen MB, Frank de Jong L, Odense University Hospital; Ågård AS, Knudsen K, Hinzel T, Århus University Hospital, Skejby; Italy, Scaramuzza A & Bertacchini S, Ferrara; Norway, Schou Landmark J, Salomonsen A, Tøien K, Walther S, Oslo University Hospital Ulleval; Muri AK, Haukeland University Hospital; Portugal, Neutel E, Gomes E, Cardoso T, Ferreira R, Machado C, Santos C, Pinto S, Hospital Santo António - Centro Hospitalar do Porto, Amaro A, Morujão E, Jerónimo A, Rodrigues T, Carvalho F, Silva A, Morais A Hospital Pedro Hispano; Sweden, Löwenmark U, Etemad W, Rosell E, Sahgrenska University Hospital; Carlson U, Wirbrand Holmquist A, Kungälv Hospital; Åkerman E, Ersson A, Malmö University Hospital; UK, Tobin C, Whiston.

    Tillgänglig från: 2011-09-09 Skapad: 2011-09-09 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
    4. Long-term effect of the ICU-diary concept on quality of life after critical illness
    Öppna denna publikation i ny flik eller fönster >>Long-term effect of the ICU-diary concept on quality of life after critical illness
    Visa övriga...
    2010 (Engelska)Ingår i: ACTA ANAESTHESIOLOGICA SCANDINAVICA, ISSN 0001-5172, Vol. 54, nr 6, s. 736-743Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background Critically ill patients often spend time in the intensive care unit (ICU) either unconscious or sedated. On recovery, they are often in a state of confusion with memory loss that may be associated with a longstanding reduction in health-related quality of life (QoL). We hypothesised that the ICU-diary concept could improve their QoL by filling in their memory gaps. Methods A non-randomised, prospective study in a non-academic eight-bedded general ICU. A group of patients (n=38) were selected to receive the ICU-diary concept (keeping a diary with photos while on the ICU plus a follow-up meeting) when a long and complicated course was expected. Health-related QoL at 6, 12, 24 and 36 months was compared with a group that did not receive the ICU-diary (n=224). The Medical Outcomes Study 36-Item Short-Form (SF-36) was used to measure health-related QoL. Multiple regression models adjusted for age, sex, illness severity, pre-existing disease and diagnostic category was used to analyse the effects of the ICU-diary concept at 6 months, and changes over time were analysed using repeated measures MANOVA. Results Crude and adjusted scores for two dimensions of SF-36 (general health and vitality) and the physical component summary score were significantly higher at 6 months in the ICU-diary group (P andlt; 0.05) and some of the effects remained during the 3-year follow-up period (P andlt; 0.05). Conclusion The ICU-diary concept was associated with improved health-related QoL during the 3-year follow-up period after a critical illness. The effect of this intervention needs to be confirmed in a larger randomised study.

    Ort, förlag, år, upplaga, sidor
    Blackwell Publishing Ltd, 2010
    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-57425 (URN)10.1111/j.1399-6576.2010.02230.x (DOI)000278292400011 ()
    Tillgänglig från: 2010-06-18 Skapad: 2010-06-18 Senast uppdaterad: 2012-03-13
    5. Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study
    Öppna denna publikation i ny flik eller fönster >>Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study
    2012 (Engelska)Ingår i: American Journal of Critical Care, ISSN 1062-3264, E-ISSN 1937-710X, Vol. 21, nr 3, s. 172-176Artikel i tidskrift (Refereegranskat) Published
    Abstract [en]

    Background: Relatives of patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD).

    Objectives: The primary aim of this pilot study was to test whether the provision of an ICU diary to the patient and their relatives reduced the level of PTSD-related symptoms in the close family members.

    Methods: Observational study of close family members of Intensive care patients, with an Intensive Care Unit (ICU) stay of more than 72 hrs, recruited in two centres of a 12 centred randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of new onset PTSD on patients. The close family members of the patients were recruited to examine the additional effect of the provision of the patient diary on their PTSD-related symptoms.

    Results 36 family members were recruited and 30 completed the study. Where the patient received their diary at 1 month the family members showed lower levels of PTSD-related symptoms (p=0.03) at the 3 month follow-up compared to the control relatives.

    Conclusions: The provision of an ICU diary may be effective in aiding psychological recovery in families after critical illness.

    Ort, förlag, år, upplaga, sidor
    Aliso Viejo, CA, USA: American Association of Critical Care Nurses, 2012
    Nyckelord
    Families, critical illness, diaries, PTSD-related symptoms, memories, intervention, follow-up, rehabilitation
    Nationell ämneskategori
    Anestesi och intensivvård
    Identifikatorer
    urn:nbn:se:liu:diva-70482 (URN)10.4037/ajcc2012569 (DOI)000310641300011 ()22549573 (PubMedID)
    Anmärkning

    The article originial title before publishing on line was Intensive Care diaries reduce PTSD-related symptom levels in relatives following critical illness: a pilot study.

    Tillgänglig från: 2011-09-09 Skapad: 2011-09-09 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
    6. A case-control study of the influence of the ICU-diary concept on mastery and hopelessness six months after critical illness
    Öppna denna publikation i ny flik eller fönster >>A case-control study of the influence of the ICU-diary concept on mastery and hopelessness six months after critical illness
    Visa övriga...
    (Engelska)Manuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The ICU-diary concept is associated with less post-traumatic stress syndrome and improved perceived health-related quality-of-life (HRQoL) after critical illness, but little is known about its effect on the coping- mastery process, or whether it reduces hopelessness.

    Objective: To see if the ICU-diary concept improves the patient’s ability to master his/her situation after critical illness, and if it reduces the feeling of hopelessness.

    Design: Case control study (subgroup analysis of a multi-centre study on health-related quality-of-life (HRQoL).

    Setting: Non-academic 8-bed general ICU.

    Patients: Adults admitted between March 2002 and June 2004.

    Measurements: Mastery and hopelessness were determined using validated questionnaires (the Mastery-Coping scale and a consolidated 2–item hopelessness questionnaire) which were sent home to patients 6 months after critical illness. Responses were compared between patients that received (Cases: n=38) or did not receive an ICU-diary (Controls: n=76) . Diaries were used when a long and complicated stay on the ICU was expected. Controls were matched with diary patients by gender and age. The effect of the ICU-diary was also examined using a multiple regression model.

    Results: The ICU-diary concept group scored significantly higher than the No-diary group in mastery (22.1 vs. 20.4, P<0.05) and lower in hopelessness scores (1.3 vs. 1.6, P<0.05). The positive influence of the ICU-diary disappeared after adjustment for confounding factors in a multiple regression model.

    Conclusion: We were unable to verify any positive influence of the ICU-diary concept on mastery and hopelessness 6 months after critical illness.

    Nationell ämneskategori
    Medicin och hälsovetenskap
    Identifikatorer
    urn:nbn:se:liu:diva-70483 (URN)
    Tillgänglig från: 2011-09-09 Skapad: 2011-09-09 Senast uppdaterad: 2011-09-09Bibliografiskt granskad
  • 5.
    Bäckman, Carl G
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Orwelius, Lotti
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Hälsouniversitetet.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten M
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    A case-control study of the influence of the ICU-diary concept on mastery and hopelessness six months after critical illnessManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    The ICU-diary concept is associated with less post-traumatic stress syndrome and improved perceived health-related quality-of-life (HRQoL) after critical illness, but little is known about its effect on the coping- mastery process, or whether it reduces hopelessness.

    Objective: To see if the ICU-diary concept improves the patient’s ability to master his/her situation after critical illness, and if it reduces the feeling of hopelessness.

    Design: Case control study (subgroup analysis of a multi-centre study on health-related quality-of-life (HRQoL).

    Setting: Non-academic 8-bed general ICU.

    Patients: Adults admitted between March 2002 and June 2004.

    Measurements: Mastery and hopelessness were determined using validated questionnaires (the Mastery-Coping scale and a consolidated 2–item hopelessness questionnaire) which were sent home to patients 6 months after critical illness. Responses were compared between patients that received (Cases: n=38) or did not receive an ICU-diary (Controls: n=76) . Diaries were used when a long and complicated stay on the ICU was expected. Controls were matched with diary patients by gender and age. The effect of the ICU-diary was also examined using a multiple regression model.

    Results: The ICU-diary concept group scored significantly higher than the No-diary group in mastery (22.1 vs. 20.4, P<0.05) and lower in hopelessness scores (1.3 vs. 1.6, P<0.05). The positive influence of the ICU-diary disappeared after adjustment for confounding factors in a multiple regression model.

    Conclusion: We were unable to verify any positive influence of the ICU-diary concept on mastery and hopelessness 6 months after critical illness.

  • 6.
    Bäckman, Carl G
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten M
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärt- och Medicincentrum, Thorax-kärlkliniken i Östergötland.
    Use of a personal diary written on the ICU during critical illness2001Ingår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 27, nr 2, s. 426-9Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore the use of a diary as an aid in debriefing patients and relatives following critical illness. Design: Observation study. Setting: Intensive care unit of a 500-bed hospital. Patients and participants: Fifty-one critically ill patients and their relatives. Method: A daily account of the patient's progress was written in everyday language by nursing staff, photographs were added as necessary. The booklet was given to the patient or a relative at a follow-up appointment 2 weeks after discharge from the unit. A standard questionnaire was mailed 6 months later, responses were analyzed by an independent observer. Measurements and results: All diaries had been read by survivors (n=41) or relatives (n=10), 51% of the diaries had been read more than 10 times. Comments in the questionnaires were graded as very positive (39%), positive (28%) and neutral (33%). Conclusions: A detailed narrative of the patient's stay is a useful tool in the debriefing process following intensive care.

  • 7.
    Bäckman, Carl
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Orwelius, Lotti
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Long-term effect of the ICU-diary concept on quality of life after critical illness2010Ingår i: ACTA ANAESTHESIOLOGICA SCANDINAVICA, ISSN 0001-5172, Vol. 54, nr 6, s. 736-743Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background Critically ill patients often spend time in the intensive care unit (ICU) either unconscious or sedated. On recovery, they are often in a state of confusion with memory loss that may be associated with a longstanding reduction in health-related quality of life (QoL). We hypothesised that the ICU-diary concept could improve their QoL by filling in their memory gaps. Methods A non-randomised, prospective study in a non-academic eight-bedded general ICU. A group of patients (n=38) were selected to receive the ICU-diary concept (keeping a diary with photos while on the ICU plus a follow-up meeting) when a long and complicated course was expected. Health-related QoL at 6, 12, 24 and 36 months was compared with a group that did not receive the ICU-diary (n=224). The Medical Outcomes Study 36-Item Short-Form (SF-36) was used to measure health-related QoL. Multiple regression models adjusted for age, sex, illness severity, pre-existing disease and diagnostic category was used to analyse the effects of the ICU-diary concept at 6 months, and changes over time were analysed using repeated measures MANOVA. Results Crude and adjusted scores for two dimensions of SF-36 (general health and vitality) and the physical component summary score were significantly higher at 6 months in the ICU-diary group (P andlt; 0.05) and some of the effects remained during the 3-year follow-up period (P andlt; 0.05). Conclusion The ICU-diary concept was associated with improved health-related QoL during the 3-year follow-up period after a critical illness. The effect of this intervention needs to be confirmed in a larger randomised study.

  • 8.
    Jones, C
    et al.
    University of Liverpool, Intensive Care Research Group, Division of Metabolic & Cellular Medicine, School of Clinical Sciences, Faculty of Medicine, L69 3GA Liverpool, UK.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Capuzzo, M
    University Hospital of Ferrara, Section of Anaesthesia and Intensive Care Medicine, Ferrara, Italy.
    Flaatten, H
    Haukeland University Hospital, Intensive Care Unit, Bergen, Norway.
    Rylander, C
    Sahlgrenska University Hospital, ICU, Gothenburg, Sweden.
    Griffiths, R D
    University of Liverpool, Intensive Care Research Group, Division of Metabolic & Cellular Medicine, School of Clinical Sciences, Faculty of Medicine, L69 3GA Liverpool, UK.
    Precipitants of post-traumatic stress disorder following intensive care: a hypothesis generating study of diversity in care2007Ingår i: Intensive Care Medicine, ISSN 0342-4642, E-ISSN 1432-1238, Vol. 33, nr 6, s. 978-85Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The development of PTSD following critical illness is associated with a number of different precipitating factors that are in part related to how patients are cared for within intensive care. This study raises the hypothesis that the impact of care within the ICU has an impact on subsequent psychological morbidity and therefore must be assessed in future studies looking at the way patients are sedated in the ICU and how physical restraint is used.

  • 9.
    Jones, Christina
    et al.
    ICU, Whiston Hospital, Prescot, UK.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Capuzzo, Maurizia
    Section of Anaesthesia and Intensive Care Medicine, University Hospital of Ferrara, Ferrara, Italy.
    Egerod, Ingrid
    Rigshospitalet Dept. 7331, University of Copenhagen, Copenhagen, Denmark.
    Flaatten, Hans
    ICU, Haukeland University Hospital, Bergen, Norway..
    Granja, Cristina
    ICU, Hospital Pedro Hispano, Matosinhos, Portugal.
    Rylander, Christian
    Sahlgrenska University Hospital, Gothenburg, Sweden..
    Griffiths, Richard D
    ICU, Whiston Hospital, Prescot, UK.
    Intensive care diaries reduce new onset post traumatic stress disorder following critical illness: a randomised, controlled trial2010Ingår i: Critical Care, ISSN 1364-8535, E-ISSN 1466-609X, Vol. 14, nr 5, artikel-id R168Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    INTRODUCTION: Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness will reduce the development of new onset PTSD.

    METHODS: Intensive care patients with an ICU stay of more than 72 hours were recruited to a randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of acute PTSD. The intervention patients received their ICU diary at 1 month following critical care discharge and the final assessment of the development of acute PTSD was made at 3 months.

    RESULTS: 352 patients were randomised to the study at 1 month. The incidence of new cases of PTSD was reduced in the intervention group compared to the control patients (5% versus 13%, P = 0.02).

    CONCLUSIONS: The provision of an ICU diary is effective in aiding psychological recovery and reducing the incidence of new PTSD.

  • 10.
    Jones, Christina
    et al.
    ICU, Whiston Hospital, Prescot, UK.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Arbets- och miljövetenskap. Linköpings universitet, Hälsouniversitetet.
    Griffiths, Richard D.
    ICU, Whiston Hospital, Prescot, UK.
    Intensive care diaries and relatives' symptoms of posttraumatic stress disorder after critical illness: a pilot study2012Ingår i: American Journal of Critical Care, ISSN 1062-3264, E-ISSN 1937-710X, Vol. 21, nr 3, s. 172-176Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: Relatives of patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD).

    Objectives: The primary aim of this pilot study was to test whether the provision of an ICU diary to the patient and their relatives reduced the level of PTSD-related symptoms in the close family members.

    Methods: Observational study of close family members of Intensive care patients, with an Intensive Care Unit (ICU) stay of more than 72 hrs, recruited in two centres of a 12 centred randomised controlled trial examining the effect of a diary outlining the details of the patients ICU stay on the development of new onset PTSD on patients. The close family members of the patients were recruited to examine the additional effect of the provision of the patient diary on their PTSD-related symptoms.

    Results 36 family members were recruited and 30 completed the study. Where the patient received their diary at 1 month the family members showed lower levels of PTSD-related symptoms (p=0.03) at the 3 month follow-up compared to the control relatives.

    Conclusions: The provision of an ICU diary may be effective in aiding psychological recovery in families after critical illness.

  • 11. Labeau, S.
    et al.
    Vandijck, D.
    Rello, J.
    Adam, S.
    Rosa, A.
    Wenisch, C.
    Bäckman, Carl
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin.
    Agbaht, K.
    Csomos, A.
    Seha, M.
    Dimopoulos, G.
    Vandewoude, K.H.
    Blot, S.
    Evidence-based guidelines for the prevention of ventilator-associated pneumonia: results of a knowledge test among European intensive care nurses2008Ingår i: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 70, nr 2, s. 180-185Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    As part of a needs analysis preceding the development of an e-learning platform on infection prevention, European intensive care unit (ICU) nurses were subjected to a knowledge test on evidence-based guidelines for preventing ventilator-associated pneumonia (VAP). A validated multiple-choice questionnaire was distributed to 22 European countries between October 2006 and March 2007. Demographics included nationality, gender, ICU experience, number of ICU beds and acquisition of a specialised degree in intensive care. We collected 3329 questionnaires (response rate 69.1%). The average score was 45.1%. Fifty-five percent of respondents knew that the oral route is recommended for intubation; 35% knew that ventilator circuits should be changed for each new patient; 38% knew that heat and moisture exchangers were the recommended humidifier type, but only 21% knew that these should be changed once weekly; closed suctioning systems were recommended by 46%, and 18% knew that these must be changed for each new patient only; 51% and 57%, respectively, recognised that subglottic drainage and kinetic beds reduce VAP incidence. Most (85%) knew that semi-recumbent positioning prevents VAP. Professional seniority and number of ICU beds were shown to be independently associated with better test scores. Further research may determine whether low scores are related to a lack of knowledge, deficiencies in training, differences in what is regarded as good practice, and/or a lack of consistent policy. 

  • 12.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Nordlund, P
    Jonkoping, Sweden .
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    COPING STRATEGY AND PERCEIVED HOPELESSNESS ARE IMPORTANT FOR HEALTH RELATED QUALITY OF LIFE AFTER CRITICAL ILLNESS in INTENSIVE CARE MEDICINE, vol 36, issue , pp S392-S3922010Ingår i: INTENSIVE CARE MEDICINE, Springer Science Business Media , 2010, Vol. 36, s. S392-S392Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 13.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Nordlund, P
    Jonkoping, Sweden .
    Walther, Sten
    Linköpings universitet, Institutionen för medicin och hälsa, Fysiologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Hjärtcentrum, Thorax-kärlkliniken.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    PERCEIVED HOPELESSNESS AFTER ICU CARE IS A PREDICTOR OF LONG TERM SURVIVAL in INTENSIVE CARE MEDICINE, vol 36, issue , pp S385-S3852010Ingår i: INTENSIVE CARE MEDICINE, Springer Science Business Media , 2010, Vol. 36, s. S385-S385Konferensbidrag (Refereegranskat)
    Abstract [en]

    n/a

  • 14.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Omvårdnad. Linköpings universitet, Hälsouniversitetet.
    Bäckman, Carl
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Arbets- och miljövetenskap.
    Fredrikson, Mats
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Yrkes- och miljömedicin. Linköpings universitet, Hälsouniversitetet.
    Simonsson, Eva
    Ryhov Hospital.
    Nordlund, Peter
    Ryhov Hospital.
    Samuelsson, Anders
    Linköpings universitet, Institutionen för medicin och hälsa, Anestesiologi med intensivvård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Intensivvårdskliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    Sjöberg, Folke
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Brännskadevård. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Östergötlands Läns Landsting, Sinnescentrum, Anestesi- och operationkliniken US.
    Social integration: an important factor for health-related quality of life after critical illness2011Ingår i: INTENSIVE CARE MEDICINE, ISSN 0342-4642, Vol. 37, nr 5, s. 831-838Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    To examine to what extent availability of social integration affects health-related quality of life (HRQoL) in former intensive care unit (ICU) patients and how it relates to corresponding findings in a general reference group. Controlled, multicenter, prospective, explorative study. HRQoL data (SF-36) were collected from three combined medical and surgical ICUs in the south-east of Sweden. Social integration was assessed by the Availability of Social Integration (AVSI) instrument (seven questions related to the social interaction of the patient). As reference group, a random sample (n = 6,093) of people from the uptake area of the hospitals was used. Social integration (AVSI), HRQoL (SF-36), and comorbidity were examined also in the reference group. None. The level of social integration significantly affected HRQoL for the former ICU patients, whereas no such effect was seen for the general reference group. For the ICU patients, social integration affected HRQoL to a larger extent than age, sex, and the ICU-related factors examined, but to a lower extent than the pre-existing diseases. For a comprehensive assessment of HRQoL in former ICU patients, it is mandatory to include the effect of social integration.

  • 15.
    Orwelius, Lotti
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Sinnescentrum, Anestesi- och intensivvårdskliniken US.
    Fredriksson, M
    Linköpings universitet, Hälsouniversitetet.
    Bäckman, Carl
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Persson, Jan
    Linköpings universitet, Institutionen för medicin och hälsa. Linköpings universitet, Medicinska fakulteten.
    Sjöberg, Folke
    Region Östergötland, Sinnescentrum, Hand- och plastikkirurgiska kliniken US. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för kliniska vetenskaper. Linköpings universitet, Medicinska fakulteten.
    Can ICU admission be predicted?2010Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    After intensive care (IC), patients report poor health-related quality of life (HRQoL). Many factors affect the patients and influence the HRQoL after discharge. One of these factors is the patient's health status before the critical care period. In a previous study we found that the IC patients have a high frequency of pre-existing diseases. However, it is unknown to what extent these pre-existing diseases affect the consumption of hospital resources (measured as days as inpatients) in the time period before admission to the ICU and during the years following it. The consumption prior to the ICU event may also be claimed to herald an increased risk for a later ICU admittance? The aim of this study was to examine the hospital care consumption of former ICU patients 3 years prior to and 3 years after the intensive care period. This was examined in relation to the pre-existing health status.

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